Autonomous Targeting of Infectious Superspreaders Using Engineered Transmissible Therapies

Metzger, Vincent T.; Lloyd-Smith, James O.; Weinberger, Leor S.

Targeting these superspreader subpopulations for therapeutic or preventive measures would tremendously increase the efficacy of disease control [3, 4] , while failure to target high-risk groups weakens efforts to achieve 'herd immunity' by vaccination and severely limits the ability to reduce disease at the population level [12] . Unfortunately, identifying these crucial high-risk populations requires in-depth knowledge of the social or sexual networks that underlie disease spread, which is rarely attainable [13] , as well as knowledge of as-yet unknown biological correlates of risk. Further aggravating the problem of targeting superspreaders are: (i) nonhealthseeking behaviors in the key populations, such as injection drug users (IDUs); and (ii) self-concealment motivated by social stigmas and criminal barriers in high-risk individuals, such as IDUs, men who have sex with men, people with extra-marital sexual partners, and commercial sex workers and their clients.