The impacts of viral interaction on household transmission of respiratory viruses

Abstract The possibility of virus-virus interaction has been hypothesized at the population level, but there are limited data regarding the effects of viral interaction on transmission. This study used data from a prospective household cohort study to examine how viral interaction impacts transmission of influenza A virus (IAV), influenza B virus (IBV), and respiratory syncytial virus (RSV). We used two main predictors of transmission: coinfection in the index case and detection of a virus other than a primary virus of interest in the susceptible contact. Household- and individual-level analyses were conducted for IAV, IBV, and RSV. To estimate the risk of transmission within households with coinfected index cases, a household-level analysis was performed using multivariable regression with Poisson mixed effects models. To estimate an individual’s risk of transmission when multiple viruses co-circulated within their household, an individual-level analysis was performed using mixed-effects logistic regression models. Coinfection among index cases was associated with reduced transmission of IAV and RSV. Infection with a different virus among household contacts was associated with an increased risk of transmission of IAV and RSV. This study enhances the understanding of viral interaction by elucidating the potential impacts of interaction on virus transmission. These findings could have important implications for public health planning and prevention efforts. Competing Interest Statement The authors have declared no competing interest. Funding Statement The HIVE study was supported by funding from the Centers for Disease Control, the National Institute of Allergy and Infectious Disease and the National Institutes of Health (75N93021C00015, HHSN272201400005C, U01IP001034, R56 AI097150, R01AI097150-01A1, U01 IP000474, U18IP000170). This work was also supported by funding for the MHome study through the National Institute of Allergy and Infectious Diseases, under R01 AI148371. Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The institutional review board at the University of Michigan Medical School (HUM00034377 & HUM00118900) gave ethical approval for this work. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability All data produced in the present study are available upon reasonable request to the authors.