Munywoki, Patrick K., Koech, Dorothy C, Agoti, Charles N., Cane, Patricia A., Medley, Graham and Nokes, D. James (2018) Continuous invasion by respiratory viruses observed in rural households during a respiratory syncytial virus seasonal outbreak in coastal Kenya. Clinical Infectious Diseases, 67 (10). pp. 1559-1567. doi:10.1093/cid/ciy313

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Abstract

Background:
Households are high intensity close-contact environments favorable for transmission of respiratory viruses, yet little is known for low-income settings.

Methods:
Active surveillance was completed on 47 households in rural coastal Kenya over six months during a respiratory syncytial virus(RSV) season. Nasopharyngeal swabs(NPS) were taken from 483 household members twice-weekly irrespective of symptoms. NPS from 6 households were screened for 15 respiratory viruses by molecular diagnostics and the remainder only for the most frequent viruses observed: rhinovirus (RV), human coronaviruses(hCoV; comprising 229E, OC43 and NL63), adenovirus(AdV) and RSV(A and B).

Results:
Of 16,928 NPS tested for the common viruses, 4,259 (25.2%) were positive for ≥1 target; 596 (13.8%) had co-infections. Detection frequencies were 10.5% RV (1780), 7.5% hCoV (1274), 7.3% AdV (1232), and 3.2% RSV (537). On average, each household and individual had six and three different viruses detected over the study period, respectively. RV and hCoV were detected in all the 47 households while AdV and RSV were detected in 45 (95.7%) and 40 (85.1%) households, respectively. The individual risk of infection over the 6-month period were 93.4%, 80.1%, 71.6%, 61.5% and 37.1% for any virus, RV, hCoV, AdV and RSV, respectively. NPS collected during symptomatic days and from younger age groups had higher prevalence of virus detection relative to respective counterparts. RSV was under-represented in households relative to hospital admission data.

Conclusions:
In this setting respiratory virus infections and associated illness, are ubiquitous in households. Future studies should address the health and economic implications of these observations.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine
Divisions:	Faculty of Science > Life Sciences (2010- )
Library of Congress Subject Headings (LCSH):	Respiratory syncytial virus -- Transmission -- Kenya, Respiratory organs -- Diseases -- Transmission -- Kenya, Respiratory organs -- Diseases -- Epidemiology
Journal or Publication Title:	Clinical Infectious Diseases
Publisher:	Oxford University Press
ISSN:	1058-4838
Official Date:	16 April 2018
Dates:	Date Event 16 April 2018 Published 13 April 2018 Accepted
Date of first compliant deposit:	2 May 2018
Volume:	67
Number:	10
Page Range:	pp. 1559-1567
DOI:	10.1093/cid/ciy313
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access
RIOXX Funder/Project Grant:	Project/Grant ID RIOXX Funder Name Funder ID 102975 Wellcome Trust http://dx.doi.org/10.13039/100004440 090853 Wellcome Trust http://dx.doi.org/10.13039/100004440 084633 Wellcome Trust http://dx.doi.org/10.13039/100004440 206748 Wellcome Trust http://dx.doi.org/10.13039/100004440

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