Experiences and needs of persons living with a household member infected with SARS-CoV-2: A mixed method study.

BACKGROUND: Households are important sites for transmission of SARS-CoV-2 and preventive measures are recommended. This study aimed to 1) investigate the impact of living with a person infected with SARS-CoV-2; 2) understand how household members implemented infection control recommendations in their home; and 3) identify the information and support needs of household members. METHODS: For this observational mixed-methods study, households with a person with confirmed SARS-CoV-2 infection were recruited via drive-through testing sites of Municipal Health Services, healthcare worker screening or hospital emergency visits in the University Medical Centre Utrecht, the Netherlands and via primary care physicians, hospital emergency visits or preoperative screening in the University Hospital of Antwerp, Belgium. We recorded household characteristics, including characteristics of all household members, together with their views on prevention measures. In a subset of households one adult household member was asked to participate in an interview investigating their views on preventive measures. Survey data were analysed using descriptive statistics and interview data by rapid framework analysis. A triangulation protocol was used to integrate findings. RESULTS: Thirty-four households (120 household members) were included in the quantitative survey. Twenty-two households were invited to be interviewed, of which 18 completed an interview (response 81.8%). Survey data showed that almost all households implemented some preventive measures, the use of face masks being least frequently reported. Measures taken depended on what was physically possible, the perceived severity of illness of the index patient and to what extent household members were willing to limit social interaction. Respondents did not believe in the effectiveness of wearing face masks within the house, and from the interviews this was explained by media coverage of face masks, impracticality and the stigma associated with wearing masks. Interviewees reported that quarantine had a high emotional burden and wished to have more information about the exact duration of quarantine, their own COVID-19 status, symptoms and when to seek medical help. CONCLUSION: People were willing to implement prevention measures, however actual adherence depended on perceived severity of illness and the perceived risk of becoming infected. Homes are social environments and recommendations for infection prevention should account for this context. Incorporating our findings into policy making could provide households with more relevant and actionable advice

Transmission of SARS-CoV-2 within households: a remote prospective cohort study in European countries.

Household transmission studies are useful to quantify SARS-CoV-2 transmission dynamics. We conducted a remote prospective household study to quantify transmission, and the effects of subject characteristics, household characteristics, and implemented infection control measures on transmission. Households with a laboratory-confirmed SARS-CoV-2 index case were enrolled  85% completed sample collection. 200 secondary SARS-CoV-2 infections were detected, yielding a household SAR of 45.7% (95% CI 39.7-51.7%) and per-person SAR of 32.6% (95%CI: 28.1-37.4%). 126 (63%) secondary cases were detected at enrollment. Mild (aRR = 0.57) and asymptomatic index cases (aRR = 0.29) were less likely to transmit SARS-CoV-2, compared to index cases with an acute respiratory illness (p = 0.03 for trend), and child index cases (< 12 years aRR = 0.60 and 12-18 years aRR = 0.85) compared to adults (p = 0.03 for trend). Infection control interventions in households had no significant effect on transmission. We found high SARs with the majority of transmissions occuring early after SARS-CoV-2 introduction into the household. This may explain the futile effect of implemented household measures. Age and symptom status of the index case influence secondary transmission. Remote, digitally-supported study designs with self-sampling are feasible for studying transmission under pandemic restrictions

Rotavirus in Nederland : Achtergrond informatie voor de Gezondheidsraad

Het rotavirus kan een maagdarminfectie veroorzaken die veel voorkomt bij jonge kinderen en soms ernstig kan verlopen. Er zijn twee vaccins beschikbaar die beide in druppelvorm via de mond worden toegediend. De Gezondheidsraad gaat de minister van VWS adviseren op welke manier vaccinatie van kinderen tegen het rotavirus oegankelijk wordt. De minister neemt op basis van dit advies een besluit. Om de Gezondheidsraad te ondersteunen heeft het RIVM achtergrondinformatie over het rotavirus bijeengebracht. De informatie betreft onder andere het aantal personen dat er jaarlijks in Nederland ziek door wordt, de effectiviteit en veiligheid van de vaccins, en hoe het publiek denkt over deze vaccinatie. Een door het rotavirus veroorzaakte maagdarminfectie komt veel in de wintermaanden voor, vooral bij kinderen tussen de 6 maanden en 2 jaar. De ziekte gaat gepaard met koorts, braken en hevige, waterdunne diarree. Doorgaans verloopt de ziekte zonder problemen, maar het komt voor dat de ziekte ernstig verloopt. Dit gebeurt vaker bij jonge kinderen, te vroeg geboren kinderen, kinderen met een laag geboortegewicht, of kinderen met aangeboren afwijkingen. De ziekte kan dan uitdrogingsgevaar veroorzaken. In deze gevallen moet een kind in het ziekenhuis worden opgenomen. De uitdroging wordt dan behandeld door via de mond of een infuus vocht toe te dienen. In zeldzame gevallen overlijdt een kind.Rotavirus can cause a gastrointestinal infection and is common in young children. There are two vaccines available; both have to be administered via the mouth. The Dutch Health Council will advise the Ministry of Health, Welfare and Sport on how childhood vaccination against rotavirus will be made available. The Minister makes a decision on the basis of this advice. To support the Health Council, the RIVM has put together background information on rotavirus disease. The information includes the number of people in the Netherlands that become ill from rotavirus every year, the effectiveness and safety of rotavirus vaccines, and how the public thinks about rotavirus vaccination. A gastrointestinal infection caused by rotavirus is common during the winter months, particularly in children between six months and two years old. The disease is characterized by fever, vomiting and diarrhoea. Usually, rotavirus disease resolves by itself without problems, but can be severe resulting in dehydration. This happens more often in young children, premature children, children with low birth weight and children with congenital problems. These severe cases may need to be admitted to the hospital. Treatment for dehydration consists of oral or intravenous rehydration. In rare cases, a child dies.VW

Impact analysis of rotavirus vaccination in various geographic regions in Western Europe.

BACKGROUND: Universal mass vaccination (UMV) against rotavirus has been implemented in many but not all European countries. This study investigated the impact of UMV on rotavirus incidence trends by comparing European countries with UMV: Belgium, England/Wales and Germany versus countries without UMV: Denmark and the Netherlands. METHODS: For this observational retrospective cohort study, time series data (2001-2016) on rotavirus detections, meteorological factors and population demographics were collected. For each country, several meteorological and population factors were investigated as possible predictors of rotavirus incidence. The final set of predictors were incorporated in negative binomial models accounting for seasonality and serial autocorrelation, and time-varying incidence rate ratios (IRR) were calculated for each age group and country separately. The overall vaccination impact two years after vaccine implementation was estimated by pooling the results using a random effects meta-analyses. Independent t-tests were used to compare annual epidemics in the pre-vaccination and post-vaccination era to explore any changes in the timing of rotavirus epidemics. RESULTS: The population size and several meteorological factors were predictors for the rotavirus epidemiology. Overall, we estimated a 42% (95%-CI 23;56%) reduction in rotavirus incidence attributable to UMV. Strongest reductions were observed for age-groups 0-, 1- and 2-years (IRR 0.47, 0.48 and 0.63, respectively). No herd effect induced by UMV in neighbouring countries was observed. In all UMV countries, the start and/or stop and corresponding peak of the rotavirus season was delayed by 4-7 weeks. CONCLUSIONS: The introduction of rotavirus UMV resulted in an overall reduction of 42% in rotavirus incidence in Western European countries two years after vaccine introduction and caused a change in seasonal pattern. No herd effect induced by UMV neighbouring countries was observed for Denmark and the Netherlands