Inapparent infections and cholera dynamics

Aaron A. King (), Edward L. Ionides, Mercedes Pascual and Menno J. Bouma
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Aaron A. King: Department of Ecology and Evolutionary Biology,
Edward L. Ionides: University of Michigan, Ann Arbor, Michigan 48109, USA
Mercedes Pascual: Department of Ecology and Evolutionary Biology,
Menno J. Bouma: London School of Hygiene and Tropical Medicine, University of London

Nature, 2008, vol. 454, issue 7206, 877-880

Abstract: Hidden truths about cholera The true extent of mild infections during cholera outbreaks is difficult to assess — estimates of the ratio of asymptomatic to symptomatic infections have ranged from as low as three to as high as a hundred — and as a result the interpretation of epidemiological records has been compromised. More compromised than was thought it seems: a new modelling study of patterns of cholera mortality in Bengal over a 50-year period suggests that the asymptomatic-to-symptomatic ratio in fact exceeds 1,000 to one. This work could dramatically revise thinking on cholera outbreaks and how to handle them, and suggests that the importance of inapparent infections in the ecology of infectious diseases in general has been underestimated.

Date: 2008
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DOI: 10.1038/nature07084

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