Human mobility and time spent at destination: Impact on spatial epidemic spreading

Host mobility plays a fundamental role in the spatial spread of infectious diseases. Previous theoretical works based on the integration of network theory into the metapopulation framework have shown that the heterogeneities that characterize real mobility networks favor the propagation of epidemics. Nevertheless, the studies conducted so far assumed the mobility process to be either Markovian (in which the memory of the origin of each traveler is lost) or non-Markovian with a fixed traveling time scale (in which individuals travel to a destination and come back at a constant rate). Available statistics however show that the time spent by travelers at destination is characterized by wide fluctuations, ranging from a single day up to several months. Such varying length of stay crucially affects the chance and duration of mixing events among hosts and may therefore have a strong impact on the spread of an emerging disease. Here, we present an analytical and a computational study of epidemic processes on a complex subpopulation network where travelers have memory of their origin and spend a heterogeneously distributed time interval at their destination. Through analytical calculations and numerical simulations we show that the heterogeneity of the length of stay alters the expression of the threshold between local outbreak and global invasion, and, moreover, it changes the epidemic behavior of the system in case of a global outbreak. Additionally, our theoretical framework allows us to study the effect of changes in the traveling behavior in response to the infection, by considering a scenario in which sick individuals do not leave their home location. Finally, we compare the results of our non-Markovian framework with those obtained with a classic Markovian approach and find relevant differences between the two, in the estimate of the epidemic invasion potential, as well as of the timing and the pattern of its spatial spread. These results highlight the importance of properly accounting for host trip duration in epidemic models and open the path to the inclusion of such an additional layer of complexity to the existing modeling approaches. (c) 2013 Elsevier Ltd. All rights reserved.