Respiratory disease contact patterns in the US are stable but heterogeneous.

This study demonstrates the importance of incorporating age-specific and spatial heterogeneity of contact patterns into future disease models to build accurate estimates of transmission risk. We demonstrate that temporal variability in contact patterns is unlikely to drive respiratory disease seasonality, that adaptive behaviors in response to disease shift risk along an urban-rural gradient, and that some vulnerable groups are at increased risk of exposure due to contact. We advocate that geographic and social heterogeneity in exposure to disease due to contact patterns be captured more comprehensively for accurate infectious disease predictions and effective and equitable disease mitigation.