Modeling the impact of changes in day-care contact patterns on the dynamics of varicella transmission in France between 1991 and 2015

PLoS Comput Biol. 2018 Aug 1;14(8):e1006334. doi: 10.1371/journal.pcbi.1006334. eCollection 2018 Aug.

Abstract

Annual incidence rates of varicella infection in the general population in France have been rather stable since 1991 when clinical surveillance started. Rates however show a statistically significant increase over time in children aged 0-3 years, and a decline in older individuals. A significant increase in day-care enrolment and structures' capacity in France was also observed in the last decade. In this work we investigate the potential interplay between an increase of contacts of young children possibly caused by earlier socialization in the community and varicella transmission dynamics. To this aim, we develop an age-structured mathematical model, informed with historical demographic data and contact matrix estimates in the country, accounting for longitudinal linear increase of early childhood contacts. While the reported overall varicella incidence is well reproduced independently of mixing variations, age-specific empirical trends are better captured by accounting for an increase in contacts among pre-school children in the last decades. We found that the varicella data are consistent with a 30% increase in the number of contacts at day-care facilities, which would imply a 50% growth in the contribution of 0-3y old children to overall yearly infections in 1991-2015. Our findings suggest that an earlier exposure to pathogens due to changes in day-care contact patterns, represents a plausible explanation for the epidemiological patterns observed in France. Obtained results suggest that considering temporal changes in social factors in addition to demographic ones is critical to correctly interpret varicella transmission dynamics.

Publication types

  • Historical Article
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Chickenpox / epidemiology*
  • Child Day Care Centers / trends*
  • Child, Preschool
  • Disease Transmission, Infectious / history
  • Female
  • France / epidemiology
  • Herpesvirus 3, Human
  • History, 20th Century
  • History, 21st Century
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Male
  • Models, Theoretical
  • Vaccination

Associated data

  • figshare/10.6084/m9.figshare.6344876

Grants and funding

VM, PP and SM received funding from the European Commission Horizon2020 CIMPLEX project, grant agreement N.641191 (https://ec.europa.eu/programmes/horizon2020/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.