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. 2014 Oct 22;69:160–171. doi: 10.1016/j.chaos.2014.09.014

The selection pressures induced non-smooth infectious disease model and bifurcation analysis

Wenjie Qin 1, Sanyi Tang 1,
PMCID: PMC7126316  PMID: 32288361

Highlights

  • A non-smooth infectious disease model to describe selection pressure is developed.

  • The effect of selection pressure on infectious disease transmission is addressed.

  • The key factors which are related to the threshold value are determined.

  • The stabilities and bifurcations of model have been revealed in more detail.

  • Strategies for the prevention of emerging infectious disease are proposed.

Abstract

Mathematical models can assist in the design strategies to control emerging infectious disease. This paper deduces a non-smooth infectious disease model induced by selection pressures. Analysis of this model reveals rich dynamics including local, global stability of equilibria and local sliding bifurcations. Model solutions ultimately stabilize at either one real equilibrium or the pseudo-equilibrium on the switching surface of the present model, depending on the threshold value determined by some related parameters. Our main results show that reducing the threshold value to a appropriate level could contribute to the efficacy on prevention and treatment of emerging infectious disease, which indicates that the selection pressures can be beneficial to prevent the emerging infectious disease under medical resource limitation.

1. Introduction

Emerging infectious disease, caused by nature or bioterrorism (such as Asiatic/Russian Flu [1], Spanish Flu [2], 2009 Flu pandemic [3], [4]) is one of the most important disasters in the history of human and threatens public health, so the government of each country and peoples pay more and more attentions on the prevention and treatment for emerging infectious diseases. World Health Organization reports expenditure of more than $468 million in 2012–2013 to control the spread of infectious diseases [5], and funds for treatment and research emerging infectious diseases are huge and increasing. It is thus important to investigate effective control strategies that can prevent outbreaks or minimize the cost.

During the last decade, the outbreak of Severe Acute Respiratory Syndrome (SARS) in 2003 and avian influenza among humans (H5N1 in 2003, H1N1 in 2009, and H7N9 in 2013) emphasized the need to enhance the capacity to fight emerging infectious diseases. Since the first outbreaks in China in early 2003 SARS had spread rapidly across China into southeast Asia and even the world, and SARS was the first severe new disease of the 21st century, so we take SARS as an example of emerging infectious disease in this paper. In the early stages of the 2003 SARS outbreak, only a very few number of individuals infected by SARS, and the early symptoms were very similar to flu and could not be diagnosed by medical personnel.

Along with the rapid spread of SARS in some countries and regions, the numbers of SARS infected cases and flu were growing, those posed a grave threat to public health as its high morbidity and mortality. On the prevention and treatment for SARS, the effective and essential measures including heightened surveillance, early detection and treatment of cases, and infection control in all health facilities have been applied. Although the emergency ambulances including development of effective drugs and rapid tools for diagnosis provided a safe and reliable mobile medical treatment platform for tacking SARS, it would put pressure on limited medical resources such as doctors, hospital beds, isolation places and bring grave challenges to each country, especially in rural areas in many developing countries [6], [7], [8], [9]. For example, it was a serious challenge for medical personnel to diagnose the patients who were infected by SARS or flu with the similar signs and symptoms such as coughs, colds, fevers and so on. Those required a lot of medical resources, which undoubtedly worse the already grave situation. Thus, medical resource limitation seriously restricted the prevention and treatment for SARS.

Therefore, faced with an increasing numbers of SARS infected cases and flu, the increasing serious situation caused the doctors have to focus their attentions on the SARS infected cases and put aside flu due to selection pressure. As such, emergency medical treatment services such as isolated treatment, personal protection, medical observation, sterilization and so on were only taken immediately for SARS. For the patients infected by flu, the doctors had to prescribe some medicines to them and advise them go home for home treatment as the selection pressure.

In order to describe the effects of limited medical resource and selection pressure, the number of the patients infected by SARS in a compartment has been chosen as an index for medical personnel to use decisions. In such a case, intervention is modeled and represented by using a piecewise function. This type of control strategy is a so-called threshold policy [10], [11], which is defined as follow: if the number of the patients infected by SARS is below the threshold level (denoted by Ic), there is no limited medical resource and selection pressure; above the threshold, due to the limited resource, and doctors treat SARS only. The threshold policy defined as above is also referred to as an on–off control which can be described by Filippov systems [12], [13]. Recently, Filippov systems have been widely used in many fields of science and engineering [14], [15], [16], [17], [18], [19], [20], [21], [22], [23], [24].

The purpose of this study is to derive a novel non-smooth infectious disease model with threshold strategy to describe both medical resources limitation and selection pressures. This study investigates how the threshold value of the infected population and selection pressure affect the prevention and treatment for SARS under medical resources limitation. Furthermore, the key control parameters which are most significantly related to this threshold value are also investigated. In particular, mathematical and bifurcation analyses with regard to the local, global stability of equilibria and local sliding bifurcations are performed.

