Reproduction numbers and sub-threshold endemic equilibria for compartmental models of disease transmission

A precise definition of the basic reproduction number, R0, is presented for a general compartmental disease transmission model based on a system of ordinary differential equations. It is shown that, if R0<1, then the disease free equilibrium is locally asymptotically stable; whereas if R0>1, then it is unstable. Thus, R0 is a threshold parameter for the model. An analysis of the local centre manifold yields a simple criterion for the existence and stability of super- and sub-threshold endemic equilibria for R0 near one. This criterion, together with the definition of R0, is illustrated by treatment, multigroup, staged progression, multistrain and vector–host models and can be applied to more complex models. The results are significant for disease control.