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Kurz H, Sever-Yildiz G, Kocsisek CV, Resch E, Großschädl C, Totschnig L, Resch B. Respiratory Syncytial Virus and Influenza During the COVID-19 Pandemic: A Two-center Experience. Pediatr Infect Dis J 2024; 43:410-414. [PMID: 38266234 PMCID: PMC11003405 DOI: 10.1097/inf.0000000000004260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/18/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND The aim of the study was to determine the burden of respiratory syncytial virus (RSV) and influenza disease during the COVID-19 pandemic at 2 Austrian urban pediatric centers between October 1, 2019 and April 30, 2022. METHODS We performed a retrospective observational 2-center study on RSV- and influenza virus-associated hospitalizations in infants and children up to 18 years at the University Hospital of Graz and the Clinic Donaustadt of Vienna from October 1, 2019 to April 30, 2022. Hospitalization had to be associated with the infectious disease, proven by polymerase chain reaction, including presence of respiratory symptoms. Demographic data including underlying diseases and treatment strategies were compared between centers and diseases, respectively. RESULTS There were 826 cases in Graz and 379 in Vienna with significant more RSV cases in Graz and more influenza cases in Vienna (RSV: 76% vs. 59%, influenza: 24% vs. 41%; both P < 0.001). One death occurred in Graz due to RSV and another due to influenza in Vienna. Seasonality only slightly differed between centers and severity of diseases was not aggravated when measured by pediatric intensive care unit admission rates, need for supplemental oxygen and respiratory support between first and last seasons. Treatment regimen differed regarding higher use of antibiotics and rates of intravenous fluids in Vienna compared to higher rates of bronchodilators, corticosteroids and nose drops in Graz. CONCLUSIONS We observed higher numbers of hospitalizations due to both viruses after the lockdown but not increased severity of the diseases; and mortality remained extremely low. Preventive measures should be implemented with high priority especially focused on infants with underlying diseases.
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Affiliation(s)
- Herbert Kurz
- From the Department of Pediatrics and Adolescents, Clinic Donaustadt, Vienna, Austria
| | - Gulsen Sever-Yildiz
- Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz
| | - Corinna V. Kocsisek
- From the Department of Pediatrics and Adolescents, Clinic Donaustadt, Vienna, Austria
| | - Elisabeth Resch
- Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz
| | - Clara Großschädl
- Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz
| | - Leonie Totschnig
- Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz
| | - Bernhard Resch
- Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
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Bender RG, Sirota SB, Swetschinski LR, Dominguez RMV, Novotney A, Wool EE, Ikuta KS, Vongpradith A, Rogowski ELB, Doxey M, Troeger CE, Albertson SB, Ma J, He J, Maass KL, A.F.Simões E, Abdoun M, Abdul Aziz JM, Abdulah DM, Abu Rumeileh S, Abualruz H, Aburuz S, Adepoju AV, Adha R, Adikusuma W, Adra S, Afraz A, Aghamiri S, Agodi A, Ahmadzade AM, Ahmed H, Ahmed A, Akinosoglou K, AL-Ahdal TMA, Al-amer RM, Albashtawy M, AlBataineh MT, Alemi H, Al-Gheethi AAS, Ali A, Ali SSS, Alqahtani JS, AlQudah M, Al-Tawfiq JA, Al-Worafi YM, Alzoubi KH, Amani R, Amegbor PM, Ameyaw EK, Amuasi JH, Anil A, Anyanwu PE, Arafat M, Areda D, Arefnezhad R, Atalell KA, Ayele F, Azzam AY, Babamohamadi H, Babin FX, Bahurupi Y, Baker S, Banik B, Barchitta M, Barqawi HJ, Basharat Z, Baskaran P, Batra K, Batra R, Bayileyegn NS, Beloukas A, Berkley JA, Beyene KA, Bhargava A, Bhattacharjee P, Bielicki JA, Bilalaga MM, Bitra VR, Brown CS, Burkart K, Bustanji Y, Carr S, Chahine Y, Chattu VK, Chichagi F, Chopra H, Chukwu IS, Chung E, Dadana S, Dai X, Dandona L, Dandona R, Darban I, Dash NR, Dashti M, Dashtkoohi M, Dekker DM, Delgado-Enciso I, Devanbu VGC, Dhama K, Diao N, Do THP, Dokova KG, Dolecek C, Dziedzic AM, Eckmanns T, Ed-Dra A, Efendi F, Eftekharimehrabad A, Eyre DW, Fahim A, Feizkhah A, Felton TW, Ferreira N, Flor LS, Gaihre S, Gebregergis MW, Gebrehiwot M, Geffers C, Gerema U, Ghaffari K, Goldust M, Goleij P, Guan SY, Gudeta MD, Guo C, Gupta VB, Gupta I, Habibzadeh F, Hadi NR, Haeuser E, Hailu WB, Hajibeygi R, Haj-Mirzaian A, Haller S, Hamiduzzaman M, Hanifi N, Hansel J, Hasnain MS, Haubold J, Hoan NQ, Huynh HH, Iregbu KC, Islam MR, Jafarzadeh A, Jairoun AA, Jalili M, Jomehzadeh N, Joshua CE, Kabir MA, Kamal Z, Kanmodi KK, Kantar RS, Karimi Behnagh A, Kaur N, Kaur H, Khamesipour F, Khan MN, Khan suheb MZ, Khanal V, Khatab K, Khatib MN, Kim G, Kim K, Kitila ATT, Komaki S, Krishan K, Krumkamp R, Kuddus MA, Kurniasari MD, Lahariya C, Latifinaibin K, Le NHH, Le TTT, Le TDT, Lee SW, LEPAPE A, Lerango TL, Li MC, Mahboobipour AA, Malhotra K, Mallhi TH, Manoharan A, Martinez-Guerra BA, Mathioudakis AG, Mattiello R, May J, McManigal B, McPhail SM, Mekene Meto T, Mendez-Lopez MAM, Meo SA, Merati M, Mestrovic T, Mhlanga L, Minh LHN, Misganaw A, Mishra V, Misra AK, Mohamed NS, Mohammadi E, Mohammed M, Mohammed M, Mokdad AH, Monasta L, Moore CE, Motappa R, Mougin V, Mousavi P, Mulita F, Mulu AA, Naghavi P, Naik GR, Nainu F, Nair TS, Nargus S, Negaresh M, Nguyen HTH, Nguyen DH, Nguyen VT, Nikolouzakis TK, Noman EA, Nri-Ezedi CA, Odetokun IA, Okwute PG, Olana MD, Olanipekun TO, Olasupo OO, Olivas-Martinez A, Ordak M, Ortiz-Brizuela E, Ouyahia A, Padubidri JR, Pak A, Pandey A, Pantazopoulos I, Parija PP, Parikh RR, Park S, Parthasarathi A, Pashaei A, Peprah P, Pham HT, Poddighe D, Pollard A, Ponce-De-Leon A, Prakash PY, Prates EJS, Quan NK, Raee P, Rahim F, Rahman M, Rahmati M, Ramasamy SK, Ranjan S, Rao IR, Rashid AM, Rattanavong S, Ravikumar N, Reddy MMRK, Redwan EMM, Reiner RC, Reyes LF, Roberts T, Rodrigues M, Rosenthal VD, Roy P, Runghien T, Saeed U, Saghazadeh A, Saheb Sharif-Askari N, Saheb Sharif-Askari F, Sahoo SS, Sahu M, Sakshaug JW, Salami AA, Saleh MA, Salehi omran H, Sallam M, Samadzadeh S, Samodra YL, Sanjeev RK, Sarasmita MA, Saravanan A, Sartorius B, Saulam J, Schumacher AE, Seyedi SA, Shafie M, Shahid S, Sham S, Shamim MA, Shamshirgaran MA, Shastry RP, Sherchan SP, Shiferaw D, Shittu A, Siddig EE, Sinto R, Sood A, Sorensen RJD, Stergachis A, Stoeva TZ, Swain CK, Szarpak L, Tamuzi JL, Temsah MH, Tessema MBT, Thangaraju P, Tran NM, Tran NH, Tumurkhuu M, Ty SS, Udoakang AJ, Ulhaq I, Umar TP, Umer AA, Vahabi SM, Vaithinathan AG, Van den Eynde J, Walson JL, Waqas M, Xing Y, Yadav MK, Yahya G, Yon DK, Zahedi Bialvaei A, Zakham F, Zeleke AM, Zhai C, Zhang Z, Zhang H, Zielińska M, Zheng P, Aravkin AY, Vos T, Hay SI, Mosser JF, Lim SS, Naghavi M, Murray CJL, Kyu HH. Global, regional, and national incidence