@article{86f7edf43f884d2f94f8ff24bd5e9cac,
title = "On the Relative Role of Different Age Groups during Epidemics Associated with Respiratory Syncytial Virus",
abstract = "While circulation of respiratory syncytial virus (RSV) results in high rates of hospitalization, particularly among young children and elderly individuals, little is known about the role of different age groups in propagating annual RSV epidemics. Methods. We evaluate the roles played by individuals in different age groups during RSV epidemics in the United States between 2001 and 2012, using the previously defined relative risk (RR) statistic estimated from the hospitalization data from the Healthcare Cost and Utilization Project. Transmission modeling was used to examine the robustness of our inference method. Results. Children aged 3.4 years and 5.6 years each had the highest RR estimate for 5 of 11 seasons included in this study, with RSV hospitalization rates in infants being generally higher during seasons when children aged 5.6 years had the highest RR estimate. Children aged 2 years had the highest RR estimate during one season. RR estimates in infants and individuals aged .11 years were mostly lower than in children aged 1.10 years. Highest RR values aligned with groups for which vaccination had the largest impact on epidemic dynamics in most model simulations. Conclusions. Our estimates suggest the prominent relative roles of children aged .10 years (particularly among those aged 3.6 years) in propagating RSV epidemics. These results, combined with further modeling work, should help inform RSV vaccination policies.",
keywords = "RSV, age groups, epidemic drivers, relative risk, transmission modeling",
author = "Edward Goldstein and Nguyen, {Hieu H.} and Patrick Liu and Cecile Viboud and Steiner, {Claudia A.} and Worby, {Colin J.} and Marc Lipsitch",
note = "Funding Information: 1Center for Communicable Disease Dynamics, Department of Epidemiology, and 2Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts; 3Yale School of Medicine, New Haven, Connecticut; 4Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, and 5Agency for HealthCare Research and Quality, Department of Health and Human Services, Rockville, Maryland; 6Institute for Health Research, Kaiser Permanente Colorado, Denver; and 7Department of Ecology and Evolutionary Biology, Princeton University, New Jersey. Funding Information: Potential conflict of interest. M. L. reports receiving grants from the National Institute of General Medical Sciences, National Institutes of Health, during the conduct of the study; and personal fees from Affinivax, personal fees from Merck, grants and personal fees from Pfizer, grants from PATH Vaccine Solutions, outside the submitted work. All other authors report no potential conflicts. Funding Information: Financial support. This work was supported by the National Institute of General Medical Sciences (award U54GM088558), support for M. L., E. G., and H. H. N.), the Bill and Melinda Gates Foundation (support for C. J. W.), and the Multinational Influenza Seasonal Mortality Study, led by the Division of International Epidemiology and Population Studies, the Fogarty International Center, and the National Institutes of Health (support for C. V.). Publisher Copyright: {\textcopyright} 2018 The Author(s).",
year = "2018",
month = jan,
day = "15",
doi = "10.1093/infdis/jix575",
language = "English (US)",
volume = "217",
pages = "238--244",
journal = "Journal of Infectious Diseases",
issn = "0022-1899",
publisher = "Oxford University Press",
number = "2",
}