Munywoki, P. | bioRxiv Science

bioRxiv2019

Reducing RSV hospitalisation in a lower-income country by vaccinating mothers-to-be and their households

Respiratory syncytial virus is the leading cause of lower respiratory tract infection among infants. RSV is a priority for vaccine development. In this study, we investigate the potential effectiveness of a two-vaccine strategy aimed at mothers-to-be, thereby boosting maternally acquired antibodies of infants, and their household cohabitants, further cocooning infants against infection. We use a dynamic RSV transmission model which captures transmission both within households and communities, adapted to the changing demographics and RSV seasonality of a low-income country. Model parameters were inferred from past RSV hospitalisations, and forecasts made over a 10-year horizon. We find that a 50% reduction in RSV hospitalisations is possible if the maternal vaccine effectiveness can achieve 75 days of additional protection for newborns combined with a 75% coverage of their birth household co-inhabitants ([~]7.5% population coverage).

epidemiology↗

bioRxiv2018

Assessing the utility of minority variant composition in elucidating RSV transmission pathways

Reconstructing transmission pathways and defining the underlying determinants of virus diversity is critical for developing effective control measures. Whole genome consensus sequences represent the dominant virus subtype which does not provide sufficient information to resolve transmission events for rapidly spreading viruses with overlapping generations. We explored whether the within-host diversity of respiratory syncytial virus quantified from deep sequence data provides additional resolution to inform on who acquires infection from whom based on shared minor variants in samples that comprised epidemiological clusters and that shared similar genetic background. We report that RSV-A infections are characterized by low frequency diversity that occurs across the genome. Shared minor variant patterns alone, were insufficient to elucidate transmission chains within household members. However, they provided inference on potential transmission links where phylogenetic methods were uninformative of transmission when consensus sequences were identical. Interpretation of minor variant patterns was tractable only for small household outbreaks.

epidemiology↗