2. Filippov infectious disease model and preliminaries

2.1. Model formulation

The basic model we consider is based on the classical infectious disease model with limited capacity for treatment [25], i.e.,

S˙(t)=A-μSS-βSI,I˙(t)=βSI-(μI+ν)I-cI1+bI,R˙(t)=νI+cI1+bI-μRR. (1)

The assumptions in model (1) are as follows:

  • S(t),I(t) and R(t) denote the numbers of susceptible, infective and recovered individuals at time t, respectively. A is the recruitment rate of susceptible individuals, μS and μR are the natural death rates of susceptible and recovered individuals, μI is the death rate of the infected individuals which includes both the disease-related death and the natural death, hence μI>μS.

  • H(I)=cI/(1+bI) represents the recovery rate from the infected compartment with hospital treatment, which is a saturated treatment function, where c represents the maximal recovery rate and b describes the effects of medical resource limitation on the treatment.

  • ν stands for the natural recovery rate of the infective individuals, obviously, ν<c, the incidence rate is assumed to be mass action incidence with bilinear interactions given by βSI, and β is the transmission coefficient.

In order to describe the selection pressure for doctors faced with both SARS and flu cases occur simultaneously in the crowd, we extend model (1) as

S˙(t)=A-μSS-β1SI1-β2SI2,I˙1(t)=β1SI1-μ1I1-ν1I1-p1c1I11+p1b1I1+p2b2I2,I˙2(t)=β2SI2-μ2I2-ν2I2-p2c2I21+p1b1I1+p2b2I2,R˙(t)=ν1I1+ν2I2+p1c1I1+p2c2I21+p1b1I1+p2b2I2-μRR. (2)

Here I1 and I2 denote the number of the patients infected by SARS and flu, respectively. βi is called the basic transmission coefficient of Ii,μi is the death rate of Ii which include both the disease-related death and the natural death, hence μi>μS,pi denotes the probability that doctors will treat Ii,ci stands for the maximum recovery rate per unit time for Ii,bi describes effects of medical resource limitation on the treatment for Ii,νi is the natural recovery rate for Ii, and νi<ci,i=1,2.

The question is how the doctors choose the patients who are either infected by SARS or flu. It is well known that both patients can be treated at the initial stage of SARS outbreak. Once the number of the patients infected by SARS increases and exceeds some threshold value, there is not enough medical resources. The doctors focus on their attentions on the patients by SARS. To determine the threshold value and consequently determine the key parameters, we consider the following function with respect to p1 and p2, i.e., we define

R(p1,p2)=p1c1I1+p2c2I21+p1b1I1+p2b2I2

and we consider R as a fitness function which is maximized. Taking simple calculation, one yields

Rp1=c1+p2I2(b2c1-b1c2)I1(1+p1b1I1+p2b2I2)2,Rp2=c2-p1I1(b2c1-b1c2)I2(1+p1b1I1+p2b2I2)2.

In consideration of selection pressure, we assume b2c1-b1c2>0, then R is maximized at p1=1, and it follows from R/p2=0 that the threshold value Ic=c2/(b2c1-b1c2).

All those show that R is a monotonic increasing (or decreasing) function with respect to p2 provided I1<Ic (or I1>Ic). Thus, in order to obtain the maximum recovery rate, we choose p2=1 for I1<Ic, that is, sufficient medical resources can treat those small number of infected patients at the early stage of SARS outbreak, the patients infected by flu can be treated simultaneously with SARS (i.e., p1=p2=1). However, along with the prevalence of SARS (i.e., I1>Ic), the limited medical resources can not satisfy the growing trend towards SARS cases. Department of health or state has to cite the urgency of fighting SARS, adopts “green passage” policy that speeds for isolation and treatment for SARS. At this moment, the doctors have to prescribe medicines for the patients infected by flu and advise them go home for home treatment (i.e., p1=1,p2=0). Meanwhile, this exposes the faultiness of state handling mechanism of paroxysmal public health events and infectious disease observation mechanism, especially in poor countries and areas. In this case, we choose p2=0 for I1>Ic.

Therefore, taking into account above facts, if the number of the patients infected by SARS is less than the threshold Ic, then model (2) becomes

S˙(t)=A-μSS-β1SI1-β2SI2,I˙1(t)=β1SI1-μ1I1-ν1I1-c1I11+b1I1+b2I2,I˙2(t)=β2SI2-μ2I2-ν2I2-c2I21+b1I1+b2I2,R˙(t)=ν1I1+ν2I2+c1I1+c2I21+b1I1+b2I2-μRR. (3)

If the number of the patients infected by SARS is large than the threshold Ic, then model (2) becomes

S˙(t)=A-μSS-β1SI1-β2SI2,I˙1(t)=β1SI1-μ1I1-ν1I1-c1I11+b1I1,I˙2(t)=β2SI2-μ2I2-ν2I2,R˙(t)=ν1I1+ν2I2+c1I11+b1I1-μRR. (4)

Without loss of generality, we consider the number of the patients infected by flu each year is a constant, i.e., I2=kZ+. Meanwhile, due to the high risk of SARS, the patients infected by SARS will be taken care immediately no matter medical resource limitation, that is b1=0.

