Coinfections by noninteracting pathogens are not independent and require new tests of interaction

If pathogen species, strains, or clones do not interact, intuition suggests the proportion of coinfected hosts should be the product of the individual prevalences. Independence consequently underpins the wide range of methods for detecting pathogen interactions from cross-sectional survey data. However, the very simplest of epidemiological models challenge the underlying assumption of statistical independence. Even if pathogens do not interact, death of coinfected hosts causes net prevalences of individual pathogens to decrease simultaneously. The induced positive correlation between prevalences means the proportion of coinfected hosts is expected to be higher than multiplication would suggest. By modelling the dynamics of multiple noninteracting pathogens causing chronic infections, we develop a pair of novel tests of interaction that properly account for nonindependence between pathogens causing lifelong infection. Our tests allow us to reinterpret data from previous studies including pathogens of humans, plants, and animals. Our work demonstrates how methods to identify interactions between pathogens can be updated using simple epidemic models

Comparative analysis of dengue versus chikungunya outbreaks in Costa Rica

For decades, dengue virus has been a cause of major public health concern in Costa Rica, due to its landscape and climatic conditions that favor the circumstances in which the vector, Aedes aegypti, thrives. The emergence and introduction throughout tropical and subtropical countries of the chikungunya virus, as of 2014, challenged Costa Rican health authorities to provide a correct diagnosis since it is also transmitted by the same vector and infected hosts may share similar symptoms. We study the 2015–2016 dengue and chikungunya outbreaks in Costa Rica while establishing how point estimates of epidemic parameters for both diseases compare to one another. Longitudinal weekly incidence reports of these outbreaks signal likely misdiagnosis of infected individuals: underreporting of chikungunya cases, while overreporting cases of dengue. Our comparative analysis is formulated with a single-outbreak deterministic model that features an undiagnosed class. Additionally, we also used a genetic algorithm in the context of weighted least squares to calculate point estimates of key model parameters and initial conditions, while formally quantifying misdiagnosis.UCR::Vicerrectoría de Docencia::Ciencias Básicas::Facultad de Ciencias::Escuela de MatemáticaUCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias Básicas::Centro de Investigaciones en Matemáticas Puras y Aplicadas (CIMPA