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Background and aim: Children play a significant role in the transmission of respiratory viruses within households and communities. This gives significance to pediatric studies in how they can provide insight about transmission within households. There are currently a limited number of RSV transmission studies in family clusters conducted in the USA. We aimed to monitor the spread of RSV in prospectively enrolled families and determine viral shedding from multiple specimens in index child (IC) and their household contacts (HHC).

Method: Children (>1 month and <18y) who tested positive for RSV at Children’s Mercy Hospital, and their HHCs were consented to provide demographic and clinical data. Multiple specimens such as nasal swab (NS), saliva (SA), stool (ST), and blood (B) from IC and HCC were collected over 3 weeks. Nucleic extractions were performed, and RSV RT-PCR was done on the samples from the different time points for viral detection.

Results: Overall, 3 families with 12 subjects (3 IC and 9 HHC) were enrolled between Feb 24- current. Median age for all subjects was 5 years (range: 0.3 - 46 years; interquartile range [IQR]: 22- 1.7 years). Median age for IC was 1.5 years (range: 0.3 - 2 years; IQR:1.75 -0.9). Among IC, all three were Black African American. Among the 12 subjects, 9 (75%) subjects had RSV detected in at least one sample, with positivity rates of 42% (5/12) in NS, 58.3% (7/12) in SA; RSV was undetected in ST. The mean Ct values for pediatric samples were 25.4 for NS and 34.9 for SA, Ct values for adult NS and SA were 33.2 and 37.4 respectively. None of the IC had prior exposure to an RSV positive adult HHC.

Conclusions: Viral detection rates differ among specimen types and current preliminary data shows that viral load was higher in NS than SA in both children and adults. Additionally, RSV transmission within the enrolled households possibly occurred from children to adults and more data is needed to infer the secondary attack rate of infection. RSV subtyping RT-PCR and digital PCR will be performed in the future to determine the RSV subtypes and viral load in the samples.

Document Type


Respiratory Syncytial Virus (RSV) Transmission in Household Settings