Spatio-temporal waves and targeted vaccination in recurrent epidemic network models.

The success of an infectious disease to invade a population is strongly controlled by the population's specific connectivity structure. Here, a network model is presented as an aid in understanding the role of social behaviour and heterogeneous connectivity in determining the spatio-temporal patterns of disease dynamics. We explore the controversial origins of long-term recurrent oscillations believed to be characteristic of diseases that have a period of temporary immunity after infection. In particular, we focus on sexually transmitted diseases such as syphilis, where this controversy is currently under review. Although temporary immunity plays a key role, it is found that, in realistic small-world networks, the social and sexual behaviour of individuals also has a great influence in generating long-term cycles. The model generates circular waves of infection with unusual spatial dynamics that depend on focal areas that act as pacemakers in the population. Eradication of the disease can be efficiently achieved by eliminating the pacemakers with a targeted vaccination scheme. A simple difference equation model is derived, which captures the infection dynamics of the network model and gives insights into their origins and their eradication through vaccination. Illustrative videos may be found in the electronic supplementary material.