THE PUBLIC AND DOMESTIC DOMAINS IN THE TRANSMISSION OF DISEASE

This paper discusses the distinction between the transmission of infec tious diseases within the domestic domain (the area normally occupied by and under the control of a household) and that in the public domain , which includes public places of work, schooling, commerce and recrea tion as well as the streets and fields. Whereas transmission in the pu blic domain can allow a single case to cause a large epidemic, transmi ssion in the domestic domain is less dramatic and often ignored, altho ugh it may account for a substantial number of cases. Statistical meth ods are available to estimate the relative importance of the two. To c ontrol transmission in the public domain, intervention by public autho rities is likely to be required. Two examples show how environmental i nterventions for disease control tend to address transmission in one o r the other domain; interventions are needed in both domains in order to interrupt transmission.