The impact of the phase of an epidemic of sexually transmitted infection on the evolution of the organism
- Department of Infectious Disease Epidemiology, Imperial College of Science, Technology and Medicine, St Mary's Campus, London W2, UK
- Correspondence to: Katherine Turner, Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College of Science, Technology and Medicine, St Mary's Campus, Norfolk Place, London W2 1PG, UK;
- Accepted 29 November 2001
The evolution of any sexually transmitted organism will be influenced by prevailing epidemiological interactions. The optimum strategy for an organism to overcome treatment, either through drug resistance or cryptic infections, depends upon whether the method for identifying patients is passive (treating symptoms alone favours asymptomatic organisms) or active (screening favours resistant organisms). The use of mathematical models of competing strains of infection allows theoretical predictions for the outcome of evolution under a range of assumptions about potential phenotypes. The course of pathogen evolution has implications for the success of interventions, but the predictions presented need to be tested at the level of the community in carefully monitored interventions.