Transmission of viral pathogens in a social network of university students: the eX-FLU study.

Previous research on respiratory infection transmission among university students has primarily focused on influenza. In this study, we explore potential transmission events for multiple respiratory pathogens in a social contact network of university students. University students residing in on-campus housing (n = 590) were followed for the development of influenza-like illness for 10-weeks during the 2012-13 influenza season. A contact network was built using weekly self-reported contacts, class schedules, and housing information. We considered a transmission event to have occurred if students were positive for the same pathogen and had a network connection within a 14-day period. Transmitters were individuals who had onset date prior to their infected social contact. Throat and nasal samples were analysed for multiple viruses by RT-PCR. Five viruses were involved in 18 transmission events (influenza A, parainfluenza virus 3, rhinovirus, coronavirus NL63, respiratory syncytial virus). Transmitters had higher numbers of co-infections (67%). Identified transmission events had contacts reported in small classes (33%), dormitory common areas (22%) and dormitory rooms (17%). These results suggest that targeting person-to-person interactions, through measures such as isolation and quarantine, could reduce transmission of respiratory infections on campus.

A large rubella outbreak, Romania--2003.

Romania experienced a large rubella outbreak in 2002-03, with more than 115,000 reported cases nationwide, and an incidence of 531 reported cases per 100,000 population. The incidence was highest in children of school age. The cohorts of adolescent girls vaccinated in 1998 and 2002 (when a rubella-containing vaccine was available) had significantly lower incidence rates (p<0.001) compared with those in boys in the same age groups who were not vaccinated. In 2003, of the 150 suspected congenital rubella syndrome (CRS) cases reported, seven (4.6%) were confirmed by positive rubella IgM antibodies. In the absence of available rubella containing vaccine for outbreak control, an outbreak response plan to improve the detection of cases and to limit rubella virus transmission was developed. The following activities were conducted: surveillance of pregnant women with suspected rubella or history of exposure to rubella virus was implemented, with follow up of pregnancy outcomes; surveillance for CRS was strengthened; existing infection control guidelines to prevent disease transmission within healthcare facilities were reinforced; and a communication plan was developed. In May 2004, Romania is introducing measles, mumps and rubella (MMR) vaccine for routine vaccination of children aged 12 to 15 months, while continuing vaccination of girls in the 8th grade of school (13-14 years of age) with rubella-only vaccine.