and mortality burden of non-COVID-19 lower respiratory infections and aetiologies, 1990-2021: a systematic analysis from the Global Burden of Disease Study 2021. Lancet Infect Dis 2024:S1473-3099(24)00176-2. [PMID: 38636536 DOI: 10.1016/s1473-3099(24)00176-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/19/2024] [Accepted: 03/07/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Lower respiratory infections (LRIs) are a major global contributor to morbidity and mortality. In 2020-21, non-pharmaceutical interventions associated with the COVID-19 pandemic reduced not only the transmission of SARS-CoV-2, but also the transmission of other LRI pathogens. Tracking LRI incidence and mortality, as well as the pathogens responsible, can guide health-system responses and funding priorities to reduce future burden. We present estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 of the burden of non-COVID-19 LRIs and corresponding aetiologies from 1990 to 2021, inclusive of pandemic effects on the incidence and mortality of select respiratory viruses, globally, regionally, and for 204 countries and territories. METHODS We estimated mortality, incidence, and aetiology attribution for LRI, defined by the GBD as pneumonia or bronchiolitis, not inclusive of COVID-19. We analysed 26 259 site-years of mortality data using the Cause of Death Ensemble model to estimate LRI mortality rates. We analysed all available age-specific and sex-specific data sources, including published literature identified by a systematic review, as well as household surveys, hospital admissions, health insurance claims, and LRI mortality estimates, to generate internally consistent estimates of incidence and prevalence using DisMod-MR 2.1. For aetiology estimation, we analysed multiple causes of death, vital registration, hospital discharge, microbial laboratory, and literature data using a network analysis model to produce the proportion of LRI deaths and episodes attributable to the following pathogens: Acinetobacter baumannii, Chlamydia spp, Enterobacter spp, Escherichia coli, fungi, group B streptococcus, Haemophilus influenzae, influenza viruses, Klebsiella pneumoniae, Legionella spp, Mycoplasma spp, polymicrobial infections, Pseudomonas aeruginosa, respiratory syncytial virus (RSV), Staphylococcus aureus, Streptococcus pneumoniae, and other viruses (ie, the aggregate of all viruses studied except influenza and RSV), as well as a residual category of other bacterial pathogens. FINDINGS Globally, in 2021, we estimated 344 million (95% uncertainty interval [UI] 325-364) incident episodes of LRI, or 4350 episodes (4120-4610) per 100 000 population, and 2·18 million deaths (1·98-2·36), or 27·7 deaths (25·1-29·9) per 100 000. 502 000 deaths (406 000-611 000) were in children younger than 5 years, among which 254 000 deaths (197 000-320 000) occurred in countries with a low Socio-demographic Index. Of the 18 modelled pathogen categories in 2021, S pneumoniae was responsible for the highest proportions of LRI episodes and deaths, with an estimated 97·9 million (92·1-104·0) episodes and 505 000 deaths (454 000-555 000) globally. The pathogens responsible for the second and third highest episode counts globally were other viral aetiologies (46·4 million [43·6-49·3] episodes) and Mycoplasma spp (25·3 million [23·5-27·2]), while those responsible for the second and third highest death counts were S aureus (424 000 [380 000-459 000]) and K pneumoniae (176 000 [158 000-194 000]). From 1990 to 2019, the global all-age non-COVID-19 LRI mortality rate declined by 41·7% (35·9-46·9), from 56·5 deaths (51·3-61·9) to 32·9 deaths (29·9-35·4) per 100 000. From 2019 to 2021, during the COVID-19 pandemic and implementation of associated non-pharmaceutical interventions, we estimated a 16·0% (13·1-18·6) decline in the global all-age non-COVID-19 LRI mortality rate, largely accounted for by a 71·8% (63·8-78·9) decline in the number of influenza deaths and a 66·7% (56·6-75·3) decline in the number of RSV deaths. INTERPRETATION Substantial progress has been made in reducing LRI mortality, but the burden remains high, especially in low-income and middle-income countries. During the COVID-19 pandemic, with its associated non-pharmaceutical interventions, global incident LRI cases and mortality attributable to influenza and RSV declined substantially. Expanding access to health-care services and vaccines, including S pneumoniae, H influenzae type B, and novel RSV vaccines, along with new low-cost interventions against S aureus, could mitigate the LRI burden and prevent transmission of LRI-causing pathogens. FUNDING Bill & Melinda Gates Foundation, Wellcome Trust, and Department of Health and Social Care (UK).
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Petros BA, Milliren CE, Sabeti PC, Ozonoff A. Increased Pediatric Respiratory Syncytial Virus Case Counts Following the Emergence of Severe Acute Respiratory Syndrome Coronavirus 2 Can Be Attributed to Changes in Testing. Clin Infect Dis 2024:ciae140. [PMID: 38602423 DOI: 10.1093/cid/ciae140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) circulation dropped markedly early in the COVID-19 pandemic, followed by a resurgence with heightened case counts. The "immunity debt" hypothesis proposes that the RSV-naїve pediatric population increased during the period of low transmission. However, the evidence supporting this hypothesis is limited, and the role of changing testing practices in the perceived surge has not been comprehensively evaluated. METHODS We conducted a multicenter, retrospective analysis of 342 530 RSV encounters and 980 546 RSV diagnostic tests occurring at 32 US pediatric hospitals in 2013-2023. We used interrupted time series analysis to estimate pandemic-associated changes in RSV patient and test volume and to quantify changes in the proportions of patients requiring hospitalization, intensive care, or mechanical ventilation. We quantified the fraction of the shifts in case counts and in the age of diagnosed patients attributable to changes in testing. RESULTS RSV patient volume increased 2.4-fold (95% confidence interval [CI]: 1.7, 3.5) in 2021-2023 relative to the pre-pandemic phase and was accompanied by an 18.9-fold increase (95% CI: 15.0, 23.9) in RSV test volume. Shifts in patient volume and in patient age were largely attributable to increased testing. The proportions of patients with RSV that required hospitalization, intensive care, or mechanical ventilation declined significantly across all patient age groups. CONCLUSIONS A surge in RSV testing, rather than in viral circulation, likely underlies the increased case counts observed in 2021-2023. These findings warrant a critical assessment of the immunity debt hypothesis and highlight the importance of considering the testing denominator when surveillance strategies are dynamic.
