<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE article  PUBLIC "-//NLM//DTD Journal Publishing DTD v3.0 20080202//EN" "http://dtd.nlm.nih.gov/publishing/3.0/journalpublishing3.dtd"><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" dtd-version="3.0" xml:lang="en" article-type="research article"><front><journal-meta><journal-id journal-id-type="publisher-id">Health</journal-id><journal-title-group><journal-title>Health</journal-title></journal-title-group><issn pub-type="epub">1949-4998</issn><publisher><publisher-name>Scientific Research Publishing</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.4236/health.2017.98086</article-id><article-id pub-id-type="publisher-id">Health-78669</article-id><article-categories><subj-group subj-group-type="heading"><subject>Articles</subject></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Biomedical&amp;Life Sciences</subject><subject> Medicine&amp;Healthcare</subject></subj-group></article-categories><title-group><article-title>
 
 
  SIR Model of Spread of Zika Virus Infections: ZIKV Linked to Microcephaly Simulations
 
</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Isack</surname><given-names>E. Kibona</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Cuihong</surname><given-names>Yang</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib></contrib-group><aff id="aff1"><addr-line>School of Mathematics and Science, Central China Normal University (CCNU), Wuhan, China</addr-line></aff><author-notes><corresp id="cor1">* E-mail:<email>ikibona@yahoo.com(IEK)</email>;</corresp></author-notes><pub-date pub-type="epub"><day>04</day><month>08</month><year>2017</year></pub-date><volume>09</volume><issue>08</issue><fpage>1190</fpage><lpage>1210</lpage><history><date date-type="received"><day>June</day>	<month>23,</month>	<year>2017</year></date><date date-type="rev-recd"><day>Accepted:</day>	<month>August</month>	<year>20,</year>	</date><date date-type="accepted"><day>August</day>	<month>23,</month>	<year>2017</year></date></history><permissions><copyright-statement>&#169; Copyright  2014 by authors and Scientific Research Publishing Inc. </copyright-statement><copyright-year>2014</copyright-year><license><license-p>This work is licensed under the Creative Commons Attribution International License (CC BY). http://creativecommons.org/licenses/by/4.0/</license-p></license></permissions><abstract><p>
 
 
  An SIR model of Zika virus (ZIKV) spread is formulated that includes ZIKV infections to newborns. Analytically, the model has one disease free and one endemic equilibrium point. The free one is stable for some conditions when 
  R
  <sub>0</sub> and unstable when 
  R
  <sub>0</sub>&gt;1. In Brazil, when 
  R
  <sub>0</sub>≈2&gt;1 ZIKV infections expand and for 
  R
  <sub>0</sub> = 0.875&lt;1 diminishes. There were 67 micro-cephaly babies confirmed to have linked with ZIKV infections as of February 2016 in Brazil. Simulation predicts that the number rose to not less than 2100 in January 2017 and expected to increase around 4350 by January 2018 if not controlled. Simulation of the endemic equilibrium point indicates that there is more number of individuals in the recovered class than in the infectious class contrasting the initial state of the epidemic. This recovered class serves as a silent natural resistance against spread of the epidemic. Measures to control ZIKV infections have been suggested by analyzing parameters linked to transmission. The base is controlling basic reproduction number (
  R
  <sub>0</sub>) of the model. There are parameters for human-mosquito transmission and some for sexual-transmission factor. It appears that controlling spread of ZIKV infections by human-mosquito transmission may greatly reduce the value of 
  R
  <sub>0</sub>.
 
</p></abstract><kwd-group><kwd>ZIKV</kwd><kwd> SIR Model</kwd><kwd> Microcephaly</kwd><kwd> Stability Analysis</kwd><kwd> Simulations</kwd></kwd-group></article-meta></front><body><sec id="s1"><title>1. Introduction</title><sec id="s1_1"><title>1.1. Historical Background</title><p>On February 1<sup>st</sup>, 2016, the World Health Organization declared ZIKV epidemic in the Americas as a Public Health Emergency of International Concern. The foremost reason is due to an emerging linkage with congenital birth anomalies such as microcephaly and Guillain-Barre syndrome [<xref ref-type="bibr" rid="scirp.78669-ref2">2</xref>] plus mode of transmission which had not known before (sexual-transmission). Since then, ZIKV is one of the most uprising viral disease in the world, especially in the Americas. Resent studies report that ZIKV is transmitted not only via mosquito bite but also via sexual contacts, blood contamination and mother-to-child-transmission [<xref ref-type="bibr" rid="scirp.78669-ref1">1</xref>] . The mosquito involved in the transmission is infected Aedes Aegypti. This particular mosquito belongs to the family Flaviviridae and Genus Flavivirus. Chikungunya, Dengue and Yellow fever are also the off shots of this family. Prenatal or perinatal complications of ZIKV infections have been noted due to ZIKV. There is some evidence that perinatal transmission may occur, most probably transplacental or during the delivery of a viraemic mother [<xref ref-type="bibr" rid="scirp.78669-ref3">3</xref>] . The virus has been detected in human saliva, semen and urine of which leads to sexual-transmission of ZIKV [<xref ref-type="bibr" rid="scirp.78669-ref4">4</xref>] [<xref ref-type="bibr" rid="scirp.78669-ref5">5</xref>] .</p><p>Despite the fact that attack of ZIKV shows moderate disease symptoms, like that of the clinical presentation and transmission cycles in the epidemiology of Chikunganya and Dengue, symptoms of ZIKV disease encompasses conjunctivitis, skin rash, fever, muscle pains in various joints, non comforting nuisance and headache, which can last normally between 2 to 7 days time period. Not limited to those, it has been found that about 80% of individuals infected by ZIKV are asymptomatic [<xref ref-type="bibr" rid="scirp.78669-ref6">6</xref>] [<xref ref-type="bibr" rid="scirp.78669-ref8">8</xref>] . In new babies, congenital microcephaly is a descriptive diagnosis. According to WHO, it is defined as a head circumference equal to or lower than two standard deviations below the mean (<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x8.png" xlink:type="simple"/></inline-formula>) for age and sex or about less than the second percentile [<xref ref-type="bibr" rid="scirp.78669-ref9">9</xref>] . Microcephaly results from reduced brain growth. Affected infants are born with a smaller head size than normal, or their head stops growing after birth. It is a rare condition with estimated incidences varying geographically; in the United States reported incidence ranges from 2 to 12 babies per 10,000 live births. There is an association between the severity of microcephaly and that of neurological impairment [<xref ref-type="bibr" rid="scirp.78669-ref7">7</xref>] [<xref ref-type="bibr" rid="scirp.78669-ref10">10</xref>] .</p><p>The causes are numerous, including chromosomal abnormalities, intrauterine infections, exposure to toxic substances during pregnancy, and severe malnutrition [<xref ref-type="bibr" rid="scirp.78669-ref11">11</xref>] . Some countries and territories in the Americas with reported congenital syndrome associated with Zika virus infection as of July 14, 2016 (<xref ref-type="fig" rid="fig1">Figure 1</xref>). WHO estimates that the fetuses of one in 100 women with Zika will go on to develop microcephaly or other abnormalities [<xref ref-type="bibr" rid="scirp.78669-ref12">12</xref>] .</p><fig id="fig1"  position="float"><label><xref ref-type="fig" rid="fig1">Figure 1</xref></label><caption><title> Reported microcephaly associated with ZIKV infection as of July 14, 2016. PAHO</title></caption><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/6-8204101x9.png"/></fig><p>No specific antiviral medication is available for ZIKV disease. Treatment is generally supportive and can include rest, fluids, and use of analgesics and antipyretics. Aspirin including other nonsteroidal anti-inflammatory drugs should be avoided until dengue can be ruled out to reduce the risk of hemorrhage. Febrile pregnant women should be treated with acetaminophen. Persons infected with ZIKV, dengue, or Chikungunya virus should be protected from further mosquito exposure during the first few days of illness to reduce the risk for local transmission [<xref ref-type="bibr" rid="scirp.78669-ref6">6</xref>] .