KEMRI-Wellcome Trust Research Programme, KEMRI Centre for Geographical Medical Research-Coast, P.O. Box 230-80108, Kilifi, Kenya.
Centre for Mathematical Modelling of Infectious Disease and Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, WC1H 9SH, UK.
Sci Rep. 2021 Jan 14;11(1):1463. doi: 10.1038/s41598-021-81078-x.
Respiratory syncytial virus (RSV) is responsible for a significant burden of severe acute lower respiratory tract illness in children under 5 years old; particularly infants. Prior to rolling out any vaccination program, identification of the source of infant infections could further guide vaccination strategies. We extended a dynamic model calibrated at the individual host level initially fit to social-temporal data on shedding patterns to include whole genome sequencing data available at a lower sampling intensity. The study population was 493 individuals (55 aged < 1 year) distributed across 47 households, observed through one RSV season in coastal Kenya. We found that 58/97 (60%) of RSV-A and 65/125 (52%) of RSV-B cases arose from infection probably occurring within the household. Nineteen (45%) infant infections appeared to be the result of infection by other household members, of which 13 (68%) were a result of transmission from a household co-occupant aged between 2 and 13 years. The applicability of genomic data in studies of transmission dynamics is highly context specific; influenced by the question, data collection protocols and pathogen under investigation. The results further highlight the importance of pre-school and school-aged children in RSV transmission, particularly the role they play in directly infecting the household infant. These age groups are a potential RSV vaccination target group.
呼吸道合胞病毒（RSV）是导致 5 岁以下儿童严重急性下呼吸道疾病的主要病原体，尤其是婴儿。在推出任何疫苗接种计划之前，确定婴儿感染的源头可以进一步指导疫苗接种策略。我们扩展了一个在个体宿主水平上进行校准的动态模型，最初适用于有关脱落模式的社会时间数据，并将其纳入了在较低采样强度下获得的全基因组测序数据。该研究人群为 493 名个体（55 名年龄<1 岁），分布在 47 个家庭中，在肯尼亚沿海地区观察了一个 RSV 季节。我们发现，97 例 RSV-A 中的 58 例（60%）和 125 例 RSV-B 中的 65 例（52%）可能是在家庭内感染的。19 例（45%）婴儿感染似乎是由其他家庭成员感染引起的，其中 13 例（68%）是由 2 至 13 岁的家庭同住者传播引起的。基因组数据在传播动力学研究中的适用性具有高度的特定背景，受到问题、数据收集协议和研究病原体的影响。研究结果进一步强调了学龄前和学龄儿童在 RSV 传播中的重要性，尤其是他们在直接感染家庭婴儿方面的作用。这些年龄组是 RSV 疫苗接种的潜在目标人群。
