The role of viral interaction in household transmission of symptomatic influenza and respiratory syncytial virus

Jessica C. Ibiebele (), Elie-Tino Godonou, Amy P. Callear, Matthew R. Smith, Rachel Truscon, Emileigh Johnson, Marisa C. Eisenberg, Adam S. Lauring, Arnold S. Monto, Sarah Cobey and Emily T. Martin
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Jessica C. Ibiebele: University of Michigan
Elie-Tino Godonou: University of Michigan
Amy P. Callear: University of Michigan
Matthew R. Smith: University of Michigan
Rachel Truscon: University of Michigan
Emileigh Johnson: University of Michigan
Marisa C. Eisenberg: University of Michigan
Adam S. Lauring: University of Michigan
Arnold S. Monto: University of Michigan
Sarah Cobey: University of Chicago
Emily T. Martin: University of Michigan

Nature Communications, 2025, vol. 16, issue 1, 1-12

Abstract: Abstract The role of viral interaction—where one virus enhances or inhibits infection with another virus—in respiratory virus transmission is not well characterized. This study used data from 4029 total participants from 957 households who participated in a prospective household cohort study in Southeast Michigan, U.S.A to examine how viral coinfection and cocirculation may impact transmission of symptomatic influenza and respiratory syncytial virus infections. We utilized multivariable mixed effects regression to estimate transmission risk when index cases were coinfected with multiple viruses and when viruses cocirculated within households. This analysis included 201 coinfections involving influenza A virus, 67 involving influenza B virus, and 181 involving respiratory syncytial virus. We show that exposure to symptomatic coinfected index cases was associated with reduced risk of influenza A virus and respiratory syncytial virus transmission compared to exposure to singly infected cases, while infection with another virus was associated with increased risk of acquisition of these viruses. Exposure to coinfected cases among contacts infected with other viruses was associated with increased risk of influenza B virus acquisition. These results suggest that viral interaction may impact symptomatic transmission of these viruses.

Date: 2025
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DOI: 10.1038/s41467-025-56285-z

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