Influence of age, severity of infection, and co-infection on the duration of respiratory syncytial virus (RSV) shedding

Abstract

SUMMARYRSV is the most important viral cause of pneumonia and bronchiolitis in children worldwide and has been associated with significant disease burden. With the renewed interest in RSV vaccines, we provide realistic estimates on duration, and influencing factors on RSV shedding which are required to better understand the impact of vaccination on the virus transmission dynamics. The data arise from a prospective study of 47 households (493 individuals) in rural Kenya, followed through a 6-month period of an RSV seasonal outbreak. Deep nasopharyngeal swabs were collected twice each week from all household members, irrespective of symptoms, and tested for RSV by multiplex PCR. The RSV G gene was sequenced. A total of 205 RSV infection episodes were detected in 179 individuals from 40 different households. The infection data were interval censored and assuming a random event time between observations, the average duration of virus shedding was 11·2 (95% confidence interval 10·1–12·3) days. The shedding durations were longer than previous estimates (3·9–7·4 days) based on immunofluorescence antigen detection or viral culture, and were shown to be strongly associated with age, severity of infection, and revealed potential interaction with other respiratory viruses. These findings are key to our understanding of the spread of this important virus and are relevant in the design of control programmes.

Association between multiple respiratory viral infections and pediatric intensive care unit admission among infants with bronchiolitis

“…Real-time multiplex PCR that detects the presence of nucleic acid from several viruses or bacteria from nasopharyngeal secretion in a single test allows for timely recognition of pathogens with high sensitivity and specificity [20]. While the rapid recognition of pathogens may help clinicians make decisions, one must be aware that the presence of viral nucleic acid based on PCR does not mean active viral infection, as it could result from subclinical viral infection or prior viral infection since the viral nucleic acid remnant may last up to 4 weeks after infection [21,22]. Therefore, the results of multiplex PCR must be interpreted together with the patients' clinical presentation.…”

Effects of weather-related social distancing on city-scale transmission of respiratory viruses

“…Values for σ -1 and γ -1 were estimated from the existing literature for the nine viruses (Table 1). [15][16][17][18][19][20][21][22][23][24][25][26][27][28] Estimates for β , β ' , p , and the proportion of the population infected at the start of the season were obtained via maximum likelihood estimation assuming daily observations were a Poisson sample from the underlying prevalence. We calculated confidence intervals by randomly drawing 200 parameter sets from the posterior distribution and generating 100 realizations (with the Poisson noise) of each, removing trajectories below the 2.5 percentile and above the 97.5 percentile.…”

Respiratory Syncytial Virus Infection

“…Nucleic acid detection tests using reverse transcriptase-polymerase chair reaction (RT-PCR) are considered the gold standard while rapid antigen tests having a sensitivity of ~70% compared to RT-PCR. (22) Viral titers are highest on admission, peak at day three of illness with shedding typically lasting 11 days (23–25)…”