</p><p>The very first incidence of ZIKV was identified in 1947 from species of monkey in the African forest called Zika from Uganda. And the first isolated case identified from humans in 1952 also from Uganda and then later from a neighbor country, the United Republic of Tanzania. However, comprehensive genomic comparison showed different sub-classes reflecting the existence of two main lineages, one African and the other from Asia lineage [<xref ref-type="bibr" rid="scirp.78669-ref13">13</xref>] [<xref ref-type="bibr" rid="scirp.78669-ref15">15</xref>] . ZIKV has been shown intermittent disease patterns among the people of Africa and Asia. Little clinical importance was attributed to ZIKV, for the reason that only few symptomatic cases were reported in some African and Southeast Asiatic countries at the time [<xref ref-type="bibr" rid="scirp.78669-ref14">14</xref>] . This situation changed in 2007, when a large outbreak was registered on the Yap Island, Micronesia, caused by the Asian ZIKV lineage. Moreover, the outbreaks reported beginning this era are from the Pacific in 2007 and 2013 from French Polynesia and Yap Island (i.e. Federated States of Micronesia) [<xref ref-type="bibr" rid="scirp.78669-ref16">16</xref>] . There were subsequent incidents of the virus spread to other areas of the region like Cook Islands, Chile, Pacific Islands including New Caledonia, Fiji, Samoa, Solomon Islands and Vanuatu (<xref ref-type="fig" rid="fig2">Figure 2</xref>).</p><fig id="fig2"  position="float"><label><xref ref-type="fig" rid="fig2">Figure 2</xref></label><caption><title> World Zika situation report as of April 2014, www.who.int</title></caption><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/6-8204101x10.png"/></fig><p>ZIKV has been steadily increasing its geographical domain, ever since its initial appearance. The pace of ZIKV outbreaks as epidemic in the Americas is on rise. Similarly, the spread of this monster is reported in more regions of the world that were previously completely unaffected, that includes Europe [<xref ref-type="bibr" rid="scirp.78669-ref18">18</xref>] . The immunity of Europeans population is relatively immature as contrast to Afro-Asian Populations. At the arrival of summer season in the northern hemisphere is the most suitable time when Aedes mosquitoes in Europe find optimum climate to get infected by ZIKV and later transmit this virus to tourists and then into local population through biting [<xref ref-type="bibr" rid="scirp.78669-ref17">17</xref>] . At this point, it is relevant to cover and analyze the monthly traffic of travelers by air, arriving into the cities of Europe from the Zika affected regions of both the American continents and Europe.</p><p>Brazil’s first confirmed Zika infection was in March 2015. Over five years preceding 2015, the country saw between 130 and 170 cases of microcephaly each year [<xref ref-type="bibr" rid="scirp.78669-ref20">20</xref>] . In the first nine months of 2015, this figure roughly doubled. By the end of 2015, over 2400 further similar cases had been reported [<xref ref-type="bibr" rid="scirp.78669-ref19">19</xref>] . Up to February 27, 2016 according to the Brazilian Ministry of Health, 5640 cases of microcephaly in the country have been reported, and 583 of them are confirmed to have microcephaly and/or other central nervous system findings, suggesting of congenital infection. Out of the total cases with confirmed microcephaly, only 67 fulfill the laboratory criteria for ZIKV infection, and 4107 across Brazil remain under investigation [<xref ref-type="bibr" rid="scirp.78669-ref14">14</xref>] .</p><p>Regarding general ZIKV infections, data announced on December 2015, by the ECDC estimate that between 440,000 and 1.3 million cases by autochthonous transmission of ZIKV have occurred in Brazil (<xref ref-type="fig" rid="fig3">Figure 3</xref>), but these data are largely underestimated and the real magnitude of the Brazilian ZIKV epidemic may be much higher [<xref ref-type="bibr" rid="scirp.78669-ref14">14</xref>] . As of June 2016, around 500,000 Zika virus disease (ZVD) cases have been estimated in Brazil, and autochthonous circulation has been observed in 40 countries from the Americas [<xref ref-type="bibr" rid="scirp.78669-ref8">8</xref>] .</p></sec><sec id="s1_2"><title>1.2. Mathematical Background</title><p>Basing on the nature of epidemic, though with a relatively long history since its knowledge in 1947, few researches have been conducted. Probably, the main reason is that its effects where not vividly clear to human being as of now. However, this does not rule out that in the past people had not been affected by the problem. About three years ago, a number of researches have been working to explore the disease down so as to come up with some means to control it. According to Rojas DP et al. [<xref ref-type="bibr" rid="scirp.78669-ref8">8</xref>] all age groups are vulnerable, but the most affected age group is 20 to 49 years of age. A similar study previously published outbreaks in Yap Island, Micronesia, and in Salvador, Brazil [<xref ref-type="bibr" rid="scirp.78669-ref21">21</xref>] . As the population was fully susceptible to ZIKV transmission before the outbreaks, it is expected that all age groups would be affected. Joacim Rocklov et al. [<xref ref-type="bibr" rid="scirp.78669-ref2">2</xref>] , studied which seasons in the year are more risk for ZIKV transmission. There are as well</p><fig id="fig3"  position="float"><label><xref ref-type="fig" rid="fig3">Figure 3</xref></label><caption><title> Zika situation report in Brazil as of April 2016 (www.who.int)</title></caption><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/6-8204101x11.png"/></fig><p>more researches in medicine and other discipline. This paper is more concerned with mathematical models exploring the epidemic. One of the model was done by Adam J. Kucharski et al. in early 2016 [<xref ref-type="bibr" rid="scirp.78669-ref22">22</xref>] . The model provided understanding ZVD in mathematical perspective, basing on some assumptions the model did not include sexual transmission. Khalid et al. in the late of 2016, have formulated the mathematical model by including sexual transmission [<xref ref-type="bibr" rid="scirp.78669-ref23">23</xref>] . One side this article is an improvement of Kucharski’s model modified to include sexual-transmission. However, not only the later but also infections to newborns through MTCT. Therefore, the model is a simple SIR model that includes newborn as part of the infected class.</p></sec></sec><sec id="s2"><title>2. Model Formulation</title><p>The model consists of two categories, the humans and mosquitoes with total population <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x12.png" xlink:type="simple"/></inline-formula> and <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x13.png" xlink:type="simple"/></inline-formula> respectively. Presumably, the humans have three classes, the susceptible (S), infectious (I) and removed (R). An individual potential for infection is considered as susceptible class member, individuals who are exposed or already brown with ZIKV symptoms are classified as infectious, and individuals who have recovered from the disease are considered as removed. Exposed and fully brown ZIKV individuals are placed together because all of them can transmit the virus. It is assumed that individuals after recovery build immune against the ZIKV infection. Mosquitoes have only susceptible (<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x14.png" xlink:type="simple"/></inline-formula>) and infectious (<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x15.png" xlink:type="simple"/></inline-formula>) class. The reason is that the life span of mosquitoes is short enough to ignore the recovery period.</p><p>Susceptible individual moves into the infectious class after effective interaction with infected mosquitoes, or sexual contact with and individual in the infectious class. Newborns with ZIKV infection by MTCT enters infected class. The mosquitoes moves from the susceptible to their infectious-class after effective infection through biting an infectious human.</p><p>In this context, in all cases the subscript <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x16.png" xlink:type="simple"/></inline-formula> signifies a transmission vector, the mosquitoes. System (1) and <xref ref-type="fig" rid="fig4">Figure 4</xref> is the model and its compartments, where as <xref ref-type="table" rid="table1">Table 1</xref> is definitions of parameters.