Behavioral avoidance of contagious and non-contagious adults.

Evolutionary theories of disease avoidance propose that humans have a set of universal psychological processes to detect environmental cues indicative of infectious disease. These processes then initiate cognitive, emotional, and behavioral responses that function to limit contact with harmful pathogens. Here, we study the conditions under which people exhibit behavioral avoidance of others with a contagious illness or a physical injury (i.e., a broken leg), and the potential mechanisms that underlie this behavior. Across three studies, participants were given the option of sitting at one of two workstations previously occupied by two confederates, one of whom either showed visible symptoms of a cold (contagion condition), wore a lower-leg orthopedic boot and used crutches (broken leg condition), or showed no signs of illness or physical injury (control). We found strong evidence that adults explicitly avoid contact with individuals who show symptoms of a contagious illness. Further, we provide some evidence that adults also avoid individuals with a physical injury, but that this behavior might be driven by implicit, unconscious processes. The findings are discussed in terms of implications for the healthy avoidance of contagion, and the risk for potential stigmatization of non-contagious groups.

Social networks and infectious diseases prevention behavior: A cross-sectional study in people aged 40 years and older.

BACKGROUND: Social networks, i.e., our in-person and online social relations, are key to lifestyle behavior and health, via mechanisms of influence and support from our relations. We assessed associations between various social network aspects and practicing behavior to prevent respiratory infectious diseases. METHODS: We analyzed baseline-data (2019) from the SaNAE-cohort on social networks and health, collected by an online questionnaire in Dutch community-dwelling people aged 40-99 years. Outcome was the number of preventive behaviors in past two months [range 0-4]. Associations between network aspects were tested using ordinal regression analyses, adjusting for confounders. RESULTS: Of 5,128 participants (mean age 63; 54% male), 94% regularly washed hands with water and soap, 55% used only paper (not cloth) handkerchiefs/tissues; 19% touched their face as little as possible; 39% kept distance from people with respiratory infectious disease symptoms; median score of behaviors was 2. Mean network size was 11 (46% family; 27% friends); six network members were contacted exclusively in-person and two exclusively via phone/internet. Participants received informational, emotional, and practical support from four, six, and two network members, respectively. Independently associated with more preventive behaviors were: 'strong relationships', i.e., large share of friends and aspects related to so called 'weak relationships', a larger share of distant living network members, higher number of members with whom there was exclusively phone/internet contact, and more network members providing informational support. Club membership and a larger share of same-aged network members were inversely associated. CONCLUSION: Friends ('strong' relationships) may play an important role in the adoption of infection-preventive behaviors. So may 'weak relationships', e.g. geographically more distant network members, who may provide informational support as via non-physical modes of contact. Further steps are to explore employment of these types of relationships when designing infectious diseases control programs aiming to promote infection-preventive behavior in middle aged-and older individuals.

Inaccuracies in Google's Health-Based Knowledge Panels Perpetuate Widespread Misconceptions Involving Infectious Disease Transmission.

Google health-based Knowledge Panels were designed to provide users with high-quality basic medical information on a specific condition. However, any errors contained within Knowledge Panels could result in the widespread distribution of inaccurate health information. We explored the potential for inaccuracies to exist within Google's health-based Knowledge Panels by focusing on a single well-studied pathogen, Ebola virus (EBOV). We then evaluated the accuracy of those transmission modes listed within the Google Ebola Knowledge Panel and investigated the pervasiveness of any misconceptions associated with inaccurate transmission modes among persons living in Africa. We found that the Google Ebola Knowledge Panel inaccurately listed insect bites or stings as modes of EBOV transmission. Our scoping review found 27 articles and reports that revealed that 9 of 11 countries where misconceptions regarding insect transmission of EBOV have been reported are locations of current (i.e., Democratic Republic of Congo and Guinea) or previous EBOV outbreaks. We found reports that up to 26.6% (155/582) of study respondents in Democratic Republic of Congo believed mosquito bite avoidance would prevent EBOV; in other locations of previous large-scale EBOV outbreaks (e.g., Guinea), up to 61.0% (304/498) of respondents believed insects were involved in EBOV transmission. Our findings highlight the potential for errors to exist within the health information contained in Google's health-based Knowledge Panels. Such errors could perpetuate misconceptions or misinformation, leading to mistrust of health workers and aid agencies and in turn undermining public health education or outbreak response efforts.