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Affiliation(s)
- Brittany A Petros
- Infectious Disease and Microbiome Program, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts, USA
- Health Sciences & Technology Program, Harvard Medical School and Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
- Harvard-Massachusetts Institute of Technology MD-PhD Program, Boston, Massachusetts, USA
- Department of Systems Biology, Harvard Medical School, Boston, Massachusetts, USA
| | - Carly E Milliren
- Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Pardis C Sabeti
- Infectious Disease and Microbiome Program, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts, USA
- Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, Massachusetts, USA
- Department of Immunology & Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
- Howard Hughes Medical Institute, Chevy Chase, Maryland, USA
| | - Al Ozonoff
- Infectious Disease and Microbiome Program, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts, USA
- Precision Vaccines Program, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
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Cong B, Koç U, Bandeira T, Bassat Q, Bont L, Chakhunashvili G, Cohen C, Desnoyers C, Hammitt LL, Heikkinen T, Huang QS, Markić J, Mira-Iglesias A, Moyes J, Nokes DJ, Ploin D, Seo E, Singleton R, Wolter N, Fu Yung C, Zar HJ, Feikin DR, Sparrow EG, Nair H, Li Y. Changes in the global hospitalisation burden of respiratory syncytial virus in young children during the COVID-19 pandemic: a systematic analysis. Lancet Infect Dis 2024; 24:361-374. [PMID: 38141633 DOI: 10.1016/s1473-3099(23)00630-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 09/30/2023] [Accepted: 10/03/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND The COVID-19 pandemic is reported to have affected the epidemiology of respiratory syncytial virus (RSV), which could have important implications for RSV prevention and control strategies. We aimed to assess the hospitalisation burden of RSV-associated acute lower respiratory infection (ALRI) in children younger than 5 years during the pandemic period and the possible changes in RSV epidemiology from a global perspective. METHODS We conducted a systematic literature search for studies published between Jan 1, 2020, and June 30, 2022, in MEDLINE, Embase, Global Health, Web of Science, the WHO COVID-19 Research Database, CINAHL, LILACS, OpenGrey, CNKI, WanFang, and CqVip. We included unpublished data on RSV epidemiology shared by international collaborators. Eligible studies reported data on at least one of the following measures for children (aged <5 years) hospitalised with RSV-associated ALRI: hospital admission rates, in-hospital case fatality ratio, and the proportion of hospitalised children requiring supplemental oxygen or requiring mechanical ventilation or admission to intensive care. We used a generalised linear mixed-effects model for data synthesis to measure the changes in the incidence, age distribution, and disease severity of children hospitalised with RSV-associated ALRI during the pandemic, compared with the year 2019. FINDINGS We included 61 studies from 19 countries, of which 14 (23%) studies were from the published literature (4052 identified records) and 47 (77%) were from unpublished datasets. Most (51 [84%]) studies were from high-income countries; nine (15%) were from upper-middle-income countries, one (2%) was from a lower-middle-income country (Kenya), and none were from a low-income country. 15 studies contributed to the estimates of hospitalisation rate and 57 studies contributed to the severity analyses. Compared with 2019, the rates of RSV-associated ALRI hospitalisation in all children (aged 0-60 months) in 2020 decreased by 79·7% (325 000 cases vs 66 000 cases) in high-income countries, 13·8% (581 000 cases vs 501 000 cases) in upper-middle-income countries, and 42·3% (1 378 000 cases vs 795 000 cases) in Kenya. In high-income countries, annualised rates started to rise in 2021, and by March, 2022, had returned to a level similar to 2019 (6·0 cases per 1000 children [95% uncertainty interval 5·4-6·8] in April, 2021, to March, 2022, vs 5·0 cases per 1000 children [3·6-6·8] in 2019). By contrast, in middle-income countries, rates remained lower in the latest period with data available than in 2019 (for upper-middle-income countries, 2·1 cases [0·7-6·1] in April, 2021, to March, 2022, vs 3·4 [1·2-9·7] in 2019; for Kenya, 2·2 cases [1·8-2·7] in 2021 vs 4·1 [3·5-4·7] in 2019). Across all time periods and income regions, hospitalisation rates peaked in younger infants (aged 0 to <3 months) and decreased with increasing age. A significantly higher proportion of children aged 12-24 months were hospitalised with RSV-associated ALRI in high-income and upper-middle-income countries during the pandemic years than in 2019, with odds ratios ranging from 1·30 (95% uncertainty interval 1·07-1·59) to 2·05 (1·66-2·54). No consistent changes in disease severity were observed. INTERPRETATION The hospitalisation burden of RSV-associated ALRI in children younger than 5 years was significantly reduced during the first year of the COVID-19 pandemic. The rebound in hospitalisation rates to pre-pandemic rates observed in the high-income region but not in the middle-income region by March, 2022, suggests a persistent negative impact of the pandemic on health-care systems and health-care access in the middle-income region. RSV surveillance needs to be established (or re-established) to monitor changes in RSV epidemiology, particularly in low-income and lower-middle-income countries. FUNDING EU Innovative Medicines Initiative Preparing for RSV Immunisation and Surveillance in Europe (PROMISE), Bill & Melinda Gates Foundation, and WHO.
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Affiliation(s)
- Bingbing Cong
- Department of Epidemiology, National Vaccine Innovation Platform, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Uğurcan Koç
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Teresa Bandeira
- Pediatric Department, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, University of Lisbon, Lisbon, Portugal
| | - Quique Bassat
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique; Catalan Institution for Research and Advanced Studies, Barcelona, Spain
| | - Louis Bont
- Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands; ReSViNET Foundation, Zeist, Netherlands
| | | | - Cheryl Cohen
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Laura L Hammitt
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Terho Heikkinen
- Department of Pediatrics, University of Turku and Turku University Hospital, Turku, Finland
| | - Q Sue Huang
- WHO National Influenza Centre, Institute of Environmental Science and Research, Wellington, New Zealand
| | - Joško Markić
- Department of Pediatrics, University Hospital Split, Split, Croatia; University of Split School of Medicine, Split, Croatia
| | - Ainara Mira-Iglesias
- Área de Investigación en Vacunas, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, Salud Pública, Valencia, Spain; CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Jocelyn Moyes
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa
| | - D James Nokes
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya; School of Life Sciences, University of Warwick, Coventry, UK
| | - Dominique Ploin
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Service de Réanimation Pédiatrique et d'Accueil des Urgences, Bron, France
| | - Euri Seo
- The Center for Viral Immunology, Korea Virus Research Institute, Institute for Basic Science, Daejeon, South Korea
| | | | - Nicole Wolter
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa; School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Chee Fu Yung
- Infectious Diseases Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore; Duke-NUS Medical School, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Heather J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa; South African Medical Research Council Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Daniel R Feikin
- Department of Immunization, Vaccines, and Biologicals, WHO, Geneva, Switzerland
| | - Erin G Sparrow
- Department of Immunization, Vaccines, and Biologicals, WHO, Geneva, Switzerland
| | - Harish Nair
- Department of Epidemiology, National Vaccine Innovation Platform, School of Public Health, Nanjing Medical University, Nanjing, China; Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - You Li
- Department of Epidemiology, National Vaccine Innovation Platform, School of Public Health, Nanjing Medical University, Nanjing, China; Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK.
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Ramanathan A, Lee W, Peplinski J, Mace AO, Foley DA. Head-to-Head Comparison Between Respiratory Syncytial Virus and Human Metapneumovirus Bronchiolitis in the Setting of Increased Viral Testing. Pediatr Infect Dis J 2024; 43:e139-e141. [PMID: 38100724 DOI: 10.1097/inf.0000000000004217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
We compared the epidemiology, severity and management of hospitalized respiratory syncytial virus (n = 305) and human metapneumovirus (n = 39) bronchiolitis in a setting with high respiratory virus testing (95% of admissions tested). Respiratory syncytial virus-positive infants were younger and tended to require more hydration support and longer hospital stays compared to human metapneumovirus-positive infants. Respiratory support requirements were similar between groups despite significant age differences.
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Affiliation(s)
- Ashwin Ramanathan
- From the Department of General Paediatrics, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Weihao Lee
- From the Department of General Paediatrics, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Joseph Peplinski
- From the Department of General Paediatrics, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Ariel O Mace
- From the Department of General Paediatrics, Perth Children's Hospital, Nedlands, Western Australia, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - David A Foley
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
- Department of Clinical Microbiology, PathWest Laboratory Medicine, Perth, Western Australia, Australia
- Medical School, University of Western Australia, Perth, Western Australia, Australia
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Leija-Martínez JJ, Esparza-Miranda LA, Rivera-Alfaro G, Noyola DE. Impact of Nonpharmaceutical Interventions during the COVID-19 Pandemic on the Prevalence of Respiratory Syncytial Virus in Hospitalized Children with Lower Respiratory Tract Infections: A Systematic Review and Meta-Analysis. Viruses 2024; 16:429. [PMID: 38543794 PMCID: PMC10974159 DOI: 10.3390/v16030429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/15/2024] [Accepted: 02/19/2024] [Indexed: 04/05/2024] Open
Abstract
During the COVID-19 pandemic, nonpharmaceutical interventions (NPIs) were implemented in order to control the transmission of SARS-CoV-2, potentially affecting the prevalence of respiratory syncytial virus (RSV). This review evaluated the impact of NPIs on RSV-related hospitalizations in children during the lockdown (2020-2021) compared to the pre-pandemic (2015-2020) and post-lockdown (2021-2022) periods. In this systematic review and meta-analysis, we searched through PubMed, Scopus, and Web of Science for studies published in English between 1 January 2015 and 31 December 2022. Additionally, we conducted hand searches of other records published between 1 January 2023 and 22 January 2024. Our target population was hospitalized children aged 0-18 years with RSV-related lower respiratory tract infections confirmed through immunofluorescence, antigen testing, or molecular assays. We focused on peer-reviewed observational studies, analyzing the primary outcome of pooled RSV prevalence. A generalized linear mixed model with a random-effects model was utilized to pool each RSV prevalence. Heterogeneity was assessed using Cochran's Q and I2 statistics, while publication bias was evaluated through funnel plots and Egger's tests. We identified and analyzed 5815 publications and included 112 studies with 308,985 participants. Notably, RSV prevalence was significantly lower during the lockdown period (5.03% [95% CI: 2.67; 9.28]) than during the pre-pandemic period (25.60% [95% CI: 22.57; 28.88], p < 0.0001). However, RSV prevalence increased notably in the post-lockdown period after the relaxation of COVID-19 prevention measures (42.02% [95% CI: 31.49; 53.33] vs. 5.03% [95% CI: 2.67; 9.28], p < 0.0001). Most pooled effect estimates exhibited significant heterogeneity (I2: 91.2% to 99.3%). Our findings emphasize the effectiveness of NPIs in reducing RSV transmission. NPIs should be considered significant public health measures to address RSV outbreaks.
