We have developed a novel framework to study the overlapping nature of couplings between functional heterogeneities relevant for dengue tranmission. The framework was published as a 'Perspective' article in the journal Trends in Parasitology (Vazquez-Prokopec et al. Trends in Parasitology 32: 356–367). in this article, we argue that research efforts should move beyond considering the impact of single sources of heterogeneity and account for complex couplings between conditions with potential synergistic impacts on parasite transmission. Using theoretical approaches and empirical evidence from various host–parasite systems, we investigate the ecological and epidemiological significance of couplings between heterogeneities and discuss their potential role in transmission dynamics and the impact of control. The figure on the right shows how disease manifestation (symptoms) can be positively (green) or negatively (red) coupled to other heterogeneities relevant for mosquito-borne pathogen transmission.
We also proved evidence of the existence of key couplings between disease manifestations (symptoms) and human mobility. A recent article published in Proc. Roy. Soc. B shows how important is the presence of symptoms in defining the activity space of individuals. When comparing healthy individuals with those sick with either dengue or influenza, the latter two showed a much reduced activity space: they tended to stay home longer times and perform less out-of-home trips. This logical outcome can have important influence in defining human exposure patterns and the propagation of pathogens. The figure on the right shows how much time is spent home for each demographic group.