Review: The mental health implications for children and adolescents impacted by infectious outbreaks - a systematic review.

BACKGROUND: This systematic review synthesized available research on the psychological implications for children and adolescents who either were directly or indirectly exposed to an infectious outbreak. On this basis, the current paper aims to provide recommendations for future research, practice and policy regarding children during pandemics. METHOD: A total of 2195 records were retrieved from the PsycINFO, SCOPUS and MEDLINE databases, and three from Google Scholar. RESULTS: Including only those papers that focused on children or adolescent's mental health in association with respiratory infectious outbreaks, 11 articles were identified. The majority of research utilized qualitative or retrospective hospital record data. Children and adolescents reported fear and anxiety, as well as disruptions to their day to day routines as a result of outbreaks. However, children were also able to demonstrate resilience during outbreaks with the right support. CONCLUSIONS: Children's psychological response to the outbreak appeared to be largely attributed to how their parents, healthcare providers and the media communicated the event. Recommendations for policy, practitioners and researchers concerning the current COVID-19 outbreak concludes the paper.

Optimal periodic closure for minimizing risk in emerging disease outbreaks.

Without vaccines and treatments, societies must rely on non-pharmaceutical intervention strategies to control the spread of emerging diseases such as COVID-19. Though complete lockdown is epidemiologically effective, because it eliminates infectious contacts, it comes with significant costs. Several recent studies have suggested that a plausible compromise strategy for minimizing epidemic risk is periodic closure, in which populations oscillate between wide-spread social restrictions and relaxation. However, no underlying theory has been proposed to predict and explain optimal closure periods as a function of epidemiological and social parameters. In this work we develop such an analytical theory for SEIR-like model diseases, showing how characteristic closure periods emerge that minimize the total outbreak, and increase predictably with the reproductive number and incubation periods of a disease- as long as both are within predictable limits. Using our approach we demonstrate a sweet-spot effect in which optimal periodic closure is maximally effective for diseases with similar incubation and recovery periods. Our results compare well to numerical simulations, including in COVID-19 models where infectivity and recovery show significant variation.

Thoughts, beliefs and concepts concerning infectious childhood diseases of physicians practicing homeopathic, anthroposophic and conventional medicine - a qualitative study.

BACKGROUND: Physicians who include complementary medicine in their practice are thought to have an understanding of health and disease different from that of colleagues practicing conventional medicine. The aim of this study was to identify and compare the thoughts and concepts concerning infectious childhood diseases (measles, mumps, rubella, chickenpox, pertussis and scarlet fever) of physicians practicing homeopathic, anthroposophic and conventional medicine. METHODS: This qualitative study used semistructured interviews. Participating physicians were either general practitioners or pediatricians. Data collection and analysis were guided by a grounded theory approach. RESULTS: Eighteen physicians were interviewed (6 homeopathic, 6 anthroposophic and 6 conventional). All physicians agreed that while many classic infectious childhood diseases such as measles, mumps and rubella are rarely observed today, other diseases, such as chickenpox and scarlet fever, are still commonly diagnosed. All interviewed physicians vaccinated against childhood diseases. A core concern for physicians practicing conventional medicine was the risk of complications of the diseases. Therefore, it was considered essential for them to advise their patients to strictly follow the vaccination schedule. Homeopathic-oriented physicians viewed acute disease as a biological process necessary to strengthen health, fortify the immune system and increase resistance to chronic disease. They tended to treat infectious childhood diseases with homeopathic remedies and administered available vaccines as part of individual decision-making approaches with parents. For anthroposophic-oriented physicians, infectious childhood diseases were considered a crucial factor in the psychosocial growth of children. They tended to treat these diseases with anthroposophic medicine and underlined the importance of the family's resources. Informing parents about the potential benefits and risks of vaccination was considered important. All physicians agreed that parent-delivered loving care of a sick child could benefit the parent-child relationship. Additionally, all recognized that existing working conditions hindered parents from providing such care for longer durations of time. CONCLUSIONS: The interviewed physicians agreed that vaccines are an important aspect of modern pediatrics. They differed in their approach regarding when and what to vaccinate against. The different conceptual understandings of infectious childhood diseases influenced this decision-making. A survey with a larger sample would be needed to verify these observations.

