Abstract
Pathogens can follow more than one transmission route during outbreaks – from needle sharing plus sexual transmission of HIV to small droplet aerosol plus fomite transmission of influenza. Thus, controlling an infectious disease outbreak often requires characterizing the risk associated with multiple mechanisms of transmission. For example, during the Ebola virus outbreak in West Africa, weighing the relative importance of funeral versus health care worker transmission was essential to stopping disease spread. Strategic policy decisions regarding interventions must rely on accurately characterizing risks associated with multiple transmission routes. The ongoing Zika virus outbreak challenges our conventional methodologies for translating case-counts into route-specific transmission risk. Critically, most approaches will fail to accurately estimate the risk of seeing sustained sexual transmission of a pathogen that is primarily vectored by a mosquito – such as the case with the risk of sustained sexual transmission of Zika virus.
Footnotes
↵* laurent{at}santafe.edu