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Affiliation(s)
- José J. Leija-Martínez
- Research Center in Health Sciences and Biomedicine (CICSaB), Universidad Autónoma de San Luis Potosí, San Luis Potosí 78210, Mexico; (J.J.L.-M.); (L.A.E.-M.); (G.R.-A.)
| | - Luis A. Esparza-Miranda
- Research Center in Health Sciences and Biomedicine (CICSaB), Universidad Autónoma de San Luis Potosí, San Luis Potosí 78210, Mexico; (J.J.L.-M.); (L.A.E.-M.); (G.R.-A.)
- Microbiology Department, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí 78210, Mexico
| | - Gerardo Rivera-Alfaro
- Research Center in Health Sciences and Biomedicine (CICSaB), Universidad Autónoma de San Luis Potosí, San Luis Potosí 78210, Mexico; (J.J.L.-M.); (L.A.E.-M.); (G.R.-A.)
| | - Daniel E. Noyola
- Research Center in Health Sciences and Biomedicine (CICSaB), Universidad Autónoma de San Luis Potosí, San Luis Potosí 78210, Mexico; (J.J.L.-M.); (L.A.E.-M.); (G.R.-A.)
- Microbiology Department, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí 78210, Mexico
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Lomholt FK, Emborg HD, Nørgaard SK, Nielsen J, Munkstrup C, Møller KL, Krog JS, Trebbien R, Vestergaard LS. Resurgence of Respiratory Syncytial Virus in the Summer of 2021 in Denmark-a Large out-of-season Epidemic Affecting Older Children. Open Forum Infect Dis 2024; 11:ofae069. [PMID: 38495773 PMCID: PMC10941316 DOI: 10.1093/ofid/ofae069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/02/2024] [Indexed: 03/19/2024] Open
Abstract
Background When coronavirus disease 2019 (COVID-19) restrictions were lifted in Denmark in the spring of 2021, a surge in respiratory syncytial virus (RSV) cases followed, causing a large out-of-season epidemic. This study aims to investigate the summer epidemic compared with 3 typical pre-COVID-19 RSV winter seasons using Danish registers to identify RSV cases, RSV-related admissions, and use of intensive care treatment. Methods Incidence rates (IR) per 1000 person-years for RSV cases, RSV-related admissions, and intensive care treatment were calculated with 95% confidence interval (CI) for each season, stratified by age groups and incidence rate ratios (IRR) with 95% CI were calculated to compare the summer epidemic with the winter season for 2019-2020. Results In the summer epidemic, the IR of RSV cases and admissions exceeded previous winter seasons for all age groups. The highest increases in IRs were seen among children aged 2 to 3 years and 4 to 5 years. The IRR of cases were 4.6 (95% CI, 4.1-5.2) and 3.3 (2.6-4.2) and the IRR of admissions were 3.3 (2.7-4.2) and 3.8 (2.3-6.5) in the 2 age groups, respectively, when compared with the winter season 2019-2020. Conclusions Likely because of immunity debt following COVID-19 restrictions, the summer epidemic was significantly larger than previous winter seasons, most markedly among children aged 2 to 3 and 4 to 5 years but had a similar disease severity spectrum.
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Affiliation(s)
| | - Hanne-Dorthe Emborg
- Department of Infections Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Sarah Kristine Nørgaard
- Department of Infections Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Jens Nielsen
- Department of Infections Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Charlotte Munkstrup
- Department of Infections Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | | | - Jesper Schak Krog
- Department of Virus and Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
| | - Ramona Trebbien
- Department of Virus and Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
| | - Lasse Skafte Vestergaard
- Department of Infections Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
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Farquharson KA, Anthony D, Menzies R, Homaira N. Burden of respiratory syncytial virus disease across the lifespan in Australia and New Zealand: a scoping review. Public Health 2024; 226:8-16. [PMID: 37980838 DOI: 10.1016/j.puhe.2023.10.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 10/04/2023] [Accepted: 10/13/2023] [Indexed: 11/21/2023]
Abstract
OBJECTIVES Respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory tract infection in young children worldwide. RSV is increasingly associated with severe respiratory disease in people aged >65 years. The heterogeneous landscape of RSV in Australia and New Zealand makes generalisation of results from global studies to local contexts difficult. Given the changing landscape of RSV, we aimed to examine the existing literature on the burden of RSV disease and identify evidence gaps in Australia and New Zealand. STUDY DESIGN Scoping review. METHODS We designed a scoping review protocol and searched the Web of Science and Scopus databases for eligible peer-reviewed publications. Data from eligible studies were charted and summarised in tabular and narrative form. RESULTS Of the 153 eligible publications identified, 123 investigated RSV disease in a hospital setting and six in primary care. Only six studies reported the economic burden of disease, all of which estimated direct healthcare costs associated with treatment and/or hospitalisation; no studies quantified the indirect costs or costs to families. CONCLUSIONS In this scoping review, we describe the effect of RSV disease in several high-risk populations, including children and adults. An improved understanding of the RSV burden of disease, both in primary care settings and economically, within the local context will assist with the implementation of preventative strategies, including vaccination programmes. Future studies to determine the true burden of RSV-associated morbidity, mortality and economic burden across the entire patient journey and among different healthcare settings will help prioritise emerging RSV therapeutics.
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Affiliation(s)
- K A Farquharson
- School of Life and Environmental Sciences, The University of Sydney, Sydney, NSW, Australia; Edge Medical Communications, Port Macquarie, NSW, Australia
| | - D Anthony
- Sanofi Vaccines ANZ, Melbourne, VIC, Australia
| | - R Menzies
- Sanofi Vaccines ANZ, Macquarie Park, Sydney, NSW, Australia
| | - N Homaira
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Sydney, Sydney, NSW, Australia; Respiratory Department, Sydney Children's Hospital, Randwick, Sydney, NSW, Australia; James P. Grant School of Public Health, BRAC University, Bangladesh.
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Foley DA, Minney-Smith CA, Lee WH, Oakes DB, Hazelton B, Ford TJ, Wadia U, Sikazwe C, Moore HC, Nicol MP, Levy A, Blyth CC. Respiratory Syncytial Virus Reinfections in Children in Western Australia. Viruses 2023; 15:2417. [PMID: 38140658 PMCID: PMC10747877 DOI: 10.3390/v15122417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/08/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
Respiratory syncytial virus (RSV) reinfection in children is poorly understood. We examined the incidence, characteristics, and outcomes of hospital-attended RSV reinfections in children <16 years in Western Australia between 2012 and 2022. Individuals with repeat RSV detections ≥56 days apart were identified using laboratory data. The incidence of reinfection in the first five years of life was estimated using the total birth population from 2012 to 2017. Clinical data on a subset of reinfection episodes were obtained from two metropolitan pediatric centers. A total of 466 children with hospital-attended reinfections were identified. The median interval between RSV detections was 460 days (interquartile range: 324, 812), with a reinfection rate of 95 per 100,000 individuals (95% confidence interval: 82, 109). Reinfection was most common in children who experienced their first RSV detection <6 months of age. Predisposing factors were identified in 56% of children; children with predisposing factors were older at first and second detections, were more likely to be admitted, and had a longer length of stay. This study highlights the significant burden of hospital-attended RSV reinfections in children with and without predisposing factors. Expanded surveillance with in-depth clinical data is required to further characterize the impact of RSV reinfection.
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Affiliation(s)
- David A. Foley
- Department of Microbiology, PathWest Laboratory Medicine WA, Nedlands, WA 6009, Australia (A.L.); (C.C.B.)
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia (H.C.M.); (M.P.N.)
- School of Medicine, University of Western Australia, Perth, WA 6009, Australia
| | - Cara A. Minney-Smith
- Department of Microbiology, PathWest Laboratory Medicine WA, Nedlands, WA 6009, Australia (A.L.); (C.C.B.)
| | - Wei Hao Lee
- School of Medicine, University of Western Australia, Perth, WA 6009, Australia
- Department of General Paediatrics, Perth Children’s Hospital, Nedlands, WA 6009, Australia
| | - Daniel B. Oakes
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia (H.C.M.); (M.P.N.)
| | - Briony Hazelton
- Department of Microbiology, PathWest Laboratory Medicine WA, Nedlands, WA 6009, Australia (A.L.); (C.C.B.)
