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Review
. 2016 Feb;24(2):123-133.
doi: 10.1016/j.tim.2015.10.012. Epub 2015 Nov 21.

Household Transmission of Influenza Virus

Tim K Tsang  1 , Lincoln L H Lau  2 , Simon Cauchemez  3 , Benjamin J Cowling  4
Affiliations
Review

Household Transmission of Influenza Virus

Tim K Tsang et al. Trends Microbiol. 2016 Feb.

Abstract

Human influenza viruses cause regular epidemics and occasional pandemics with a substantial public health burden. Household transmission studies have provided valuable information on the dynamics of influenza transmission. We reviewed published studies and found that once one household member is infected with influenza, the risk of infection in a household contact can be up to 38%, and the delay between onset in index and secondary cases is around 3 days. Younger age was associated with higher susceptibility. In the future, household transmission studies will provide information on transmission dynamics, including the correlation of virus shedding and symptoms with transmission, and the correlation of new measures of immunity with protection against infection.

Keywords: control; households; influenza; public health; transmission.

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Figures

Figure 1
Figure 1
Comparison of the Design of Household Cohort Studies and Household Transmission Studies. In the cohort study, households are recruited before, and followed throughout, an epidemic, and some individuals are determined to have been infected by analysis of serological data (infected persons indicated as dark circles). By contrast, the household transmission study recruits households during the epidemic and includes only those households in which at least one person was infected. In this example, the index case in household A does not cause any secondary case, the index case in household B causes one secondary case, and household C is enrolled in the study twice – the first time when an index case causes two secondary cases, and the second time when another index case occurs (perhaps with a different type of influenza virus).
Figure 2
Figure 2
Estimates of Secondary Infection Risk and Serial Interval. (A) Estimates of the secondary infection risk determined by the proportion of household contacts with PCR-confirmed infection (circles), influenza-like illness (ILI, triangles), or acute respiratory illness (ARI, diamonds). (B) Estimates of the mean and median of serial intervals of influenza virus. Data in these graphs are in Tables S1 and S2 in the supplemental information online.
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