The Source of Respiratory Syncytial Virus Infection in Infants: a Household Cohort Study in Rural Kenya

Overview

Journal J Infect Dis

Publisher Oxford University Press

Specialty Infectious Diseases

Date 2013 Dec 25

PMID 24367040

Citations 79

Authors

Patrick K Munywoki

Dorothy C Koech

Charles N Agoti

Clement Lewa

Patricia A Cane

Graham F Medley

D J Nokes

Affiliations

Soon will be listed here.

Abstract

Background: Respiratory syncytial virus (RSV) vaccine development for direct protection of young infants faces substantial obstacles. Assessing the potential of indirect protection using different strategies, such as targeting older children or mothers, requires knowledge of the source of infection to the infants.

Methods: We undertook a prospective study in rural Kenya. Households with a child born after the preceding RSV epidemic and ≥ 1 elder sibling were recruited. Nasopharyngeal swab samples were collected every 3-4 days irrespective of symptoms from all household members throughout the RSV season of 2009-2010 and tested for RSV using molecular techniques.

Results: From 451 participants in 44 households a total of 15 396 nasopharyngeal swab samples were samples were collected, representing 86% of planned sampling. RSV was detected in 37 households (84%) and 173 participants (38%) and 28 study infants (64%). The infants acquired infection from within (15 infants; 54%) or outside (9 infants; 32%) the household; in 4 households the source of infant infection was inconclusive. Older children were index case patients for 11 (73%) of the within-household infant infections, and 10 of these 11 children were attending school.

Conclusion: We demonstrate that school-going siblings frequently introduce RSV into households, leading to infection in infants.

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