Emerging infectious disease and the challenges of social distancing in human and non-human animals.

The 'social distancing' that occurred in response to the COVID-19 pandemic in humans provides a powerful illustration of the intimate relationship between infectious disease and social behaviour in animals. Indeed, directly transmitted pathogens have long been considered a major cost of group living in humans and other social animals, as well as a driver of the evolution of group size and social behaviour. As the risk and frequency of emerging infectious diseases rise, the ability of social taxa to respond appropriately to changing infectious disease pressures could mean the difference between persistence and extinction. Here, we examine changes in the social behaviour of humans and wildlife in response to infectious diseases and compare these responses to theoretical expectations. We consider constraints on altering social behaviour in the face of emerging diseases, including the lack of behavioural plasticity, environmental limitations and conflicting pressures from the many benefits of group living. We also explore the ways that social animals can minimize the costs of disease-induced changes to sociality and the unique advantages that humans may have in maintaining the benefits of sociality despite social distancing.

Trending on Social Media: Integrating Social Media into Infectious Disease Dynamics.

Social media plays an important role in alerting and educating the public during disease outbreaks. By increasing awareness of the disease and its prevention, it can lead to a modification of behaviour which then affects contact/incidence rates. Social media data may also be used when formulating, developing and parameterising models. As mobile technology continues to evolve and proliferate, social media is expected to occupy an increasingly prominent role in the field of infectious disease modelling to improve their predictive power. This article presents a review of existing models incorporating media in general and highlights opportunities for social media to enhance traditional compartmental models so as to make the best use of this resource in controlling the spread of disease.

Willingness to pay for an early warning system for infectious diseases.

Early warning systems for infectious diseases and foodborne outbreaks are designed with the aim of increasing the health safety of citizens. As a first step to determine whether investing in such a system offers value for money, this study used contingent valuation to estimate people's willingness to pay for such an early warning system in six European countries. The contingent valuation experiment was conducted through online questionnaires administered in February to March 2018 to cross-sectional, representative samples in the UK, Denmark, Germany, Hungary, Italy, and The Netherlands, yielding a total sample size of 3140. Mean willingness to pay for an early warning system was €21.80 (median €10.00) per household per month. Pooled regression results indicate that willingness to pay increased with household income and risk aversion, while they decreased with age. Overall, our results indicate that approximately 80-90% of people would be willing to pay for an increase in health safety in the form of an early warning system for infectious diseases and food-borne outbreaks. However, our results have to be interpreted in light of the usual drawbacks of willingness to pay experiments.

Relationship between Child Sexual Abuse, Psychiatric Disorders and Infectious Diseases: A Matched-Cohort Study.

