Emerging Challenges and Opportunities in Infectious Disease Epidemiology

Am J Epidemiol. 2019 May 1;188(5):873-882. doi: 10.1093/aje/kwy264.

Abstract

Much of the intellectual tradition of modern epidemiology stems from efforts to understand and combat chronic diseases persisting through the 20th century epidemiologic transition of countries such as the United States and United Kingdom. After decades of relative obscurity, infectious disease epidemiology has undergone an intellectual rebirth in recent years amid increasing recognition of the threat posed by both new and familiar pathogens. Here, we review the emerging coalescence of infectious disease epidemiology around a core set of study designs and statistical methods bearing little resemblance to the chronic disease epidemiology toolkit. We offer our outlook on challenges and opportunities facing the field, including the integration of novel molecular and digital information sources into disease surveillance, the assimilation of such data into models of pathogen spread, and the increasing contribution of models to public health practice. We next consider emerging paradigms in causal inference for infectious diseases, ranging from approaches to evaluating vaccines and antimicrobial therapies to the task of ascribing clinical syndromes to etiologic microorganisms, an age-old problem transformed by our increasing ability to characterize human-associated microbiota. These areas represent an increasingly important component of epidemiology training programs for future generations of researchers and practitioners.

Keywords: infectious diseases; methods; modeling; surveillance.

Publication types

  • Review

MeSH terms

  • Anti-Infective Agents / therapeutic use
  • Causality
  • Communicable Disease Control / methods
  • Communicable Diseases / drug therapy
  • Communicable Diseases / epidemiology*
  • Communicable Diseases / transmission
  • Data Interpretation, Statistical
  • Disaster Planning / organization & administration
  • Epidemiologic Methods*
  • Humans
  • Observational Studies as Topic / methods
  • Observational Studies as Topic / standards
  • Population Surveillance / methods
  • Public Health Practice*
  • United Kingdom
  • United States
  • Vaccines / administration & dosage
  • Vaccines / adverse effects

Substances

  • Anti-Infective Agents
  • Vaccines