Publications
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Lessler J, Salje H, van Kerkhove M, et al., 2016, Estimating the Severity and Subclinical Burden of Middle East Respiratory Syndrome Coronavirus Infection in the Kingdom of Saudi Arabia, American Journal of Epidemiology, Vol: 183, Pages: 657-663, ISSN: 1476-6256
Not all persons infected with Middle East respiratory syndrome coronavirus (MERS-CoV) develop severe symptoms, which likely leads to an underestimation of the number of people infected and an overestimation of the severity. To estimate the number of MERS-CoV infections that have occurred in the Kingdom of Saudi Arabia, we applied a statistical model to a line list describing 721 MERS-CoV infections detected between June 7, 2012, and July 25, 2014. We estimated that 1,528 (95% confidence interval (CI): 1,327, 1,883) MERS-CoV infections occurred in this interval, which is 2.1 (95% CI: 1.8, 2.6) times the number reported. The probability of developing symptoms ranged from 11% (95% CI: 4, 25) in persons under 10 years of age to 88% (95% CI: 72, 97) in those 70 years of age or older. An estimated 22% (95% CI: 18, 25) of those infected with MERS-CoV died. MERS-CoV is deadly, but this work shows that its clinical severity differs markedly between groups and that many cases likely go undiagnosed.
Cucunubá ZM, Okuwoga O, Basanez MG, et al., 2016, Increased mortality attributed to Chagas disease: a systematic review and meta-analysis., Parasites & Vectors, Vol: 9, ISSN: 1756-3305
BACKGROUND: The clinical outcomes associated with Chagas disease remain poorly understood. In addition to the burden of morbidity, the burden of mortality due to Trypanosoma cruzi infection can be substantial, yet its quantification has eluded rigorous scrutiny. This is partly due to considerable heterogeneity between studies, which can influence the resulting estimates. There is a pressing need for accurate estimates of mortality due to Chagas disease that can be used to improve mathematical modelling, burden of disease evaluations, and cost-effectiveness studies. METHODS: A systematic literature review was conducted to select observational studies comparing mortality in populations with and without a diagnosis of Chagas disease using the PubMed, MEDLINE, EMBASE, Web of Science and LILACS databases, without restrictions on language or date of publication. The primary outcome of interest was mortality (as all-cause mortality, sudden cardiac death, heart transplant or cardiovascular deaths). Data were analysed using a random-effects model to obtain the relative risk (RR) of mortality, the attributable risk percent (ARP), and the annual mortality rates (AMR). The statistic I(2) (proportion of variance in the meta-analysis due to study heterogeneity) was calculated. Sensitivity analyses and publication bias test were also conducted. RESULTS: Twenty five studies were selected for quantitative analysis, providing data on 10,638 patients, 53,346 patient-years of follow-up, and 2739 events. Pooled estimates revealed that Chagas disease patients have significantly higher AMR compared with non-Chagas disease patients (0.18 versus 0.10; RR = 1.74, 95 % CI 1.49-2.03). Substantial heterogeneity was found among studies (I(2) = 67.3 %). The ARP above background mortality was 42.5 %. Through a sub-analysis patients were classified by clinical group (severe, moderate, asymptomatic). While RR did not differ significantly betw
Agua-Agum J, Ariyarajah A, Blake IM, et al., 2016, Ebola virus disease among male and female persons in West Africa, New England Journal of Medicine, Vol: 374, Pages: 96-98, ISSN: 1533-4406
Nouvellet P, Garske T, Mills HL, et al., 2015, The role of rapid diagnostics in managing Ebola epidemics, Nature, Vol: 528, Pages: S109-S116, ISSN: 0028-0836
Ebola emerged in West Africa around December 2013 and swept through Guinea, Sierra Leone and Liberia, giving rise to 27,748 confirmed, probable and suspected cases reported by 29 July 2015. Case diagnoses during the epidemic have relied on polymerase chain reaction-based tests. Owing to limited laboratory capacity and local transport infrastructure, the delays from sample collection to test results being available have often been 2 days or more. Point-of-care rapid diagnostic tests offer the potential to substantially reduce these delays. We review Ebola rapid diagnostic tests approved by the World Health Organization and those currently in development. Such rapid diagnostic tests could allow early triaging of patients, thereby reducing the potential for nosocomial transmission. In addition, despite the lower test accuracy, rapid diagnostic test-based diagnosis may be beneficial in some contexts because of the reduced time spent by uninfected individuals in health-care settings where they may be at increased risk of infection; this also frees up hospital beds. We use mathematical modelling to explore the potential benefits of diagnostic testing strategies involving rapid diagnostic tests alone and in combination with polymerase chain reaction testing. Our analysis indicates that the use of rapid diagnostic tests with sensitivity and specificity comparable with those currently under development always enhances control, whether evaluated at a health-care-unit or population level. If such tests had been available throughout the recent epidemic, we estimate, for Sierra Leone, that their use in combination with confirmatory polymerase chain-reaction testing might have reduced the scale of the epidemic by over a third.
