The interaction between host demography and tuberculosis transmission: disease dynamics, control and evolution.
Lead Research Organisation:
University of Cambridge
Department Name: Veterinary Medicine
Abstract
TB is the leading single cause of death in humans due to an infectious agent. Approximately 30% of the world's population is latently infected and 0.1% has active disease. TB is characterised by long-term asymptomatic infection that can progress to active disease years or decades after exposure. Active disease can produce a persistent cough, fever, weight loss and, if untreated, death in approximately 50% of cases. In recent years rates have escalated due to the interaction with the HIV epidemic and the emergence of drug resistant strains. TB affects many other mammals as well as humans. Bovine TB is endemic in many domestic cattle populations. Transmission to humans can occur via contaminated milk or direct contact. In Great Britain, bovine TB is one of the most complex and persistent problems facing the cattle industry, with an estimated annual cost of 90 million. Transmission of bovine TB between farms occurs via a combination of local infection and the movement of infected animals. While much less is understood about the natural history of disease in cattle, many of the principles involved in understanding TB spread apply to both humans and cattle. Mathematical models are used to predict how TB will spread in a population and the kind of interventions that might lead to eradication. Models include factors that are known to affect the spread of TB such as stress or overcrowding. Furthermore, progression rates are highly dependent on age of infection. This means that an ageing population is very different, in terms of TB, than a population with high birth rates. The effect of changing demography on TB spread has not been investigated in TB models, and so predictions about how to control the disease are not as accurate as they could be. This project will develop a new, comprehensive framework to understand the transmission dynamics and evolution of chronic diseases, with a particular focus on TB. The framework will be flexible to the needs of TB epidemiologists by incorporating transmission, age-dependent immune response, demographic changes and variation in genetic susceptibility.
Planned Impact
During the course of the fellowship, I propose to undertake a body of work that will advance current thinking about modelling and control of chronic diseases. The initial impact of the work will be aimed at the academic community through publishing articles in the modelling and interdisciplinary literature, attending conferences and establishing collaborations with researchers. This research is fundamentally interdisciplinary, and therefore will impact both theoretical and applied research. In particular, the new knowledge will be shared with infectious disease modellers, demographers, TB clinicians and epidemiologists, veterinarians and researchers studying bovine TB transmission in cattle and wildlife populations. I will maintain a web server with background information and major findings. This will include the framework and code for basic TB models, so that modelling can be included in field studies at an early stage by non-expert modellers. The advances in understanding TB population dynamics will have direct implications for public health and the control of livestock diseases and will contribute to maintaining the UK's position at the forefront of infectious disease modelling and disease control. Collaboration with the World Health Organization (WHO), the Health Protection Agency (HPA) and the Department for Environment, Food and Rural Affairs (Defra) will be an essential means of realising the maximum long-term health and economic benefits of this work. Promotion of my work in public spaces, such as at museums and online, will increase its access for a wide range of people. Presentations and posters at agricultural and countryside shows and events will improve the awareness of the research among farming communities and a presence at medical conferences and publication in medical journals will facilitate communication with the healthcare industry.
People |
ORCID iD |
Ellen Brooks-Pollock (Principal Investigator) |
Publications
Eames KT
(2012)
Rapid assessment of influenza vaccine effectiveness: analysis of an internet-based cohort.
in Epidemiology and infection
Eames KT
(2012)
Measured dynamic social contact patterns explain the spread of H1N1v influenza.
in PLoS computational biology
Conlan AJ
(2012)
Estimating the hidden burden of bovine tuberculosis in Great Britain.
in PLoS computational biology
Amos W
(2013)
Genetic predisposition to pass the standard SICCT test for bovine tuberculosis in British cattle.
in PloS one
Brooks-Pollock E
(2013)
Age-dependent patterns of bovine tuberculosis in cattle.
in Veterinary research
Brooks-Pollock, E.
