Estimation of introduction and transmission rates of SARS-CoV-2 in a prospective household study.
Estimation of introduction and transmission rates of SARS-CoV-2 in a prospective household study.
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前瞻性家庭研究中 SARS-CoV-2 引入和传播率的估计。
DOI：
10.1101/2023.06.02.23290879
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发表时间：
2023
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作者：
vanBoven,Michiel;vanDorp,ChristiaanH;Westerhof,Ilse;Jaddoe,Vincent;Heuvelman,Valerie;Duijts,Liesbeth;Fourie,Elandri;Sluiter-Post,Judith;vanHouten,MarliesA;Badoux,Paul;Euser,Sjoerd;Herpers,Bjorn;Eggink,Dirk;deHoog,Marieke;
家庭研究为研究传染病的传播提供了一种有效的手段，能够按人种估计易感性和传染性。这类研究的一个主要纳入标准通常是感染者的存在。这就排除了对病原体进入家庭的危险的估计。在这里，我们使用荷兰一项基于家庭的前瞻性研究的数据，估计了与年龄和时间相关的家庭引入风险以及家庭内的传播率。从2020年8月到2021年3月，共有307户家庭，1209人。在2020年8月至2021年8月期间对家庭进行了后续行动，每个家庭的最长后续行动大多限于161天。几乎每5户家庭中就有1户(59/307)有SARS-CoV-2传入的证据。我们分别用惩罚样条法和随机流行病模型估计了研究种群的传入风险和家庭内传播率。儿童(0-12岁)家庭感染SARS-CoV-2的估计危险性低于成人(相对危险性：0.62；95%CRI：0.34-1.0)。估计的引入危险在2020年10月中旬、2020年12月中旬和2021年4月中旬达到峰值，比住院高峰提前1-2周。最适合的传播模型包括儿童相对于成人和青少年的传染性增加，因此估计的儿童向儿童传播的概率(0.62；95%CRI：0.40-0.81)显著高于成人向成人传播的概率(0.12；95%CRI：0.057-0.19)。情景分析表明，成人接种疫苗可以大大降低家庭感染发病率，而增加青少年接种疫苗带来的额外好处有限。
Household studies provide an efficient means to study transmission of infectious diseases, enabling estimation of susceptibility and infectivity by person-type. A main inclusion criterion in such studies is usually the presence of an infected person. This precludes estimation of the hazards of pathogen introduction into the household. Here we estimate age- and time-dependent household introduction hazards together with within household transmission rates using data from a prospective household-based study in the Netherlands. A total of 307 households containing 1,209 persons were included from August 2020 until March 2021. Follow-up of households took place between August 2020 and August 2021 with maximal follow-up per household mostly limited to 161 days. Almost 1 out of 5 households (59/307) had evidence of an introduction of SARS-CoV-2. We estimate introduction hazards and within-household transmission rates in our study population with penalized splines and stochastic epidemic models, respectively. The estimated hazard of introduction of SARS-CoV-2 in the households was lower for children (0-12 years) than for adults (relative hazard: 0.62; 95%CrI: 0.34-1.0). Estimated introduction hazards peaked in mid October 2020, mid December 2020, and mid April 2021, preceding peaks in hospital admissions by 1-2 weeks. Best fitting transmission models included increased infectivity of children relative to adults and adolescents, such that the estimated child-to-child transmission probability (0.62; 95%CrI: 0.40-0.81) was considerably higher than the adult-to-adult transmission probability (0.12; 95%CrI: 0.057-0.19). Scenario analyses indicate that vaccination of adults can strongly reduce household infection attack rates and that adding adolescent vaccination offers limited added benefit.