Thus, models (3), (4) can be rewritten as the following non-smooth dynamic system [12], [13]

S˙(t)=A-μS-β1SI1,I˙1(t)=β1SI1-νI1-c1I11+εb2k, (5)

with

ε=1,H(Z)<0,0,H(Z)>0, (6)

where μ=μS+β2k,ν=μ1+ν1,Ic=c2/(b2c1) and H(Z)=I1-Ic with vector Z=(S,I1)T. Model (5) with (6) is a description of the threshold policy, which is referred to as an on–off control, see [10], [11] for more detailed introduction.

For convenience, we further denote

FS1(Z)=A-μS-β1SI1,β1SI1-νI1-c1I11+b2kT,FS2(Z)=A-μS-β1SI1,β1SI1-νI1-c1I1T.

Then model (5) with (6) can be rewritten as the following Filippov system [12], [13]

Z˙(t)=FS1(Z),ZS1,FS2(Z),ZS2, (7)

where S1={ZR+2H(Z)<0},S2={ZR+2H(Z)>0}. Furthermore, the discontinuity boundary (or manifold) Σ separating two regions S1 and S2 is described as Σ={ZR+2|H(Z)=0}, and H is a smooth scalar function with non-vanishing gradient HZ on Σ. From now on, we call Filippov system (7) defined in region S1 as system S1, and defined in region S2 as system S2.

Let

σ(Z)=HZ(Z),FS1(Z)·HZ(Z),FS2(Z)=FS1H(Z)·FS2H(Z),

where · denotes the standard scalar product, and FSiH(Z)=FSi·gradH(Z) is the Lie derivative [26] of H with respect to the vector field FSi at Z for i=1,2, then the sliding domain can be defined as Σs={ZΣ|σ(Z)0}.

The following definitions on all types of equilibria of Filippov system [27], [28] are necessary throughout the paper.

Definition 2.1

A point Z is called a real equilibrium of Filippov system (7) if FS1(Z)=0,H(Z)<0, or FS2(Z)=0,H(Z)>0. Similarly, a point Z is called a virtual equilibrium if FS1(Z)=0,H(Z)>0, or FS2(Z)=0,H(Z)<0. Both the real and virtual equilibria are called regular equilibria.

Definition 2.2

A point Z is called a pseudo-equilibrium if it is an equilibrium of the sliding mode of system (7), i.e., λFS1(Z)+(1-λ)FS2(Z)=0,H(Z)=0 and 0<λ<1, where λ=FS2H(Z)/[(FS2-FS1)H(Z)].

Definition 2.3

A point Z is called a boundary equilibrium of Filippov system (7) if FS1(Z)=0,H(Z)=0, or FS2(Z)=0,H(Z)=0.

Further, we say the boundary equilibrium bifurcation occurs at Z if FSi(Z) is invertible (or equivalently the eigenvalues of detFSi(Z) have real part different from zero and FSjH(Z)0,i,j=1,2;ij). These bifurcations are classified as boundary focus, boundary node and boundary saddle in [29].

Definition 2.4

A point Z is called a tangency point of Filippov system (7) if ZΣs and FS1H(Z)=0 or FS2H(Z)=0.

2.2. Qualitative analysis of subsystems

For subsystem S1, it has the disease-free equilibrium E0 and the endemic equilibrium E1, and

E0=Aμ,0,E1=(S1,I1)=1β1ν+c11+b2k,μβ1(R01-1),

where

R01=β1ν+c11+b2kAμ

is the basic reproduction number of subsystem S1.

For the global stabilities of E0 and E1, we can choose Lyapunov functions

V0(t)=I1(t),V1(S,I1)=12S1(S-S1)2+I1-I1-I1lnI1I1

for two equilibria, and using Lasalle invariant set principle, we get the global stabilities of E0 and E1 easily provided R01<1 and R01>1, respectively.

Analogously, for subsystem S2, it has the disease-free equilibrium E0=(A/μ,0) which is globally asymptotically stable if R02<1, and the endemic equilibrium

E2=(S2,I2)=1β1(ν+c1),μβ1(R02-1)

is globally asymptotically stable if R02>1. Here

R02=β1ν+c1Aμ

is the basic reproduction number of subsystem S2.

Meanwhile, the characteristic polynomial of subsystem Si about the endemic equilibrium Ei=(Si,Ii) is

λ2+ASiλ+β1(A-μSi)=0

and Ei could be a node or focus point which depends on the sign of

i=A2Si2-4β1(A-μSi),i=1,2.

Further, noting that R02<R01. Thus, if R01<1, both free system S1 and control system S2 stabilize at its disease-free equilibrium; If R02>1, these two subsystems S1 and S2 have their own endemic states.

3. Basic properties of Filippov system (7)

3.1. Existence of sliding domain

It follows from the definition of function σ(Z) that we have

σ(Z)=I12β1S-ν-c11+b2k(β1S-ν-c1),ZΣ, (8)

which is equivalent to check if the components of vector Z˙=(S˙,I˙1) are transversal to Σ. That is I˙1 evaluated for I1=Ic with the second equation in both subsystems S1 and S2 can be of opposite sign.

Therefore, the sliding domain Σs can be obtained as

Σs=ZΣ1β1ν+c11+b2kS1β1(ν+c1),I1=Ic,

that is,

Σs=ZΣS1SS2,I1=Ic.

