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On the relative role of different age groups during epidemics associated with the respiratory syncytial virus

E. Goldstein, H. H. Nguyen, P. Liu, C. Viboud, C.A. Steiner, C. J. Worby, M. Lipsitch
doi: https://doi.org/10.1101/173351
E. Goldstein
1Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA 02115
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  • For correspondence: egoldste@hsph.harvard.edu
H. H. Nguyen
1Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA 02115
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P. Liu
2Department of Applied Mathematics, Harvard University, Cambridge, MA 02138
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C. Viboud
3Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, MD20892
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  • For correspondence: viboudc@mail.nih.gov
C.A. Steiner
4Agency for HealthCare Research and Quality, U.S. Department of Health & Human Services, Rockville, MD 20850 - Currently works at Institute for Health Research, Kaiser Permanente Colorado, Denver, CO 80231
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C. J. Worby
5Woodrow Wilson School of Public and International Affairs, Princeton University, Princeton, NJ 08544
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M. Lipsitch
1Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA 02115
6Department of Immunology and Infectious Diseases, Harvard TH Chan School of Public Health, Boston, MA 02115
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Abstract

Background While RSV circulation results in high burden of hospitalization, particularly among infants, young children and the elderly, little is known about the role of different age groups in propagating annual RSV epidemics in the community.

Methods During a communicable disease outbreak, some subpopulations may play a disproportionate role during the outbreak's ascent due to increased susceptibility and/or contact rates. Such subpopulations can be identified by considering the proportion that cases in a subpopulation represent among all cases in the population occurring before (Bp) and after the epidemic peak (Ap) to calculate the subpopulation's relative risk, RR=Bp/Ap. We estimated RR for several age groups using data on RSV hospitalizations in the US between 2001-2012 from the Healthcare Cost and Utilization Project (HCUP).

Results Children aged 3-4y and 5-6y each had the highest RR estimate for 5/11 seasons in the data, with RSV hospitalization rates in infants being generally higher during seasons when children aged 5-6y had the highest RR estimates. Children aged 2y had the highest RR estimate during one season. RR estimates in infants and individuals aged 11y and older were mostly lower than in children aged 1-10y.

Conclusions The RR estimates suggest that preschool and young school-age children have the leading relative roles during RSV epidemics. We hope that those results will aid in the design of RSV vaccination policies.

Copyright 
The copyright holder for this preprint is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-ND 4.0 International license.
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Posted August 11, 2017.
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On the relative role of different age groups during epidemics associated with the respiratory syncytial virus
E. Goldstein, H. H. Nguyen, P. Liu, C. Viboud, C.A. Steiner, C. J. Worby, M. Lipsitch
bioRxiv 173351; doi: https://doi.org/10.1101/173351
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On the relative role of different age groups during epidemics associated with the respiratory syncytial virus
E. Goldstein, H. H. Nguyen, P. Liu, C. Viboud, C.A. Steiner, C. J. Worby, M. Lipsitch
bioRxiv 173351; doi: https://doi.org/10.1101/173351

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