The Library

Estimating the transmission parameters of pneumococcal carriage in households

Tools

Melegaro, Alessia, Gay, N. J. and Medley, Graham. (2004) Estimating the transmission parameters of pneumococcal carriage in households. Epidemiology and Infection, Vol.132 (No.3). pp. 433-441. ISSN 0950-2688

Preview

PDF
WRAP_Medley_estimating_transmission.pdf - Requires a PDF viewer such as GSview, Xpdf or Adobe Acrobat Reader
Download (155Kb)

Official URL: http://dx.doi.org/10.1017/S0950268804001980

Abstract

This paper analyses Streptococcus pneumoniae transmission dynamics in households using longitudinal data on pneumococcal (Pnc) carriage in the United Kingdom. Ten consecutive swabs were taken at 4-week intervals from all members of 121 households. The family status is derived from the observed Pnc carriage status of each family member. Transition matrices are built for each family size and composition containing the observed frequency of transitions between family statuses over a 28-day interval. A density-dependent transmission model is fitted to derive maximum-likelihood estimates of the duration of carriage and acquisition rates from the community and from infected individuals within the household. Parameter values are estimated for children (<5 years) and adults (5+years). The duration of carriage is longer in children <5 years of age than in older family members (51 vs. 19 days). Children are 3–4 times more likely than adults to acquire Pnc infection from the community. Transmission rates within the household suggest that adults are more infectious but less susceptible than children. Transmission within the household is most important in large families. The proportion of household-acquired infection ranges from 29 to 46% in households of three persons to 38–50% in larger households. Evidence of density-dependent within-household transmission is found, although the strength of this relationship is not clear from the model estimates.

Item Type:	Journal Article
Subjects:	R Medicine > RB Pathology R Medicine > RA Public aspects of medicine
Divisions:	Faculty of Science > Life Sciences (2010- ) > Biological Sciences ( -2010)
Library of Congress Subject Headings (LCSH):	Streptococcus pneumoniae, Communicable diseases -- Transmission, Respiratory infections, Epidemiology -- Research
Journal or Publication Title:	Epidemiology and Infection
Publisher:	Cambridge University Press
ISSN:	0950-2688
Date:	June 2004
Volume:	Vol.132
Number:	No.3
Page Range:	pp. 433-441
Identification Number:	10.1017/S0950268804001980
Status:	Peer Reviewed
Access rights to Published version:	Open Access
Funder:	European Union (EU)
Grant number:	QLG4-CT-2000- 00640 (EU)
References:	1. Fedson DS, Scott JA, Scott G. The burden of pneumococcal disease among adults in developed and developing countries : what is and is not known. Vaccine 1999; 17: S11–S18. 2. Robinson K, Baughman W, Rothrock G, et al. Epidemiology of invasive Streptococcus pneumoniae infections in the United States, 1995–1998. Opportunities for prevention in the conjugate vaccine era. JAMA 2001; 285: 1729–1735. 3. Miller E, Waight P, Efstratiou A, Brisson M, Johnson A, George R. Epidemiology of invasive and other pneumococcal disease in children in England and Wales 1996–1998. Acta Paediatr Suppl 2000; 435: 11–16. 4. Lloyd-Evans N, O’Dempsey TJ, Baldeh I, et al. Nasopharyngeal carriage of pneumococci in Gambian children and in their families. Pediatr Infect Dis J 1996; 15: 866–871. 5. Djuretic T, Ryan M, Miller E, Fairley CK, Goldblatt D. Hospital admission in children due to pneumococcal pneumonia in England. J Infect 1998; 37: 54–58. 6. Schaechter M, Engleberg N, Eisenstein BI, Medoff G. Mechanisms of microbial disease. 3rd edn. Baltimore: Lippincott Williams & Wilkins, 1998. 7. Black SB, Shinefield HR, Fireman B, et al. Efficacy, safety and immunogenicity of heptavalent pneumococcal conjugate vaccine in children. Pediatr Infect Dis J 2000; 19: 187–195. 8. Fireman B, Black SB, Shinefield HR, Lee J, Lewis E, Ray P. Impact of the pneumococcal conjugate vaccine on otitis media. Pediatr Infect Dis J 2003; 22: 10–16. 9. Black SB, Shinefield HR, Ling S, et al. Effectiveness of heptavalent pneumococcal conjugate vaccine in children younger than five years of age for prevention of pneumonia. Pediatr Infect Dis J 2002; 21: 810–815. 10. Eskola J, Kilpi T, Palmu A, et al. Efficacy of a pneumococcal conjugate vaccine against acute otitis media. N Engl J Med 2001; 344: 403–409. 11. Dagan R, Givon-Lavi N, Zamir O, et al. Reduction of nasopharyngeal carriage of Streptococcus pneumoniae after administration of a 9-valent pneumococcal conjugate vaccine to toddlers attending day care centers. J Infect Dis 2002; 185: 927–936. 12. Smith T, Lehmann D, Montgomery J, Gratten M, Riley ID, Alpers MP. Acquisition and invasiveness of different serotypes of Streptococcus pneumoniae in young children. Epidemiol Infect 1993; 111: 27–39. 13. Ekdahl K, Ahlinder I, Hansson HB, et al. Duration of nasopharyngeal carriage of penicillin-resistant Streptococcus Pneumoniae: experiences from the South Swedish Pneumococcal Intervention Project. Clin Inf Dis 1997; 25: 1113–1117. 14. Auranen K, Arjas E, Leino T, Takala AK. Transmission of pneumococcal carriage in families : a latent Markov Process Model for binary longitudinal data. J Am Stat Assoc 2000; 95: 1044–1053. 15. Hussain M, Clark M, Tew A, Williams L, Miller E. Upper respiratory tract carriage and transmission of pneumococci in families in UK and possible introduction of the new pneumococcal conjugate vaccine. Nursing Times, in press. 16. Auranen K, Ranta J, Takala AK, Arjas E. A statistical model of transmission of Hib bacteria in a family. Stat Med 1996; 15: 2235–2252. 17. Aitkin M. Profile likelihood. In: Armitage P, Colton T, eds. Encyclopedia of biostatistics. New York: John Wiley and Sons, 1998: 3534–3536. 18. Chin Long Chiang. An introduction to stochastic processes and their applications. New York: Robert E. Krieger, 1980. 19. Finkenstadt B, Bjornstad O, Grenfell B. A stochastic model for extinction and recurrence of epidemics: estimation and inference for measles outbreaks. Biostatistics 2002; 3: 493–510. 20. McCallum H, Barlow N, Hone J. How should pathogen transmission be modelled? Trends Ecol Evol 2001; 16: 295–300.
URI:	http://wrap.warwick.ac.uk/id/eprint/755