KEMRI- Wellcome Trust Research Programme, Kilifi, Kenya.
J Infect Dis. 2014 Jun 1;209(11):1685-92. doi: 10.1093/infdis/jit828. Epub 2013 Dec 23.
Respiratory syncytial virus (RSV) vaccine development for direct protection of young infants faces substantial obstacles. Assessing the potential of indirect protection using different strategies, such as targeting older children or mothers, requires knowledge of the source of infection to the infants.
We undertook a prospective study in rural Kenya. Households with a child born after the preceding RSV epidemic and ≥ 1 elder sibling were recruited. Nasopharyngeal swab samples were collected every 3-4 days irrespective of symptoms from all household members throughout the RSV season of 2009-2010 and tested for RSV using molecular techniques.
From 451 participants in 44 households a total of 15 396 nasopharyngeal swab samples were samples were collected, representing 86% of planned sampling. RSV was detected in 37 households (84%) and 173 participants (38%) and 28 study infants (64%). The infants acquired infection from within (15 infants; 54%) or outside (9 infants; 32%) the household; in 4 households the source of infant infection was inconclusive. Older children were index case patients for 11 (73%) of the within-household infant infections, and 10 of these 11 children were attending school.
We demonstrate that school-going siblings frequently introduce RSV into households, leading to infection in infants.
针对婴幼儿的呼吸道合胞病毒 (RSV) 疫苗的研发面临着巨大的障碍。通过不同策略（如针对年龄较大的儿童或母亲）评估间接保护的潜力，需要了解感染源到婴儿的途径。
我们在肯尼亚农村进行了一项前瞻性研究。招募了在前一次 RSV 流行后出生且有≥1个年龄较大的兄弟姐妹的家庭。在 2009-2010 年 RSV 季节期间，所有家庭成员无论有无症状，每 3-4 天采集一次鼻咽拭子样本，并使用分子技术检测 RSV。
在 44 个家庭的 451 名参与者中，共采集了 15396 份鼻咽拭子样本，占计划采样量的 86%。37 个家庭（84%）和 173 名参与者（38%）以及 28 名研究婴儿（64%）检测到 RSV。婴儿的感染源来自家庭内部（15 名婴儿；54%）或外部（9 名婴儿；32%）；4 个家庭的婴儿感染源无法确定。11 名（73%）家庭内部感染的婴儿的年龄较大的儿童是首发病例患者，其中 10 名儿童正在上学。
我们证明，上学的兄弟姐妹经常将 RSV 带入家庭，导致婴儿感染。
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