Dynamics of two-strain influenza with isolation and partial cross-immunity ∗

TL;DR: It is established that cross-immunity and host isolation lead to periodic epidemic outbreaks (sustained oscillations) in this multistrain system and subthreshold coexistence driven by cross-IMmunity is possible even when the isolation reproductive number of one strain is below 1.

Abstract: The time evolution of the influenza A virus is linked to a nonfixed landscape driven by interactions between hosts and competing influenza strains. Herd-immunity, cross-immunity, and age-structure are among the factors that have been shown to support strain coexistence and/or disease oscillations. In this study, we put two influenza strains under various levels of (interference) competition. We establish that cross-immunity and host isolation lead to periodic epidemic outbreaks (sustained oscillations) in this multistrain system. We compute the isolation reproductive number for each strain ($\Re_i$) independently, as well as for the full system ($\Re_q$), and show that when $\Re_q < 1$, both strains die out. Subthreshold coexistence driven by cross-immunity is possible even when the isolation reproductive number of one strain is below 1. Conditions that guarantee a winning type or coexistence are established in general. Oscillatory coexistence is established via Hopf bifurcation theory and confirmed via n...