The Open UniversitySkip to content

Correlated infections: quantifying individual heterogeneity in the spread of infectious diseases

Farrington, Paddy; Whitaker, Heather; Unkel, Steffen and Pebody, Richard (2013). Correlated infections: quantifying individual heterogeneity in the spread of infectious diseases. American Journal of Epidemiology, 177(5) pp. 474–486.

DOI (Digital Object Identifier) Link:
Google Scholar: Look up in Google Scholar


In this paper, we propose new methods for investigating the extent of heterogeneity in effective contact rates relevant to the transmission of infections. These methods exploit the correlations between ages at infection for different infections within individuals. The methods are developed for serological surveys, which provide accessible individual data on several infections, and are applied to a wide range of infections. We find that childhood infections are often highly correlated within individuals in early childhood, with the correlations persisting into adulthood only for infections sharing a transmission route. We discuss 2 applications of the methods: 1) to making inferences about routes of transmission when these are unknown or uncertain and 2) to estimating epidemiologic parameters such as the basic reproduction number and the critical immunization threshold. Two examples of such applications are presented: elucidating the transmission route of polyomaviruses BK and JC and estimating the basic reproduction number and critical immunization coverage of varicella-zoster infection in Belgium, Italy, Poland, and England and Wales. We speculate that childhood correlations stem from confounding of different transmission routes and represent heterogeneity in childhood circumstances, notably nursery-school attendance. In contrast, it is suggested that correlations in adulthood are route-specific.

Item Type: Journal Item
Copyright Holders: 2013 The Author
ISSN: 1476-6256
Keywords: basic reproduction number; communicable diseases; correlations; infectious disease transmission; frailty; heterogeneity; mass vaccination; serological tests
Academic Unit/School: Faculty of Science, Technology, Engineering and Mathematics (STEM) > Mathematics and Statistics
Faculty of Science, Technology, Engineering and Mathematics (STEM)
Related URLs:
Item ID: 34506
Depositing User: Paddy Farrington
Date Deposited: 09 Oct 2012 08:32
Last Modified: 07 Dec 2018 10:08
Share this page:


Altmetrics from Altmetric

Citations from Dimensions

Actions (login may be required)

Policies | Disclaimer

© The Open University   contact the OU