Modelling seasonal variations in the age and incidence of Kawasaki disease to explore possible infectious aetiologies
Modelling seasonal variations in the age and incidence of Kawasaki disease to explore possible infectious aetiologies
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DOI：
10.1098/rspb.2011.2464
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发表时间：
2012-07-22
影响因子：
4.7
通讯作者：
Lipsitch, Marc
中科院分区：
文献类型：
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作者：
Pitzer, Virginia E.;Burgner, David;Lipsitch, Marc
在季节性流行期间，平均感染年龄预计会以流行病学特征（如传染性持续时间和人口混合性质）可预测的方式变化。然而，尚不清楚是否可以使用常规收集的数据来检测和验证这些变化。我们使用疫苗接种前麻疹和轮状病毒的数据检查了每周病例数和平均年龄之间的相关性。我们表明，年龄发病率模式可以观察和预测这些儿童感染。结合有关传动动力学重要特征的附加信息，可以改善模型预测与经验数据之间的对应关系。然后，我们探讨了年龄-发病率模式的知识是否可以揭示未知病因疾病的流行病学特征，如川崎病（KD）。我们的研究结果表明，KD不太可能由单一的急性免疫感染引发，但与持续时间较长的感染、非免疫感染或与急性病原体合并感染以及持续时间较长的感染一致。年龄发病率模式有助于深入了解感染的重要流行病学特征，为已知感染提供与传播相关的人口混合信息，并为复杂儿科疾病的病因提供线索。
The average age of infection is expected to vary during seasonal epidemics in a way that is predictable from the epidemiological features, such as the duration of infectiousness and the nature of population mixing. However, it is not known whether such changes can be detected and verified using routinely collected data. We examined the correlation between the weekly number and average age of cases using data on pre-vaccination measles and rotavirus. We show that age-incidence patterns can be observed and predicted for these childhood infections. Incorporating additional information about important features of the transmission dynamics improves the correspondence between model predictions and empirical data. We then explored whether knowledge of the age-incidence pattern can shed light on the epidemiological features of diseases of unknown aetiology, such as Kawasaki disease (KD). Our results indicate KD is unlikely to be triggered by a single acute immunizing infection, but is consistent with an infection of longer duration, a non-immunizing infection or co-infection with an acute agent and one with longer duration. Age-incidence patterns can lend insight into important epidemiological features of infections, providing information on transmission-relevant population mixing for known infections and clues about the aetiology of complex paediatric diseases.