</p><disp-formula id="scirp.78669-formula237"><label>(1)</label><graphic position="anchor" xlink:href="http://html.scirp.org/file/6-8204101x17.png"  xlink:type="simple"/></disp-formula><fig id="fig4"  position="float"><label><xref ref-type="fig" rid="fig4">Figure 4</xref></label><caption><title> Model compartments flow diagram</title></caption><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/6-8204101x18.png"/></fig><table-wrap id="table1" ><label><xref ref-type="table" rid="table1">Table 1</xref></label><caption><title> Definition of Parameters</title></caption><table><tbody><thead><tr><th align="center" valign="middle" >Parameter</th><th align="center" valign="middle" >Definition</th></tr></thead><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x19.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >constant rate of incoming susceptible</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x20.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >natural death rates</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x21.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >birth rate of newborn who are infected</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x22.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >rate of transfer I individuals to R</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x23.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >rate of infection by mosquitoes</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x24.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >rate of infections through sexual transmission</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x25.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >rate of mosquitoes infected by humans</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x26.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >effective bites between infected mosquitoes and susceptible humans</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x27.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >effective contacts from humans to humans</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x28.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >effective bites between infected humans to susceptible mosquitoes</td></tr></tbody></table></table-wrap><disp-formula id="scirp.78669-formula238"><graphic  xlink:href="http://html.scirp.org/file/6-8204101x29.png"  xlink:type="simple"/></disp-formula><p>Assign <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x30.png" xlink:type="simple"/></inline-formula> then the system (1) may be considered as model (2).</p><disp-formula id="scirp.78669-formula239"><label>(2)</label><graphic position="anchor" xlink:href="http://html.scirp.org/file/6-8204101x31.png"  xlink:type="simple"/></disp-formula><p><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x32.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x32.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x33.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x32.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x33.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x34.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x32.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x33.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x34.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x35.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x32.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x33.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x34.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x35.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x36.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x32.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x33.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x34.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x35.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x36.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x37.png" xlink:type="simple"/></inline-formula>, are initial values notations.</p></sec><sec id="s3"><title>3. The Basic Reproduction Number (<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x38.png" xlink:type="simple"/></inline-formula>)</title><p>Consider to evaluate the basic reproduction number, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x39.png" xlink:type="simple"/></inline-formula>from next generation method. Recall model (2), and assign roman numeral to every equation as:</p><disp-formula id="scirp.78669-formula240"><label>(3)</label><graphic position="anchor" xlink:href="http://html.scirp.org/file/6-8204101x40.png"  xlink:type="simple"/></disp-formula><p><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x41.png" xlink:type="simple"/></inline-formula>be the disease free equilibrium point of the model, of which <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x41.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x42.png" xlink:type="simple"/></inline-formula> and<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x41.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x42.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x43.png" xlink:type="simple"/></inline-formula>. On the other hand, at disease free equilibrium point, the model (3) is reduced to</p><disp-formula id="scirp.78669-formula241"><graphic  xlink:href="http://html.scirp.org/file/6-8204101x44.png"  xlink:type="simple"/></disp-formula><p>Equations i and iv are solved simultaneously, so that <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x45.png" xlink:type="simple"/></inline-formula> and<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x45.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x46.png" xlink:type="simple"/></inline-formula>. So that the disease free equilibrium point, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x45.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x46.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x47.png" xlink:type="simple"/></inline-formula>is given by</p><disp-formula id="scirp.78669-formula242"><label>(4)</label><graphic position="anchor" xlink:href="http://html.scirp.org/file/6-8204101x48.png"  xlink:type="simple"/></disp-formula><p>From the system of Equation (3), <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x49.png" xlink:type="simple"/></inline-formula>,<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x49.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x50.png" xlink:type="simple"/></inline-formula>. Thus, model (3) can be written as:</p><disp-formula id="scirp.78669-formula243"><graphic  xlink:href="http://html.scirp.org/file/6-8204101x51.png"  xlink:type="simple"/></disp-formula><disp-formula id="scirp.78669-formula244"><graphic  xlink:href="http://html.scirp.org/file/6-8204101x52.png"  xlink:type="simple"/></disp-formula><p>Summary of infection rates, gains or losses in classes <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x53.png" xlink:type="simple"/></inline-formula> and<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x53.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x54.png" xlink:type="simple"/></inline-formula>: gains in<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x53.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x54.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x55.png" xlink:type="simple"/></inline-formula>; losses from<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x53.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x54.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x55.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x56.png" xlink:type="simple"/></inline-formula>; gains in<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x53.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x54.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x55.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x56.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x57.png" xlink:type="simple"/></inline-formula>; and losses from<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x53.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x54.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x55.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x56.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x57.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x58.png" xlink:type="simple"/></inline-formula>. Therefore, the gain-terms matrix,<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x53.