The influence of immune cross-reaction on phase structure in resonant solutions of a multi-strain seasonal SIR model

Resonance in seasonally forced SIR epidemiological models may lead to stable solutions in which the epidemic period is an integer multiple of the forcing period. We examine the influence of immune cross-protection and cross-enhancement on the epidemic phase relationship of resonance solutions in an annually forced two-strain SIR model. Solutions with epidemics of the two strains in-phase commonly occur for wide ranges of cross-reaction intensity. Solutions with epidemics out-of-phase are less common and limited to narrow ranges of cross-reaction intensity. This is broadly as predicted-by the two natural periods of the system. The natural period corresponding to out-of-phase solutions is sensitive to changes in the cross-reaction parameter but the natural period corresponding to in-phase solutions is constant. Bifurcation analysis indicates that the stability of in-phase orbits is controlled by pitchfork and period doubling bifurcations while out-of-phase orbits may also be influenced by Andronov-Hopf bifurcations. In order to develop an intuitive understanding of the epidemiological factors governing the occurrence of different solutions we consider how the susceptible, infected and removed components of the system must interact to form a stable solution. This shows that the impact of cross-reaction is moderated by in-phase structures but amplified by out-of-phase structures. Although the average infection rate over long time periods is not affected by phase structure, this analysis indicates that in-phase epidemic patterns are likely to be more consistent and thus allow more effective health care management. (c) 2007 Elsevier Ltd. All rights reserved.