Integrating epidemiological and genetic data with different sampling intensities into a dynamic model of respiratory syncytial virus transmission

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Abstract Background Respiratory syncytial virus (RSV) is responsible for a significant burden of acute respiratory illness in children under 5 years old. Prior to rolling out any vaccination program, identification of the source of infant infections could further guide vaccination strategies. Methods We extended a dynamic model calibrated at the individual host level initially fit to social-temporal data on shedding patterns to include whole genome sequencing data available at a lower sampling intensity. Results In this study population of 493 individuals with 55 infants under the age of 1 year distributed across 47 households, we found that 52% of RSV-B and 60% of RSV-A cases arose from infection within the household. Forty-five percent of infant infections appeared to occur in the household, of which 68% were a result of transmission from a child aged between 2 and 13 years living in the same household as the infant. Conclusion These results further highlight the importance of pre-school and school-aged children in RSV transmission, particularly the role they play in directly infecting the household infant. These age groups are a potential RSV vaccination target group.

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