- Department of Infectious Diseases, Perth Children’s Hospital, Nedlands, WA 6009, Australia
| | - Timothy J. Ford
- School of Medicine, University of Western Australia, Perth, WA 6009, Australia
- Department of Infectious Diseases, Perth Children’s Hospital, Nedlands, WA 6009, Australia
| | - Ushma Wadia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia (H.C.M.); (M.P.N.)
- Department of Infectious Diseases, Perth Children’s Hospital, Nedlands, WA 6009, Australia
- Department of General Paediatrics, Fiona Stanley Hospital, Murdoch, WA 6150, Australia
| | - Chisha Sikazwe
- Department of Microbiology, PathWest Laboratory Medicine WA, Nedlands, WA 6009, Australia (A.L.); (C.C.B.)
- Marshall Centre for Infectious Diseases, School of Biomedical Sciences, University of Western Australia, Perth, WA 6009, Australia
| | - Hannah C. Moore
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia (H.C.M.); (M.P.N.)
- School of Population Health, Curtin University, Perth, WA 6009, Australia
| | - Mark P. Nicol
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia (H.C.M.); (M.P.N.)
- Marshall Centre, Biomedical Sciences, University of Western Australia, Perth, WA 6009, Australia
| | - Avram Levy
- Department of Microbiology, PathWest Laboratory Medicine WA, Nedlands, WA 6009, Australia (A.L.); (C.C.B.)
- Marshall Centre for Infectious Diseases, School of Biomedical Sciences, University of Western Australia, Perth, WA 6009, Australia
| | - Christopher C. Blyth
- Department of Microbiology, PathWest Laboratory Medicine WA, Nedlands, WA 6009, Australia (A.L.); (C.C.B.)
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia (H.C.M.); (M.P.N.)
- School of Medicine, University of Western Australia, Perth, WA 6009, Australia
- Department of Infectious Diseases, Perth Children’s Hospital, Nedlands, WA 6009, Australia
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Rice E, Oakes DB, Holland C, Moore HC, Blyth CC. Respiratory syncytial virus in children: epidemiology and clinical impact post-COVID-19. Curr Opin Infect Dis 2023; 36:522-528. [PMID: 37830952 DOI: 10.1097/qco.0000000000000967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
PURPOSE OF REVIEW Respiratory syncytial virus (RSV) remains a leading cause of mortality and morbidity worldwide. RSV seasonality was disrupted by COVID-19-associated nonpharmaceutical interventions (NPIs). We review RSV seasonality, molecular epidemiology, clinical manifestations, and community awareness to inform future prevention strategies. RECENT FINDINGS An initial reduction of RSV disease observed with NPIs, and subsequent global resurgence was associated with a collapse in genetic diversity. A lack of immunity is suggested to have contributed to the resurgence of RSV cases experienced post COVID-19. The median age of children admitted with RSV increased during the resurgence, likely secondary to the expanded cohort of RSV-immune naive children. The pandemic also played a role in increased community awareness, which can be utilized as part of a coordinated public health effort to introduce prevention strategies. Further education on signs and symptoms of RSV is still required. SUMMARY mAbs and maternal vaccines targeting RSV have the potential to reduce paediatric morbidity, however this new era of RSV prevention will require ongoing research to facilitate community awareness and engagement, and better respiratory surveillance. Tackling the global burden of RSV will require a coordinated effort and measures to ensure access and affordability of new prevention strategies.
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Affiliation(s)
- Emily Rice
- Department of General Paediatrics, Perth Children's Hospital, Hospital Avenue
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia
| | - Daniel B Oakes
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia
| | - Charlie Holland
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia
- School of Population Health, Curtin University
| | - Hannah C Moore
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia
- School of Population Health, Curtin University
| | - Christopher C Blyth
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia
- Department of Infectious Diseases, Perth Children's Hospital, Hospital Avenue
- School of Medicine, University of Western Australia
- Department of Microbiology, PathWest Laboratory Medicine, QEII Medical Centre, Perth, Western Australia
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Fukuda Y, Togashi A, Hirakawa S, Yamamoto M, Fukumura S, Nawa T, Honjo S, Kunizaki J, Nishino K, Tanaka T, Kizawa T, Yamamoto D, Takeuchi R, Sasaoka Y, Kikuchi M, Ito T, Nagai K, Asakura H, Kudou K, Yoshida M, Nishida T, Tsugawa T. Changing Patterns of Infectious Diseases Among Hospitalized Children in Hokkaido, Japan, in the Post-COVID-19 Era, July 2019 to June 2022. Pediatr Infect Dis J 2023; 42:766-773. [PMID: 37257096 PMCID: PMC10627402 DOI: 10.1097/inf.0000000000003982] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/19/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Many reports have reported a reduction in respiratory infectious diseases and infectious gastroenteritis immediately after the coronavirus disease 2019 (COVID-19) pandemic, but data continuing into 2022 are very limited. We sought to understand the current situation of various infectious diseases among children in Japan as of July 2022 to improve public health in the post-COVID-19 era. METHODS We collected data on children hospitalized with infectious diseases in 18 hospitals in Japan from July 2019 to June 2022. RESULTS In total, 3417 patients were hospitalized during the study period. Respiratory syncytial virus decreased drastically after COVID-19 spread in early 2020, and few patients were hospitalized for it from April 2020 to March 2021. However, an unexpected out-of-season re-emergence of respiratory syncytial virus was observed in August 2021 (50 patients per week), particularly prominent among older children 3-6 years old. A large epidemic of delayed norovirus gastroenteritis was observed in April 2021, suggesting that the nonpharmaceutical interventions for COVID-19 are less effective against norovirus. However, influenza, human metapneumovirus, Mycoplasma pneumoniae , and rotavirus gastroenteritis were rarely seen for more than 2 years. CONCLUSIONS The incidence patterns of various infectious diseases in Japan have changed markedly since the beginning of the COVID-19 pandemic to the present. The epidemic pattern in the post-COVID-19 era is unpredictable and will require continued careful surveillance.
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Affiliation(s)
- Yuya Fukuda
- From the Department of Pediatrics, Japan Red Cross Urakawa Hospital, Hokkaido, Japan
- Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Atsuo Togashi
- Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Satoshi Hirakawa
- Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Masaki Yamamoto
- Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Shinobu Fukumura
- Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tomohiro Nawa
- Department of Pediatric Cardiology and Pediatric Intensive Care, Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo, Japan
| | - Saho Honjo
- Department of Pediatrics, Iwamizawa Municipal General Hospital, Hokkaido, Japan
| | - Jun Kunizaki
- Department of Pediatrics, NTT EC Sapporo Medical Center, Sapporo, Japan
| | - Kouhei Nishino
- Department of Pediatrics, Otaru Kyokai Hospital, Hokkaido, Japan
| | - Toju Tanaka
- Department of Pediatrics, Hokkaido Medical Center, Sapporo, Japan
| | - Toshitaka Kizawa
- Department of Pediatrics, Japan Community Health care Organization Sapporo Hokushin Hospital, Sapporo, Japan
| | - Dai Yamamoto
- Department of Pediatrics, Kushiro City General Hospital, Hokkaido, Japan
| | - Ryoh Takeuchi
- Department of Pediatrics, Nemuro City Hospital, Hokkaido, Japan
| | - Yuta Sasaoka
- Department of Pediatrics, Hakodate Municipal Hospital, Hokkaido, Japan
| | - Masayoshi Kikuchi
- Department of Pediatrics, Sunagawa City Medical Center, Hokkaido, Japan
| | - Takuro Ito
- Department of Pediatrics, Steel Memorial Muroran Hospital, Hokkaido, Japan
| | - Kazushige Nagai
- Department of Pediatrics, Takikawa Municipal Hospital, Hokkaido, Japan
| | - Hirofumi Asakura
- Department of Pediatrics, Hokkaido Esashi Hospital, Hokkaido, Japan
| | - Katsumasa Kudou
- Department of Pediatrics, Tomakomai City Hospital, Hokkaido, Japan
| | - Masaki Yoshida
- Department of Pediatrics, Yakumo General Hospital, Hokkaido, Japan
| | - Takeshi Nishida
- Department of Pediatrics, Rumoi City Hospital, Hokkaido, Japan
| | - Takeshi Tsugawa
- Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Japan
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Viñeta Paramo M, Ngo LP, Abu-Raya B, Reicherz F, Xu RY, Bone JN, Srigley JA, Solimano A, Goldfarb DM, Skowronski DM, Lavoie PM. Respiratory syncytial virus epidemiology and clinical severity before and during the COVID-19 pandemic in British Columbia, Canada: a retrospective observational study. Lancet Reg Health Am 2023; 25:100582. [PMID: 37705884 PMCID: PMC10495630 DOI: 10.1016/j.lana.2023.100582] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 07/10/2023] [Accepted: 08/17/2023] [Indexed: 09/15/2023]
Abstract
Background The COVID-19 pandemic has perturbed the seasonality of respiratory syncytial virus (RSV) infections. However, we lack data on how this impacted the severity of paediatric RSV cases. The objective of this study was to describe the clinical severity of RSV cases before, during and after pandemic measures in British Columbia (BC), Canada. Methods Retrospective study of RSV cases from September 1st, 2017 to May 15th, 2023, with a review of RSV outcomes in children below 18 years old at BC's paediatric hospital. Temporal changes in RSV cases and hospitalisations were quantified using interrupted time series. Findings BC experienced only 11 RSV cases (from 95,266 tests) between September 2020 and August 2021. This was followed by a resurgence of 9,529 RSV cases (219,566 tests [4.3% positive tests]) in 2021-22 and 8,215 cases (124,449 tests [6.6% positive tests]) in 2022-23, increased compared to 1,750 cases (48,664 tests [3.6% positive tests]) per corresponding yearly period in 2017-20. From September 2017 to May 2023, the median age of children with RSV at BC Children's Hospital increased from 8.7 [IQR: 2.0-26.0] to 19.6 [3.9-43.7] months per yearly period. More children were hospitalised in 2022-23 (n = 360), compared to 2017-20 (n = 168 per period) and 2021-22 (n = 172). However, we detected no increase in hospitalisations or ICU admissions in children born prematurely or with chronic cardiorespiratory conditions. Interpretation The increased detection of symptomatic RSV cases in older children in 2021-22 and increased RSV-related hospitalisations in 2022-23 suggest a gradual increase in the pool of immunologically vulnerable children due to a prolonged lack of viral exposure. Funding Government of Canada via its COVID-19 Immunity Task Force.
