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Chris von Csefalvay Biography

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“The same dynamics that keep us safe in a pack, herd or society, and comfortable in our family, friends or neighbours also serves as a way for pathogenic transmissions. The warmth of a human dwelling or the immense complexity of a bee hive is also an opportunity for a pathogen to tap into a susceptible population. Network interdiction is a comprehensive name for algorithms intended to disrupt such connections.”

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“Any subject whose history ranges from pump handles on London's Broad Street, tide tables, naval gunfire and models of social segregation is bound to have rich parentage. It took 'a village' to beget computational epidemiology: as a true multi-disciplinary subject, it evolved at the crossroads of mathematics, computation, statistics and medicine, with some contributions from systems biology, virology, microbiology, game theory, geography and perhaps even the social sciences.”

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“The small town of Gunnison, Colorado, lies at the bottom of the valley carved by the Gunnison River into the Rocky Mountains. It is now crossed by the Colorado stretch of U.S. Highway 50, but in 1918, the town was mainly supplied by train and two at best mediocre roads. When the 1918–19 influenza pandemic reached Colorado as an unwelcome stowaway on a train carrying servicemen from Montana to Boulder, the town of Gunnison took decisive action. As the November 1, 1918, edition of the Gunnison News-Champion documents, a Dr. Rockefeller from the nearby town of Crested Butte was "given entire charge of both towns and county to enforce a quarantine against all the world". He instituted a strict reverse quarantine regime that almost entirely isolated Gunnison from the rest of the world. Gunnison became one of the few communities that largely escaped the ravages of the influenza pandemic, at least in the beginning – in an instructive example of the limited human patience for the social, psychological and economic disruption of quarantine, adherence eventually waned and the front page of the Gunnison News-Champion's March 14, 1919, issue reports that the influenza pandemic got to Gunnison, too. Nevertheless, Gunnison had a very lucky escape – of a population of over 6,900 (including the county), there were only a few cases and a single death.”

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“As epidemiologists, we are interested in equilibria because stable equilibria tell us when a system has attained stability -- or where it will, eventually, attain stability. Epidemics are 'extraordinary events'. The term 'outbreak', beloved of the popular media when commenting on epidemics, emphasises that we are dealing with a phenomenon that goes counter to 'business as usual'. Stable equilibria are nothing more than mathematical descriptions of states in which the system can settle again and attain a measure of normalcy.”

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“The world came uncomfortably close to a pandemic in late 1989, when – largely overshadowed by the sweeping political changes and the end of the Cold War –, cynomolgus monkeys (crab-eating macaques, Macaca fascicularis) at a quarantine facility in Reston, Virginia, began to succumb with rather frightening rapidity to an outbreak of a haemorrhagic fever.”

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“Few diseases have had an impact on human evolution, culture and society on par with malaria. It is one of the oldest documented infectious diseases. Indeed, it has been hypothesised that the protective effect bestowed by a heterozygous sickle cell allele explains its survival to the modern day. As such, malaria has left its footprint on human evolution in a profound way few other diseases have. Yet its true origins were the matter of considerable controversy. The clue is in the name – the prevailing theory until Ross's discovery was that malaria resulted from 'mala aria', that is, 'bad air'. It took the advent of modern evidence-based medical science to challenge this 'miasma theory'. Ross's elucidation of the role of mosquitoes in the lifecycle of malaria has opened up a new subject for epidemiological consideration: the vector-borne disease.”

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“higher antimicrobial loads will result in a lower total pathogenic load but also a lower involvement of the immune system and therefore less immunity in the long run (as indeed has been empirically demonstrated in a number of experiments summarised in a sweeping review by Benoun (2016)). Thus, while rapid and aggressive antimicrobial treatment is sometimes appropriate, the long-term absence of ensuing CD4+ immunity is its cost.”

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“Mary Mallon was born in 1869 in Cookstown, County Tyrone, then part of British-ruled Ireland. Like many of her countrymen, she immigrated to the United States at a young age, where she eventually found employment as a cook. During her lifetime, it was suspected that she has unintentionally (albeit perhaps negligently) infected over fifty people with typhoid. Typhoid fever is a bacterial disease caused by gastrointestinal infection by Salmonella enterica serovar Typhi. In most patients, it causes an unpleasant but manageable disease that resolves fully. However, as many as one in twenty patients become chronic carriers, who continue to be infectious for their lifetimes. Mary Mallon was one of the unfortunate few who fell into that category. It is hypothesised today that she contracted typhoid at birth. Her case, which involved prolonged quarantine on North Brother Island for almost half her life, raises complex moral and ethical questions about reconciling the interests of public health with the moral imperative to respect individual liberties and treat the sick (even if asymptomatic) with compassion.”

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