在一项前瞻性家庭研究中估计 SARS-CoV-2 的引入和传播率。

Estimation of introduction and transmission rates of SARS-CoV-2 in a prospective household study.

机构信息

Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.

Center for Complex Systems Studies (CCSS), Utrecht University, Utrecht, The Netherlands.

出版信息

PLoS Comput Biol. 2024 Jan 29;20(1):e1011832. doi: 10.1371/journal.pcbi.1011832. eCollection 2024 Jan.

Abstract

Household studies provide an efficient means to study transmission of infectious diseases, enabling estimation of susceptibility and infectivity by person-type. A main inclusion criterion in such studies is usually the presence of an infected person. This precludes estimation of the hazards of pathogen introduction into the household. Here we estimate age- and time-dependent household introduction hazards together with within household transmission rates using data from a prospective household-based study in the Netherlands. A total of 307 households containing 1,209 persons were included from August 2020 until March 2021. Follow-up of households took place between August 2020 and August 2021 with maximal follow-up per household mostly limited to 161 days. Almost 1 out of 5 households (59/307) had evidence of an introduction of SARS-CoV-2. We estimate introduction hazards and within-household transmission rates in our study population with penalized splines and stochastic epidemic models, respectively. The estimated hazard of introduction of SARS-CoV-2 in the households was lower for children (0-12 years) than for adults (relative hazard: 0.62; 95%CrI: 0.34-1.0). Estimated introduction hazards peaked in mid October 2020, mid December 2020, and mid April 2021, preceding peaks in hospital admissions by 1-2 weeks. Best fitting transmission models included increased infectivity of children relative to adults and adolescents, such that the estimated child-to-child transmission probability (0.62; 95%CrI: 0.40-0.81) was considerably higher than the adult-to-adult transmission probability (0.12; 95%CrI: 0.057-0.19). Scenario analyses indicate that vaccination of adults can strongly reduce household infection attack rates and that adding adolescent vaccination offers limited added benefit.

摘要

家庭研究提供了一种有效的方法来研究传染病的传播,可以通过人员类型估计易感性和传染性。此类研究的主要纳入标准通常是存在感染者。这排除了估计病原体引入家庭的危害。在这里,我们使用荷兰一项前瞻性家庭为基础的研究的数据,估计年龄和时间依赖性家庭引入危害以及家庭内传播率。从 2020 年 8 月至 2021 年 3 月,共纳入 307 户家庭,共 1209 人。从 2020 年 8 月至 2021 年 8 月对家庭进行随访,每个家庭的最大随访时间大多限制在 161 天内。近 1/5 的家庭(59/307)有 SARS-CoV-2 引入的证据。我们分别使用惩罚样条和随机流行模型来估计我们研究人群中的引入危害和家庭内传播率。家庭中 SARS-CoV-2 的引入危害对于儿童(0-12 岁)低于成人(相对危害:0.62;95%CrI:0.34-1.0)。估计的 SARS-CoV-2 引入危害在 2020 年 10 月中旬、2020 年 12 月中旬和 2021 年 4 月中旬达到高峰,比医院入院高峰提前 1-2 周。拟合最好的传播模型包括儿童相对于成人和青少年的传染性增加,因此估计的儿童到儿童的传播概率(0.62;95%CrI:0.40-0.81)远高于成人到成人的传播概率(0.12;95%CrI:0.057-0.19)。情景分析表明,成人接种疫苗可以大大降低家庭感染发病率,而增加青少年接种疫苗则带来有限的额外益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a25/10852262/e777be73884f/pcbi.1011832.g001.jpg

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