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Affiliation(s)
- Marina Viñeta Paramo
- Department of Paediatrics, University of British Columbia, Vancouver, Canada
- Women+ and Children’s Health Sciences, Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada
- British Columbia Children's Hospital Research Institute, Vancouver, Canada
| | - Lilian P.L. Ngo
- Department of Paediatrics, University of British Columbia, Vancouver, Canada
| | - Bahaa Abu-Raya
- Department of Paediatrics, University of British Columbia, Vancouver, Canada
- British Columbia Children's Hospital Research Institute, Vancouver, Canada
| | - Frederic Reicherz
- Department of Paediatrics, University of British Columbia, Vancouver, Canada
- British Columbia Children's Hospital Research Institute, Vancouver, Canada
| | - Rui Yang Xu
- Department of Paediatrics, University of British Columbia, Vancouver, Canada
- British Columbia Children's Hospital Research Institute, Vancouver, Canada
| | - Jeffrey N. Bone
- Women+ and Children’s Health Sciences, Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada
- British Columbia Children's Hospital Research Institute, Vancouver, Canada
| | - Jocelyn A. Srigley
- British Columbia Children's Hospital Research Institute, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, BC Children’s Hospital and BC Women’s Hospital + Health Centre, Vancouver, Canada
| | - Alfonso Solimano
- Department of Paediatrics, University of British Columbia, Vancouver, Canada
| | - David M. Goldfarb
- British Columbia Children's Hospital Research Institute, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, BC Children’s Hospital and BC Women’s Hospital + Health Centre, Vancouver, Canada
| | - Danuta M. Skowronski
- Immunization Programs and Vaccine Preventable Diseases Service, British Columbia Centre for Disease Control, Vancouver, Canada
| | - Pascal M. Lavoie
- Department of Paediatrics, University of British Columbia, Vancouver, Canada
- Women+ and Children’s Health Sciences, Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada
- British Columbia Children's Hospital Research Institute, Vancouver, Canada
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Lee CY, Wu TH, Fang YP, Chang JC, Wang HC, Lin SJ, Mai CH, Chang YC. Impact of public health measures and new introducing variants on Respiratory syncytial virus recrudescence in Taiwan during the COVID-19 pandemic. J Clin Virol 2023; 166:105531. [PMID: 37473610 DOI: 10.1016/j.jcv.2023.105531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 06/29/2023] [Accepted: 07/03/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVES Respiratory syncytial virus (RSV) causes clinically significant distress in children and adults. Non-pharmaceutical interventions against SARS-CoV-2 have affected the seasonal activity of common respiratory pathogens. This seems exceptionally true regarding RSV's seasonal circulation, hence we have investigated the changes in the epidemiology of RSV in Taiwan during the pandemic. MATERIALS A prospective surveillance of RSV among hospitalized children was carried out between 2020 and 2022 in central Taiwan. Of all PCR-detected RSV, genotype and evolutionary analysis were further investigated. Demographics and clinical features were compared between each outbreak. RESULTS Throughout the consecutive three years of the SARS-CoV-2 pandemic, RSV outbreaks took place in Taiwan first in 2020 and a second time in 2022. We enrolled 80 and 105 hospitalized child cases, in each surge respectively. The RSV G protein genomic analysis revealed that RSV ON1 and RSV BA9 were separately contributing to these two outbreaks, and evolutionary evidence indicated these RSV variants are new to Taiwan, with their own featured sets of mutations. Clinically, a shift in age of RSV infected children was found, but the clinical severity was not worse and remained independent of RSV genotype. CONCLUSIONS There were two delayed RSV surges after the relaxation of public measures during the pandemic in Taiwan, and both outbreaks were driven by new RSV genetic variants rather than cryptic circulation of the previous genetic clusters in Taiwan. These findings highlight the importance of continued surveillance on the trend and evolution of RSV after the COVID-19 pandemic.
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Affiliation(s)
- Chun Yi Lee
- Department of Pediatrics, Chang Bing Show Chwan Memorial Hospital, No.6, Lugong Rd., Lukang Township, Changhua, Taiwan.
| | - Tsung Hua Wu
- Department of Pediatrics, Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Yu Ping Fang
- Department of Pediatrics, Chang Bing Show Chwan Memorial Hospital, No.6, Lugong Rd., Lukang Township, Changhua, Taiwan
| | - Jih Chin Chang
- Department of Pediatrics, Chang Bing Show Chwan Memorial Hospital, No.6, Lugong Rd., Lukang Township, Changhua, Taiwan
| | - Hung Chun Wang
- Department of Pediatrics, Chang Bing Show Chwan Memorial Hospital, No.6, Lugong Rd., Lukang Township, Changhua, Taiwan
| | - Shou Ju Lin
- Department of Pediatrics, Chang Bing Show Chwan Memorial Hospital, No.6, Lugong Rd., Lukang Township, Changhua, Taiwan
| | - Chen Hao Mai
- Department of Pediatrics, Chang Bing Show Chwan Memorial Hospital, No.6, Lugong Rd., Lukang Township, Changhua, Taiwan
| | - Yu Chuan Chang
- Department of Pediatrics, Chang Bing Show Chwan Memorial Hospital, No.6, Lugong Rd., Lukang Township, Changhua, Taiwan
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Foley DA, Yeoh DK, Minney-Smith CA, Shin C, Hazelton B, Hoeppner T, Moore HC, Nicol M, Sikazwe C, Borland ML, Levy A, Blyth CC. A surge in human metapneumovirus paediatric respiratory admissions in Western Australia following the reduction of SARS-CoV-2 non-pharmaceutical interventions. J Paediatr Child Health 2023; 59:987-991. [PMID: 37219060 DOI: 10.1111/jpc.16445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/11/2023] [Accepted: 05/13/2023] [Indexed: 05/24/2023]
Abstract
AIM Western Australian laboratory data demonstrated a decrease in human metapneumovirus (hMPV) detections through 2020 associated with SARS-CoV-2-related non-pharmaceutical interventions (NPIs), followed by a subsequent surge in metropolitan region in mid-2021. We aimed to assess the impact of the surge in hMPV on paediatric hospital admissions and the contribution of changes in testing. METHODS All respiratory-coded admissions of children aged <16 years at a tertiary paediatric centre between 2017 and 2021 were matched with respiratory virus testing data. Patients were grouped by age at presentation and by ICD-10 AM codes into bronchiolitis, other acute lower respiratory infection (OALRI), wheeze and upper respiratory tract infection (URTI). For analysis, 2017-2019 was utilised as a baseline period. RESULTS hMPV-positive admissions in 2021 were more than 2.8 times baseline. The largest increase in incidence was observed in the 1-4 years group (incidence rate ratio (IRR) 3.8; 95% confidence interval (CI): 2.5-5.9) and in OALRI clinical phenotype (IRR 2.8; 95% CI: 1.8-4.2). The proportion of respiratory-coded admissions tested for hMPV in 2021 doubled (32-66.2%, P < 0.001), with the greatest increase in wheeze (12-75% in 2021, P < 0.001). hMPV test percentage positivity in 2021 was higher than in the baseline period (7.6% vs. 10.1% in 2021, P = 0.004). CONCLUSION The absence and subsequent surge underline the susceptibility of hMPV to NPIs. Increased hMPV-positive admissions in 2021 can be partially attributable to testing, but test-positivity remained high, consistent with a genuine increase. Continued comprehensive testing will help ascertain true burden of hMPV respiratory diseases.
