Li Ke, Pitzer Virginia E, Weinberger Daniel M
Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.
medRxiv. 2024 Dec 26:2024.12.23.24319532. doi: 10.1101/2024.12.23.24319532.
Respiratory syncytial virus (RSV) infections are a significant public health concern for pediatric populations and older adults, with seasonal winter outbreaks in the United States (US). Little is known about the timing of RSV epidemics across age groups and the relative contribution of within-group and between-group transmission of RSV in each age group. The lack of understanding of age-specific RSV transmission patterns limits our ability to inform vaccination policies. In this study, we examine the timing and transmission patterns of RSV epidemics across different age groups in 12 US states from 2018 to 2024. We found that infants under 1 year and young children aged 1-4 years experienced the earliest epidemic timing, while the elderly group had the latest. Using a semi-mechanistic age-structured spatiotemporal model, we further showed that between-group transmission greatly contributes (>50%) to the burden of RSV hospitalizations for children under 1, school-age children aged 5-17, and adults aged 18-64. By contrast, incidence in the elderly group (above 65 years) was primarily driven by transmission within the age group. Our findings indicate that distinct age groups play unique roles in propagating RSV epidemics in the US, with age-specific transmission patterns that can guide more effective RSV vaccination policies.
呼吸道合胞病毒（RSV）感染是美国儿科人群和老年人的一个重大公共卫生问题，在美国冬季会出现季节性爆发。目前对于RSV在各年龄组间流行的时间以及每个年龄组内和组间RSV传播的相对贡献了解甚少。对特定年龄的RSV传播模式缺乏了解限制了我们制定疫苗接种政策的能力。在本研究中，我们调查了2018年至2024年美国12个州不同年龄组RSV流行的时间和传播模式。我们发现，1岁以下婴儿和1 - 4岁幼儿经历了最早的流行时间，而老年组的流行时间最晚。使用一个半机制年龄结构的时空模型，我们进一步表明，组间传播对1岁以下儿童、5 - 17岁学龄儿童和18 - 64岁成年人的RSV住院负担有很大贡献（>50%）。相比之下，老年组（65岁以上）的发病率主要由年龄组内的传播驱动。我们的研究结果表明，在美国，不同年龄组在传播RSV疫情中发挥着独特作用，其特定年龄的传播模式可为更有效的RSV疫苗接种政策提供指导。
