{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T19:55:32Z","timestamp":1781294132200,"version":"3.54.1"},"reference-count":41,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2019,10,14]],"date-time":"2019-10-14T00:00:00Z","timestamp":1571011200000},"content-version":"unspecified","delay-in-days":286,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2019]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:p>Viral pneumonia is an important cause of death and morbidity among infants worldwide. Transmission of non-influenza respiratory viruses in households can inform preventative interventions and has not been well-characterised in South Asia. From April 2011 to April 2012, household members of pregnant women enrolled in a randomised trial of influenza vaccine in rural Nepal were surveyed weekly for respiratory illness until 180 days after birth. Nasal swabs were tested by polymerase chain reaction for respiratory viruses in symptomatic individuals. A transmission event was defined as a secondary case of the same virus within 14 days of initial infection within a household. From 555 households, 825 initial viral illness episodes occurred, resulting in 79 transmission events. The overall incidence of transmission was 1.14 events per 100 person-weeks. Risk of transmission incidence was associated with an index case age 1\u20134 years (incidence rate ratio (IRR) 2.35; 95% confidence interval (CI) 1.40\u20133.96), coinfection as initial infection (IRR 1.94; 95% CI 1.05\u20133.61) and no electricity in household (IRR 2.70; 95% CI 1.41\u20135.00). Preventive interventions targeting preschool-age children in households in resource-limited settings may decrease the risk of transmission to vulnerable household members, such as young infants.<\/jats:p>","DOI":"10.1017\/s0950268819001754","type":"journal-article","created":{"date-parts":[[2019,10,14]],"date-time":"2019-10-14T04:41:03Z","timestamp":1571028063000},"source":"Crossref","is-referenced-by-count":10,"title":["Risk factors and patterns of household clusters of respiratory viruses in rural Nepal"],"prefix":"10.1017","volume":"147","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9295-9320","authenticated-orcid":false,"given":"E. M.","family":"Scott","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Magaret","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Kuypers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. M.","family":"Tielsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Katz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. K.","family":"Khatry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Stewart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Shrestha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. C.","family":"LeClerq","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. A.","family":"Englund","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. Y.","family":"Chu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2019,10,14]]},"reference":[{"key":"S0950268819001754_ref41","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1093\/infdis\/jiy232","article-title":"Heterotypic infection and spread of rhinovirus A, B, and C among child care attendees","volume":"218","author":"Martin","year":"2018","journal-title":"The Journal of Infectious Diseases"},{"key":"S0950268819001754_ref38","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1186\/s12916-015-0283-x","article-title":"Evaluating vaccination strategies for reducing infant respiratory syncytial virus infection in low-income settings","volume":"13","author":"Poletti","year":"2015","journal-title":"BMC Medicine"},{"key":"S0950268819001754_ref37","doi-asserted-by":"crossref","first-page":"2496","DOI":"10.1056\/NEJMra1509044","article-title":"Maternal immunization","volume":"376","author":"Omer","year":"2017","journal-title":"The New England Journal of Medicine"},{"key":"S0950268819001754_ref31","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1017\/S0950268814001393","article-title":"Influence of age, severity of infection, and co-infection on the duration of respiratory syncytial virus (RSV) shedding","volume":"143","author":"Munywoki","year":"2015","journal-title":"Epidemiology and Infection"},{"key":"S0950268819001754_ref29","doi-asserted-by":"crossref","first-page":"27","DOI":"10.12688\/wellcomeopenres.10284.1","article-title":"Quantification and determinants of the amount of respiratory syncytial virus (RSV) shed using real time PCR data from a longitudinal household study","volume":"1","author":"Wathuo","year":"2016","journal-title":"Wellcome Open Research"},{"key":"S0950268819001754_ref28","doi-asserted-by":"crossref","first-page":"1711","DOI":"10.1093\/infdis\/jiv263","article-title":"Frequent asymptomatic respiratory syncytial virus infections during an epidemic in a Rural Kenyan Household Cohort","volume":"212","author":"Munywoki","year":"2015","journal-title":"The Journal of Infectious Diseases"},{"key":"S0950268819001754_ref27","unstructured":"Sharma P , Guha-Khasnobis B and Khanal DR (2014) Nepal human development report 2014. United Nations Development Programme: In Kathmandu 2014; Published online: 2014."