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Affiliation(s)
- David A Foley
- Department of Microbiology, PathWest Laboratory Medicine WA, Perth, Western Australia, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Daniel K Yeoh
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
- Department of Infectious Diseases, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Cara A Minney-Smith
- Department of Microbiology, PathWest Laboratory Medicine WA, Perth, Western Australia, Australia
| | | | - Briony Hazelton
- Department of Microbiology, PathWest Laboratory Medicine WA, Perth, Western Australia, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Tobias Hoeppner
- Emergency Department, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Hannah C Moore
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Mark Nicol
- Marshall Centre, Biomedical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Chisha Sikazwe
- Department of Microbiology, PathWest Laboratory Medicine WA, Perth, Western Australia, Australia
- Marshall Centre, Biomedical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Meredith L Borland
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia
- Emergency Department, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Avram Levy
- Department of Microbiology, PathWest Laboratory Medicine WA, Perth, Western Australia, Australia
- Marshall Centre, Biomedical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Chris C Blyth
- Department of Microbiology, PathWest Laboratory Medicine WA, Perth, Western Australia, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia
- Department of Infectious Diseases, Perth Children's Hospital, Perth, Western Australia, Australia
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15
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Cong B, Dighero I, Zhang T, Chung A, Nair H, Li Y. Understanding the age spectrum of respiratory syncytial virus associated hospitalisation and mortality burden based on statistical modelling methods: a systematic analysis. BMC Med 2023; 21:224. [PMID: 37365569 DOI: 10.1186/s12916-023-02932-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 06/08/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Statistical modelling studies based on excess morbidity and mortality are important for understanding RSV disease burden for age groups that are less frequently tested for RSV. We aimed to understand the full age spectrum of RSV morbidity and mortality burden based on statistical modelling studies, as well as the value of modelling studies in RSV disease burden estimation. METHODS The databases Medline, Embase and Global Health were searched to identify studies published between January 1, 1995, and December 31, 2021, reporting RSV-associated excess hospitalisation or mortality rates of any case definitions using a modelling approach. All reported rates were summarised using median, IQR (Interquartile range) and range by age group, outcome and country income group; where applicable, a random-effects meta-analysis was conducted to combine the reported rates. We further estimated the proportion of RSV hospitalisations that could be captured in clinical databases. RESULTS A total of 32 studies were included, with 26 studies from high-income countries. RSV-associated hospitalisation and mortality rates both showed a U-shape age pattern. Lowest and highest RSV acute respiratory infection (ARI) hospitalisation rates were found in 5-17 years (median: 1.6/100,000 population, IQR: 1.3-18.5) and < 1 year (2235.7/100,000 population, 1779.1-3552.5), respectively. Lowest and highest RSV mortality rates were found in 18-49 years (0.1/100,000 population, 0.06-0.2) and ≥ 75 years (80.0/100,000 population, 70.0-90.0) for high-income countries, respectively, and in 18-49 years (0.3/100,000 population, 0.1-2.4) and < 1 year (143.4/100,000 population, 143.4-143.4) for upper-middle income countries. More than 70% of RSV hospitalisations in children < 5 years could be captured in clinical databases whereas less than 10% of RSV hospitalisations could be captured in adults, especially for adults ≥ 50 years. Using pneumonia and influenza (P&I) mortality could potentially capture half of all RSV mortality in older adults but only 10-30% of RSV mortality in children. CONCLUSIONS Our study provides insights into the age spectrum of RSV hospitalisation and mortality. RSV disease burden using laboratory records alone could be substantially severely underreported for age groups ≥ 5 years. Our findings confirm infants and older adults should be prioritised for RSV immunisation programmes. TRIAL REGISTRATION PROSPERO CRD42020173430.
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Affiliation(s)
- Bingbing Cong
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Izzie Dighero
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Tiantian Zhang
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Alexandria Chung
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Harish Nair
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - You Li
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK.
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16
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Shichijo K, Fukura S, Takeuchi S, Tayama T, Ono A, Ichihara Y, Suga K, Sato H, Takechi A, Matsumoto S, Fujino S, Taniguchi T, Takahashi A, Watanabe T, Kondo S. A surge in respiratory syncytial virus infection-related hospitalizations associated with the COVID-19 pandemic: An observational study at pediatric emergency referral hospitals in Tokushima Prefecture. PLOS Glob Public Health 2023; 3:e0001974. [PMID: 37267243 DOI: 10.1371/journal.pgph.0001974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/11/2023] [Indexed: 06/04/2023]
Abstract
The outbreak of coronavirus disease (COVID-19) resulted in implementation of social distancing and other public health measures to control the spread of infection and improve prevention, resulting in a decrease in respiratory syncytial virus (RSV) and pediatric respiratory tract infection rates. However, there was a rapid and large re-emergence of RSV infection in Japan. Notably, we were faced with a difficult situation wherein there was a shortage of hospital beds. This study aimed to examine the epidemiological patterns of RSV-related hospitalizations among children before and after the COVID-19 pandemic onset at two pediatric emergency referral hospitals covering the entire Tokushima Prefecture. Data were extracted from electronic medical records of children hospitalized with RSV infection between January 1, 2018, and December 31, 2021. All patients meeting the eligibility criteria were included in this study. The rates of study outcomes were documented annually during 2018-2021 and compared between the 2018-2020 and 2021 periods. In 2020, there was no RSV infection outbreak. Hospitalizations at the peak week in 2021 were 2.2- and 2.8-fold higher than those in 2018 and 2019, respectively. Hospitalizations in 2021 were concentrated within a short period. In addition, there was a significant increase in hospitalizations among children aged 3-5 months and those older than 24 months. The high-flow nasal cannula (HFNC) use rate nearly doubled in 2021. A new pandemic in the future may cause an outbreak of RSV infection that can result in an intensive increase in the number of hospitalizations of pediatric patients requiring respiratory support, especially in infants aged <6 months. There is an urgent need to improve the preparedness of medical systems, particularly in terms of the number of inpatient beds and the immediate availability of HFNC.
