Document Detail

Earthquakes, influenza and cycles of Indian kala-azar.
MedLine Citation:
PMID:  3256984     Owner:  NLM     Status:  MEDLINE    
It is suggested that previous data indicate 3 major epidemics of kala-azar in Assam between 1875 and 1950, with inter-epidemic periods of 30-45 and 20 years. This deviates from the popular view of regular cycles with a 10-20 year period. A deterministic mathematical model of kala-azar is used to find the simplest explanation for the timing of the 3 epidemics, paying particular attention to the role of extrinsic (drugs, natural disasters, other infectious diseases) versus intrinsic (host and vector dynamics, birth and death rates, immunity) processes in provoking the second. We conclude that, whilst widespread influenza in 1918-1919 may have magnified the second epidemic, intrinsic population processes provide the simplest explanation for its timing and synchrony throughout Assam. The model also shows that the second inter-epidemic period is expected to be shorter than the first, even in the absence of extrinsic agents, and highlights the importance of a small fraction of patients becoming chronically infectious (with post kala-azar dermal leishmaniasis) after treatment during an epidemic.
C Dye; D M Wolpert
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Transactions of the Royal Society of Tropical Medicine and Hygiene     Volume:  82     ISSN:  0035-9203     ISO Abbreviation:  Trans. R. Soc. Trop. Med. Hyg.     Publication Date:  1988  
Date Detail:
Created Date:  1989-10-25     Completed Date:  1989-10-25     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  7506129     Medline TA:  Trans R Soc Trop Med Hyg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  843-50     Citation Subset:  IM    
Department of Medical Parasitology, London School of Hygiene and Tropical Medicine, UK.
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MeSH Terms
Disease Outbreaks*
Influenza, Human / epidemiology*
Leishmaniasis, Visceral / epidemiology*
Models, Theoretical
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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