(2014)
50 Visions of Mathematics
Brooks-Pollock E
(2014)
A dynamic model of bovine tuberculosis spread and control in Great Britain.
in Nature
Dawson PM
(2015)
Epidemic predictions in an imperfect world: modelling disease spread with partial data.
in Proceedings. Biological sciences
Brooks-Pollock E
(2015)
Eight challenges in modelling infectious livestock diseases.
in Epidemics
Brooks-Pollock E
(2015)
Eliminating bovine tuberculosis in cattle and badgers: insight from a dynamic model.
in Proceedings. Biological sciences
Description | During my fellowship, I worked on methods to understand and quantify the transmission of tuberculosis and bovine tuberculosis. Using cattle movement data and bovine tuberculosis surveillance data from Great Britain, I demonstrated that a small percentage of farms cause the majority of new cases. I developed tools to quantify the age-specific risks of bovine tuberculosis in cattle in Great Britain and was able to show that young dairy and beef animals experience similar infection rates. I developed an axiomatic model of tuberculosis transmission between cattle and badgers that demonstrated how badgers can be essential for maintaining infection in cattle without being responsible for the majority of cases in cattle. |
Exploitation Route | My work is being developed by the Tuberculosis Modelling Consortium to provide a "plug-and-play" epidemic model for use by the Animal and Plant Health Agency. More generally, I would like farmers to feel more empowered in controlling bovine tuberculosis in their herds. |
Sectors | Agriculture Food and Drink Healthcare |
URL | http://www.ellbp.net/research/bovinetb |
Description | The mathematical model and parameter inference methods developed during my fellowship (Brooks-Pollock, Roberts & Keeling "A dynamic model of bovine tuberculosis in Great Britain" Nature 511, 228231. doi:10.1038/nature13529.) are being used as a basis for further modelling work as part of a Tuberculosis Modelling Consortium established and funded by the Department for the Environment, Food and Rural Affairs (Defra). |
First Year Of Impact | 2014 |
Sector | Agriculture, Food and Drink |
Impact Types | Policy & public services |
Description | Membership of Defra Tuberculosis modelling initiative |
Geographic Reach | National |
Policy Influence Type | Citation in other policy documents |
Description | A study to design risk based bTB surveillance regimes in England and Wales |
Amount | £269,277 (GBP) |
Organisation | Department For Environment, Food And Rural Affairs (DEFRA) |
Sector | Public |
Country | United Kingdom |
Start | 08/2011 |
End | 09/2013 |
Description | Charles Slater Award |
Amount | £2,000 (GBP) |
Organisation | University of Cambridge |
Sector | Academic/University |
Country | United Kingdom |
Start | 07/2012 |
End | 09/2012 |
Description | Development and testing of Operational Models of Bovine Tuberculosis in British Cattle and Badgers |
Amount | £458,738 (GBP) |
Funding ID | SE3290 |
Organisation | Department For Environment, Food And Rural Affairs (DEFRA) |
Sector | Public |
Country | United Kingdom |
Start | 08/2016 |
End | 09/2018 |
Description | Tuberculosis Modelling Initiative |
Organisation | Department For Environment, Food And Rural Affairs (DEFRA) |
Country | United Kingdom |
Sector | Public |
PI Contribution | The consortium is using my national scale model as a basis for the modelling work. |
Collaborator Contribution | Rowland Kao in Glasgow is the Principle Investigator. |
Impact | None to date |
Start Year | 2014 |
Description | Article in Pioneer, the EPRSC magazine |
Form Of Engagement Activity | A magazine, newsletter or online publication |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Other audiences |
Results and Impact | Article in Pioneer about my work on tuberculosis in cattle and badgers. |
Year(s) Of Engagement Activity | 2013 |
Description | Article in The Conversation |
Form Of Engagement Activity | Engagement focused website, blog or social media channel |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Public/other audiences |
Results and Impact | Together with Ewan Harrison, I wrote an article for The Conversation on zoonotic infections. |
Year(s) Of Engagement Activity | 2013 |
URL | https://theconversation.com/badger-cull-why-we-must-keep-a-close-eye-on-animal-health-16101 |
Description | Interview on BBC Midlands Today |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Public/other audiences |
Results and Impact | Matt Keeling and I were interviewed on Midlands Today about a national TB model. |
Year(s) Of Engagement Activity | 2014 |
Description | Interview on Countryfile on BBC1 |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | Yes |
Geographic Reach | National |
Primary Audience | Public/other audiences |
Results and Impact | Myself and Professor Matt Keeling were interviewed on Countryfile on BBC1, where the results of our study were discussed. I received multiple emails and letters from people who had seen the programme, including from farmers and teachers interested in the area. |