3.2. Sliding mode dynamics

Here we employ Utkin’s equivalent control method introduced in [13] to obtain the differential equation for sliding dynamics defined in the region ΣS. It follows from H=0 that

Ht=I1=β1SIc-νIc-c1Ic1+εb2k=0,

solving the above equation with respect to ε yields

ε=c1+ν-β1Sb2k(β1S-ν).

According to Utkin’s equivalent control method the dynamics on the sliding domain ΣS can be determined by the following scalar differential equation

S˙(t)=A-μS-β1SIc, (9)

where S(S1,S2)Sd. Obviously, the sliding mode (9) exists a unique pseudo-equilibrium EP=(Sp,Ic) provided SpSd, where Sp=A/(μ+β1Ic), and SpSd is equivalent to

μβ1(R02-1)<Ic<μβ1(R01-1).

Noting that

Ic=c2b2c1,I1=μβ1(R01-1),I2=μβ1(R02-1),

we can rewrite the above inequality as

H1b2c1I2<c2<b2c1I1H2. (10)

For the scalar equation (9), it is easy to show that the pseudo-equilibrium EP is locally asymptotically stable on the sliding domain Σs.

4. Sliding bifurcation analysis

4.1. Bifurcation sets of equilibria and sliding modes

In this subsection, we will address the richness of all possible equilibria and sliding mode that Filippov system (7) can exhibit. To do this, parameters k and c2 are chosen to build the bifurcation diagram and all other parameters are chosen as those in Fig. 1 .

Fig. 1.

Fig. 1

Bifurcation diagram for Filippov system (7) with respect to k and c2, five curves are L0={(k,c2)|c2=ν2} and Li={(k,c2)|c2=Hi,i=1,2,3,4}. Parameters are A=0.6,β1=1,β2=0.01,μS=0.39,μ1=0.5,μR=0.38,ν1=0.01,ν2=0.05,b2=2,c1=0.5.

Note that R01>R02 and I1>I2. Therefore, if c2>H2 (i.e., Ω1Ω2Ω3 in Fig. 1), then the equilibria E1 and E2 are real and virtual (denoted as ER1 and EV2), respectively. If H1<c2<H2 (i.e., Ω4Ω5 in Fig. 1), then both equilibria E1 and E2 are virtual (denoted as EV1 and EV2). In this case the pseudo-equilibrium EP is a only feasible equilibrium which is locally asymptotically stable. If c2<H1 (i.e., Ω6 in Fig. 1), then the equilibria E1 and E2 are virtual and real (denoted as EV1 and ER2), respectively.

To investigate the global stability and the long-term dynamics of Filippov system (7), we initially explore the relationship between the sliding domain Σs and the invariance region of Filippov system (7)

ΩS+I1R+2|0<S+I1d=Amin{μS,μ1,μR},S0,I10.

The sliding domain Σs lies in the invariance region Ω if S2<d-Ic, i.e.,

c2<b2c1(d-S2)H3 (11)

and Σs is out of Ω if S1>d-Ic, i.e.,

c2>b2c1(d-S1)H4. (12)

Especially, when H3<c2<H4 (i.e., region Ω2Ω4 in Fig. 1), part of the sliding domain Σs is out of the invariance region Ω and part of it is in Ω.

4.2. Boundary equilibrium bifurcation

Boundary equilibrium bifurcations in Filippov system are characterized by the collision of pseudo-equilibrium, tangent point, and real equilibrium (or tangent point and real equilibrium) at the discontinuity surface when one parameter passes through a critical value. Throughout this section, we will investigate the boundary equilibrium bifurcation of Filippov system (7), and we first discuss the tangent point and boundary equilibrium as following.

Tangent point of Filippov system (7) satisfies

β1SI1-νI1-c1I11+εb2k=0,I1=Ic,

solving the above equations with respect to S yields ET1=(S1,Ic) or ET2=(S2,Ic). Note that ET1 and ET2 are the endpoints of the sliding segment ΣS.

Boundary equilibrium of Filippov system (7) satisfies

A-μS-β1SI1=0,β1SI1-νI1-c1I11+εb2k=0,I1=Ic,

which indicate that if

Aμ+β1Ic=1β1ν+c11+εb2k,

then we have the boundary equilibrium EB1=(S1,Ic) or EB2=(S2,Ic).

Further, we have

FS1H(EB2)=β1S2-ν-c11+b2kI2=c1b2kμ(R02-1)β1(1+b2k)>0,FS2H(EB1)=β1S1-ν-c1I1=c1b2kμ(1-R01)β11+b2kμβ1<0

and from the expression of Δi in Section 2.2, we know that det(FSi(EBi)) possesses complex eigenvalues with nonzero real part -A/(2Si) or nonzero real eigenvalues -A±ΔiSi/(2Si) depends on the sign of Δi,i=1,2. According to Definition 2.3, a boundary equilibrium bifurcation occurs at EBi. That is, the existence of a boundary equilibrium indicates the existence of a boundary equilibrium bifurcation.

In summary, we get the following conclusion.

Theorem 4.1

A boundary focus (node) bifurcation occurs at EBi if Δi<0 (Δi0),i=1,2 .

