Super-spreader

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Super-spreaders contribute disproportionately to the spread of several infectious diseases. They appear to spread environmentally statistically more innoculating doses of an infectious agent than the mean for a population. They are well described in a number of recent infectious disease outbreaks involving MERS-CoV, SARS-CoV, and Ebola virus[1]. Children tend to be super-spreaders of many respiratory pathogens such as influenza[2]. Many diseases appear to follow the 20/80 rule where 20% of carriers are responsible for 80% of infections. In the case of faecal route transmitted pathogens the incontinent are likely to be super-spreaders[3]. The reason that some become super-spreaders is likely to vary with infectious agent but for example an association with ability to create IgA secretory antibody would not be surprising. However targetting such super-spreaders with say a vaccine strategy in man can be counter-productive as it transpires the psych-social effect of a campaign targeting an identifiable subsection of the population leads to increased policy resistance in that subpopulation[4]. The concepts involved can be mathematically modelled and are also important in rapid dissemination of information or one supposes misinformation[5].

References

  1. Wong G, Liu W, Liu Y, Zhou B, Bi Y, Gao GF. MERS, SARS, and Ebola: The Role of Super-Spreaders in Infectious Disease. Cell host & microbe. 2015 Oct; 18(4):398-401.(Print) (Link to article – subscription may be required.)
  2. Killingley B, Greatorex J, Digard P, Wise H, Garcia F, Varsani H, Cauchemez S, Enstone JE, Hayward A, Curran MD, Read RC, Lim WS, Nicholson KG, Nguyen-Van-Tam JS. The environmental deposition of influenza virus from patients infected with influenza A(H1N1)pdm09: Implications for infection prevention and control. Journal of infection and public health. 2016 May-Jun; 9(3):278-288.(Print-Electronic) (Link to article – subscription may be required.)
  3. Lerner A, Adler A, Abu-Hanna J, Cohen Percia S, Kazma Matalon M, Carmeli Y. Spread of KPC-producing carbapenem-resistant Enterobacteriaceae: the importance of super-spreaders and rectal KPC concentration. Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. 2015 May; 21(5):470.e1-7.(Print-Electronic) (Link to article – subscription may be required.)
  4. Wells CR, Klein EY, Bauch CT. Policy resistance undermines superspreader vaccination strategies for influenza. PLoS computational biology. 2013 ; 9(3):e1002945.(Print-Electronic) (Link to article – subscription may be required.)
  5. Zhang JX, Chen DB, Dong Q, Zhao ZD. Identifying a set of influential spreaders in complex networks. Scientific reports. 2016; 6:27823.(Electronic) (Link to article – subscription may be required.)