PT - JOURNAL ARTICLE AU - Abdou Moutalab Fofana AU - Amy Hurford TI - Parasite-induced shifts in host movement may explain the transient coexistence of high- and low-pathogenic disease strains AID - 10.1101/623660 DP - 2019 Jan 01 TA - bioRxiv PG - 623660 4099 - http://biorxiv.org/content/early/2019/04/30/623660.short 4100 - http://biorxiv.org/content/early/2019/04/30/623660.full AB - Many parasites induce decreased host movement, known as lethargy, which can impact disease spread and the evolution of virulence. Mathematical models have investigated virulence evolution when parasites cause host death, but disease-induced decreased host movement has received relatively less attention. Here, we consider a model where, due to the within-host parasite replication rate, an infected host can become lethargic and shift from a moving to a resting state, where it can die. We find that when the lethargy and disease-induced mortality costs to the parasites are not high, then evolutionary bistability can arise, and either moderate or high virulence can evolve depending on the initial virulence and the magnitude of mutation. These results suggest, firstly, the transient coexistence of strains with different virulence, which may explain the coexistence of low- and high-pathogenic strains of avian influenza and human immunodeficiency viruses, and secondly, that medical interventions to treat the symptoms of lethargy or prevent disease-induced host deaths can result in a large jump in virulence and the rapid evolution of high virulence. In complement to existing results that show bistability when hosts are heterogeneous at the population-level, we show that evolutionary bistability may arise due to transmission heterogeneity at the individual host-level.