Optimal voluntary and mandatory insect repellent usage and emigration strategies to control the chikungunya outbreak on Reunion Island

Abstract

In 2005, a chikungunya virus outbreak devastated the tropical island of Reunion, infecting a third of the total population. Motivated by the Reunion Island case study, we investigate the theoretic potential for two intervention measures under both voluntary and mandatory protocols to control a vector-borne disease when there is risk of the disease becoming endemic. The first measure uses insect repellent to prevent mosquito bites, while the second involves emigrating to the neighboring Mauritius Island to avoid infection. There is a threshold on the cost of using repellent above which both voluntary and mandatory regimes find it optimal to forgo usage. Below that threshold, mandatory usage protocols will eradicate the disease; however, voluntary adoption leaves the disease at a small endemic level. Emigrating from the island to avoid infection results in a tragedy-of-the-commons effect: while being potentially beneficial to specific susceptible individuals, the remaining islanders paradoxically face a higher risk of infection. Mandated relocation of susceptible individuals away from the epidemic is viable only if the cost of this relocation is several magnitudes lower than the cost of infection. Since this assumption is unlikely to hold for chikungunya, it is optimal to discourage such emigration for the benefit of the entire population. An underlying assumption about the conservation of human-vector encounter rates in mosquito biting behavior informs our conclusions and may warrant additional experimental verification.

A game-theoretic model of lymphatic filariasis prevention

“…On the other hand, our results is in striking contrast with models for other vector-borne diseases such as malaria [ 56 ], dengue [ 28 ], chikungunya [ 57 ] and visceral leishmaniasis [ 58 ] or diseases like Ebola [ 59 ]. It should be noted that in all these cases, cost of disease prevention is low relative to the cost of the disease.…”

Game-Theoretical Model of the Voluntary Use of Insect Repellents to Prevent Zika Fever

“…Another interesting prediction is that the optimal voluntary use of DEET brings ZIKV very close to elimination levels. This agrees with predictions for other vector-borne diseases such as malaria [ 15 ], dengue [ 27 ], chikungunya [ 40 ] and visceral leishmaniasis [ 31 ] or diseases like Ebola [ 13 ]. In all these cases, cost of disease prevention is low relative to the cost of the disease.…”

“…Starting with [ 10 ], game theory has been increasingly applied to help with the modeling of the prevention of diseases such as African trypanosomiases [ 24 ], chikungunya [ 40 ], Ebola [ 13 ], Hepatitis C [ 67 ], meningitis [ 50 ], monkeypox [ 8 ], toxoplasmosis [ 70 ] and others; see [ 18 , 75 ] for recent reviews.…”

Mathematical modelling of the use of insecticide-treated nets for elimination of visceral leishmaniasis in Bihar, India

“…This social dilemma is captured by the game theory framework [65]. The framework has now been applied to help model the prevention of many diseases such as African trypanosomiases [68], chikungunya [69], cholera [70], dengue [71], Ebola [72], hepatitis B [73], hepatitis C [74], meningitis [75], monkeypox [76], polio [77], toxoplasmosis [78] and many others, see for example [67,79] for recent reviews. It has already been demonstrated theoretically [65,80] as well as empirically [66] that individuals behave rationally and that the high cost of vaccination or ITNs [81] is often the reason why the protection is not adopted.…”