Respiratory Syncytial Virus Infections within Families

Abstract

To examine intrafamily spread of respiratory syncytial virus infections and their associated illnesses, 36 families with 188 members were studied during an outbreak of such infections. Nurses visited every three to four days to obtain specimens for viral isolation and interview household members. The virus infected 44.4 per cent of families, and 21.9 per cent of all members. All age groups had appreciable attack rates (with a range of 16.8 per cent in adults to 29.4 per cent in infants). In infected families, 45.9 per cent of members became infected, including 10 of 16 infants. Secondary attack rate for all ages was 27 per cent, and that for infants 45.4 per cent. An infant's older sibling appeared most likely to introduce the virus into the family. Associated acute respiratory illnesses occurred in 94.9 per cent of cases, and appeared more severe than those not associated with respiratory syncytial virus. When the virus was introduced into a family the high attack rate produced an illness of age-related severity.

Cytokine responses in primary and secondary respiratory syncytial virus infections

“…Those who were RSV positive were assumed to be experiencing a secondary RSV infection and were included in the study. This assumption is based on the fact that it is well recognized that almost all children will have had RSV at least once previously by their second birthday (25)(26)(27)(28).…”

“…The study design was based on the well-established observation that most infants are infected with RSV during their first Articles winter and that all have been infected by the end of their second winter, while re-infection with the virus is frequent throughout life, including during the preschool years (25)(26)(27)(28). Hence, infants admitted to hospital with a severe RSV infection will be experiencing a primary infection, while their symptomatic preschool siblings with an RSV infection would be experiencing a secondary infection.…”

The transmission dynamics of groups A and B human respiratory syncytial virus (hRSV) in England & Wales and Finland: seasonality and cross-protection

“…This variability is reflected antigenically, and hRSV can be divided into two groups (A and B) on the basis of reactions with panels of monoclonal antibodies [3,4]. Children usually experience their first infection before the age of 2 years, and reinfection is a common occurrence in older children and also in adults [5][6][7][8][9]. Disease resulting from infection occurs principally in young children, particularly following primary infection [5,10,11] but is also observed in vulnerable adults.…”

“…Epidemics have been recorded in community and family study settings, and the link between elder school siblings and primary infant cases is strong [6,16,17]. However, the exact role of reinfection in the maintenance of hRSV transmission in communities, and hence the relationship between (observed) epidemics of primary infections and (unobserved) seasonal epidemics of re-infection in the general population is not clear.…”

Respiratory syncytial virus infection following hematopoietic stem cell transplantation

“…[1][2][3][4][5] Re-infection in immunocompetent adults exposed to an RSV-positive child, manifesting primarily as an upper respiratory tract illness, can be as high as 47%. 6 Whereas mortality rates in previously healthy infants with RSV pneumonia and/or bronchiolitis are less than 0.5%, approximately 3 to 5% of …”