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Integrating Transgenic Vector Manipulation with Clinical Interventions to Manage Vector-Borne Diseases

Many vector-borne diseases lack effective vaccines and medications, and the limitations of traditional vector control have inspired novel approaches based on using genetic engineering to manipulate vector populations and thereby reduce transmission. Yet both the short- and long-term epidemiological...

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Autores principales: Okamoto, Kenichi W., Gould, Fred, Lloyd, Alun L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4786096/
https://www.ncbi.nlm.nih.gov/pubmed/26962871
http://dx.doi.org/10.1371/journal.pcbi.1004695
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author Okamoto, Kenichi W.
Gould, Fred
Lloyd, Alun L.
author_facet Okamoto, Kenichi W.
Gould, Fred
Lloyd, Alun L.
author_sort Okamoto, Kenichi W.
collection PubMed
description Many vector-borne diseases lack effective vaccines and medications, and the limitations of traditional vector control have inspired novel approaches based on using genetic engineering to manipulate vector populations and thereby reduce transmission. Yet both the short- and long-term epidemiological effects of these transgenic strategies are highly uncertain. If neither vaccines, medications, nor transgenic strategies can by themselves suffice for managing vector-borne diseases, integrating these approaches becomes key. Here we develop a framework to evaluate how clinical interventions (i.e., vaccination and medication) can be integrated with transgenic vector manipulation strategies to prevent disease invasion and reduce disease incidence. We show that the ability of clinical interventions to accelerate disease suppression can depend on the nature of the transgenic manipulation deployed (e.g., whether vector population reduction or replacement is attempted). We find that making a specific, individual strategy highly effective may not be necessary for attaining public-health objectives, provided suitable combinations can be adopted. However, we show how combining only partially effective antimicrobial drugs or vaccination with transgenic vector manipulations that merely temporarily lower vector competence can amplify disease resurgence following transient suppression. Thus, transgenic vector manipulation that cannot be sustained can have adverse consequences—consequences which ineffective clinical interventions can at best only mitigate, and at worst temporarily exacerbate. This result, which arises from differences between the time scale on which the interventions affect disease dynamics and the time scale of host population dynamics, highlights the importance of accounting for the potential delay in the effects of deploying public health strategies on long-term disease incidence. We find that for systems at the disease-endemic equilibrium, even modest perturbations induced by weak interventions can exhibit strong, albeit transient, epidemiological effects. This, together with our finding that under some conditions combining strategies could have transient adverse epidemiological effects suggests that a relatively long time horizon may be necessary to discern the efficacy of alternative intervention strategies.
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spelling pubmed-47860962016-03-23 Integrating Transgenic Vector Manipulation with Clinical Interventions to Manage Vector-Borne Diseases Okamoto, Kenichi W. Gould, Fred Lloyd, Alun L. PLoS Comput Biol Research Article Many vector-borne diseases lack effective vaccines and medications, and the limitations of traditional vector control have inspired novel approaches based on using genetic engineering to manipulate vector populations and thereby reduce transmission. Yet both the short- and long-term epidemiological effects of these transgenic strategies are highly uncertain. If neither vaccines, medications, nor transgenic strategies can by themselves suffice for managing vector-borne diseases, integrating these approaches becomes key. Here we develop a framework to evaluate how clinical interventions (i.e., vaccination and medication) can be integrated with transgenic vector manipulation strategies to prevent disease invasion and reduce disease incidence. We show that the ability of clinical interventions to accelerate disease suppression can depend on the nature of the transgenic manipulation deployed (e.g., whether vector population reduction or replacement is attempted). We find that making a specific, individual strategy highly effective may not be necessary for attaining public-health objectives, provided suitable combinations can be adopted. However, we show how combining only partially effective antimicrobial drugs or vaccination with transgenic vector manipulations that merely temporarily lower vector competence can amplify disease resurgence following transient suppression. Thus, transgenic vector manipulation that cannot be sustained can have adverse consequences—consequences which ineffective clinical interventions can at best only mitigate, and at worst temporarily exacerbate. This result, which arises from differences between the time scale on which the interventions affect disease dynamics and the time scale of host population dynamics, highlights the importance of accounting for the potential delay in the effects of deploying public health strategies on long-term disease incidence. We find that for systems at the disease-endemic equilibrium, even modest perturbations induced by weak interventions can exhibit strong, albeit transient, epidemiological effects. This, together with our finding that under some conditions combining strategies could have transient adverse epidemiological effects suggests that a relatively long time horizon may be necessary to discern the efficacy of alternative intervention strategies. Public Library of Science 2016-03-10 /pmc/articles/PMC4786096/ /pubmed/26962871 http://dx.doi.org/10.1371/journal.pcbi.1004695 Text en © 2016 Okamoto et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Okamoto, Kenichi W.
Gould, Fred
Lloyd, Alun L.
Integrating Transgenic Vector Manipulation with Clinical Interventions to Manage Vector-Borne Diseases
title Integrating Transgenic Vector Manipulation with Clinical Interventions to Manage Vector-Borne Diseases
title_full Integrating Transgenic Vector Manipulation with Clinical Interventions to Manage Vector-Borne Diseases
title_fullStr Integrating Transgenic Vector Manipulation with Clinical Interventions to Manage Vector-Borne Diseases
title_full_unstemmed Integrating Transgenic Vector Manipulation with Clinical Interventions to Manage Vector-Borne Diseases
title_short Integrating Transgenic Vector Manipulation with Clinical Interventions to Manage Vector-Borne Diseases
title_sort integrating transgenic vector manipulation with clinical interventions to manage vector-borne diseases
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4786096/
https://www.ncbi.nlm.nih.gov/pubmed/26962871
http://dx.doi.org/10.1371/journal.pcbi.1004695
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