Heterogeneities in the transmission of infectious agents: implications for the design of control programs.

Mark E Woolhouse, C Dye, J F Etard, T. Smith, JD Charlwood, GP Garnett, P Hagan, JL Hii, PD Ndhlovu, RJ Quinnell, CH Watts, S.K. Chandiwana, R M Anderson

Research output: Contribution to journalArticlepeer-review


From an analysis of the distributions of measures of transmission rates among hosts, we identify an empirical relationship suggesting that, typically, 20% of the host population contributes at least 80% of the net transmission potential, as measured by the basic reproduction number, R0. This is an example of a statistical pattern known as the 20/80 rule. The rule applies to a variety of disease systems, including vector-borne parasites and sexually transmitted pathogens. The rule implies that control programs targeted at the "core" 20% group are potentially highly effective and, conversely, that programs that fail to reach all of this group will be much less effective than expected in reducing levels of infection in the population as a whole.
Original languageEnglish
Pages (from-to)338-42
Number of pages5
JournalProceedings of the National Academy of Sciences
Issue number1
Publication statusPublished - 1997


  • Animals
  • Communicable Disease Control
  • Disease Transmission, Infectious
  • Disease Vectors
  • HIV Infections
  • Health Planning
  • Humans
  • Leishmaniasis
  • Models, Theoretical
  • Schistosomiasis


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