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An Improved and High Throughput Respiratory Syncytial Virus RSV Micro-neutralization Assay
Published on: January 26, 2019
Population-based serology reveals risk factors for RSV infection in children younger than 5 years
Stijn P Andeweg1, Rutger M Schepp2, Jan van de Kassteele2
1Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3720 BA, Bilthoven, The Netherlands. stijn.andeweg@rivm.nl.
Insights
Most infants contract respiratory syncytial virus (RSV) before age two. Birth season significantly impacts RSV infection timing, with summer births showing higher infection probabilities, influencing vaccination strategies.
Area of Science:
- Pediatric infectious diseases
- Immunology
- Public health epidemiology
Background:
- Respiratory syncytial virus (RSV) is a primary cause of infant hospitalizations.
- Risk factors for RSV infection in the general population remain under-investigated, with prior research focusing on severe clinical outcomes.
Purpose of the Study:
- To investigate underlying risk factors for RSV infection in young children.
- To determine the influence of age and birth date on RSV infection probability.
- To inform vaccination and monoclonal antibody prophylaxis strategies.
Main Methods:
- Utilized RSV-specific IgG and IgA antibody measurements from two Dutch population-based serosurveys (n=682).
- Classified children up to 5 years old as seronegative or seropositive for RSV.
- Employed a generalized additive model to estimate RSV infection probability based on age, birth date, and other factors.
Main Results:
- The majority of children experience RSV infection by age two.
- Age and birth date were identified as significant predictors of RSV infection.
- Children born in summer exhibited a higher estimated probability of RSV infection compared to those born in winter (e.g., 0.56 vs. 0.32 at age 1).
Conclusions:
- Mean age at RSV infection is influenced by date of birth.
- Findings have implications for optimizing infant vaccination programs.
- Results can guide prioritization for prophylactic monoclonal antibody use in infants.
Abstract:
Respiratory syncytial virus (RSV) infection is a leading cause of hospitalization in infants. Underlying risk factors for RSV infection in the general population are not well understood, as previous work has focused on severe outcomes of infection in a clinical setting. Here we use RSV-specific IgG and IgA antibody measurements from two population-based cross-sectional serosurveys carried out in the Netherlands (n = 682) to classify children up to 5 years as seronegative or seropositive. We employ a generalized additive model to estimate the probability of prior RSV infection as function of age, date of birth within the year, and other risk factors. The analyses show that the majority of children have experienced a RSV infection before the age of 2 years. Age and birthdate are strong predictors of RSV infection in the first years of life, and children born in summer have higher estimated probability of infection than those born in winter [e.g., 0.56 (95% CI 0.45-0.66) vs. 0.32 (0.21-0.45) at age 1 year]. Our analyses reveal that the mean age at infection depends on date of birth, which has implications for the design of vaccination programmes and prioritisation schemes for the prophylactic use of monoclonal antibodies.
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