Transmission of respiratory and gastrointestinal infections in German households with children attending child care

• Published in: Epidemiology and infection 2018-04, Vol.146 (5), p.627-632
• Main Authors: Schlinkmann, K. M., Bakuli, A., Karch, A., Meyer, F., Dreesman, J., Monazahian, M., Mikolajczyk, R.
• Format: Article
• Language: English
• Subjects: Acute Disease; Age; Child; Child care; Child Care - statistics & numerical data; Child, Preschool; Children; Children & youth; Confidence intervals; Epidemiology; Families & family life; Family Characteristics; Female; Gastroenteritis; Gastrointestinal Diseases - epidemiology; Gastrointestinal Diseases - etiology; Germany - epidemiology; Health care; Health surveillance; Households; Humans; Identification; Illnesses; Incidence; Infant; Infant, Newborn; Infections; Infectious diseases; Influenza; Laboratories; Male; Original Paper; Pathogens; Pediatrics; Population; Prospective Studies; Public health; Respiratory and Gastrointestinal Infection; Respiratory diseases; Respiratory Tract Infections - epidemiology; Respiratory Tract Infections - etiology; Respiratory Tract Infections - transmission; Sensitivity analysis; Studies; Systematic review; Viral infections; Viruses
• ISSN: 0950-2688; 1469-4409
• DOI: 10.1017/S0950268818000316

Transmission of acute respiratory infections (ARI) and acute gastroenteritis (AGE) often occurs in households. The aim of this study was to assess which proportion of ARI and AGE is introduced and transmitted by children in German households with children attending child care. We recruited families with children aged 0–6 years in Braunschweig (Germany), for a 4 months prospective cohort study in the winter period 2014/2015. Every household member was included in a health diary and used nasal swabs for pathogen identification in case of ARI. We defined a transmission if two persons had overlapping periods with symptoms and used additional definitions for sensitivity analyses. In total, 77 households participated with 282 persons. We observed 277 transmission events for ARI and 23 for AGE. In most cases, the first infected person in a household was a child (ARI: 63%, AGE: 53%), and the risk of within-household transmission was two times higher when the index case was a child. In 26 ARI-transmission events, pathogens were detected for both cases; hereof in 35% (95% confidence interval (17–56%)) the pathogens were different. Thus, symptomatic infections in household members, apparently linked in time, were in 2/3 associated with the same pathogens.