Agua-Agum J, Ariyarajah A, Blake IM, et al., 2015, Ebola virus disease among children in West Africa, New England Journal of Medicine, Vol: 372, Pages: 1274-1277, ISSN: 1533-4406
Agua-Agum J, Ariyarajah A, Aylward B, et al., 2015, West African Ebola epidemic after one year - slowing but not yet under control, New England Journal of Medicine, Vol: 372, Pages: 584-587, ISSN: 1533-4406
Dye C, 2015, Goal-Directed Resuscitation in Septic Shock, NEW ENGLAND JOURNAL OF MEDICINE, Vol: 372, Pages: 189-189, ISSN: 0028-4793
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- Citations: 11
Nouvellet P, Cucunuba ZM, Gourbiere S, 2015, Ecology, Evolution and Control of Chagas Disease: A Century of Neglected Modelling and a Promising Future, MATHEMATICAL MODELS FOR NEGLECTED TROPICAL DISEASES: ESSENTIAL TOOLS FOR CONTROL AND ELIMINATION, PT A, Vol: 87, Pages: 135-191, ISSN: 0065-308X
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- Citations: 48
Lessler J, Rodriguez-Barraquer I, Cummings T, et al., 2014, Estimating potential incidence of MERS-CoV associated with Hajj pilgrims to Saudi Arabia, 2014, PLoS Currents, Vol: Edition 1, ISSN: 2157-3999
Between March and June 2014 the Kingdom of Saudi Arabia (KSA) had a large outbreak of MERS-CoV, renewing fears of a major outbreak during the Hajj this October. Using KSA Ministry of Health data, the MERS-CoV Scenario and Modeling Working Group forecast incidence under three scenarios. In the expected incidence scenario, we estimate 6.2 (95% Prediction Interval [PI]: 1–17) pilgrims will develop MERS-CoV symptoms during the Hajj, and 4.0 (95% PI: 0–12) foreign pilgrims will be infected but return home before developing symptoms. In the most pessimistic scenario, 47.6 (95% PI: 32–66) cases will develop symptoms during the Hajj, and 29.0 (95% PI: 17–43) will be infected but return home asymptomatic. Large numbers of MERS-CoV cases are unlikely to occur during the 2014 Hajj even under pessimistic assumptions, but careful monitoring is still needed to detect possible mass infection events and minimize introductions into other countries.
WHO Ebola Response Team, 2014, Ebola virus disease in West Africa — The first 9 months of the epidemic and forward projections, New England Journal of Medicine, Vol: 371, Pages: 1481-1495, ISSN: 0028-4793
BACKGROUNDOn March 23, 2014, the World Health Organization (WHO) was notified of an outbreak of Ebola virus disease (EVD) in Guinea. On August 8, the WHO declared the epidemic to be a “public health emergency of international concern.”METHODSBy September 14, 2014, a total of 4507 probable and confirmed cases, including 2296 deaths from EVD (Zaire species) had been reported from five countries in West Africa — Guinea, Liberia, Nigeria, Senegal, and Sierra Leone. We analyzed a detailed subset of data on 3343 confirmed and 667 probable Ebola cases collected in Guinea, Liberia, Nigeria, and Sierra Leone as of September 14.RESULTSThe majority of patients are 15 to 44 years of age (49.9% male), and we estimate that the case fatality rate is 70.8% (95% confidence interval [CI], 69 to 73) among persons with known clinical outcome of infection. The course of infection, including signs and symptoms, incubation period (11.4 days), and serial interval (15.3 days), is similar to that reported in previous outbreaks of EVD. On the basis of the initial periods of exponential growth, the estimated basic reproduction numbers (R0) are 1.71 (95% CI, 1.44 to 2.01) for Guinea, 1.83 (95% CI, 1.72 to 1.94) for Liberia, and 2.02 (95% CI, 1.79 to 2.26) for Sierra Leone. The estimated current reproduction numbers (R) are 1.81 (95% CI, 1.60 to 2.03) for Guinea, 1.51 (95% CI, 1.41 to 1.60) for Liberia, and 1.38 (95% CI, 1.27 to 1.51) for Sierra Leone; the corresponding doubling times are 15.7 days (95% CI, 12.9 to 20.3) for Guinea, 23.6 days (95% CI, 20.2 to 28.2) for Liberia, and 30.2 days (95% CI, 23.6 to 42.3) for Sierra Leone. Assuming no change in the control measures for this epidemic, by November 2, 2014, the cumulative reported numbers of confirmed and probable cases are predicted to be 5740 in Guinea, 9890 in Liberia, and 5000 in Sierra Leone, exceeding 20,000 in total.CONCLUSIONSThese data indicate that without drastic improvements in control measures, the numbers of
Nouvellet P, Dumonteil E, Gourbiere S, 2013, The Improbable Transmission <i>of Trypanosoma cruzi</i> to Human: The Missing Link in the Dynamics and Control of Chagas Disease, PLOS NEGLECTED TROPICAL DISEASES, Vol: 7, ISSN: 1935-2735
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- Citations: 61
Donnelly CA, Nouvellet P, 2013, The contribution of badgers to confirmed tuberculosis in cattle in high-incidence areas in England., PLoS Curr, Vol: 5
