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Transmission of Viral Pathogens in a Social Network of University Students: The eX-FLU Study


Zivich, Paul N.; Eisenberg, Marisa C.; Monto, Arnold S.; Uzicanin, Amra; Baric, Ralph S.; Sheahan, T. P.; Rainey, Jeanette J.; Gao, H.; & Aiello, Allison E. (2020). Transmission of Viral Pathogens in a Social Network of University Students: The eX-FLU Study. Epidemiology & Infection, 148, e267. PMCID: PMC7689784


Previous research on respiratory infection transmission among university students has primarily focused on influenza. In this study, we explore potential transmission events for multiple respiratory pathogens in a social contact network of university students. University students residing in on-campus housing (n=590) were followed for the development of influenza-like illness for 10-weeks during the 2012-13 influenza season. A contact network was built using weekly self-reported contacts, class schedules, and housing information. We considered a transmission event to have occurred if students were positive for the same pathogen and had a network connection within a 14-day period. Transmitters were individuals who had onset date prior to their infected social contact. Throat and nasal samples were analyzed for multiple viruses by RT-PCR. Five viruses were involved in 18 transmission events (influenza A, parainfluenza virus 3, rhinovirus, coronavirus NL63, respiratory syncytial virus). Transmitters had higher numbers of co-infections (67%). Identified transmission events had contacts reported in small classes (33%), dormitory common areas (22%), and dormitory rooms (17%). These results suggest that targeting person-to-person interactions, through measures such as isolation and quarantine, could reduce transmission of respiratory infections on campus.


Reference Type

Journal Article

Article Type


Year Published


Journal Title

Epidemiology & Infection


Zivich, Paul N.
Eisenberg, Marisa C.
Monto, Arnold S.
Uzicanin, Amra
Baric, Ralph S.
Sheahan, T. P.
Rainey, Jeanette J.
Gao, H.
Aiello, Allison E.



Data Set/Study

eX-FLU Cluster Randomised Trial


United States of America