Contact patterns play a key role in disease transmission, and variation in contacts during the course of illness can influence transmission, particularly when accompanied by changes in host infectiousness. We used surveys among 1,642 contacts of 94 Nipah case-patients in Bangladesh to determine how contact patterns (physical and with bodily fluids) changed as disease progressed in severity. The number of contacts increased with severity and, for case-patients who died, peaked on the day of death. Given transmission has only been observed among fatal Nipah cases, our findings suggest changes in contact patterns during illness contribute to risk of infection.
Lee KH, Nikolay B, Sazzad HMS, Hossain MJ, Khan AKMD, Rahman M, Satter SM, Nichol ST, Klena JD, Pulliam JRC, Kilpatrick AM, Sultana S, Afroj S, Daszak P, Luby S, Cauchemez S, Salje H, Gurley E. (2020). Changing contact patterns over disease progression: Nipah virus as a case study. The Journal of infectious diseases