},{"key":"S0950268819001754_ref1","doi-asserted-by":"crossref","first-page":"1380","DOI":"10.1016\/S0140-6736(12)61901-1","article-title":"Global and regional burden of hospital admissions for severe acute lower respiratory infections in young children in 2010: a systematic analysis","volume":"381","author":"Nair","year":"2013","journal-title":"The Lancet"},{"key":"S0950268819001754_ref25","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1093\/bib\/bbn013","article-title":"Recent developments in the MAFFT multiple sequence alignment program","volume":"9","author":"Katoh","year":"2008","journal-title":"Briefings in Bioinformatics"},{"key":"S0950268819001754_ref7","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1093\/cid\/civ486","article-title":"Community surveillance of respiratory viruses among families in the Utah Better Identification of Germs-Longitudinal Viral Epidemiology (BIG-LoVE) Study","volume":"61","author":"Byington","year":"2015","journal-title":"Clinical Infectious Diseases"},{"key":"S0950268819001754_ref6","doi-asserted-by":"crossref","first-page":"1685","DOI":"10.1093\/infdis\/jit828","article-title":"The source of respiratory syncytial virus infection in infants: a household cohort study in rural Kenya","volume":"209","author":"Munywoki","year":"2014","journal-title":"The Journal of Infectious Diseases"},{"key":"S0950268819001754_ref10","doi-asserted-by":"crossref","first-page":"B209","DOI":"10.1016\/j.vaccine.2012.11.106","article-title":"Strategic priorities for respiratory syncytial virus (RSV) vaccine development","volume":"31","author":"Anderson","year":"2013","journal-title":"Vaccine"},{"key":"S0950268819001754_ref2","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1016\/S0140-6736(10)61459-6","article-title":"Viral pneumonia","volume":"377","author":"Ruuskanen","year":"2011","journal-title":"The Lancet"},{"key":"S0950268819001754_ref32","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1093\/infdis\/jis934","article-title":"Epidemiology of multiple respiratory viruses in childcare attendees","volume":"207","author":"Martin","year":"2013","journal-title":"The Journal of Infectious Diseases"},{"key":"S0950268819001754_ref13","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1111\/irv.12331","article-title":"Factors associated with transmission of influenza-like illness in a cohort of households containing multiple children","volume":"9","author":"Brown","year":"2015","journal-title":"Influenza and Other Respiratory Viruses"},{"key":"S0950268819001754_ref18","unstructured":"Vibh\u0101ga NKT (2012) National Population and Housing Census, 2011: National Report. Government of Nepal, National Planning Commission Secretariat, Central Bureau of Statistics."},{"key":"S0950268819001754_ref34","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1111\/j.1750-2659.2011.00265.x","article-title":"Multiple versus single virus respiratory infections: viral load and clinical disease severity in hospitalized children","volume":"6","author":"Martin","year":"2012","journal-title":"Influenza and Other Respiratory Viruses"},{"key":"S0950268819001754_ref30","doi-asserted-by":"crossref","first-page":"E322","DOI":"10.1111\/1469-0691.12193","article-title":"Virus shedding after human rhinovirus infection in children, adults and patients with hypogammaglobulinaemia","volume":"19","author":"Peltola","year":"2013","journal-title":"Clinical Microbiology and Infections"},{"key":"S0950268819001754_ref3","doi-asserted-by":"crossref","first-page":"e491","DOI":"10.1371\/journal.pone.0000491","article-title":"A prospective three-year cohort study of the epidemiology and virology of acute respiratory infections of children in rural India","volume":"2","author":"Broor","year":"2007","journal-title":"PLoS ONE"},{"key":"S0950268819001754_ref35","doi-asserted-by":"crossref","first-page":"e0118457","DOI":"10.1371\/journal.pone.0118457","article-title":"A household-based study of contact networks relevant for the spread of infectious diseases in the highlands of Peru","volume":"10","author":"Grijalva","year":"2015","journal-title":"PLoS ONE"},{"key":"S0950268819001754_ref4","doi-asserted-by":"crossref","first-page":"e0130233","DOI":"10.1371\/journal.pone.0130233","article-title":"Incidence and risk factors for respiratory syncytial virus and human metapneumovirus infections among children in the remote highlands of Peru","volume":"10","author":"Wu","year":"2015","journal-title":"PLoS ONE"},{"key":"S0950268819001754_ref39","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1093\/infdis\/jiy621","article-title":"An intensive, active surveillance reveals continuous invasion and high diversity of rhinovirus in households","volume":"219","author":"Kamau","year":"2019","journal-title":"The Journal of Infectious Diseases"},{"key":"S0950268819001754_ref36","unstructured":"Nepal C (2011) Nepal Living Standards Survey 2011\/11: Statistical Report. Vol. 1. Computer disk. Washington, DC. Published online: 2011."},{"key":"S0950268819001754_ref11","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1056\/NEJM197602192940803","article-title":"Respiratory syncytial virus infections within families","volume":"294","author":"Hall","year":"1976","journal-title":"The New England Journal of Medicine"},{"key":"S0950268819001754_ref26","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/S0140-6736(13)60993-9","article-title":"Mortality risk in preterm and small-for-gestational-age infants in low-income and middle-income countries: a pooled country analysis","volume":"382","author":"Katz","year":"2013","journal-title":"The Lancet"},{"key":"S0950268819001754_ref12","doi-asserted-by":"crossref","first-page":"13239","DOI":"10.1073\/pnas.1522597113","article-title":"Vaccination strategies against respiratory syncytial virus","volume":"113","author":"Yamin","year":"2016","journal-title":"Proceedings of the National Academy