Abstract
Background: The natural history and transmission patterns of endemic human coronaviruses are of increased interest following the emergence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Methods: In rural Kenya 483 individuals from 47 households were followed for six months (2009-10) with nasopharyngeal swabs collected twice weekly regardless of symptoms. A total of 16,918 swabs were tested for human coronavirus (hCoV) OC43, NL63 and 229E and other respiratory viruses using polymerase chain reaction. Results: From 346 (71.6%) household members, 629 hCoV infection episodes were defined, with 36.3% being symptomatic: varying by hCoV type and decreasing with age. Symptomatic episodes (aHR=0.6 (95% CI:0.5-0.8) or those with elevated peak viral load (medium aHR=0.4 (0.3-0.6); high aHR=0.31 (0.2-0.4)) had longer viral shedding compared to their respective counterparts. Homologous reinfections were observed in 99 (19.9%) of 497 first infections. School-age children (55%) were the most common index cases with those having medium (aOR=5.3 (2.3 - 12.0)) or high (8.1 (2.9 - 22.5)) peak viral load most often generating secondary cases. Conclusion: Household coronavirus infection was common, frequently asymptomatic and mostly introduced by school-age children. Secondary transmission was influenced by viral load of index cases. Homologous-type reinfection was common. These data may be insightful for SARS-CoV-2.
Highlights
Four endemic species of human coronavirus, HKU1, OC43, NL63 and 229E, are widespread and associated primarily with mild acute respiratory illness[1]
We investigate the natural history of infection and transmission patterns of three endemic human coronavirus (hCoV) within these households
A total of 16,918 Nasopharyngeal specimens (NPS) from 483 individuals were successfully tested for OC43, 229E and NL63
Summary
Four endemic species of human coronavirus (hCoV), HKU1, OC43, NL63 and 229E, are widespread and associated primarily with mild acute respiratory illness[1]. A focus on the natural history and transmission characteristics of current little-studied endemic species of hCoV may give insight to the future behaviour of this emergent relative[7]. We investigate the natural history of infection and transmission patterns of three endemic hCoV within these households. The natural history and transmission patterns of endemic human coronaviruses are of increased interest following the emergence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). School-age children (55%) were the most common index cases with those having medium (aOR=5.3 (2.3 – 12.0)) or high (8.1 (2.9 - 22.5)) peak viral load most often generating secondary cases. Conclusion: Household coronavirus infection was common, frequently asymptomatic and mostly introduced by school-age children. These data may be insightful for SARS-CoV-2
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