Pareto rules for malaria super-spreaders and super-spreading

Laura Cooper, Su Yun Kang, Donal Bisanzio, Kilama Maxwell, Isabel Rodriguez-Barraquer, Bryan Greenhouse, Chris Drakeley, Emmanuel Arinaitwe, Sarah G. Staedke, Peter W. Gething, Philip Eckhoff, Robert C. Reiner, Simon I. Hay, Grant Dorsey, Moses R. Kamya, Steven W. Lindsay, Bryan T. Grenfell, David L. Smith

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


Heterogeneity in transmission is a challenge for infectious disease dynamics and control. An 80-20 “Pareto” rule has been proposed to describe this heterogeneity whereby 80% of transmission is accounted for by 20% of individuals, herein called super-spreaders. It is unclear, however, whether super-spreading can be attributed to certain individuals or whether it is an unpredictable and unavoidable feature of epidemics. Here, we investigate heterogeneous malaria transmission at three sites in Uganda and find that super-spreading is negatively correlated with overall malaria transmission intensity. Mosquito biting among humans is 90-10 at the lowest transmission intensities declining to less than 70-30 at the highest intensities. For super-spreaders, biting ranges from 70-30 down to 60-40. The difference, approximately half the total variance, is due to environmental stochasticity. Super-spreading is thus partly due to super-spreaders, but modest gains are expected from targeting super-spreaders.

Original languageEnglish (US)
Article number3939
JournalNature communications
Issue number1
StatePublished - Dec 1 2019

All Science Journal Classification (ASJC) codes

  • General
  • General Physics and Astronomy
  • General Chemistry
  • General Biochemistry, Genetics and Molecular Biology


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