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Family members likely sources of RSV in infants
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Older siblings or parents appear to be the likely source of respiratory syncytial virus infections in infants, according to data published in Open Forum Infectious Diseases.
“Although young infants experience the most severe forms of RSV illness, RSV also affects a surprisingly large proportion of other family members,” Terho Heikkinen, MD, PhD, assistant professor of pediatrics at the University of Turku in Finland, told Infectious Disease News. “In three-fourths of the families we evaluated, at least one other family member was positive for RSV, and half of all family members had an RSV infection around the time of the infant’s hospitalization. In light of these findings, it’s understandable that in most cases, older siblings or parents were the likely source of the infant’s infection.”
Heikkinen and colleagues conducted a prospective study at the Turku University Hospital during the RSV season of 2005-2006. All family members of children hospitalized with lower respiratory tract infection and who had a positive rapid RSV test were enrolled. The study included 52 families that consisted of 199 family members, including 53 index children. Nasal swab samples were taken from all participants, which were tested for RSV. The families were asked to record any symptoms of respiratory tract infection, and take self-sample nasal swabs if symptoms developed.
Terho Heikkinen
In 40 families (77%), at least one other family member was positive for RSV. In 18 families, the index child was the primary case of RSV, whereas a parent or sibling was considered the primary case in 30 of the families. The primary case could not be determined in the other four families. Overall, RSV was detected in 60 of the 129 family members (47%) within 1 week of the index child’s hospitalization and 49 of these (82%) involved respiratory symptoms. Viral load analysis on 97 of the swabs indicated that the number of viral copies per swab was highest in index children and lowest among parents (P<.0001).
“It is well known that the production of an effective RSV vaccine that could be administered to young infants directly is very challenging,” Heikkinen said. “Our results indicate that young infants might be best protected from RSV illness by vaccination of their family members and other close contacts. In this context, RSV vaccination of pregnant women might be a particularly good approach because it would also provide protection to the newborn infant.” – by Emily Shafer
Terho Heikkinen, MD, PhD, can be reached at: terho.heikkinen@utu.fi.
Disclosure: Heikkinen reports no relevant financial disclosures.
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