Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
Yale School of Medicine, New Haven, Connecticut.
J Infect Dis. 2018 Jan 4;217(2):238-244. doi: 10.1093/infdis/jix575.
While circulation of respiratory syncytial virus (RSV) results in high rates of hospitalization, particularly among young children and elderly individuals, little is known about the role of different age groups in propagating annual RSV epidemics.
We evaluate the roles played by individuals in different age groups during RSV epidemics in the United States between 2001 and 2012, using the previously defined relative risk (RR) statistic estimated from the hospitalization data from the Healthcare Cost and Utilization Project. Transmission modeling was used to examine the robustness of our inference method.
Children aged 3-4 years and 5-6 years each had the highest RR estimate for 5 of 11 seasons included in this study, with RSV hospitalization rates in infants being generally higher during seasons when children aged 5-6 years had the highest RR estimate. Children aged 2 years had the highest RR estimate during one season. RR estimates in infants and individuals aged ≥11 years were mostly lower than in children aged 1-10 years. Highest RR values aligned with groups for which vaccination had the largest impact on epidemic dynamics in most model simulations.
Our estimates suggest the prominent relative roles of children aged ≤10 years (particularly among those aged 3-6 years) in propagating RSV epidemics. These results, combined with further modeling work, should help inform RSV vaccination policies.
呼吸道合胞病毒（RSV）的传播会导致高住院率，尤其是在幼儿和老年人中，但对于不同年龄组在传播年度 RSV 流行中的作用知之甚少。
我们使用来自医疗保健成本和利用项目的住院数据计算先前定义的相对风险（RR）统计量，评估了 2001 年至 2012 年期间美国不同年龄组在 RSV 流行中的作用。我们使用传输建模来检验我们推断方法的稳健性。
在本研究纳入的 11 个季节中，年龄在 3-4 岁和 5-6 岁的儿童有 5 个季节的 RR 估计值最高，而在年龄在 5-6 岁的儿童 RR 估计值最高的季节，婴儿的 RSV 住院率通常较高。在一个季节，年龄在 2 岁的儿童的 RR 估计值最高。婴儿和年龄≥11 岁的个体的 RR 估计值大多低于年龄在 1-10 岁的儿童。RR 值最高的群体与疫苗对大多数模型模拟中流行动态影响最大的群体相对应。
我们的估计表明，≤10 岁的儿童（尤其是 3-6 岁的儿童）在传播 RSV 流行中起着重要的相对作用。这些结果，结合进一步的建模工作，应该有助于制定 RSV 疫苗接种政策。