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Affiliation(s)
- Koichi Shichijo
- Department of Pediatrics, Tokushima Prefectural Central Hospital, Tokushima, Japan
| | - Shoko Fukura
- Department of Pediatrics, Tokushima Prefectural Central Hospital, Tokushima, Japan
| | - Shunsuke Takeuchi
- Department of Pediatrics, Tokushima Prefectural Central Hospital, Tokushima, Japan
| | - Takahiro Tayama
- Department of Pediatrics, Tokushima Prefectural Central Hospital, Tokushima, Japan
| | - Akemi Ono
- Department of Pediatrics, Tokushima Prefectural Central Hospital, Tokushima, Japan
| | - Yuko Ichihara
- Department of Pediatrics, Tokushima Prefectural Central Hospital, Tokushima, Japan
| | - Kenichi Suga
- Department of Pediatrics, Tokushima Prefectural Central Hospital, Tokushima, Japan
| | - Hiroki Sato
- Department of Pediatrics, Tokushima Red Cross Hospital, Komatsushima, Japan
| | - Atsumi Takechi
- Department of Pediatrics, Tokushima Red Cross Hospital, Komatsushima, Japan
| | - Sonomi Matsumoto
- Department of Pediatrics, Tokushima Red Cross Hospital, Komatsushima, Japan
| | - Shuji Fujino
- Department of Pediatrics, Tokushima Red Cross Hospital, Komatsushima, Japan
| | - Takako Taniguchi
- Department of Pediatrics, Tokushima Red Cross Hospital, Komatsushima, Japan
| | - Akiyoshi Takahashi
- Department of Pediatrics, Tokushima Red Cross Hospital, Komatsushima, Japan
| | - Tsutomu Watanabe
- Department of Pediatrics, Tokushima Red Cross Hospital, Komatsushima, Japan
| | - Shuji Kondo
- Department of Pediatrics, Tokushima Prefectural Central Hospital, Tokushima, Japan
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Menasalvas Ruiz AI. Respiratory syncytial virus infection in COVID-19 times: Trick or threat? Enferm Infecc Microbiol Clin 2023; 41:319-320. [PMID: 37273943 PMCID: PMC10233274 DOI: 10.1016/j.eimc.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Ana Isabel Menasalvas Ruiz
- Unidad de Infectología Pediátrica, Servicio de Pediatría, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
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18
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Virant MJ, Luštrek M, Kogoj R, Petrovec M, Uršič T. Changes in HRSV Epidemiology but Not Circulating Variants in Hospitalized Children due to the Emergence of SARS-CoV-2. Viruses 2023; 15:1218. [PMID: 37376518 DOI: 10.3390/v15061218] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/17/2023] [Accepted: 05/21/2023] [Indexed: 06/29/2023] Open
Abstract
This study assesses the circulation of human respiratory syncytial virus (HRSV) genotypes before, during, and toward the end of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in children and determines the influence of the pandemic on HRSV circulation patterns and evolution. Phylogenetic analysis of the hypervariable glycoprotein G gene was performed on 221/261 (84.7%) HRSV-positive samples and shows two separated clusters, one belonging to HRSV-A (129/221) and another to HRSV-B (92/221). All Slovenian HRSV-A strains contained the 72-nucleotide-long duplicated region in the attachment glycoprotein G gene and were classified as lineage GA2.3.5. All Slovenian HRSV-B strains similarly contained a 60-nucleotide-long duplicated region in the attachment glycoprotein G gene and were classified as lineage GB5.0.5a. During the 3-year period (2018-2021) covered by the study, no significant differences were observed within strains detected before the SARS-CoV-2 pandemic, during it, and after the implementation of nonpharmaceutical preventive measures. Slovenian HRSV-A strains seem to be more diverse than HRSV-B strains. Therefore, further whole-genome investigations would be required for better monitoring of the long-term impact of SARS-CoV-2 endemic circulation and the formation of new HRSV lineages and epidemiological patterns.
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Affiliation(s)
- Monika Jevšnik Virant
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia
| | - Manca Luštrek
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia
| | - Rok Kogoj
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia
| | - Miroslav Petrovec
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia
| | - Tina Uršič
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia
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19
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Menasalvas Ruiz AI. Respiratory syncytial virus infection in COVID-19 times: Trick or threat? Enferm Infecc Microbiol Clin (Engl Ed) 2023:S2529-993X(23)00098-9. [PMID: 37076333 PMCID: PMC10233205 DOI: 10.1016/j.eimce.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 01/08/2023] [Indexed: 04/21/2023]
Affiliation(s)
- Ana Isabel Menasalvas Ruiz
- Unidad de Infectología Pediátrica, Servicio de Pediatría, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.
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Kruizinga MD, Noordzij JG, van Houten MA, Wieringa J, Tramper-Stranders GA, Hira V, Bekhof J, Vet NJ, Driessen GJA, van Veen M. Effect of lockdowns on the epidemiology of pediatric respiratory disease-A retrospective analysis of the 2021 summer epidemic. Pediatr Pulmonol 2023; 58:1229-1236. [PMID: 36695757 DOI: 10.1002/ppul.26327] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 01/13/2023] [Accepted: 01/19/2023] [Indexed: 01/26/2023]
Abstract
BACKGROUND The imposition of lockdowns during the severe acute respiratory syndrome coronavirus-2 pandemic led to a significant decrease in pediatric care utilization in 2020. After restrictions were loosened, a surge in pediatric respiratory disease was observed in pediatric wards. The aim of this study was to quantify the effect of the lockdown(s) on the incidence of pediatric respiratory disease. METHODS For this multicenter retrospective study, emergency department (ED) visit and admission data between January 2017 and September 2021 was collected from eight general hospitals in the Netherlands. Clinical diagnoses were extracted and categorized in groups ("communicable infectious disease," "all respiratory infections," "upper respiratory tract infection," "lower respiratory tract infection," and "asthma/preschool wheezing"). The incidence of admissions and ED visits during 2020 and 2021 was compared to the incidence in 2017-2019. RESULTS Successive lockdowns resulted in a maximum decrease of 61% and 57% in ED visits and admissions, respectively. After loosening restrictions during the summer of 2021, a 48% overall increase in ED visits and 31% overall increase in admission numbers was observed in July compared to the average July in 2017-2019. This was explained by a 381% increase in ED visits and a 528% increase in ward admissions due to overall respiratory infections, mainly due to lower respiratory tract infections. CONCLUSIONS Successive lockdowns in the spring and winter of 2020 and 2021 led to a decreased incidence of communicable infections, especially respiratory tract infections. The resulting lack of pediatric immunity resulted in an off-season surge in care utilization at an unexpected moment.
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Affiliation(s)
| | - Jeroen G Noordzij
- Department of Pediatrics, Reinier de Graaf Ziekenhuis, Delft, The Netherlands
| | | | - Jantien Wieringa
- Department of Pediatrics, Haaglanden Medical Centre, Den Haag, The Netherlands
| | | | - Vishal Hira
- Department of Medical Microbiology and Infection Prevention, Groene Hart Ziekenhuis, Gouda, The Netherlands
| | - Jolita Bekhof
- Department of Pediatrics, Isala ziekenhuis, Zwolle, The Netherlands
| | - Nienke J Vet
- Department of Pediatrics, St. Antonius Ziekenhuis, Utrecht, The Netherlands
| | - Gertjan J A Driessen
- Department of Pediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Mirjam van Veen
- Juliana Children's Hospital, Haga Teaching Hospital, Den Haag, The Netherlands
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21
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Hönemann M, Thiem S, Bergs S, Berthold T, Propach C, Siekmeyer M, Frille A, Wallborn T, Maier M, Pietsch C. In-Depth Analysis of the Re-Emergence of Respiratory Syncytial Virus at a Tertiary Care Hospital in Germany in the Summer of 2021 after the Alleviation of Non-Pharmaceutical Interventions Due to the SARS-CoV-2 Pandemic. Viruses 2023; 15:v15040877. [PMID: 37112857 PMCID: PMC10144477 DOI: 10.3390/v15040877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/24/2023] [Accepted: 03/28/2023] [Indexed: 04/29/2023] Open
Abstract
Following the extensive non-pharmaceutical interventions (NPIs) and behavioral changes in the wake of the SARS-CoV-2 pandemic, an interseasonal rise in respiratory syncytial virus (RSV) cases was observed in Germany in 2021. The aim of this study was to characterize the local molecular epidemiology of RSV infections in comparison to the three pre-pandemic seasons. Additionally, clinical data were retrieved from patient charts to determine the clinical significance of RSV infections. RSV detections peaked in calendar week 40 of 2021, 18 weeks earlier than the usual peak observed in the three pre-pandemic seasons. Sequence analysis revealed a close phylogenetic relatedness regardless of the season of origin. A significantly higher amount of pediatric cases (88.9% of all cases, p < 0.001) was observed for season 2021/2022. For the pediatric cases, significant differences were observed for an increased number of siblings in the household (p = 0.004), a lower rate of fever (p = 0.007), and a reduced amount of co-infections (p = 0.001). Although the mean age of the adult patients was significantly younger (47.1 vs. 64.7, p < 0.001), high rates of comorbidities, lower respiratory tract infections and intensive care unit admissions prevailed. The NPIs in the wake of the SARS-CoV-2 pandemic had a tremendous impact on the epidemiologic characteristics and seasonality of RSV and warrant further epidemiologic studies of this important pathogen.
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Affiliation(s)
- Mario Hönemann
- Virology Department, Institute of Medical Microbiology and Virology, University of Leipzig, Johannisallee 30, 04103 Leipzig, Germany
| | - Stephanie Thiem
- Virology Department, Institute of Medical Microbiology and Virology, University of Leipzig, Johannisallee 30, 04103 Leipzig, Germany
| | - Sandra Bergs
- Virology Department, Institute of Medical Microbiology and Virology, University of Leipzig, Johannisallee 30, 04103 Leipzig, Germany
| | - Tom Berthold
- Virology Department, Institute of Medical Microbiology and Virology, University of Leipzig, Johannisallee 30, 04103 Leipzig, Germany
| | - Christian Propach
- Virology Department, Institute of Medical Microbiology and Virology, University of Leipzig, Johannisallee 30, 04103 Leipzig, Germany
| | - Manuela Siekmeyer
- Department of Pediatrics, University of Leipzig, