Open AccessA need for null models in understanding disease transmission: the example ofMycobacterium ulcerans(Buruli ulcer disease)
Author(s) -
Joseph P. Receveur,
Alexandra Bauer,
Jennifer L. Pechal,
Sophie Picq,
Magdalene Dogbe,
Heather R. Jordan,
Alex W. Rakestraw,
Kayla M. Fast,
Michael J. Sandel,
Christine Chevillon,
JeanFrançois Guégan,
John R. Wallace,
M. Eric Benbow
Publication year - 2021
Publication title -
fems microbiology reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.91
H-Index - 212
eISSN - 1574-6976
pISSN - 0168-6445
DOI - 10.1093/femsre/fuab045
Subject(s) - mycobacterium ulcerans , buruli ulcer , biology , transmission (telecommunications) , context (archaeology) , biological dispersal , disease , wildlife , wildlife disease , tropical disease , vector (molecular biology) , ecology , inference , mycobacterium , disease transmission , infectious disease (medical specialty) , virology , environmental health , medicine , genetics , population , bacteria , pathology , artificial intelligence , computer science , recombinant dna , telecommunications , paleontology , gene
Understanding the interactions of ecosystems, humans and pathogens is important for disease risk estimation. This is particularly true for neglected and newly emerging diseases where modes and efficiencies of transmission leading to epidemics are not well understood. Using a model for other emerging diseases, the neglected tropical skin disease Buruli ulcer (BU), we systematically review the literature on transmission of the etiologic agent, Mycobacterium ulcerans (MU), within a One Health/EcoHealth framework and against Hill's nine criteria and Koch's postulates for making strong inference in disease systems. Using this strong inference approach, we advocate a null hypothesis for MU transmission and other understudied disease systems. The null should be tested against alternative vector or host roles in pathogen transmission to better inform disease management. We propose a re-evaluation of what is necessary to identify and confirm hosts, reservoirs and vectors associated with environmental pathogen replication, dispersal and transmission; critically review alternative environmental sources of MU that may be important for transmission, including invertebrate and vertebrate species, plants and biofilms on aquatic substrates; and conclude with placing BU within the context of other neglected and emerging infectious diseases with intricate ecological relationships that lead to disease in humans, wildlife and domestic animals.