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Model-based estimates of transmission of respiratory syncytial virus within households

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Kombe, Ivy K., Munywoki, Patrick K., Baguelin, Marc, Nokes, D. James and Medley, Graham (2018) Model-based estimates of transmission of respiratory syncytial virus within households. Epidemics . doi:10.1016/j.epidem.2018.12.001 (In Press)

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Official URL: http://dx.doi.org/10.1016/j.epidem.2018.12.001

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Abstract

Introduction

Respiratory syncytial virus (RSV) causes a significant respiratory disease burden in the under 5 population. The transmission pathway to young children is not fully quantified in low-income settings, and this information is required to design interventions.

Methods

We used an individual level transmission model to infer transmission parameters using data collected from 493 individuals distributed across 47 households over a period of 6 months spanning the 2009/2010 RSV season. A total of 208 episodes of RSV were observed from 179 individuals. We model competing transmission risk from within household exposure and community exposure while making a distinction between RSV groups A and B.

Results

We find that 32-53% of all RSV transmissions are between members of the same household; the rate of pair-wise transmission is 58% (95% CrI: 30-74%) lower in larger households (≥8 occupants) than smaller households; symptomatic individuals are 2-7 times more infectious than asymptomatic individuals i.e. 2.48 (95% CrI: 1.22-5.57) among symptomatic individuals with low viral load and 6.7(95% CrI: 2.56-16) among symptomatic individuals with high viral load; previous infection reduces susceptibility to re-infection within the same epidemic by 47% (95% CrI: 17%-68%) for homologous RSV group and 39% (95%CrI: -8%-69%) for heterologous group; RSV B is more frequently introduced into the household, and RSV A is more rapidly transmitted once in the household.

Discussion

Our analysis presents the first transmission modelling of cohort data for RSV and we find that it is important to consider the household social structuring and household size when modelling transmission. The increased infectiousness of symptomatic individuals implies that a vaccine against RSV related disease would also have an impact on infection transmission. Together, the weak cross immunity between RSV groups and the possibility of different transmission niches could form part of the explanation for the group co-existence.

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 -- Mathematical models
Journal or Publication Title: Epidemics
Publisher: Elsevier BV
ISSN: 1755-4365
Official Date: 15 December 2018
Dates:
DateEvent
15 December 2018Available
14 December 2018Accepted
Date of first compliant deposit: 18 December 2018
DOI: 10.1016/j.epidem.2018.12.001
Status: Peer Reviewed
Publication Status: In Press
Access rights to Published version: Open Access
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
UNSPECIFIEDAfrican Academy of SciencesUNSPECIFIED
UNSPECIFIEDNew Partnership for Africa's Developmenthttp://dx.doi.org/10.13039/501100009250
107769/Z/10/ZWellcome Trusthttp://dx.doi.org/10.13039/100010269
102975 Wellcome Trusthttp://dx.doi.org/10.13039/100010269
090853Wellcome Trusthttp://dx.doi.org/10.13039/100010269

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