Parasite resource manipulation drives bimodal variation in infection duration

Anieke Van Leeuwen, Sarah A. Budischak, Andrea Linn Graham, Clayton E. Cressler

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Over a billion people on earth are infected with helminth parasites and show remarkable variation in parasite burden and chronicity. These parasite distributions are captured well by classic statistics, such as the negative binomial distribution. But the within-host processes underlying this variation are not well understood. In this study, we explain variation in macroparasite infection outcomes on the basis of resource flows within hosts. Resource flows realize the interactions between parasites and host immunity and metabolism. When host metabolism is modulated by parasites, we find a positive feedback of parasites on their own resources. While this positive feedback results in parasites improving their resource availability at high burdens, giving rise to chronic infections, it also results in a threshold biomass required for parasites to establish in the host, giving rise to acute infections when biomass fails to clear the threshold. Our finding of chronic and acute outcomes in bistability contrasts with classic theory, yet is congruent with the variation in helminth burdens observed in human and wildlife populations.

Original languageEnglish (US)
Article number20190456
JournalProceedings of the Royal Society B: Biological Sciences
Issue number1902
StatePublished - May 15 2019

All Science Journal Classification (ASJC) codes

  • General Immunology and Microbiology
  • General Environmental Science
  • General Biochemistry, Genetics and Molecular Biology
  • General Agricultural and Biological Sciences


  • Acute
  • Chronic
  • Immunity
  • Parasite
  • Resource manipulation
  • Within-host


Dive into the research topics of 'Parasite resource manipulation drives bimodal variation in infection duration'. Together they form a unique fingerprint.

Cite this