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Characterizing the risk of respiratory syncytial virus in infants with older siblings: a population-based birth

P Jacoby1, K Glass2, H C Moore1

  • 1Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, Australia.

Epidemiology and Infection
|November 9, 2016
PubMed

Insights

Older siblings significantly increase infant respiratory syncytial virus (RSV) risk, with 45% of infections linked to them. Vaccinating family members could protect newborns.

Area of Science:

  • Epidemiology
  • Pediatrics
  • Infectious Diseases

Background:

  • Respiratory syncytial virus (RSV) is a common cause of infant respiratory illness.
  • Understanding transmission routes is crucial for effective prevention strategies.
  • The role of household contacts, particularly siblings, in infant RSV infection requires further investigation.

Purpose of the Study:

  • To quantify the association between the number of older siblings and the risk of infant RSV detection.
  • To estimate the proportion of infant RSV detections attributable to older siblings.
  • To explore the impact of infant age during the peak RSV season on the sibling transmission effect.

Main Methods:

  • Utilized a population-based birth cohort from Western Australia (1996-2005).
  • Linked laboratory and birth record datasets for a subcohort of 87,981 infants (2000-2004).
  • Employed log binomial regression to analyze the relationship between sibling number and RSV detection risk.

Main Results:

  • Infant RSV detection risk increased significantly with the number of older siblings.
  • Infants with ⩾3 older siblings had nearly three times the risk (RR 2.83) compared to firstborns.
  • An estimated 45% of infant RSV detections were attributable to transmission from older siblings; this effect was more pronounced in younger infants during winter.

Conclusions:

  • Older siblings are a significant source of infant RSV infection, often with milder symptoms in the older child.
  • The findings support family-centered vaccination strategies to maximize protection for infants.
  • Targeting interventions within households can be effective in reducing the burden of infant RSV.

Keywords:
Epidemiologyhouseholdrespiratory syncytial virusvaccine policy development

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