Contact profiles in eight European countries and implications for modelling the spread of airborne infectious diseases.
BACKGROUND
For understanding the spread of infectious diseases it is crucial to have knowledge of the patterns of contacts in a population during which the infection can be transmitted. Besides contact rates and mixing between age groups, the way individuals distribute their contacts across different locations may play an important role in determining how infections spread through a population.


RESULTS
Representative surveys were performed in eight countries to assess the number of social contacts (talking to another person at close distance either with or without physical contact), using a diary approach in which participants recorded individual contacts. The overall sample size was 7290 respondents. We analyzed the reported numbers of contacts per respondent in six different settings (household, work, school, leisure, transportation and others) to define different contact profiles. The identification of the profiles and classification of respondents according to these profiles was conducted using a two-step cluster analysis algorithm as implemented in SPSS. We identified seven distinct contact profiles: respondents having (1) mixed: contacts predominantly at school, during transportation and leisure time, (2) contacts during leisure time, (3) contacts mainly in the household (large family), (4) contacts at work, (5) contacts solely at school, (6) contacts in other places and finally (7) respondents having a low number of contacts in any setting. Similar contact profiles can be found in all eight European countries which participated in the study. The distributions of respondents across the profiles were similar in all countries. The profiles are dominated by work, school and household contacts. But also contacts during leisure activities play an important role in the daily lives of a large fraction of individuals. A surprisingly large number of individuals has only few contacts in all locations. There was a distinct age-dependence in the distribution of the population across contact profiles.


CONCLUSIONS
In contrast with earlier studies that focussed on the contribution of different age groups to the spread of an infectious disease, our results open up the opportunity to analyze how an infection spreads between locations and how locations as work or school are interconnected via household contacts. Mathematical models that take these local contact patterns into account can be used to assess the effect of intervention measures like school closure and cancelling of leisure activities on the spread of influenza.
Kretzschmar
Mirjam
M
Centre for Infectious Disease Control, RIVM, Bilthoven, The Netherlands.
Mikolajczyk
Rafael T
RT
D000465:Algorithms; D016000:Cluster Analysis; D003141:Communicable Diseases / Q000635:transmission*; D005060:Europe; D005191:Family Characteristics; D006801:Humans; D007251:Influenza, Human / Q000453:epidemiology / Q000635:transmission; D008962:Models, Theoretical; D015203:Reproducibility of Results; D012574:Schools; D011795:Surveys and Questionnaires