Especially, from Fig. 2 , we can see that the stable focus ER2 and a tangent point ET2 collide together as the parameter c2 passes through the critical value c2=0.2631 (in this case, Ic=0.2631,Δ2=-0.5825<0), the boundary focus bifurcation occurs at EB2. A stable focus ER2 and a tangent point ET2 coexist, as shown in Fig. 2(A) when c2<0.2631. They collide at c2=0.2631 (see Fig. 2) and are substituted by a pseudo-equilibrium EP and a tangent point ET2 as c2>0.2631, see Fig. 2(C) for more details.

Fig. 2.

Fig. 2

Boundary focus bifurcation for Filippov system (7). Here we choose c2 as a bifurcation parameter and fix all other parameters as follows: A=0.7,β1=1,β2=0.01,μS=0.39,μ1=0.5,μR=0.38,ν1=0.01,b2=2,c1=0.5,k=4,and(A)c2=0.1;(B)c2=0.2631;(C)c2=0.6.

Similarly, a boundary node bifurcation of Filippov system (7) occurs at EB1 as c2=0.6477 (in such case, Ic=0.6477,Δ1=0.0667>0), see Fig. 3 . A stable node ER1 and a tangent point ET1 coexist, as shown in Fig. 3(A) when c2>0.6477. They collide at c2=0.6477 (see Fig. 3) and are substituted by a pseudo-equilibrium EP and a tangent point ET1 when c2<0.6477, as shown in Fig. 3(C).

Fig. 3.

Fig. 3

Boundary node bifurcation for Filippov system (7). Here we choose c2 as a bifurcation parameter, (A) c2=0.75; (B) c2=0.6477; (C) c2=0.4. The other parameters are identical to those in Fig. 2.

5. Global behavior

In this section, we focus on the asymptotical behaviors of all the possible equilibria including two real equilibria ERi,i=1,2 and pseudo-equilibrium EP for Filippov system (7) provided R02>1. To do so, we need to rule out the existence of limit cycle. For convenience, we summarize three types of limit cycles in Ω for Filippov system (7) as following.

  • I. Limit cycle composed only by the orbit of the vector field FS1(Z) or FS2(Z), as shown in Fig. 4 (A).

  • II. Crossing cycle tangents to the sliding segment Σs (see Fig. 4(B)) or contains part of the sliding segment Σs (see Fig. 4(C)).

  • III. Crossing cycle surrounds the sliding segment Σs, as shown in Fig. 4(D).

Fig. 4.

Fig. 4

Phase plane SI1 of Filippov system (7) to illustrate all the types of possible limit cycles in the invariance region Ω.

5.1. Non-existence of limit cycle

In order to prove the global stability of the equilibrium of system (7), we need to rule out the existence of limit cycles listed above. We initially preclude the existence of the first type of limit cycle, i.e., limit cycle totally in region S1 or S2. Denote the right-hand side of system Si by f(i)(Z), where f(i)(Z)=(f1(i)(Z),f2(i)(Z)),i=1,2.

Lemma 5.1

There exists no limit cycle totally composed by the orbit of the vector field FSi(Z),i=1,2 .

Proof

Let the Dulac function be B(S,I1)=1/(SI1) for subsystem Si, we have

(Bf1(i))S+(Bf2(i))I1=-AS2I1<0,

so there is no limit cycle totally in region Si for i=1,2. Therefore, there exists no limit cycle totally composed by the orbit of the vector field FS1(Z) or FS2(Z). This completes the proof of Lemma 5.1. □

Next, we preclude the existence of the second type of limit cycles.

Lemma 5.2

There exists no limit cycle surrounding a sliding segment, which contains a tangent point only or part of a sliding segment.

Proof

In order to proof Lemma 5.2, we consider the following three cases.

Case i: Assume that I2<Ic<I1, i.e., H1<c2<H2. It follows that there exists a pseudo-equilibrium EP which is locally asymptotically stable in the sliding domain Σs. The local stability of EP on the sliding domain indicates that the conclusion in Lemma 5.2 follows.

Case ii: Assume that Ic<I2, i.e., c2<H1.

In the sliding domain Σs (here the segment ET1ET2 in Fig. 5 ), we have

S˙(t)=A-μS-β1SIc>0,

which shows that the trajectory moves from the left to the right on Σs.

We should show that the orbit l1 initiating at ET2 will not hit the sliding domain Σs again. Note that the orbit l1 starting at ET2 either tends to the stable equilibrium ER2 directly or spirally since ER2 could be a stable node or focus in region S2. If the latter happens, then the orbit l1 intersects with the horizontal isocline gI2 as the point M1 first, and N1 second, where N1 is on the segment ET2ER2. Obviously, the two points M1 and N1 are above the point ET2. Hence, l1 starting at ET2 cannot form a cycle, as shown in Fig. 5.

Case iii: Assume that Ic>I1, i.e., c2>H2. We can use a similar process as Case ii to prove the conclusion.

Therefore, the combination of Cases i–iii, there exists no limit cycle contains a tangent point only or part of a sliding segment. This completes the proof of Lemma 5.2. □

In order to preclude the existence of the third type of limit cycle, we give the following lemma and detailed proof.

Lemma 5.3

There exists no limit cycle surrounding the whole sliding segment.

