Characterizing the risk of respiratory syncytial virus in infants with older siblings: a population-based birth cohort study.
From a population-based birth cohort of 245 249 children born in Western Australia during 1996-2005, we used linkage of laboratory and birth record datasets to obtain data including all respiratory syncytial virus (RSV) detections during infancy from a subcohort of 87 981 singleton children born in the Perth metropolitan area from 2000 to 2004. Using log binomial regression, we found that the risk of infant RSV detection increases with the number of older siblings, with those having ⩾3 older siblings experiencing almost three times the risk (relative risk 2·83, 95% confidence interval 2·46-3·26) of firstborn children. We estimate that 45% of the RSV detections in our subcohort were attributable to infection from an older sibling. The sibling effect was significantly higher for those infants who were younger during the season of peak risk (winter) than those who were older. Although older siblings were present in our cohort, they had very few RSV detections which could be temporally linked to an infant's infection. We conclude that RSV infection in older children leads to less severe symptoms but is nevertheless an important source of infant infection. Our results lend support to a vaccination strategy which includes family members in order to provide maximum protection for newborn babies.
Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, Australia.
P
P
Jacoby
National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia.
K
K
Glass
Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, Australia.
H C
HC
Moore
D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D018562:Disease Transmission, Infectious; D005192:Family Health; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D018357:Respiratory Syncytial Virus Infections / Q000453:epidemiology* / Q000473:pathology / Q000635:transmission; D012136:Respiratory Syncytial Viruses / Q000302:isolation & purification*; D018570:Risk Assessment; D035781:Siblings; D014505:Urban Population; D014904:Western Australia / Q000453:epidemiology; D055815:Young Adult
Epidemiology; household; respiratory syncytial virus; vaccine policy development