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x54.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x55.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x56.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x57.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x58.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x59.png" xlink:type="simple"/></inline-formula>:</p><disp-formula id="scirp.78669-formula245"><graphic  xlink:href="http://html.scirp.org/file/6-8204101x60.png"  xlink:type="simple"/></disp-formula><p>The loss-terms matrix,<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x61.png" xlink:type="simple"/></inline-formula>:</p><disp-formula id="scirp.78669-formula246"><graphic  xlink:href="http://html.scirp.org/file/6-8204101x62.png"  xlink:type="simple"/></disp-formula><disp-formula id="scirp.78669-formula247"><graphic  xlink:href="http://html.scirp.org/file/6-8204101x63.png"  xlink:type="simple"/></disp-formula><p>Calculations for <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x64.png" xlink:type="simple"/></inline-formula></p><disp-formula id="scirp.78669-formula248"><graphic  xlink:href="http://html.scirp.org/file/6-8204101x65.png"  xlink:type="simple"/></disp-formula><p>The eigenvalues, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x66.png" xlink:type="simple"/></inline-formula>of <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x66.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x67.png" xlink:type="simple"/></inline-formula> is given: <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x66.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x67.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x68.png" xlink:type="simple"/></inline-formula>.<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x66.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x67.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x68.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x69.png" xlink:type="simple"/></inline-formula>, since <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x66.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x67.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x68.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x69.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x70.png" xlink:type="simple"/></inline-formula> takes the dominant eigenvalue of<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x66.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x67.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x68.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x69.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x70.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x71.png" xlink:type="simple"/></inline-formula>. Therefore, the basic reproduction number,</p><p><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x72.png" xlink:type="simple"/></inline-formula>.</p></sec><sec id="s4"><title>4. Stability of the Equilibrium Points</title><sec id="s4_1"><title>4.1. The Endemic Equilibrium Point of the Model</title><p>For endemic equilibrium, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x73.png" xlink:type="simple"/></inline-formula>,<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x73.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x74.png" xlink:type="simple"/></inline-formula>. The system of Equation (3) reduces to</p><p><img data-original="http://html.scirp.org/file/6-8204101x75.png" />Solving this simultaneously, the equilibrium point is:<img data-original="http://html.scirp.org/file/6-8204101x76.png" /> (5)<img data-original="http://html.scirp.org/file/6-8204101x77.png" />is obtained from the equation:<img data-original="http://html.scirp.org/file/6-8204101x78.png" /> (6)<img data-original="http://html.scirp.org/file/6-8204101x79.png" />The equilibrium point reduces to a disease free when<img data-original="http://html.scirp.org/file/6-8204101x80.png" />.<img data-original="http://html.scirp.org/file/6-8204101x81.png" />4.1.1. Existence of the Endemic EquilibriumConsider Equation (6):<img data-original="http://html.scirp.org/file/6-8204101x82.png" />. Assign<img data-original="http://html.scirp.org/file/6-8204101x83.png" />. Endemic equilibrium exists whenever there is a positive solution (i.e. value of<img data-original="http://html.scirp.org/file/6-8204101x84.png" />). When<img data-original="http://html.scirp.org/file/6-8204101x85.png" />,<img data-original="http://html.scirp.org/file/6-8204101x86.png" />.When<img data-original="http://html.scirp.org/file/6-8204101x87.png" />,<img data-original="http://html.scirp.org/file/6-8204101x88.png" />. Therefore at some point in the interval <img data-original="http://html.scirp.org/file/6-8204101x89.png" /> there exists<img data-original="http://html.scirp.org/file/6-8204101x90.png" />, which proves the existence of endemic equilibrium. As an example, consider a simulation: Choose any<img data-original="http://html.scirp.org/file/6-8204101x91.png" />; say</p><p><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x95.png" xlink:type="simple"/></inline-formula>. Then<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x95.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x96.png" xlink:type="simple"/></inline-formula>. That is, the value for <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x95.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x96.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x97.png" xlink:type="simple"/></inline-formula> is <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x95.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x96.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x97.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x98.png" xlink:type="simple"/></inline-formula> (<xref ref-type="fig" rid="fig5">Figure 5</xref>).</p><sec id="s4_1_1"><title>4.1.2. The Positivity and Boundedness of the Model Solution</title><p>By definition, the lower boundaries of the population are zero. Yet, the upper bounds can be deduced from the given dynamical equations. As it is for</p><p><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x99.png" xlink:type="simple"/></inline-formula>, from the fact that <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x99.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x100.png" xlink:type="simple"/></inline-formula></p><disp-formula id="scirp.78669-formula249"><graphic  xlink:href="http://html.scirp.org/file/6-8204101x101.png"  xlink:type="simple"/></disp-formula><p>That is<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x102.png" xlink:type="simple"/></inline-formula>, that<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x102.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x103.png" xlink:type="simple"/></inline-formula>.</p><p>Therefore,<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x105.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x105.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x104.png" xlink:type="simple"/></inline-formula>.</p><p>A similar approach is used to show that<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x106.png" xlink:type="simple"/></inline-formula>, where <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x106.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x107.png" xlink:type="simple"/></inline-formula> is the initial population.</p></sec><sec id="s4_1_2"><title>4.1.3. Local Stability of the Disease free Equilibrium Point of the Model</title><p>In order to understand the local stability of the model, Jacobian matrix, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x108.png" xlink:type="simple"/></inline-formula>is determined from the model (2) and used to study the local stability of the equilibrium point. Jacobian matrix, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x108.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x109.png" xlink:type="simple"/></inline-formula>is given as</p><disp-formula id="scirp.78669-formula250"><graphic  xlink:href="http://html.scirp.org/file/6-8204101x110.png"  xlink:type="simple"/></disp-formula><p>Recall the disease free equilibrium (4), <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x111.png" xlink:type="simple"/></inline-formula>. At this point, Jacobian matrix, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x111.