Transmission of Respiratory Syncytial Virus Among Children Under 5 Years in Households of Rural Communities, the Philippines

Hirono Otomaru, Taro Kamigaki, Raita Tamaki, Michiko Okamoto, Portia Parian Alday, Alvin Gue Tan, Joanna Ina Manalo, Edelwisa Segubre-Mercado, Marianette Tawat Inobaya, Veronica Tallo, Socorro Lupisan, Hitoshi Oshitani, Hirono Otomaru, Taro Kamigaki, Raita Tamaki, Michiko Okamoto, Portia Parian Alday, Alvin Gue Tan, Joanna Ina Manalo, Edelwisa Segubre-Mercado, Marianette Tawat Inobaya, Veronica Tallo, Socorro Lupisan, Hitoshi Oshitani

Abstract

Background: To develop a more effective vaccination strategy for reducing the impact of respiratory syncytial virus (RSV) infection, especially in young infants (<6 months old), it is necessary to understand the transmission dynamics of RSV.

Methods: We conducted a community-based prospective cohort study from 2014 to 2016 in Biliran Province, the Philippines, on children <5 years old. We collected nasopharyngeal swabs from symptomatic children with acute respiratory infection (ARI) during household visits and at health facilities. In households (n = 181) with RSV-positive ARI cases (RSV-ARI), we also identified ARI episodes among other children <5 years old in the same household. In addition, we determined the serial interval to estimate the basic reproduction number (R 0), the average number of secondary cases generated by a single primary case.

Results: In the 181 households analyzed, we found 212 RSV-ARI in 152 households with a single case and 29 households with multiple cases, which included 29 1st RSV-ARI and 31 2nd RSV-ARI. We also found possible index cases among children <5 years old in the same household for 29.0% (18 of 62) of young infants with RSV-ARI. The estimated mean serial interval was 3.2 days, and R 0 was estimated to be 0.92-1.33 for RSV-A and 1.04-1.76 for RSV-B, which varied between different times (2014 and 2015) and places.

Conclusions: Young infants are likely to acquire RSV infection from older children in the same household. Therefore, vaccination targeting older children might protect infants from RSV infection.

Keywords: basic reproduction number; household transmission; respiratory syncytial virus; serial interval; transmission dynamics.

Figures

Figure 1.
Figure 1.
Flow chart of the household analysis. ARI, acute respiratory infection; RSV, respiratory syncytial virus; RSV-HH1, households with 1 RSV-ARI patient; RSV-HH2, households with two or more RSV-ARI patient.

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Source: PubMed

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