Proof

We supposed that Filippov system (7) has a limit cycle Γ in Ω, and Γ surrounds the sliding segment T1T2. As shown in Fig. 6 , Γ is divided into two parts Γ1 and Γ2 by the manifold Σ, we denote the intersection points by H1 and H2. Meanwhile, the intersection points between Γ and the auxiliary line I1=Ic- (or I1=Ic+) are A1,A2 (or A3,A4), where >0 is sufficiently small. The region bounded by Γ1 (or Γ2) and segment A1A2 (or A3A4) is denoted with G1 (or G2), and we denote the boundary of G1 (or G2) by L1 (or L2), respectively, and the directions indicated in Fig. 6. Let the Dulac function be B=1/(SI1), it follows from Green’s theorem that

G1(Bf1(1))S+(Bf2(1))I1dSdI1=BL1f1(1)dI1-f2(1)dS=-A2A1Bf2(1)dS.

Similarly, we have

G2(Bf1(2))S+(Bf2(2))I1dSdI1=-A3A4Bf2(2)dS.

If G0G1, we have

ξG0(Bf1(1))S+(Bf2(1))I1dSdI1<0,

then we obtain

0>ξ>G1(Bf1(1))S+(Bf2(1))I1dSdI1+G2(Bf1(2))S+(Bf2(2))I1dSdI1=-A2A1Bf2(1)dS-A3A4Bf2(2)dS. (13)

For the sake of simplicity of computation, we denote the abscissas of the points H1,H2,A1,A2,A3,A4 by x1,x2,x1+h1(),x2-h2(),x1+h3(),x2-h4(), where hi()>0 is continuous and satisfies lim0hi()=0 for i=1,2,3,4. Thus, we have

lim0-A2A1Bf2(1)dS=lim0x1+h1()x2-h2()β1-ν+c11+b2kSdS=lim0β(x2-h2()-x1-h1())-ν+c11+b2klnx2-h2()x1+h1()=β(x2-x1)-ν+c11+b2klnx2x1.

Analogously, we get

lim0-A3A4Bf2(2)dS=β(x1-x2)+(ν+c1)lnx2x1.

Therefore,

lim0-A2A1Bf2(1)dS-A3A4Bf2(2)dS=c1b2k1+b2klnx2x1>0

which contradicts with (13). This precludes the existence of the limit cycle. This completes the proof of Lemma 5.3.

Fig. 5.

Fig. 5

Phase plane SI1 of Filippov system (7) to show the null isoclines (gIi and gSi,i=1,2), the equilibria (EV1 and ER2), the sliding domain Σs and the invariance region Ω. For subsystem S1, gI1{(S,I1)|S=S1} and gS1{(S,I1)|I1=(A-μS)/(β1S)}. For subsystem S2,gI2{(S,I1)|S=S2} and gS2{(S,I1)|I1=(A-μS)/(β1S)}. The orbit l1 is plotted for showing the asymptotical stability of the focus ER2.

Fig. 6.

Fig. 6

Phase plane SI1 of Filippov system (7), the diagram of Γ1 and Γ2 split from the limit cycle Γ and the diagram of G1 and G2.

5.2. Global stability of Filippov system (7)

To establish all possible behaviors that Filippov system (7) can exhibit, we choose the corresponding parameter values such that the dynamics in all regions are presented in Fig. 1. We initially show that ER1 is globally asymptotically stable as following.

Theorem 5.4

For Filippov system (7) , the endemic equilibrium ER1 is globally asymptotically stable if c2>H2 (i.e., Ic>I1 ).

Proof

By calculation, the two endemic equilibria ER1 and EV2 for two structures lie on the same side of Σ as c2>H2. Although there exists the sliding domain Σs in Ω, no pseudo-equilibrium exists in Σs. The endemic equilibrium ER1 is locally asymptotically stable in S1 since R01>1. It follows from the sliding domain Σs that

S˙(t)=A-μS-β1SIc<0,

which indicates that the trajectory moves from the right to the left on the sliding segment ET1ET2 (see Fig. 7 ).

Noting that H3H4,H1H2,H1H3,H2H4. Then, either H3<H2 or H3>H2 may hold true. For different sets of values of the parameters, the sliding segment may be exclusively, partly, or totally in the invariance region Ω, so we consider the following three cases.

Case i. If c2>H4 (the region Ω1 shown in Fig. 1), the sliding segment ET1ET2 lies in Ω, as shown in Fig. 7(A).

According to Lemma 5.1, Lemma 5.2, Lemma 5.3, we can preclude the existence of three types limit cycles listed above. Hence, the endemic equilibrium ER1 is globally asymptotically stable.

Case ii. If max{H2,H3}<c2<H4 (the region Ω2 shown in Fig. 1), the part of the sliding segment ET1ET2 lies in Ω, as shown in Fig. 7(B). Note that again the direction of the vector field in region S2Ω points downward. Moreover, according to Lemma 5.2, we know that there exists no closed orbit containing part of the sliding segment ET1ET2. Hence, the endemic equilibrium ER1 is globally asymptotically stable.

Case iii. If c2<max{H2,H3} (the region Ω3 shown in Fig. 1), the sliding segment is out of Ω, as shown in Fig. 7(C).