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x112.png" xlink:type="simple"/></inline-formula>is</p><disp-formula id="scirp.78669-formula251"><graphic  xlink:href="http://html.scirp.org/file/6-8204101x113.png"  xlink:type="simple"/></disp-formula><p>The characteristic equation, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x114.png" xlink:type="simple"/></inline-formula></p><disp-formula id="scirp.78669-formula252"><graphic  xlink:href="http://html.scirp.org/file/6-8204101x115.png"  xlink:type="simple"/></disp-formula><p>That is<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x117.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x117.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x116.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x117.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x116.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x118.png" xlink:type="simple"/></inline-formula>If<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x117.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x116.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x118.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x119.png" xlink:type="simple"/></inline-formula>, then<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x117.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x116.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x118.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x119.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x120.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x117.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x116.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x118.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x119.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x120.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x121.png" xlink:type="simple"/></inline-formula>,<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x117.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x116.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x118.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x119.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x120.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x121.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x122.png" xlink:type="simple"/></inline-formula>. That means there is stable equilibrium if <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x117.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x116.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x118.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x119.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x120.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x121.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x122.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x123.png" xlink:type="simple"/></inline-formula> <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x117.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x116.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x118.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x119.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x120.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x121.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x122.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x123.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x124.png" xlink:type="simple"/></inline-formula> <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x117.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x116.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x118.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x119.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x120.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x121.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x122.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x123.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x124.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x125.png" xlink:type="simple"/></inline-formula>. It can be deduced that disease free equilibrium is stable in this case if<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x117.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x116.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x118.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x119.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x120.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x121.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x122.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x123.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x124.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x125.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x126.png" xlink:type="simple"/></inline-formula>.</p><p>Proof: Recall that:<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x127.png" xlink:type="simple"/></inline-formula>.</p><p><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x130.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x130.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x129.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x130.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x129.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x128.png" xlink:type="simple"/></inline-formula>or<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x130.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x129.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x128.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x131.png" xlink:type="simple"/></inline-formula>. For <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x130.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x129.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x128.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x131.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x132.png" xlink:type="simple"/></inline-formula> means there is no mosquito transmission at all, then <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x130.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x129.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x128.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x131.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x132.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x133.png" xlink:type="simple"/></inline-formula>.</p><p>For<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x134.png" xlink:type="simple"/></inline-formula>, that is:</p><disp-formula id="scirp.78669-formula253"><graphic  xlink:href="http://html.scirp.org/file/6-8204101x135.png"  xlink:type="simple"/></disp-formula><p>Choose<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x136.png" xlink:type="simple"/></inline-formula>:</p><disp-formula id="scirp.78669-formula254"><graphic  xlink:href="http://html.scirp.org/file/6-8204101x137.png"  xlink:type="simple"/></disp-formula><p>Which suggests that <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x138.png" xlink:type="simple"/></inline-formula> is numerically less than unit, this completes the proof.</p><p>On the other hand when <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x139.png" xlink:type="simple"/></inline-formula> the disease free equilibrium is unstable. Now that suppose<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x139.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x140.png" xlink:type="simple"/></inline-formula>, and assign<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x139.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x140.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x141.png" xlink:type="simple"/></inline-formula>.</p><disp-formula id="scirp.78669-formula255"><graphic  xlink:href="http://html.scirp.org/file/6-8204101x142.png"  xlink:type="simple"/></disp-formula><p>The characteristic equation is Hurwitz provided that <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x143.png" xlink:type="simple"/></inline-formula> <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x143.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x144.png" xlink:type="simple"/></inline-formula> <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x143.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x144.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x145.png" xlink:type="simple"/></inline-formula> and<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x143.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x144.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x145.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x146.png" xlink:type="simple"/></inline-formula>. Thus suggesting that <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x143.