The role of badgers in the transmission and maintenance of bovine tuberculosis (TB) in British cattle is widely debated as part of the wider discussions on whether badger culling and/or badger vaccination should play a role in the government's strategy to eradicate cattle TB. The key source of information on the contribution from badgers within high-cattle-TB-incidence areas of England is the Randomised Badger Culling Trial (RBCT), with two analyses providing estimates of the average overall contribution of badgers to confirmed cattle TB in these areas. A dynamical model characterizing the association between the estimated prevalence of Mycobacterium bovis (the causative agent of bovine TB) among badgers culled in the initial RBCT proactive culls and the incidence among sympatric cattle herds prior to culling is used to estimate the average overall contribution of badgers to confirmed TB herd breakdowns among proactively culled areas. The resulting estimate based on all data (52%) has considerable uncertainty (bootstrap 95% confidence interval (CI): 9.1-100%). Separate analyses of experimental data indicated that the largest estimated reduction in confirmed cattle TB achieved inside the proactive culling areas was 54% (overdispersion-adjusted 95% CI: 38-66%), providing a lower bound for the average overall contribution of badgers to confirmed cattle TB. Thus, taking into account both results, the best estimate of the average overall contribution of badgers is roughly half, with 38% being a robustly estimated lower bound. However, the dynamical model also suggested that only 5.7% (bootstrap 95% CI: 0.9-25%) of the transmission to cattle herds is badger-to-cattle with the remainder of the average overall contribution from badgers being in the form of onward cattle-to-cattle transmission. These estimates, confirming that badgers do play a role in bovine TB transmission, inform debate even if they do not point to a single way forward.
Dumonteil E, Nouvellet P, Rosecrans K, et al., 2013, Eco-Bio-Social Determinants for House Infestation by Non-domiciliated <i>Triatoma dimidiata</i> in the Yucatan Peninsula, Mexico, PLOS NEGLECTED TROPICAL DISEASES, Vol: 7, ISSN: 1935-2735
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- Citations: 58
Nouvellet P, Gourbiere S, 2013, Biased sex-ratio and sex-biased heterozygote disadvantage affect the maintenance of a genetic polymorphism and the properties of hybrid zones, JOURNAL OF EVOLUTIONARY BIOLOGY, Vol: 26, Pages: 1774-1783, ISSN: 1010-061X
Nouvellet P, Newman C, Buesching CD, et al., 2013, A Multi-Metric Approach to Investigate the Effects of Weather Conditions on the Demographic of a Terrestrial Mammal, the European Badger (<i>Meles meles</i>), PLOS ONE, Vol: 8, ISSN: 1932-6203
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- Citations: 31
Nouvellet P, Donnelly CA, Nardi MD, et al., 2013, Rabies and Canine Distemper Virus Epidemics in the Red Fox Population of Northern Italy (2006-2010), PLOS One, Vol: 8, ISSN: 1932-6203
Since 2006 the red fox (Vulpes vulpes) population in north-eastern Italy has experienced an epidemic of canine distemper virus (CDV). Additionally, in 2008, after a thirteen-year absence from Italy, fox rabies was re-introduced in the Udine province at the national border with Slovenia. Disease intervention strategies are being developed and implemented to control rabies in this area and minimise risk to human health. Here we present empirical data and the epidemiological picture relating to these epidemics in the period 2006–2010. Of important significance for epidemiological studies of wild animals, basic mathematical models are developed to exploit information collected from the surveillance program on dead and/or living animals in order to assess the incidence of infection. These models are also used to estimate the rate of transmission of both diseases and the rate of vaccination, while correcting for a bias in early collection of CDV samples. We found that the rate of rabies transmission was roughly twice that of CDV, with an estimated effective contact between infected and susceptible fox leading to a new infection occurring once every 3 days for rabies, and once a week for CDV. We also inferred that during the early stage of the CDV epidemic, a bias in the monitoring protocol resulted in a positive sample being almost 10 times more likely to be collected than a negative sample. We estimated the rate of intake of oral vaccine at 0.006 per day, allowing us to estimate that roughly 68% of the foxes would be immunised. This was confirmed by field observations. Finally we discuss the implications for the eco-epidemiological dynamics of both epidemics in relation to control measures.
