van Gaalen Rolina D, van de Kassteele Jan, Hahné Susan J M, Bruijning-Verhagen Patricia, Wallinga Jacco
From the aCenter for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands; bJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands; and cDepartment of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands.
Epidemiology. 2017 Jul;28(4):503-513. doi: 10.1097/EDE.0000000000000654.
Rotavirus is a common viral infection among young children. As in many countries, the infection dynamics of rotavirus in the Netherlands are characterized by an annual winter peak, which was notably low in 2014. Previous study suggested an association between weather factors and both rotavirus transmission and incidence. From epidemic theory, we know that the proportion of susceptible individuals can affect disease transmission. We investigated how these factors are associated with rotavirus transmission in the Netherlands, and their impact on rotavirus transmission in 2014. We used available data on birth rates and rotavirus laboratory reports to estimate rotavirus transmission and the proportion of individuals susceptible to primary infection. Weather data were directly available from a central meteorological station. We developed an approach for detecting determinants of seasonal rotavirus transmission by assessing nonlinear, delayed associations between each factor and rotavirus transmission. We explored relationships by applying a distributed lag nonlinear regression model with seasonal terms. We corrected for residual serial correlation using autoregressive moving average errors. We inferred the relationship between different factors and the effective reproduction number from the most parsimonious model with low residual autocorrelation. Higher proportions of susceptible individuals and lower temperatures were associated with increases in rotavirus transmission. For 2014, our findings suggest that relatively mild temperatures combined with the low proportion of susceptible individuals contributed to lower rotavirus transmission in the Netherlands. However, our model, which overestimated the magnitude of the peak, suggested that other factors were likely instrumental in reducing the incidence that year.
轮状病毒是幼儿中常见的病毒感染。与许多国家一样，荷兰轮状病毒的感染动态特征是每年冬季出现高峰，2014年该高峰显著较低。先前的研究表明天气因素与轮状病毒传播及发病率之间存在关联。从流行理论可知，易感个体的比例会影响疾病传播。我们调查了这些因素如何与荷兰的轮状病毒传播相关联，以及它们在2014年对轮状病毒传播的影响。我们利用出生率和轮状病毒实验室报告的现有数据来估计轮状病毒传播情况以及对初次感染易感个体的比例。天气数据可直接从一个中央气象站获取。我们开发了一种方法，通过评估每个因素与轮状病毒传播之间的非线性、延迟关联来检测季节性轮状病毒传播的决定因素。我们通过应用带有季节项的分布滞后非线性回归模型来探索关系。我们使用自回归移动平均误差对残差序列相关性进行校正。我们从具有低残差自相关性的最简约模型中推断不同因素与有效繁殖数之间的关系。易感个体比例较高和温度较低与轮状病毒传播增加有关。对于2014年，我们的研究结果表明，相对温和的温度与易感个体比例较低共同导致了荷兰轮状病毒传播较低。然而，我们高估了高峰幅度的模型表明，其他因素可能对当年发病率的降低起到了作用。