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x144.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x145.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x146.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x147.png" xlink:type="simple"/></inline-formula> is bifurcation point.</p></sec></sec></sec><sec id="s5"><title>5. Estimation of ZIKV Infected Newborns (M)</title><p>In the system of Equation (8), <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x148.png" xlink:type="simple"/></inline-formula>is coupled with model (2), the mission</p><p>is to estimate the number of newborns who have been infected with ZIKV since beginning of the epidemic in a given community. The assumption is that the rate of infections (<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x149.png" xlink:type="simple"/></inline-formula>) is constant. Newborns are dying but this is not considered because the estimation is total number of infected newborns.</p><disp-formula id="scirp.78669-formula256"><label>(7)</label><graphic position="anchor" xlink:href="http://html.scirp.org/file/6-8204101x150.png"  xlink:type="simple"/></disp-formula><p>order to estimate the number of infected newborns (<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x151.png" xlink:type="simple"/></inline-formula>), the differential equation <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x151.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x152.png" xlink:type="simple"/></inline-formula> has been evaluated by simulation in section 6.1.1.</p></sec><sec id="s6"><title>6. Model Simulations</title><p>There are a approximations and assumptions for estimating parameters that have been used to simulate the model. Due to inaccessibility of some parameters, assumptions have been made for some in order to fit the model with current trend of epidemic. For the purpose of simulation in the Americas, Brazil is considered as illustrative example. Model is suggesting possible outcomes but also is providing us with the virtual of ZIKV disease features. <xref ref-type="table" rid="table2">Table 2</xref> and <xref ref-type="table" rid="table3">Table 3</xref> are respectively list of parameter values and initial populations estimations for Brazil in 2016.</p><table-wrap id="table2" ><label><xref ref-type="table" rid="table2">Table 2</xref></label><caption><title> Estimations of parameter values and their sources for year 2016</title></caption><table><tbody><thead><tr><th align="center" valign="middle" >Parameter</th><th align="center" valign="middle" >Units (% per year)</th><th align="center" valign="middle" >Description</th><th align="center" valign="middle" >Source</th></tr></thead><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x153.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >0.83</td><td align="center" valign="middle" >susceptible recruitment rate</td><td align="center" valign="middle" >geoba.se</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x154.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >0.180</td><td align="center" valign="middle" >mosquitoes recruitment rate</td><td align="center" valign="middle" >assumptions</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x155.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >1.666</td><td align="center" valign="middle" >natural birth rate</td><td align="center" valign="middle" >geoba.se</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x156.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >0.644</td><td align="center" valign="middle" >natural death rate</td><td align="center" valign="middle" >geoba.se</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x157.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >0.600</td><td align="center" valign="middle" >recovering rate</td><td align="center" valign="middle" >assumptions</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x158.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >36</td><td align="center" valign="middle" >mosquito natural death rate</td><td align="center" valign="middle" >assumptions</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x159.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >0.756</td><td align="center" valign="middle" >rate of ZVD newborns</td><td align="center" valign="middle" >assumptions</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x160.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >0.375</td><td align="center" valign="middle" >Effective contact rate H to <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x161.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >[<xref ref-type="bibr" rid="scirp.78669-ref24">24</xref>]</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x162.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >1.125</td><td align="center" valign="middle" >Effective contact rate H to H</td><td align="center" valign="middle" >[<xref ref-type="bibr" rid="scirp.78669-ref24">24</xref>]</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x163.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >1.125</td><td align="center" valign="middle" >Effective contact rate <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x164.png" xlink:type="simple"/></inline-formula> to H</td><td align="center" valign="middle" >[<xref ref-type="bibr" rid="scirp.78669-ref24">24</xref>]</td></tr></tbody></table></table-wrap><table-wrap id="table3" ><label><xref ref-type="table" rid="table3">Table 3</xref></label><caption><title> Values of Initial populations for model simulation as of Jan 2016 in Brazil</title></caption><table><tbody><thead><tr><th align="center" valign="middle" >Initials (2016)</th><th align="center" valign="middle" >Amount &#215; 10<sup>6</sup></th><th align="center" valign="middle" >Initial value for</th><th align="center" valign="middle" >Source</th></tr></thead><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x165.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >210</td><td align="center" valign="middle" >N</td><td align="center" valign="middle" >worldmeters.com</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x166.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >209</td><td align="center" valign="middle" >S</td><td align="center" valign="middle" >worldmeters.com</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x167.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >0.672</td><td align="center" valign="middle" >I</td><td align="center" valign="middle" >Estimations [<xref ref-type="bibr" rid="scirp.78669-ref14">14</xref>]</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x168.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >0.000067</td><td align="center" valign="middle" >M</td><td align="center" valign="middle" >[<xref ref-type="bibr" rid="scirp.78669-ref14">14</xref>]</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x169.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >0.00</td><td align="center" valign="middle" >R</td><td align="center" valign="middle" >Assumptions</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x170.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >10.0</td><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x171.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >Estimations</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x172.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >7.0</td><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x173.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >Estimations</td></tr></tbody></table></table-wrap><sec id="s6_1"><title>6.1. Fitting the Model into Brazil ZIKV Infections State</title><p>The graphs in <xref ref-type="fig" rid="fig6">Figure 6</xref> depict the dynamics of ZIKV for the first 10 years in Brazil starting June 2016. The graphs for I and R classes are not clearly seen in <xref ref-type="fig" rid="fig6">Figure 6</xref>(a), therefore can be seen in <xref ref-type="fig" rid="fig6">Figure 6</xref>(b). Although initial number individuals in a recovery class may be lower than infectious class (<xref ref-type="fig" rid="fig6">Figure 6</xref>(b)), but the prevalence of recovery class grows faster than the infected class. In the later time of the epidemic there more individuals in the recovery than infectious class.