Large-scale spatial-transmission models of infectious disease.

During transmission of seasonal endemic diseases such as measles and influenza, spatial waves of infection have been observed between large distant populations. Also, during the initial stages of an outbreak of a new or reemerging pathogen, disease incidence tends to occur in spatial clusters, which makes containment possible if you can predict the subsequent spread of disease. Spatial models are being used with increasing frequency to help characterize these large-scale patterns and to evaluate the impact of interventions. Here, I review several recent studies on four diseases that show the benefits of different methodologies: measles (patch models), foot-and-mouth disease (distance-transmission models), pandemic influenza (multigroup models), and smallpox (network models). This review highlights the importance of the household in spatial studies of human diseases, such as smallpox and influenza. It also demonstrates the need to develop a simple model of household demographics, so that these large-scale models can be extended to the investigation of long-time scale human pathogens, such as tuberculosis and HIV.