Nouvellet P, Rasmussen GSA, Macdonald DW, et al., 2012, Noisy clocks and silent sunrises: measurement methods of daily activity pattern., Journal of Zoology, Vol: 286, Pages: 179-184, ISSN: 0952-8369
Nouvellet P, Campbell RD, Newman C, et al., 2012, The influence of mean climate trends and climate variance on beaver survival and recruitment dynamics, Global Change Biology, Vol: 18, Pages: 2730-2742
Nouvellet P, Dugdale HL, Newman C, et al., 2011, Mouthing off about fitness: palate asymmetry reveals impact of juvenile parasitoses in the European badger., Journal of Zoology, Vol: 283, Pages: 52-62
Nouvellet P, Ramirez-Sierra MJ, Dumonteil E, et al., 2011, Effects of genetic factors and infection status on wing morphology of Triatoma dimidiata species complex in the Yucatan peninsula, Mexico., Infection Genetics and Evolution, Vol: 11, Pages: 1243-1249
Nouvellet P, Bacon JP, Waxman D, 2011, Testing the Level of Ant Activity Associated with Quorum Sensing; an Empirical Approach Leading to Establishment and Test of a Null-Model (response to the comment of Richardson et al.)., Journal of Theoretical Biology
Czaczkes T, Nouvellet P, Ratnieks F, 2011, Cooperative transport in the Neotropical ant Pheidole oxyops., Insectes Sociaux, Vol: 58, Pages: 153-161
Nouvellet P, Bacon JP, Waxman D, 2010, Testing the level of ant activity associated with quorum sensing: An empirical approach leading to the establishment and test of a null-model, JOURNAL OF THEORETICAL BIOLOGY, Vol: 266, Pages: 573-583, ISSN: 0022-5193
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- Citations: 7
Dugdale HL, Nouvellet P, Pope LC, et al., 2010, Fitness measures in selection analyses: sensitivity to the overall number of offspring produced in a lifetime, JOURNAL OF EVOLUTIONARY BIOLOGY, Vol: 23, Pages: 282-292, ISSN: 1010-061X
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- Citations: 11
Macdonald DW, Newman C, Buesching CD, et al., 2010, Are badgers ‘under the weather’? Direct and Indirect Impacts of climate variation on European Badger (Meles meles) Population dynamics., Global Change Biology, Vol: 16, Pages: 2913-2922
Nouvellet P, Bacon JP, Waxman D, 2009, Fundamental Insights into the Random Movement of Animals from a Single Distance-Related Statistic, AMERICAN NATURALIST, Vol: 174, Pages: 506-514, ISSN: 0003-0147
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- Citations: 31
Macdonald DW, Newman C, Nouvellet P, et al., 2009, An analysis of Eurasian Badger (Meles meles) population dynamics: implications for regulatory mechanisms., Journal of Mammalogy, Vol: 90, Pages: 1392-1403
Broom M, Nouvellet P, Bacon JP, et al., 2006, Parameter-free testing of the shape of a probability distribution, BIOSYSTEMS, Vol: 90, Pages: 509-515, ISSN: 0303-2647
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- Citations: 1
Marais G, Nouvellet P, Keightley PD, et al., 2005, Intron size and exon evolution in Drosophila, GENETICS, Vol: 170, Pages: 481-485, ISSN: 0016-6731
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- Citations: 92
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