A disease is holoendemic when essentially every individual in a population is infected. Although the

infection An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable dise ...

is ubiquitous, symptoms of disease do not appear equally across age groups. The young are more likely to express

pathogenic In biology, a pathogen ( el, πάθος, "suffering", "passion" and , "producer of") in the oldest and broadest sense, is any organism or agent that can produce disease. A pathogen may also be referred to as an infectious agent, or simply a germ ...

responses, whilst the older hosts will carry the disease

asymptomatic In medicine, any disease is classified asymptomatic if a patient tests as carrier for a disease or infection but experiences no symptoms. Whenever a medical condition fails to show noticeable symptoms after a diagnosis it might be considered asy ...

ally, or with reduced damage, due to

adaptive immunity The adaptive immune system, also known as the acquired immune system, is a subsystem of the immune system that is composed of specialized, systemic cells and processes that eliminate pathogens or prevent their growth. The acquired immune system ...

. Therefore, holoendemic diseases differ from

hyperendemic In epidemiology, the term hyperendemic disease is used to refer to a disease which is constantly and persistently present in a population at a high rate of incidence and/or prevalence (occurrence) and which equally affects (i.e. which is equally en ...

diseases, of which symptoms are expressed equally by members across all age groups of a population. Holoendemicity is frequently seen with

malaria Malaria is a mosquito-borne infectious disease that affects humans and other animals. Malaria causes symptoms that typically include fever, tiredness, vomiting, and headaches. In severe cases, it can cause jaundice, seizures, coma, or death. S ...

, specifically the strain caused by ''

Plasmodium falciparum ''Plasmodium falciparum'' is a Unicellular organism, unicellular protozoan parasite of humans, and the deadliest species of ''Plasmodium'' that causes malaria in humans. The parasite is transmitted through the bite of a female ''Anopheles'' mosqu ...

'', in several regions of

sub-Saharan Africa Sub-Saharan Africa is, geographically, the area and regions of the continent of Africa that lies south of the Sahara. These include West Africa, East Africa, Central Africa, and Southern Africa. Geopolitically, in addition to the List of sov ...

(one study found that 98.6% of the population had traces of the

pathogen In biology, a pathogen ( el, πάθος, "suffering", "passion" and , "producer of") in the oldest and broadest sense, is any organism or agent that can produce disease. A pathogen may also be referred to as an infectious agent, or simply a germ ...

within a 4 month period). While individuals of all ages risk exposure to malaria, those under the age of five are particularly susceptible to the disease. Children account for the majority of both local and global malaria cases because they lack the adaptive immunity that comes with repeated exposure. Other examples of holoendemic diseases include ocular

trachoma Trachoma is an infectious disease caused by bacterium ''Chlamydia trachomatis''. The infection causes a roughening of the inner surface of the eyelids. This roughening can lead to pain in the eyes, breakdown of the outer surface or cornea of ...

in certain areas in sub-Saharan Africa, where virtually all children in those populations have been infected, and

hepatitis B Hepatitis B is an infectious disease caused by the ''Hepatitis B virus'' (HBV) that affects the liver; it is a type of viral hepatitis. It can cause both acute and chronic infection. Many people have no symptoms during an initial infection. Fo ...

in areas of the

Marquesas Islands The Marquesas Islands (; french: Îles Marquises or ' or '; Marquesan: ' ( North Marquesan) and ' ( South Marquesan), both meaning "the land of men") are a group of volcanic islands in French Polynesia, an overseas collectivity of France in th ...

References

{{Concepts in infectious disease Infectious diseases