| Autor: |
van Boven M; Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands., van de Kassteele J; Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands., Korndewal MJ; Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.; Leiden University Medical Center, Department of Medical Microbiology, Leiden, the Netherlands., van Dorp CH; Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.; Theoretical Biology and Bioinformatics, Utrecht University, Utrecht, the Netherlands., Kretzschmar M; Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands., van der Klis F; Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands., de Melker HE; Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands., Vossen AC; Leiden University Medical Center, Department of Medical Microbiology, Leiden, the Netherlands., van Baarle D; Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands. |
| Abstrakt: |
Human cytomegalovirus (CMV) is a herpes virus with poorly understood transmission dynamics. Person-to-person transmission is thought to occur primarily through transfer of saliva or urine, but no quantitative estimates are available for the contribution of different infection routes. Using data from a large population-based serological study (n = 5,179), we provide quantitative estimates of key epidemiological parameters, including the transmissibility of primary infection, reactivation, and re-infection. Mixture models are fitted to age- and sex-specific antibody response data from the Netherlands, showing that the data can be described by a model with three distributions of antibody measurements, i.e. uninfected, infected, and infected with increased antibody concentration. Estimates of seroprevalence increase gradually with age, such that at 80 years 73% (95%CrI: 64%-78%) of females and 62% (95%CrI: 55%-68%) of males are infected, while 57% (95%CrI: 47%-67%) of females and 37% (95%CrI: 28%-46%) of males have increased antibody concentration. Merging the statistical analyses with transmission models, we find that models with infectious reactivation (i.e. reactivation that can lead to the virus being transmitted to a novel host) fit the data significantly better than models without infectious reactivation. Estimated reactivation rates increase from low values in children to 2%-4% per year in women older than 50 years. The results advance a hypothesis in which transmission from adults after infectious reactivation is a key driver of transmission. We discuss the implications for control strategies aimed at reducing CMV infection in vulnerable groups. |
