Investigating the impact of symptom propagation on epidemiological and health economic outcomes

In traditional models of infectious diseases, the symptom severity of an infected individual does not impact the symptom severity of those infected by them. However, there is evidence in the literature that an individual’s disease severity may pass on to those they infect, meaning that symptoms propagate with infection. The extent to which a symptom propagation exists and its subsequent impact on epidemiological and health economic outcomes are still relatively unknown.

We are exploring these research questions as part of Phoebe Asplin’s PhD project at the University of Warwick. The project is a collaboration with Matt Keeling (University of Warwick) and Rebecca Mancy (Cardiff University/University of Glasgow).

Peer-reviewed publications:

• Symptom propagation in respiratory pathogens of public health concern: a review of the evidence.
  Phoebe Asplin, Rebecca Mancy, Thomas Finnie, Fergus Cumming, Matt J Keeling, Edward M Hill. (2024)
  Journal of the Royal Society Interface, 21(216): 20240009. doi:10.1098/rsif.2024.0009
  

• Epidemiological and health economic implications of symptom propagation in respiratory pathogens: A mathematical modelling investigation.
  Phoebe Asplin, Matt J Keeling, Rebecca Mancy, Edward M Hill. (2024)
  PLoS Computational Biology, 20(5): e1012096. doi:10.1371/journal.pcbi.1012096
  

Preprints:

• Estimating the strength of symptom propagation from primary-secondary case pair data
  Phoebe Asplin, Rebecca Mancy, Matt J Keeling, Edward M Hill. (2026)
  medRxiv. doi:10.64898/2026.04.07.26350037