Model-based estimates of transmission of respiratory syncytial virus within households
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 individu...
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doaj-cb30c4adc9ec4daea3b7be42234b99a02020-11-25T00:27:51ZengElsevierEpidemics1755-43652019-06-0127111Model-based estimates of transmission of respiratory syncytial virus within householdsIvy K. Kombe0Patrick K. Munywoki1Marc Baguelin2D. James Nokes3Graham F. Medley4KEMRI-Wellcome Trust Research Programme, KEMRI Center for Geographical Medical Research-Coast, P.O. Box 230-80108, Kilifi, Kenya; Centre for Mathematical Modelling of Infectious Disease and Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, WC1H 9SH, UK; Corresponding author at: KEMRI-Wellcome Trust Research Programme, KEMRI Center for Geographical Medical Research-Coast, P.O. Box 230-80108, Kilifi, Kenya.KEMRI-Wellcome Trust Research Programme, KEMRI Center for Geographical Medical Research-Coast, P.O. Box 230-80108, Kilifi, KenyaCentre for Mathematical Modelling of Infectious Disease and Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, WC1H 9SH, UKKEMRI-Wellcome Trust Research Programme, KEMRI Center for Geographical Medical Research-Coast, P.O. Box 230-80108, Kilifi, Kenya; School of Life Sciences and Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, University of Warwick, Coventry, CV4 7AL, UKCentre for Mathematical Modelling of Infectious Disease and Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, WC1H 9SH, UKIntroduction: 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. Keywords: Respiratory syncytial virus, Household, Transmissionhttp://www.sciencedirect.com/science/article/pii/S1755436518300793 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ivy K. Kombe Patrick K. Munywoki Marc Baguelin D. James Nokes Graham F. Medley |
spellingShingle |
Ivy K. Kombe Patrick K. Munywoki Marc Baguelin D. James Nokes Graham F. Medley Model-based estimates of transmission of respiratory syncytial virus within households Epidemics |
author_facet |
Ivy K. Kombe Patrick K. Munywoki Marc Baguelin D. James Nokes Graham F. Medley |
author_sort |
Ivy K. Kombe |
title |
Model-based estimates of transmission of respiratory syncytial virus within households |
title_short |
Model-based estimates of transmission of respiratory syncytial virus within households |
title_full |
Model-based estimates of transmission of respiratory syncytial virus within households |
title_fullStr |
Model-based estimates of transmission of respiratory syncytial virus within households |
title_full_unstemmed |
Model-based estimates of transmission of respiratory syncytial virus within households |
title_sort |
model-based estimates of transmission of respiratory syncytial virus within households |
publisher |
Elsevier |
series |
Epidemics |
issn |
1755-4365 |
publishDate |
2019-06-01 |
description |
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. Keywords: Respiratory syncytial virus, Household, Transmission |
url |
http://www.sciencedirect.com/science/article/pii/S1755436518300793 |
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