June 15, 2009 -- During a disease epidemic, officials tend to focus on urban areas, where people are packed into close, viral-spreading quarters. A new study suggests that rural areas deserve just as much attention.
Even though human density is lower in the countryside, people there are more likely to check in on their sick neighbors, more likely to be near animals with diseases that can jump to people, and less likely to have easy access to hospitals and other good medical care.
"Obviously, if you think about big cities, people get together in trains, in theaters, and you have a lot of contact there," said Caterina Scoglio, an electrical and computer engineer at Kansas State University in Manhattan. "The numbers of people involved in rural areas are smaller, but ... some very serious epidemics can start in rural areas and then propagate from there."
Along with an industrial engineer and a social scientist, Scoglio surveyed people in two rural counties in Kansas. The researchers found that only 49 percent of those people had been vaccinated against the flu. Thirty-five percent said they would visit other homes during a major epidemic.
While the researchers don't know how those numbers compare to city-dwellers, these preliminary results suggest that efforts to control epidemics might need to target rural areas in unique ways that take into account cultural considerations.
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With the new study, which is just the first step in a more ambitious project, Scoglio is also revising standard computer models that look at how diseases spread through populations. So far, most of those models have focused on densely populated areas.
"We try to build a network where people are nodes, and links among nodes show contact between people," Scoglio said. "We want to build the right contact networks for rural areas."
The work is especially important in light of growing concerns about diseases spreading from animals to people, said Gregory Gray, Director of the Center for Emerging Infectious Diseases at the University of Iowa College of Public Health in Iowa City.
"Classically people retreated to rural areas during epidemics," Gray said. Even as far back as the Middle Ages, nobles would leave cities for their summer homes. "Today, we think that rural areas, particularly those closely associated with large populations of animals, might be at increased risk of infections."
Other research, Gray said, shows that people who work in facilities with lots of animals are at increased risk of catching and spreading viruses.
"It's like a new mom sending her child to day care for the first time," Gray said. "The child serves as a bridge for viruses from the day care to the parents."
Vaccinating people who live in rural areas and educating them about epidemics, the new research suggests, are more important than ever.
Related Links:
Treehugger.com: Neglected Diseases You've Never Heard Of
Jennifer Viegas blog: Born Animal
Home page for Caterina Scoglio
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