The two endemic equilibria ER1 and EV2 lie in S1Ω, and the direction of the vector field in S2Ω points downward. Hence, there exists no limit cycle in Ω which is partly in S1 and partly in S2. In addition, by Lemma 5.1, there is no limit cycle totally in S1. Therefore, the endemic equilibrium ER1 is globally asymptotically stable.

Note that both ER1 and EV2 lie in S1, which indicate that all trajectories will attain the subregion of Ω below the manifold Σ. Moreover, they will remain in it and approach the endemic equilibrium ER1. Hence ER1 is globally asymptotically stable. This completes the proof of Theorem 5.4. □

Next, we will show that EP is globally asymptotically stable in the sliding domain Σs as following.

Theorem 5.5

For Filippov system (7) , the pseudo-equilibrium EP is globally asymptotically stable if H1<c2<H2 (i.e., I2<Ic<I1 ).

Proof

It is easy to see that both equilibria E1 and E2 are virtual (i.e., EV1 and EV2), and the pseudo-equilibrium EP exists in Σs which is locally asymptotically stable. Note that the sliding segment Σs may be partly or totally in Ω. Then there are two possibilities to consider.

Case i. If c2min{H2,H3} (the region Ω4 shown in Fig. 1), and part of the sliding segment ET1ET2 lies in Ω, as shown in Fig. 8 (A), we can preclude the existence of limit cycles by using a similar method to Case ii in Theorem 5.4.

Case ii. If c2<min{H2,H3} (the region Ω5 shown in Fig. 1), and the whole sliding segment lies in Ω, as shown in Fig. 8(B). We can rule out the existence of limit cycles surrounds Σs by Lemma 5.3.

From what we have discussed above, there exists no limit cycle in Ω. Hence, the pseudo-equilibrium EP is globally asymptotically stable. This completes the proof of Theorem 5.5. □

Finally, we show that ER2 is globally asymptotically stable as following.

Theorem 5.6

For Filippov system (7) , the endemic equilibrium ER2 is globally asymptotically stable if c2<H1 (i.e., Ic<I2 ).

Proof

If c2<H1 (the region Ω6 shown in Fig. 1), and the whole sliding segment lies in Ω, as shown in Fig. 9 .

Obviously, there exist two endemic equilibria EV1 and ER2 and no pseudo-equilibrium. The sliding mode Σs does exist, and the trajectory moves from left to right on ET1ET2 in this case, as shown in Fig. 9. Using a similar method to Case i of Theorem 5.4, we can rule out the existence of limit cycle totally in Ω. Hence, the endemic equilibrium ER2 is globally asymptotically stable. This completes the proof of Theorem 5.6. □

Remark

If R01<1, Filippov system (7) will stabilize at E0 which is the disease-free equilibrium of free system S1 (as shown in Fig. 10 ). In fact, if R01<1, Filippov system (7) does not have any regular equilibrium and sliding segment. According to Lemma 5.1, there exists no limit cycle for Filippov system (7). Consequently all the trajectories of Filippov system (7) will definitely hit the switching surface Σ, and finally stabilize at the boundary equilibrium E0 of free system S1.

Fig. 7.

Fig. 7

Global stability of the endemic equilibrium ER1. Parameters are: A=0.6,β1=2,β2=0.05,μS=0.39,μ1=0.5,μR=0.38,ν1=0.01,b2=1,k=2 and (A) c1=0.9,c2=0.7; (B) c1=0.9,c2=0.85; (C) c1=0.8,c2=1.

Fig. 8.

Fig. 8

Global stability of the pseudo-equilibrium EP. Parameters are: β1=1,β2=0.01,μS=0.39,μ1=0.5,μR=0.38,ν1=0.01,b2=2,c1=0.5,k=4, and (A) A=0.55,c2=0.5; (B) A=0.7,c2=0.32.

Fig. 9.

Fig. 9

Global stability of the endemic equilibrium ER2. Parameters are: A=0.7,β1=1,β2=0.01,μS=0.39,μ1=0.5,μR=0.38,ν1=0.01,b2=2,c1=0.5,c2=0.14,k=4.

Fig. 10.

Fig. 10

Dynamical behavior of the disease-free equilibrium E0. Parameters are: A=0.7,β1=0.3,β2=0.01,μS=0.39,μ1=0.5,μR=0.38,ν1=0.01,b2=2,c1=0.5,c2=0.1,k=4.

5.3. Key parameters and biological significance

What we consider in the following is the effects of key parameters on the threshold values R01 and R02.

Although the threshold values R01 and R02 depend on all parameters of Filippov system (7), the most interesting parameter here is c1, which is an important factor in controlling the spread of SARS. Obviously, R01 and R02 are monotonic decreasing functions with respect to c1 as R01/c1<0 and R02/c1<0. Meanwhile, we can calculate the threshold

c1=(Aβ1-μν)(1+b2k)μ,

such that R01(c1)=1. So R01(c1)<1 provided c1>c1.

