目的:儿童通常被认为是呼吸道病毒传播的主要驱动因素,但是SARS-CoV-2的出现挑战了这种模式。人类鼻病毒(RV)在整个大流行期间继续共同传播,允许在SARS-CoV-2人群免疫力较低的时期,直接比较这些病毒在家庭中的年龄特异性传染性和易感性。
方法:在2020年8月至2021年7月期间,对有孩子的家庭进行了≥23周的前瞻性监测。在家庭中出现呼吸道症状时,开始了爆发研究,包括对所有家庭成员进行问卷调查和重复的鼻腔自我抽样。通过PCR测试拭子。比较了SARS-CoV-2和RV之间按年龄分层的家庭内二次发作率(SARs)。
结果:307个家庭参与,包括582名儿童和627名成人。SARS-CoV-2的总体SAR低于RV(aOR0.55),并且两种病毒之间的年龄分布不同(p<0.001)。家庭暴露后,与RV相比,儿童感染SARS-CoV-2的可能性显着降低(aOR0.16),而这在成人中相反(aOR1.71)。
结论:在家庭中,对SARS-CoV-2和RV的年龄特异性易感性不同,并导致这些病原体之间在家庭传播方面的差异。这突出了表征特定年龄传播风险的重要性,特别是对于新出现的感染,指导适当的感染控制干预措施。
OBJECTIVE: Children are generally considered main drivers of transmission for respiratory viruses, but the emergence of SARS-CoV-2 challenged this paradigm. Human rhinovirus (RV) continued to co-circulate throughout the pandemic, allowing for direct comparison of age-specific infectivity and susceptibility within households between these viruses during a time of low SARS-CoV-2 population immunity.
METHODS: Households with children were prospectively monitored for ≥23 weeks between August 2020 and July 2021. Upon onset of respiratory symptoms in a household, an outbreak study was initiated, including questionnaires and repeated nasal self-sampling in all household members. Swabs were tested by PCR. Age-stratified within-household secondary attack rates (SARs) were compared between SARS-CoV-2 and RV.
RESULTS: A total of 307 households participated, including 582 children and 627 adults. Overall, SAR was lower for SARS-CoV-2 than for RV (aOR 0.55) and age distributions differed between both viruses (p < 0.001). Following household exposure, children were significantly less likely to become infected with SARS-CoV-2 compared to RV (aOR 0.16), whereas this was opposite in adults (aOR 1.71).
CONCLUSIONS: In households, age-specific susceptibility to SARS-CoV-2 and RV differs and drives differences in household transmission between these pathogens. This highlights the importance of characterizing age-specific transmission risks, particularly for emerging infections, to guide appropriate infection control interventions.