Risk factors and patterns of household clusters of respiratory viruses in rural Nepal

Scott, E. M.; Magaret, A.; Kuypers, J.; Tielsch, J. M.; Katz, J.; Khatry, S. K.; Stewart, L.; Shrestha, L.; LeClerq, S. C.; Englund, J. A.; Chu, H. Y.

Studies in rural Kenya have identified school-age children as the primary introducers of RSV into households where an infant subsequently became infected [6] . These results were in agreement with a US study from the 1960s reporting older siblings aged 2-16 years as most likely to introduce RSV disease into families [11] . In contrast, modelling suggests that young children <5 years are more likely to transmit RSV and are the most efficient population to vaccinate in order to prevent disease in other groups [12] . Few studies have analysed the transmission of other non-influenza respiratory viruses, such as human metapneumovirus (MPV) and human rhinovirus (HRV), and no studies have examined the household transmission dynamics of respiratory viruses in rural South Asia, a region characterised by high rates of preterm birth and infant mortality [8, [13] [14] [15] .