Household Transmission of Human Metapneumovirus and Human Parainfluenza Viruses 1-4 in the United States, 2022-2024
Roychoudhury, P.; Elias-Warren, A.; Wetzler, E.; Kim, H. G.; Kong, K.; Xie, H.; Spring, C.; Mills, M. G.; Harteloo, A.; Frivold, C.; Hollcroft, M.; Drummond, M.; Hatchie, T.; Clark, E.; Ehmen, B.; Han, P. D.; Gamboa, L.; Grindstaff, S.; Stone, J.; Hoffman, K. L.; Greninger, A. L.; Starita, L. M.; Lockwood, C.; Englund, J. A.; Weil, A. A.; Reich, S. L.; Mularski, R. A.; Schmidt, M. A.; Kuntz, J. L.; Naleway, A. L.; Chu, H. Y.
Show abstract
Human metapneumovirus (HMPV) and human parainfluenza viruses (HPIV 1-4) are common causes of seasonal respiratory illness, but their household transmission dynamics remain poorly defined. We analyzed weekly symptom data and nasal swabs from a prospective household surveillance study in Washington and Oregon from June 2022 to March 2024. Swabs were tested for HMPV and HPIV, and a subset underwent whole-genome sequencing. Distinct index cases occurred in 236 (23%) and 341 (36%) of 1,040 households for HMPV and HPIV, respectively. Household secondary attack rates (SAR) and median generation times were similar for HMPV (8.7%, 7 days) and HPIV (7.3%, 7 days). Sequenced samples reflected contemporaneous circulating strains during the same period, with household sequences clustering closely together. High-quality viral whole genome sequences were recovered for two or more individuals within a household in a total of 26 households for HMPV and 45 households for HPIV. Intra-household pairwise nucleotide (nt) distance ranged from 0 to 14 nt (median 0) for HMPV and 0-8 nt (median 1) for HPIV when cases occurred 0-15 days apart. Transmission occurred primarily from children to adults, emphasizing the importance of childcare- and school-associated spread and supporting child-focused prevention strategies to reduce household transmission.
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