Determinants of influenza transmission in South East Asia: insights from a household cohort study in Vietnam.

To guide control policies, it is important that the determinants of influenza transmission are fully characterized. Such assessment is complex because the risk of influenza infection is multifaceted and depends both on immunity acquired naturally or via vaccination and on the individual level of exp...

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Autores principales:	Simon Cauchemez, Neil M Ferguson, Annette Fox, Le Quynh Mai, Le Thi Thanh, Pham Quang Thai, Dang Dinh Thoang, Tran Nhu Duong, Le Nguyen Minh Hoa, Nguyen Tran Hien, Peter Horby
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Immunologic diseases. Allergy RC581-607 Biology (General) QH301-705.5
Acceso en línea:	https://doaj.org/article/89e8f9e9e13440c99f7d263067b9316a
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spelling	oai:doaj.org-article:89e8f9e9e13440c99f7d263067b9316a2021-11-25T05:46:08ZDeterminants of influenza transmission in South East Asia: insights from a household cohort study in Vietnam.1553-73661553-737410.1371/journal.ppat.1004310https://doaj.org/article/89e8f9e9e13440c99f7d263067b9316a2014-08-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/25144780/?tool=EBIhttps://doaj.org/toc/1553-7366https://doaj.org/toc/1553-7374To guide control policies, it is important that the determinants of influenza transmission are fully characterized. Such assessment is complex because the risk of influenza infection is multifaceted and depends both on immunity acquired naturally or via vaccination and on the individual level of exposure to influenza in the community or in the household. Here, we analyse a large household cohort study conducted in 2007-2010 in Vietnam using innovative statistical methods to ascertain in an integrative framework the relative contribution of variables that influence the transmission of seasonal (H1N1, H3N2, B) and pandemic H1N1pdm09 influenza. Influenza infection was diagnosed by haemagglutination-inhibition (HI) antibody assay of paired serum samples. We used a Bayesian data augmentation Markov chain Monte Carlo strategy based on digraphs to reconstruct unobserved chains of transmission in households and estimate transmission parameters. The probability of transmission from an infected individual to another household member was 8% (95% CI, 6%, 10%) on average, and varied with pre-season titers, age and household size. Within households of size 3, the probability of transmission from an infected member to a child with low pre-season HI antibody titers was 27% (95% CI 21%-35%). High pre-season HI titers were protective against infection, with a reduction in the hazard of infection of 59% (95% CI, 44%-71%) and 87% (95% CI, 70%-96%) for intermediate (1∶20-1∶40) and high (≥1∶80) HI titers, respectively. Even after correcting for pre-season HI titers, adults had half the infection risk of children. Twenty six percent (95% CI: 21%, 30%) of infections may be attributed to household transmission. Our results highlight the importance of integrated analysis by influenza sub-type, age and pre-season HI titers in order to infer influenza transmission risks in and outside of the household.Simon CauchemezNeil M FergusonAnnette FoxLe Quynh MaiLe Thi ThanhPham Quang ThaiDang Dinh ThoangTran Nhu DuongLe Nguyen Minh HoaNguyen Tran HienPeter HorbyPublic Library of Science (PLoS)articleImmunologic diseases. AllergyRC581-607Biology (General)QH301-705.5ENPLoS Pathogens, Vol 10, Iss 8, p e1004310 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Immunologic diseases. Allergy RC581-607 Biology (General) QH301-705.5
spellingShingle	Immunologic diseases. Allergy RC581-607 Biology (General) QH301-705.5 Simon Cauchemez Neil M Ferguson Annette Fox Le Quynh Mai Le Thi Thanh Pham Quang Thai Dang Dinh Thoang Tran Nhu Duong Le Nguyen Minh Hoa Nguyen Tran Hien Peter Horby Determinants of influenza transmission in South East Asia: insights from a household cohort study in Vietnam.
description	To guide control policies, it is important that the determinants of influenza transmission are fully characterized. Such assessment is complex because the risk of influenza infection is multifaceted and depends both on immunity acquired naturally or via vaccination and on the individual level of exposure to influenza in the community or in the household. Here, we analyse a large household cohort study conducted in 2007-2010 in Vietnam using innovative statistical methods to ascertain in an integrative framework the relative contribution of variables that influence the transmission of seasonal (H1N1, H3N2, B) and pandemic H1N1pdm09 influenza. Influenza infection was diagnosed by haemagglutination-inhibition (HI) antibody assay of paired serum samples. We used a Bayesian data augmentation Markov chain Monte Carlo strategy based on digraphs to reconstruct unobserved chains of transmission in households and estimate transmission parameters. The probability of transmission from an infected individual to another household member was 8% (95% CI, 6%, 10%) on average, and varied with pre-season titers, age and household size. Within households of size 3, the probability of transmission from an infected member to a child with low pre-season HI antibody titers was 27% (95% CI 21%-35%). High pre-season HI titers were protective against infection, with a reduction in the hazard of infection of 59% (95% CI, 44%-71%) and 87% (95% CI, 70%-96%) for intermediate (1∶20-1∶40) and high (≥1∶80) HI titers, respectively. Even after correcting for pre-season HI titers, adults had half the infection risk of children. Twenty six percent (95% CI: 21%, 30%) of infections may be attributed to household transmission. Our results highlight the importance of integrated analysis by influenza sub-type, age and pre-season HI titers in order to infer influenza transmission risks in and outside of the household.
format	article
author	Simon Cauchemez Neil M Ferguson Annette Fox Le Quynh Mai Le Thi Thanh Pham Quang Thai Dang Dinh Thoang Tran Nhu Duong Le Nguyen Minh Hoa Nguyen Tran Hien Peter Horby
author_facet	Simon Cauchemez Neil M Ferguson Annette Fox Le Quynh Mai Le Thi Thanh Pham Quang Thai Dang Dinh Thoang Tran Nhu Duong Le Nguyen Minh Hoa Nguyen Tran Hien Peter Horby
author_sort	Simon Cauchemez
title	Determinants of influenza transmission in South East Asia: insights from a household cohort study in Vietnam.
title_short	Determinants of influenza transmission in South East Asia: insights from a household cohort study in Vietnam.
title_full	Determinants of influenza transmission in South East Asia: insights from a household cohort study in Vietnam.
title_fullStr	Determinants of influenza transmission in South East Asia: insights from a household cohort study in Vietnam.
title_full_unstemmed	Determinants of influenza transmission in South East Asia: insights from a household cohort study in Vietnam.
title_sort	determinants of influenza transmission in south east asia: insights from a household cohort study in vietnam.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/89e8f9e9e13440c99f7d263067b9316a
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Determinants of influenza transmission in South East Asia: insights from a household cohort study in Vietnam.

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