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School-age children spread RSV to household members
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In rural Kenya, children who attend school are the primary sources of respiratory syncytial virus infection to other household members, including infants who are most vulnerable to severe disease, according to recent study findings published in The Journal of Infectious Diseases.
Patrick K. Munywoki, BSc, MSc, PhD, of KEMRI–Wellcome Trust Research Program in Kenya, and colleagues evaluated 451 participants from 44 households to determine the frequency of RSV infection.
Enrollment criteria included a household with a child born after April 1, 2009, following the end of the 2008-2009 RSV epidemic, and one or more sibling younger than 13 years.
Thirty-seven households and 173 participants had at least one episode of RSV infection. Overall, of 32 outbreaks, the study infant was infected in 87.5%. Of the 278 study infants infected, 21 had one episode, five had two infections and two infants had three infections.
Among households with RSV spread among members, there were higher numbers of older children compared with households without RSV infection (P=.08).
Fifty percent of the infants with RSV acquired the infection from within the household compared with 32% outside of the household. In 73% of the household infections, older children were the primary cases, and 10 of the 11 attended school.
“In conclusion, we demonstrate that in this rural Kenyan location, for a high proportion of infant RSV infections, the source is from within the household and predominantly introduced by an elder school-going sibling,” the researchers wrote. “Thus there is a potential for targeted immunization of older siblings of naive infants, or universal vaccination of older infants and children, to reduce the spread of RSV and the risk of infection entering households and to delay first infection in infants to an older age where associated disease is less of a risk.”
Disclosure: The study was funded in part by the Wellcome Trust.
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