Immunizing childhood infections have provided a unique system for exploring the paradigm of metapopulation dynamics. The requirement for a minimal population size for these infections to persist without suffering stochastic extinction has made cities the natural unit of study. However, as vaccination coverage increases and the landscape of susceptibility become more heterogeneous, it is of growing importance to understand the patterns shaping transmission and maintenance across the matrix between cities. We discuss this using data across a range of scales for two childhood infections.
Results/Conclusions
Limitations in the data restrict detailed understanding of the underlying case burden, but modeling of population density across scales combined with maps of susceptibility indicates considerable potential for persistence of such infecitous diseases predicated on between city populations.