Optimization of control strategies for epidemics in heterogeneous populations with symmetric and asymmetric transmission.

There is growing interest in incorporating economic factors into epidemiological models in order to identify optimal strategies for disease control when resources are limited. In this paper we consider how to optimize the control of a pathogen that is capable of infecting multiple hosts with different rates of transmission within and between species. Our objective is to find control strategies that maximize the discounted number of healthy individuals. We consider two classes of host-pathogen system, comprising two host species and a common pathogen, one with asymmetrical and the other with symmetrical transmission rates, applicable to a wide range of SI (susceptible-infected) epidemics of plant and animal pathogens. We motivate the analyses with an example of sudden oak death in California coastal forests, caused by Phytophthora ramorum, in communities dominated by bay laurel (Umbellularia californica) and tanoak (Lithocarpus densiflorus). We show for the asymmetric case that it is optimal to give priority in treating disease to the more infectious species, and to treat the other species only when there are resources left over. For the symmetric case, we show that although a switching strategy is an optimum, in which preference is first given to the species with the lower level of susceptibles and then to the species with the higher level of susceptibles, a simpler strategy that favors treatment of infected hosts for the more susceptible species is a robust alternative for practical application when the optimal switching time is unknown. Finally, since transmission rates are notoriously difficult to estimate, we analyze the robustness of the strategies when the true state with respect to symmetry or otherwise is unknown but one or other is assumed. (c) 2009 Elsevier Ltd. All rights reserved.