</p>Simulation of ZIKV Infected Newborns<p>For M estimations, the differential equation <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x174.png" xlink:type="simple"/></inline-formula> from the model (8) is</p><p>simulated for 25 months (<xref ref-type="fig" rid="fig7">Figure 7</xref>). In this case the objective is to estimate the</p><fig id="fig5"  position="float"><label><xref ref-type="fig" rid="fig6">Figure 6</xref></label><caption><title> Graphs to estimate ZIKV situation for the next 10 years starting June 2016. (a) Graphs of populations (S, I, R) growth; (b) Growth of infected (I) and recovery (R) class</title></caption><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/6-8204101x175.png"/></fig><fig id="fig6"  position="float"><label><xref ref-type="fig" rid="fig7">Figure 7</xref></label><caption><title> Graphical simulation of ZIKV infected newborns starting January 2016 in months. (a) Plot of M; (b) Plots of I, R, and M</title></caption><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/6-8204101x176.png"/></fig><p>total number of children who has been inflicted by ZIKV. It is clear that this accounts for all children including the initial amount as of January 2016. Up to February 27, 2016 according to Brazilian Ministry of Health, out of all reported microcephaly cases only 67 fulfill the laboratory criteria for ZIKV infection [<xref ref-type="bibr" rid="scirp.78669-ref14">14</xref>] .</p><p>Then, the February 2016 cases of microcephaly is assumed to be initial value for January 2016 in this simulation. Estimation for all newborns regardless of those who die later after birth, so long as had been diagnosed with microcephaly linking to ZIKV then are part of this integral. After 25 months since January 2016, the number of ZIKV infected newborns in the same month 2017 is approximated above 2100 (<xref ref-type="fig" rid="fig7">Figure 7</xref>(a)) and expected to rise up about 4350 in January 2018. The plot of M is an accumulation curve (it is not prevalence), (<xref ref-type="fig" rid="fig7">Figure 7</xref>(a) and <xref ref-type="fig" rid="fig7">Figure 7</xref>(b)). The graph of M is not a straight line, but is an increasing function (<xref ref-type="fig" rid="fig7">Figure 7</xref>(b)).</p><p><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x177.png" xlink:type="simple"/></inline-formula>as in <xref ref-type="fig" rid="fig8">Figure 8</xref>(a), infectious class growth is accompanied with a silent recovery class escalation. Note that there is a great number of individuals 80% who are asymptotic to the disease [<xref ref-type="bibr" rid="scirp.78669-ref6">6</xref>] [<xref ref-type="bibr" rid="scirp.78669-ref8">8</xref>] , of which they may recover without their knowledge this is not accounted for in this case. What is considered are recovery individuals who where once diagnosed with ZIKV infection. Also the prevalence for recovery is called silent simply because generally no one cares when an individual is recovered, therefore there prevalence is unnoticed. Later the recovery class R may increasingly out number the size of population in the Infectious class I (<xref ref-type="fig" rid="fig6">Figure 6</xref>(b)). Whenever <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x177.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x178.png" xlink:type="simple"/></inline-formula> increases which leads to increase in the infections, number of individual recovering also increases considerably maintaining the recovered population size more than the infectious class (<xref ref-type="fig" rid="fig8">Figure 8</xref>(b)).</p></sec><sec id="s6_2"><title>6.2. Natural Resistance Against ZIKV Epidemics</title><p>At the latest, if the situation is not attended or interrupted, naturally may lead to</p><fig id="fig7"  position="float"><label><xref ref-type="fig" rid="fig8">Figure 8</xref></label><caption><title> Later the prevalence of Recovered class out sizes infected class. (a)<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x180.png" xlink:type="simple"/></inline-formula>; (b)<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x180.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x181.png" xlink:type="simple"/></inline-formula></title></caption><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/6-8204101x179.png"/></fig><fig id="fig8"  position="float"><label><xref ref-type="fig" rid="fig9">Figure 9</xref></label><caption><title> Recovered class creates a silent resistant to the epidemic. (a) Recovered gets higher in zize than infected class; (b) Possible endemic equilibrium point to be reached</title></caption><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/6-8204101x182.png"/></fig><p>equilibrium as in <xref ref-type="fig" rid="fig9">Figure 9</xref>. The recovered class has two important roles in suppressing the epidemic. One is that the recovered individuals build up immune against ZIKV infection. The other reason is that since the higher density of recovered individuals is in the most affected regions, this minimizes interactions between susceptible and infectious, therefore reducing spread of the epidemic. So when more individuals are recovered compared to infectious (<xref ref-type="fig" rid="fig9">Figure 9</xref>(a)), natural resistance is strengthened. This may save to take the endemic equilibrium point of the epidemic at a state where there is very few infectious of ZIKV for long time. This may explain a situation in the countries with historic start of ZIKV like Africa and Asia, particularly in Uganda and Tanzania. In such regions occasionally, new born with microcephaly may happen and is likely to be ignored so long as there is no substantial outbreak of the epidemic. Basing on the model simulation such a situation is reach around one generation time since start of the epidemic.</p><p>Among other reasons that can lead to microcephaly situation side track the societies attention to ZIKV disease outbreak especially when the infections are low and unnoticeable is not keeping records, especially in most villages of the developing countries. Therefore, appreciation should be given to the Americas, like Brazil for keeping records of microcephaly born children which is one of the reasons lead to notice the break of epidemic [<xref ref-type="bibr" rid="scirp.78669-ref20">20</xref>] .</p></sec><sec id="s6_3"><title>6.3. Intervention for Epidemic Elimination</title><p>According to the model (2), two main factors to be controlled in order to diminish or eliminate the epidemic basing on the model include reducing both unsafe sexual-interaction and mosquitoes bites against humans. Controlling the two factors to the extent that <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x183.png" xlink:type="simple"/></inline-formula> such as <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x183.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x184.png" xlink:type="simple"/></inline-formula> may avert the growing epidemic to one dying (<xref ref-type="fig" rid="fig1">Figure 1</xref>0(a)).</p><fig id="fig9"  position="float"><label><xref ref-type="fig" rid="fig1">Figure 1</xref>0</label><caption><title> <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x186.png" xlink:type="simple"/></inline-formula>leads to free the society from Epidemic in 15 years. (a) The epidemic dies off; (b) The total population gets free of the epidemic</title></caption><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/6-8204101x185.png"/></fig><p>The model (2) estimates that in 15 years for <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x187.png" xlink:type="simple"/></inline-formula> the region can be free of the epidemic, thus leaving growth of susceptible class growing at its natural pace for Brazil <xref ref-type="fig" rid="fig1">Figure 1</xref>0(b). It has been found that contribution in the spread of ZIKV infections by sexual-transmission is in low percentage compared to human-mosquito interaction [<xref ref-type="bibr" rid="scirp.78669-ref25">25</xref>] [<xref ref-type="bibr" rid="scirp.78669-ref26">26</xref>] . Therefore, effective elimination of the epidemics is basically freeing individuals from mosquitoes bites. This include getting rid off still water bodies, use of mosquito nets, insect repellents and use of insecticides to help exterminate mosquitoes cultures. Nevertheless, sexual-transmission has to be controlled as the second adverse case of transmission. That is, avoid or have safe sexual-interactions, especially with people traveling to and from infected regions. This may involve use of condoms, circumcision and all that contribute to secured sexual-interaction [<xref ref-type="bibr" rid="scirp.78669-ref26">26</xref>] .