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Timing of First Respiratory Virus Detections in Infants: A Community-Based Birth Cohort Study
Mohinder Sarna1,2, Robert S Ware2,3, Stephen B Lambert2
1School of Public Health, University of Queensland, Brisbane.
Insights
Infants experience first human rhinovirus (HRV) detection episodes early, around 2.9 months. Other respiratory virus detections occur later, highlighting the need for timely infant interventions and vaccination strategies.
Area of Science:
- Pediatrics
- Infectious Diseases
- Virology
Background:
- Understanding the timing of first virus detection episodes (fVDEs) in infants is crucial for identifying high-risk periods.
- This knowledge informs the development of targeted preventive strategies, including vaccination schedules.
Purpose of the Study:
- To describe the age and characteristics of fVDEs in a cohort of infants.
- To explore factors associated with symptomatic fVDEs in early childhood.
Main Methods:
- The study utilized the Observational Research in Childhood Infectious Diseases (ORChID) cohort.
- Infant symptoms were recorded daily, and nasal swabs were collected weekly for polymerase chain reaction testing of 17 respiratory viruses.
Main Results:
- The median age for fVDEs was 2.9 months for human rhinovirus (HRV), significantly earlier than other viruses (≥13.9 months).
- Symptomatic episodes occurred in 52% of HRV fVDEs versus 57%-83% for other viruses. Respiratory syncytial virus and human metapneumovirus infections were more severe than HRV.
- Older age and winter season were linked to symptomatic fVDEs.
Conclusions:
- Infants may not always exhibit symptoms during their first virus detection episodes.
- Early HRV detection emphasizes the importance of early-life interventions.
- Later fVDEs for other viruses coincide with waning maternal vaccine immunity, suggesting a critical window for infant vaccination.
Background:
Determining timing of first virus detection episodes (fVDEs) for different respiratory viruses in infants identifies risk periods and informs preventive interventions, including vaccination. We describe the ages and nature of fVDEs in an infant birth cohort and explore factors associated with increased odds of symptomatic fVDEs.
Methods:
The Observational Research in Childhood Infectious Diseases (ORChID) study is a community-based birth cohort describing acute respiratory infections in infants until their second birthday. Parents recorded daily symptoms and collected nose swabs weekly, which were batch-tested using polymerase chain reaction assays for 17 respiratory viruses.
Results:
One hundred fifty-eight infants participated in ORChID. The median age for fVDEs was 2.9 months for human rhinovirus (HRV) but was ≥13.9 months for other respiratory viruses. Overall, 52% of HRV fVDEs were symptomatic, compared with 57%-83% of other fVDEs. Respiratory syncytial virus and human metapneumovirus fVDEs were more severe than HRV fVDEs. Older age and the winter season were associated with symptomatic episodes.
Conclusions:
Infants do not always experience respiratory symptoms with their fVDE. Predominance of early HRV detections highlights the need for timing any intervention early in life. fVDEs from other respiratory viruses most commonly occur when maternal vaccines may no longer provide protection.
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