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Muylaert RL, Wilkinson DA, Kingston T, D'Odorico P, Rulli MC, Galli N, John RS, Alviola P, Hayman DTS. Using drivers and transmission pathways to identify SARS-like coronavirus spillover risk hotspots. Nat Commun 2023; 14:6854. [PMID: 37891177 PMCID: PMC10611769 DOI: 10.1038/s41467-023-42627-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
The emergence of SARS-like coronaviruses is a multi-stage process from wildlife reservoirs to people. Here we characterize multiple drivers-landscape change, host distribution, and human exposure-associated with the risk of spillover of zoonotic SARS-like coronaviruses to help inform surveillance and mitigation activities. We consider direct and indirect transmission pathways by modeling four scenarios with livestock and mammalian wildlife as potential and known reservoirs before examining how access to healthcare varies within clusters and scenarios. We found 19 clusters with differing risk factor contributions within a single country (N = 9) or transboundary (N = 10). High-risk areas were mainly closer (11-20%) rather than far ( < 1%) from healthcare. Areas far from healthcare reveal healthcare access inequalities, especially Scenario 3, which includes wild mammals and not livestock as secondary hosts. China (N = 2) and Indonesia (N = 1) had clusters with the highest risk. Our findings can help stakeholders in land use planning, integrating healthcare implementation and One Health actions.
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Affiliation(s)
- Renata L Muylaert
- School of Veterinary Science, Massey University, Palmerston North, New Zealand.
| | - David A Wilkinson
- UMR ASTRE, CIRAD, INRAE, Université de Montpellier, Plateforme Technologique CYROI, Sainte-Clotilde, La Réunion, France
| | - Tigga Kingston
- Department of Biological Sciences, Texas Tech University, Lubbock, TX, USA
| | - Paolo D'Odorico
- Department of Environmental Science, Policy, and Management, University of California, Berkeley, Berkeley, CA, USA
| | - Maria Cristina Rulli
- Department of Civil and Environmental Engineering, Politecnico di Milano, Milan, Italy
| | - Nikolas Galli
- Department of Civil and Environmental Engineering, Politecnico di Milano, Milan, Italy
| | - Reju Sam John
- Department of Physics, Faculty of Science, University of Auckland, Auckland, New Zealand
| | - Phillip Alviola
- Institute of Biological Sciences, University of the Philippines- Los Banos, Laguna, Philippines
| | - David T S Hayman
- School of Veterinary Science, Massey University, Palmerston North, New Zealand
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Kostandova N, Loisate S, Winter A, Moss WJ, Giles JR, Metcalf C, Mutembo S, Wesolowski A. Impact of disruptions to routine vaccination programs, quantifying burden of measles, and mapping targeted supplementary immunization activities. Epidemics 2022; 41:100647. [PMID: 36343498 PMCID: PMC9742850 DOI: 10.1016/j.epidem.2022.100647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 09/27/2022] [Accepted: 10/21/2022] [Indexed: 12/29/2022] Open
Abstract
Measles is a highly transmissible disease that requires high levels of vaccination coverage for control and elimination. Areas that are unable to achieve and maintain high coverage levels are at risk for measles outbreaks resulting in increased morbidity and mortality. Public health emergencies, such as the current COVID-19 pandemic, pose a threat to the functioning of health systems by disrupting immunization services which can derail measles vaccination efforts. Efforts to bridge coverage gaps in immunization include the rapid return to fully functioning services as well as deploying supplementary immunization activities (SIAs), which are additional vaccination campaigns intended to catch-up children who have missed routine services. However, SIAs, which to date tend to be national efforts, can be difficult to mobilize quickly, resource-intensive, and even more challenging to deploy during a public health crisis. By mapping expected burden of measles, more effective SIAs that are setting-specific and resource-efficient can be planned and mobilized. Using a spatial transmission model of measles dynamics, we projected and estimated the expected burden of national and local measles outbreaks in Zambia with the current COVID-19 pandemic as a framework to inform disruptions to routine vaccination. We characterize the impact of disruptions to routine immunization services on measles incidence, map expected case burden, and explore SIA strategies to mitigate measles outbreaks. We find that disruptions lasting six months or longer as well as having low MCV1 coverage prior to disruptions resulted in an observable increase of measles cases across provinces. Targeting provinces at higher risk of measles outbreaks for SIAs is an effective strategy to curb measles virus incidence following disruptions to routine immunization services.
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Affiliation(s)
- Natalya Kostandova
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Stacie Loisate
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Amy Winter
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, USA
| | - William J. Moss
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - John R. Giles
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - C.J.E. Metcalf
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA,Princeton School of Public and International Affairs, Princeton University, Princeton, NJ, USA
| | - Simon Mutembo
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Ministry of Health, Government of the Republic of Zambia, Lusaka, Zambia
| | - Amy Wesolowski
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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