</p><p>As for women who want to get pregnant but are not sure of ZIKV infections (no symptoms) but they have been exposed to ZIKV infected regions or had sex with ZIKV diagnosed partners, should wait at least eight weeks after exposure. For those with diagnosed ZIKV infections, wait after eight weeks since the start of symptoms (<xref ref-type="fig" rid="fig1">Figure 1</xref>1).</p></sec></sec><sec id="s7"><title>7. Conclusions</title><p>The fundamental part in the analysis of model (2) is the basic reproduction number (<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x188.png" xlink:type="simple"/></inline-formula>).<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x188.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x189.png" xlink:type="simple"/></inline-formula>has been analyzed both analytically and at least one example numerically. An insight into the stability of disease free equilibrium point is that for some conditions it is stable if<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x188.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x189.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x190.png" xlink:type="simple"/></inline-formula>, unstable when<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x188.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x189.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x190.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x191.png" xlink:type="simple"/></inline-formula>.</p><p>Model simulations have been conducted, considering Brazil as an example. However, values of the parameters have been a challenge, some range between values, some no information and others just varies. Parameters for simulation in</p><fig id="fig10"  position="float"><label><xref ref-type="fig" rid="fig1">Figure 1</xref>1</label><caption><title> Provided by the U.S. Centers for Disease Control and Prevention (CDC)</title></caption><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/6-8204101x192.png"/></fig><p>this case have been assumed to be constant, therefore some assumptions or estimations have been done in some way to fit the current trend of the epidemic in Brazil. A population of more than 208 million as of January 2016 is found with 672,000 infected individual. Up to February 27, 2016; 67 newborns with microcephaly were confirmed to have been due to ZIKV infections. On simulations, there are at least 2100 in total of babies who have been ZIKV infected by January 2017, this number is expected to rise up about 4350 by January 2018 (<xref ref-type="fig" rid="fig7">Figure 7</xref>(a)). Moreover, numerically, the endemic equilibrium exist and in lower amount of infectious than recovered class, contrasting a situation in the beginning of epidemic. This suggests why most of the countries experienced ZIKV infections some past years are not easily getting erupted with the ZIKV epidemic. Among reasons behind this is that recovered class individuals not only are resistant to ZIKV infections but also reduces the interaction between infected and susceptible individuals simply by their density in the area being higher than susceptible.</p><p>The value of <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x193.png" xlink:type="simple"/></inline-formula> is simulated and found to escalate the epidemic and gets worse when<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x193.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x194.png" xlink:type="simple"/></inline-formula>. However, when<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x193.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x194.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x195.png" xlink:type="simple"/></inline-formula>, specifically <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x193.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x194.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x195.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x196.png" xlink:type="simple"/></inline-formula> the epidemic diminishes, it is expected that with <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x193.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x194.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x195.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x196.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x197.png" xlink:type="simple"/></inline-formula> the elimination of epidemic is even more effective. The model suggests mainly two ways to avoid ZIKV infections. First of all, avoid mosquito bites, which is suggested that in percentage mosquito-transmission is more calling as severe than sexual-transmission. This can be done by eradicating unnecessary still water bodies, use of bed nets, mosquito repellent and insecticides. Secondly, conduct safe sexual relations especially with one who have been exposed to ZIKV infected regions, bearing in mind that 80% of ZIKV infections are asymptotic [<xref ref-type="bibr" rid="scirp.78669-ref8">8</xref>] . As for women who want or are preparing to get pregnant then if previously had exposed to ZIKV infected regions, having infectious symptoms or not, one is advised to wait until after 8 weeks since last exposure or start of symptoms.</p>Gaps in This Study<p>The study has a lot open for further studies. Analytically, the disease free equilibrium has not fully been analyzed, the obtained disease free equilibrium holds for some conditions leaving one side open for investigations. The endemic equilibrium exists but its stability has been discussed numerically, hence calling for further insights in analytically. As for model simulation, assumptions and estimations for current parameters have been used to assign values. Shall it be possible to finely obtain better parameter estimations, model simulation would produce more reliable results. Nevertheless the model can be modified by reducing assumptions so as to make it more realistic. For example, some rates are not constant, therefore may be made non-constant accordingly to fit the reality hence improving the model. Therefore, for some reasons this study calls for more research into the epidemic of ZIKV infections.</p></sec><sec id="s8"><title>Acknowledgements</title><p>Sincere thanks to the members of SCIRP for their professional performance, and special thanks to managing editor Karen ZHANG for a rare attitude of high quality. Finally, but not the least it is grateful to the National Natural Science Foundation of China (No. 11371161, 11471133) and the Foundation Research Funds for the Central Universities, Central China Normal University (No. CCNU15A02055) for partially supporting this research financially.</p></sec><sec id="s9"><title>Cite this paper</title><p>Kibona, I.E. and Yang, C.H. (2017) SIR Model of Spread of Zika Virus Infections: ZIKV Linked to Microcephaly Simulations. Health, 9, 1190-1210. https://doi.org/10.4236/health.2017.98086</p></sec><sec id="s10"><title>Acronyms</title><p>CDC Centers for Disease Control and Prevention in USA</p><p>ECDC European Centre for Disease Prevention and Control</p><p>MTCT Mother-to-child-transmission</p><p>PAHO Pan American Health Organization</p><p><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/6-8204101x198.png" xlink:type="simple"/></inline-formula> Basic Reproduction Number</p><p>SIR Susceptible Infectives and Recovery</p><p>WHO World Health Organization</p><p>ZIKV Zika virus</p><p>ZVD Zika virus disease</p><disp-formula id="scirp.78669-formula257"><graphic  xlink:href="http://html.scirp.org/file/6-8204101x199.png"  xlink:type="simple"/></disp-formula><p>Submit or recommend next manuscript to SCIRP and we will provide best service for you:</p><p>Accepting pre-submission inquiries through Email, Facebook, LinkedIn, Twitter, etc.</p><p>A wide selection of journals (inclusive of 9 subjects, more than 200 journals)</p><p>Providing 24-hour high-quality service</p><p>User-friendly online submission system</p><p>Fair and swift peer-review system</p><p>Efficient typesetting and proofreading procedure</p><p>Display of the result of downloads and visits, as well as the number of cited articles</p><p>Maximum dissemination of your research work</p><p>Submit your manuscript at: http://papersubmission.scirp.org/</p><p>Or contact health@scirp.org</p></sec></body><back><ref-list><title>References</title><ref id="scirp.78669-ref1"><label>1</label><mixed-citation publication-type="other" xlink:type="simple">Manrique, O.A., Munoz, P.D.M., Loaiza, A.M., Olarte García, J.A., Abello Munoz, C.A., Osorio, S.R., Osorio, A.J., Contreras, H.M. and Arredondo Montoya, J.F. 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