Estimating influenza transmission parameters: Comparing two study designs, 2023–2024
Year: 2026
Type: article
Study design: Observational Study
Abstract: Household studies play a critical role in estimating influenza transmission parameters, which are essential for real-time modeling of epidemic and pandemic dynamics to inform influenza control strategies. We compared two approaches for estimating household influenza transmission parameters from multisite studies conducted in the United States during the 2023-2024 influenza season: interviewing index cases about illnesses among household contacts (n = 1537 contacts) and prospective enrollment of index cases and their household contacts with systematic, daily symptom assessment and testing (n = 857 contacts). We compared the detection of symptomatic illness, influenza-like illness (ILI; fever and either cough or sore throat), influenza virus infection, and estimated serial illness onset intervals among household contacts across studies. Symptomatic illness episodes among household contacts were identified in 40 % of contacts by index case interview compared to 59 % of contacts from individual daily follow-up. Reports of ILI were more comparable between platforms (20 % vs. 26 % respectively). Index case interviews identified 12 % of household contacts with positive influenza tests while systematic, daily testing in the individual daily follow-up platform identified influenza infection among 44 % of household contacts. Both platforms yielded a median serial interval of 4 days. While index case interviews offer rapid, resource-efficient data collection and can inform epidemiological outcomes such as age-related risks and serial intervals, they substantially underestimate laboratory-confirmed influenza cases compared to systematic daily follow-up. These findings highlight the importance of study design in accurately capturing transmission dynamics and underscore the need for systematic laboratory testing to inform public health responses.
Source: Epidemics
Authors: Jessica E. Biddle, Stacey House, Jennie H. Kwon, Rachel M. Presti, Stephanie A. Fritz, Tara Curley, Son H. McLaren, Melissa S. Stockwell, Jonathan Schmitz, H. Keipp Talbot, Carlos G. Grijalva, Elie A. Saade, Zainab Albar, Vel Murugan, Rick A. Cruz, Emily T. Martin, Ivana A. Vaughn, Karen J. Wernli, Brianna M. Wickersham, Richard K. Zimmerman, Krissy Moehling Geffel, Manjusha Gaglani, Michael E. Smith, Emmanuel B. Walter, Natalie A.B. Bontrager, Lydia Bristol, Ashley M. Price, Jessie R. Chung, Brendan Flannery, Melissa A. Rolfes, Alexandra M. Mellis, Caroline A. O’Neil, Kim T. Vu, Francesca Yerbic, Mengesha Teshome, Alexandra Astarita, Sara Hubert, Mary G. Boyle, Alaina L. Schneider, Lisa M. Richardson, Yuwei Zhu, Theresa A. Scott, Judy A. King, Erica Anderson, Brianna Schibley-Laird, Rebecca Goodridge, Onika Abrams, Sydney A. Cornelison, Dandan Liu, Celibell Y. Vargas, Ellen Sano, Liqun Wang, Elizabeth Capasso-Gulve, Kiran Faryar, Curtis Donskey, David Canaday, Gia Gibson, Karen Aguilar, Olivia Maras, Donny Hearn, Jean A. Lava, Joe Choe, Matthew Nguyen, C. Hallie Phillips, Alexandra Weissman, Tracey Conti, Louise H. Taylor, Amanda McKillop, Spencer Rose, Kempapura Murthy, Olivia L. Williams
Institutions: Centers for Disease Control and Prevention, Washington University in St. Louis, Columbia University, Vanderbilt University Medical Center, University Hospitals of Cleveland, University Hospitals Cleveland Medical Center, Case Western Reserve University, Arizona State University, University of Michigan, Henry Ford Health, Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Bernard J. Tyson School of Medicine, University of Pittsburgh, Baylor Scott & White Medical Center - Temple, Baylor Scott & White Health, Duke University
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,730
Awards: RFA-IP-22-004, US Platform to Measure Effectiveness of Seasonal Influenza, COVID-19 and other Respiratory Virus Vaccines for the Prevention of Acute Illness in Ambulatory Settings, G297095765, G3359565395, RFA-IP-22-004, Multidisciplinary Approach to Understanding Vaccine Efficacy and Transmission of Viral Respiratory Tract Infections in the Real World, G3553599859, G4387795898, RFA-IP-22-004, Evaluating respiratory virus vaccine effectiveness in a large, diverse healthcare system, G5586232859, G6143247251, G6275730792, G6318112662, G6650665501, G7737614293, Evaluating influenza, SARS-CoV-2, and other respiratory virus vaccine effectiveness in prevention of acute illness in Washington state 2022-2027, University of Pittsburgh Clinical and Translational Science Institute
OpenAlex ID: W7122833847