Child sexual abuse (CSA) has been strongly associated with a range of psychological and physical problems in childhood and adulthood, such as anxiety, post-traumatic stress disorder (PTSD), and infectious diseases. Despite the strength of these associations, no studies to date have investigated psychobiological processes that might underlie the relationship between CSA and physical health problems occurring during childhood, such as infectious diseases. The goal of the current study is to evaluate PTSD as a potential mediator between CSA and the occurrence of infectious diseases among children and adolescents. Furthermore, we postulate that PTSD plays a specific role as an indicator of chronic stress during childhood, in comparison to other mental disorders, such as anxious and non-anxious disorders (e.g., depression). Via a prospective matched-cohort design, administrative data were used to document PTSD, anxious and non-anxious disorders, and infectious diseases. The sample size was 882 persons with a substantiated report of sexual abuse and 882 matched controls. Negative binomial regressions revealed that CSA is associated with a greater number of anxious diseases diagnoses that, in turn, predict more infectious diseases diagnoses. These findings highlight the importance of preventing and intervening among sexually abused youth with anxious disorder symptoms to limit negative outcomes on physical health.

The Timing and Nature of Behavioural Responses Affect the Course of an Epidemic.

During an epidemic, the interplay of disease and opinion dynamics can lead to outcomes that are different from those predicted based on disease dynamics alone. Opinions and the behaviours they elicit are complex, so modelling them requires a measure of abstraction and simplification. Here, we develop a differential equation model that couples SIR-type disease dynamics with opinion dynamics. We assume a spectrum of opinions that change based on current levels of infection as well as interactions that to some extent amplify the opinions of like-minded individuals. Susceptibility to infection is based on the level of prophylaxis (disease avoidance) that an opinion engenders. In this setting, we observe how the severity of an epidemic is influenced by the distribution of opinions at disease introduction, the relative rates of opinion and disease dynamics, and the amount of opinion amplification. Some insight is gained by considering how the effective reproduction number is influenced by the combination of opinion and disease dynamics.

The Role of Age and Gender in Perceived Vulnerability to Infectious Diseases.

Background: The study of the immune system has been approached using two separate paths, the biological immune system and the behavioral immune system. Recently, Gangestad and Grebe proposed a unique integrated compensatory immune system, where both systems work together and one of them could compensate for the other when necessary. However, few studies have confirmed the existence of this integrated compensatory immune system. Our study represents an attempt to explore the existence of this unique immune system, investigating if the behavioral immune system variables increase when the biological immune system weakens with age. Material andMethods. The cross-sectional design study was made up of a final sample of 1108 participants (45.2% men and 54.2 women) aged 18-64 years. The younger group (18-21 years) was made up of students, whilst the older groups (22 to 64 years) were composed by their relatives and acquaintances, following the snow ball process. The participants completed the Perceived Vulnerability to Disease Questionnaire that assesses perceived infectability and germ aversion. Correlations, analyses of variance (ANOVAs), and independent group comparisons were performed. These analyses showed the relationships between the variables studied, the effects of age and gender in perceived infectability and germ aversion, and the differences that perceived infectability and germ aversion presented in different age-groups separated by gender. Results: A pattern emerged where germ aversion increases as both men and women get older, but perceived infectability decreases up to the age of 50, and then it increases in women from that age onward. Gender differences are only significant in younger participants, with women having higher scores than men in both variables. Conclusion: The results partially support the existence of a unique integrated compensatory biological/behavioral immune system.

Individual-Level Analyses of the Impact of Parasite Stress on Personality: Reduced Openness Only for Older Individuals.

The parasite stress hypothesis predicts that individuals living in regions with higher infectious disease rates will show lower openness, agreeableness, and extraversion, but higher conscientiousness. This article, using data from more than 250,000 U.S. Facebook users, reports tests of these predictions at the level of both U.S. states and individuals and evaluates criticisms of previous findings. State-level results for agreeableness and conscientiousness are consistent with previously reported cross-national findings, but others (a significant positive correlation with extraversion and no correlation with openness) are not. However, effects of parasite stress on conscientiousness and agreeableness are not found when analyses account for the data's hierarchical structure and include controls. We find that only openness is robustly related to parasite stress in these analyses, and we also find a significant interaction with age: Older, but not younger, inhabitants of areas of high parasite stress show lower openness. Interpretations of the findings are discussed.