The epidemiology of heartwater: Establishment and maintenance of endemic stability.

Although heartwater (Cowdria ruminantium infection) is one of the most economically important tick-borne diseases of sub-Saharan Africa, its epidemiology he's remained poorly understood until recently. New data, suggesting that heartwater is present in an endemically stable state in much of sub-Saharan Africa and demonstrating vertical transmission of Cowdria ruminantium in the field, have altered previously accepted views on heartwater epidemiology. In this paper, Sharon Deem and colleagues present an overview of the epidemiology of heartwater based on recent studies, discuss the factors that make endemic stability possible, make recommendations for future directions in research, and provide a foundation for the development of epidemiological models.