Year(s) Of Engagement Activity | 2014 |
Description | Interviews on BBC Radio 4 Farming Today |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Public/other audiences |
Results and Impact | Interviewed on Farming Today in 2014 about national-scale TB model and in 2016 about cattle-badger model. |
Year(s) Of Engagement Activity | 2014,2015 |
Description | Invited Talk at IMA Mathematics 2013 |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Public/other audiences |
Results and Impact | My presentation sparked lively discussion and requests from a couple of teachers for more information so that they could include it in classroom activities. |
Year(s) Of Engagement Activity | 2013 |
URL | http://www.ima.org.uk/conferences/conferences_calendar/ima_mathematics_2013.cfm |
Description | Meet the Scientist event at the Birmingham Science Museum |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | Yes |
Geographic Reach | Regional |
Primary Audience | Public/other audiences |
Results and Impact | I organised a day event at the Birmingham Science museum where myself and colleagues from the London School of Hygiene and Tropical Medicine presented "The Science behind Influenza Epidemics". |
Year(s) Of Engagement Activity | 2011 |
URL | http://www.birmingham.ac.uk/university/colleges/mds/events/2014/10/think-tank.aspx |
Description | Organiser of the Mentor Scheme at the European Conference of Mathematical and Theoretical Biology |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | Yes |
Geographic Reach | International |
Primary Audience | Postgraduate students |
Results and Impact | I set up and ran the mentor scheme at an international conference. Many of the students reported that the meeting with a senior scientist improved their conference experience and future prospects. |
Year(s) Of Engagement Activity | 2011 |
Description | Press briefing at the Science Media Centre |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Media (as a channel to the public) |
Results and Impact | Matt Keeling and I gave a presentation on our national scale TB model at the Science Media Centre. Attendees Claire Marshall - BBC News Jamie Day - Animal Pharm Damian Carrington - Guardian Emily Beaumont - Press Association Ben Spencer - Daily Mail Laura Mulholland - BBC Newsnight Alastair Driver - Farmer's Guardian Alan Bullion - Agra Europe (Informa) Recordings: https://db.tt/sAwmbSqP Recording sent to Kate Kelland (Reuters), Tom Heap (Countryfile?), & Ben Webster (Times) Media Enquiries Ben Webster (Times) spoke to Ellen Brooks-Pollock and Matt Keeling Briefing coverage Guardian http://www.theguardian.com/environment/2014/jul/02/tuberculosis-tb-threat-mass-cull-cattle-not-badgers-study New Scientist http://www.newscientist.com/article/dn25830-kill-cattle-not-badgers-to-halt-uks-tb-epidemic.html#.U7Q70LEYDm4 BBC News http://www.bbc.co.uk/news/uk-england-28132627 Financial Times http://www.ft.com/cms/s/0/42f48fda-0127-11e4-b94d-00144feab7de.html#axzz36KdznfQL Farmers Guardian http://www.farmersguardian.com/home/hot-topics/bovine-tb/defra-dismisses-research-questioning-badger-cull-value/65703.article BBC News http://www.bbc.co.uk/news/science-environment-28033649 Daily Mail http://www.dailymail.co.uk/news/article-2678630/Culling-Britains-badgers-not-stop-spread-TB-cattle-killing-640-000-cows-year-will.html?ITO=1490&ns_mchannel=rss&ns_campaign=1490 Telegraph http://www.telegraph.co.uk/earth/environment/10942274/Culling-cattle-not-badgers-only-way-to-stop-bovine-TB.html Independent Print only, NIB, p20 |
Year(s) Of Engagement Activity | 2014 |
Description | Royal Society Pairing Scheme |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Policymakers/politicians |
Results and Impact | • One of 33 scientists selected for the scheme • Develops links between scientists, parliamentarians and Civil Servants via a week in Westminster and reciprocal visits • Paired with Sarah Brown from the Health and Safety Executive |
Year(s) Of Engagement Activity | 2013,2014 |
Description | School workshop on the Maths of culling badgers, Sir William Borlase's Grammar School, Marlow. |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Schools |
Results and Impact | I was invited by Andrew Conlan to talk about the maths of culling badgers to maths A-level students at Sir William Borlase's Grammar School in Marlow. A lively debate followed my talk and the students were interested in this application of Maths. |
Year(s) Of Engagement Activity | 2013 |
Description | ScienceGrrl for International Women's Day, Science Museum, London |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Public/other audiences |
Results and Impact | As part of International Women's day, I took part in the ScienceGrrl event at the Science Museum in London. I spoke to museum visitors about my work. |
Year(s) Of Engagement Activity | 2013 |