不同年龄组在呼吸道合胞病毒相关流行病中的相对作用
On the relative role of different age groups during epidemics associated with the respiratory syncytial virus
摘要：
背景资料：虽然RSV循环导致高住院负担，特别是在婴儿、幼儿和老年人中，但对不同年龄组在社区传播年度RSV流行病中的作用知之甚少。研究方法：在传染病暴发期间，由于易感性和/或接触率增加，一些亚群可能在暴发上升期间发挥不成比例的作用。这样的亚群可以通过考虑亚群中的病例在流行高峰之前（Bp）和之后（Ap）发生的所有病例中所占的比例来确定，以计算亚群的相对风险，RR=Bp/Ap。我们使用来自医疗保健成本和利用项目（HCUP）的2001-2012年美国RSV住院数据估计了几个年龄组的RR。结果如下：在数据中，3- 4岁和5- 6岁的儿童在5/11个季节的RR估计值最高，在5- 6岁儿童RR估计值最高的季节，婴儿的RSV住院率通常较高。2岁儿童在一个季节内的RR估计值最高。婴儿和11岁及以上个体的RR估计值大多低于1- 10岁儿童。结论：RR估计表明学龄前和学龄前儿童在RSV流行中具有主导作用。我们希望这些结果将有助于RSV疫苗接种政策的设计。
英文摘要：
Background: While RSV circulation results in high burden of hospitalization, particularly among infants, young children and the elderly, little is known about the role of different age groups in propagating annual RSV epidemics in the community. Methods: During a communicable disease outbreak, some subpopulations may play a disproportionate role during the outbreak's ascent due to increased susceptibility and/or contact rates. Such subpopulations can be identified by considering the proportion that cases in a subpopulation represent among all cases in the population occurring before (Bp) and after the epidemic peak (Ap) to calculate the subpopulation's relative risk, RR=Bp/Ap. We estimated RR for several age groups using data on RSV hospitalizations in the US between 2001-2012 from the Healthcare Cost and Utilization Project (HCUP). Results: Children aged 3-4y and 5-6y each had the highest RR estimate for 5/11 seasons in the data, with RSV hospitalization rates in infants being generally higher during seasons when children aged 5-6y had the highest RR estimates. Children aged 2y had the highest RR estimate during one season. RR estimates in infants and individuals aged 11y and older were mostly lower than in children aged 1-10y. Conclusions: The RR estimates suggest that preschool and young school-age children have the leading relative roles during RSV epidemics. We hope that those results will aid in the design of RSV vaccination policies.
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