家庭中流感病例个体传染性中病毒排出、年龄和症状之间的相互作用

Interplay Between Viral Shedding, Age, and Symptoms in Individual Infectiousness of Influenza Cases in Households.

作者信息

Zhang Chengyao, Fang Vicky J, Chan Kwok-Hung, Leung Gabriel M, Ip Dennis K M, Peiris J S Malik, Cowling Benjamin J, Tsang Tim K

机构信息

WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region, China.

Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region, China.

出版信息

J Infect Dis. 2025 Feb 20;231(2):462-470. doi: 10.1093/infdis/jiae434.

DOI:10.1093/infdis/jiae434

PMID:39197019

Abstract

BACKGROUND

Understanding factors affecting the infectiousness of influenza cases is crucial for disease prevention and control. Viral shedding is expected to correlate with infectiousness of cases, but it is strongly associated with age and the presence of symptoms.

METHODS

To elucidate this complex interplay, we analyze with an individual-based household transmission model a detailed household transmission study of influenza with 442 households and 1710 individuals from 2008 to 2017 in Hong Kong, to characterize the household transmission dynamics and identify factors affecting transmissions.

RESULTS

We estimate that age, fever symptoms, and viral load were all associated with higher infectiousness. However, by model comparison, the best model included age and fever as factors affecting individual infectiousness, and estimates that preschool and school-aged children were 317% (95% credible interval [CrI], 103%, 1042%) and 161% (95% CrI, 33%, 601%) more infectious than adults, respectively, and patients having fever had 146% (95% CrI, 37%, 420%) higher infectiousness. Adding heterogeneity on individual infectiousness of cases does not improve the model fit, suggesting these factors could explain the difference in individual infectiousness.

CONCLUSIONS

Our study clarifies the contribution of age, symptoms, and viral shedding to individual infectiousness of influenza cases in households.

摘要

背景

了解影响流感病例传染性的因素对于疾病预防和控制至关重要。病毒 shedding 预计与病例的传染性相关，但它与年龄和症状的存在密切相关。

方法

为了阐明这种复杂的相互作用，我们使用基于个体的家庭传播模型分析了2008年至2017年在香港进行的一项针对442户家庭和1710名个体的流感家庭传播详细研究，以描述家庭传播动态并确定影响传播的因素。

结果

我们估计年龄、发热症状和病毒载量均与较高的传染性相关。然而，通过模型比较，最佳模型将年龄和发热作为影响个体传染性的因素，估计学龄前儿童和学龄儿童的传染性分别比成年人高317%（95%可信区间[CrI]，103%，1042%）和161%（95% CrI，33%，601%），发热患者的传染性高146%（95% CrI，37%，420%）。在病例的个体传染性上增加异质性并不能改善模型拟合，表明这些因素可以解释个体传染性的差异。