It follows from Ic=c2/(c1b2) that Ic is a monotonic decreasing function with respect to c1. Thus, based on the critical value c1 the threshold value Ic should be reduced as

Ic=c2c1b2=c2μb2(Aβ1-μν)(1+b2k), (14)

which could contribute to the efficacy on prevention and treatment of SARS. So the doctors choose the threshold hold Ic no more than Ic to implement selection treatment for SARS cases, as shown in Fig. 11 . That is, at the outset of SARS outbreak (i.e., I1<Ic), SARS can be well-controlled by effective treatments, once the number of infected SARS cases reaches the threshold Ic (i.e., I1>Ic), the limited medical resource can not prevent SARS from spinning out of control (the dotted red line shows in Fig. 11), at this moment, we should take the highly selective treatment for SARS, and it will be brought under control (the solid blue line shows in Fig. 11). Therefore, the selection pressures can help us to prevent and treat SARS under limited medical resource.

Fig. 11.

Fig. 11

The monotonicities of R01 and R02 with respect to Ic. Parameters are: A=0.64,β1=0.4,β2=0.01,μS=0.39,μ1=0.5,ν1=0.01,b2=1.2,c2=0.5,k=8. (For interpretation of the references to color in this figure caption, the reader is referred to the web version of this article.)

Further, we investigate how the threshold value Ic affects the spread of SARS. To do this, we let c1 vary and fix all other parameters as those shown in Fig. 12 . It is easy to calculate the threshold value Ic0.29 according to (14). From Fig. 12, the blue line shows that SARS can be controlled as Ic<Ic, while the red and magenta lines show that SARS will be out of control as Ic>Ic, which indicates that it is very important to choose an appropriate threshold value Ic to decide when the selective strategy should be implemented for prevention and treatment of SARS.

Fig. 12.

Fig. 12

The time series of I1 with different threshold value Ic. Parameters are: A=0.9,β1=0.8,β2=0.05,μS=0.2,μ1=0.7,μR=0.38,ν1=0.01,b2=1,c2=1,k=10 and (S0,I10)=(0.1,0.2). The values of c1 from top to bottom are 0.4,2,3.5,4. (For interpretation of the references to color in this figure caption, the reader is referred to the web version of this article.)

Therefore, in order to prevent and treat the patients infected by SARS, it points to the urgent need for improvements in medical facilities, access to a rapidly, accurate and efficient way for wild-ranged screening and early diagnosis for SARS. It is best to timely selective treatment for SARS infected cases so as not to miss the best timing of treatment. Meanwhile, it is essential for the doctors to develop more effective drugs for diseases prevalent. This can greatly relieve the pressure of limited medical resource on the doctors or hospital.

6. Biological conclusion and discussion

In present work, we have proposed a non-smooth infectious disease model induced by selection pressures under medical resource limitation. In order to understand the effects of selection pressure on infectious disease transmission, by employing the qualitative theory and bifurcation techniques of non-smooth systems [13], [27], [28], [29], we deliberately investigate the long-term dynamic behavior of the proposed Filippov model. In particular, the sliding mode dynamics, the sliding bifurcations and global dynamics of the proposed model have been addressed.

By using Utkin’s equivalent control method introduced in [13], we first obtain the differential equation for sliding dynamics of the Filippov system (7), and then the sliding mode dynamics and the local sliding bifurcations have been addressed by applying bifurcation theories [27], [28], [29], see Fig. 2, Fig. 3. Meanwhile, the global dynamical behavior has been established by excluding the existence of limit cycles for system (7), as shown in Fig. 7, Fig. 8, Fig. 9.

Model (7) could stabilize at either one of the two equilibria (ER1 and ER2) or the pseudo-equilibrium EP on the switching surface, depending on the threshold level Ic which is determined by c1,c2,b2 (i.e., Ic=c2/(c1b2)). Especially, Fig. 8 indicates that the pseudo-equilibrium EP is globally asymptotically stable, which indicates that the infected population can stabilize at a previously chosen level Ic once the threshold policy and some related parameters (i.e., c1,c2,b2) are chosen properly. Hence, it is very crucial to choose appropriate control parameters for making the decision to trigger the intervention on infectious disease transmission.

The main results also show that on the prevention and treatment of SARS, we should choose an appropriate threshold Ic (i.e., Ic<Ic) at which the selection treatment strategy should be implemented and decided. That is, if the number of people infected by SARS is large than the threshold Ic, then we should take emergency medical treatment services (such as isolated treatment, personal protection, medical observation, sterilization and so on) immediately only for SARS cases due to medical resource limitation. Only in this way, SARS can be controlled as soon as possible. Those indicate that the results obtained here could be beneficial for accurately assessing the effect of selection pressure in the control and treatment of SARS (as shown in Fig. 11, Fig. 12). In particular, the selection treatment strategy can help us to prevent the new emerging infectious disease.

However, this study is a special case that the patients infected by SARS will be taken care immediately no matter medical resource limit (i.e., b1=0). In fact, there exists limited medical resource in real world especially in rural areas for new emerging infectious disease. Therefore, if b1>0, the dynamical behavior of both subsystems become much more complex and what we want to investigate is how the dynamic behavior of the model could be dramatically affected by the existence of medical resource limitation, and consequently influences the prevention and control for emerging infectious disease. Hence, we leave this work as our future study.

Acknowledgement

This work is supported by the National Natural Science Foundation of China (NSFCs: 11471201, 11171199, 11401360, 11371030, 11301320) and the Fundamental Research Funds for the Central Universities of China (GK201305010, GK201401004).

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