of Sciences of the USA"},{"key":"S0950268819001754_ref5","doi-asserted-by":"crossref","first-page":"1559","DOI":"10.1093\/cid\/ciy313","article-title":"Continuous invasion by respiratory viruses observed in rural households during a respiratory syncytial virus seasonal outbreak in coastal Kenya","volume":"67","author":"Munywoki","year":"2018","journal-title":"Clinical Infectious Diseases"},{"key":"S0950268819001754_ref16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12884-015-0470-y","article-title":"Designs of two randomized, community-based trials to assess the impact of influenza immunization during pregnancy on respiratory illness among pregnant women and their infants and reproductive outcomes in rural Nepal","volume":"15","author":"Tielsch","year":"2015","journal-title":"BMC Pregnancy and Childbirth"},{"key":"S0950268819001754_ref24","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1093\/sysbio\/syq010","article-title":"New algorithms and methods to estimate maximum-likelihood phylogenies: assessing the performance of PhyML 3.0","volume":"59","author":"Guindon","year":"2010","journal-title":"Systematic Biology"},{"key":"S0950268819001754_ref23","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/j.jcv.2013.04.011","article-title":"Molecular epidemiology of respiratory syncytial virus transmission in childcare","volume":"57","author":"Chu","year":"2013","journal-title":"Journal of Clinical Virology"},{"key":"S0950268819001754_ref14","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1186\/1471-2334-12-345","article-title":"Household transmission of respiratory viruses \u2013 assessment of viral, individual and household characteristics in a population study of healthy Australian adults","volume":"12","author":"McCaw","year":"2012","journal-title":"BMC Infectious Diseases"},{"key":"S0950268819001754_ref40","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1017\/S0950268816002181","article-title":"The presence of fever in adults with influenza and other viral respiratory infections","volume":"145","author":"Chughtai","year":"2017","journal-title":"Epidemiology and Infection"},{"key":"S0950268819001754_ref15","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1086\/525542","article-title":"Rhinovirus transmission within families with children: incidence of symptomatic and asymptomatic infections","volume":"197","author":"Peltola","year":"2008","journal-title":"The Journal of Infectious Diseases"},{"key":"S0950268819001754_ref19","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.jcv.2004.03.018","article-title":"Evaluation of quantitative and type-specific real-time RT-PCR assays for detection of respiratory syncytial virus in respiratory specimens from children","volume":"31","author":"Kuypers","year":"2004","journal-title":"Journal of Clinical Virology"},{"key":"S0950268819001754_ref17","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1016\/S1473-3099(17)30252-9","article-title":"Year-round influenza immunisation during pregnancy in Nepal: a phase 4, randomised, placebo-controlled trial","volume":"17","author":"Steinhoff","year":"2017","journal-title":"The Lancet Infectious Diseases"},{"key":"S0950268819001754_ref9","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1056\/NEJMoa0804877","article-title":"The burden of respiratory syncytial virus infection in young children","volume":"360","author":"Hall","year":"2009","journal-title":"New England Journal of Medicine"},{"key":"S0950268819001754_ref20","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1128\/JCM.01739-07","article-title":"Real-time reverse transcription-PCR assay for comprehensive detection of human rhinoviruses","volume":"46","author":"Lu","year":"2008","journal-title":"Journal of Clinical Microbiology"},{"key":"S0950268819001754_ref21","doi-asserted-by":"crossref","first-page":"2382","DOI":"10.1128\/JCM.00216-06","article-title":"Comparison of real-time PCR assays with fluorescent-antibody assays for diagnosis of respiratory virus infections in children","volume":"44","author":"Kuypers","year":"2006","journal-title":"Journal of Clinical Microbiology"},{"key":"S0950268819001754_ref33","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/S0022-3476(81)80969-9","article-title":"Modes of transmission of respiratory syncytial virus","volume":"99","author":"Hall","year":"1981","journal-title":"The Journal of Pediatrics"},{"key":"S0950268819001754_ref8","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.jcv.2016.07.014","article-title":"Epidemiology and etiology of influenza-like-illness in households in Vietnam; it's not all about the kids!","volume":"82","author":"Nguyen","year":"2016","journal-title":"Journal of Clinical Virology"},{"key":"S0950268819001754_ref22","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.jcv.2014.11.006","article-title":"Molecular epidemiology of human rhinovirus infections in the pediatric emergency department","volume":"62","author":"Martin","year":"2015","journal-title":"Journal of Clinical Virology"}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268819001754","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,10,14]],"date-time":"2019-10-14T04:41:44Z","timestamp":1571028104000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268819001754\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019]]},"references-count":41,"alternative-id":["S0950268819001754"],"URL":"https:\/\/doi.org\/10.1017\/s0950268819001754","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019]]},"article-number":"e288"}}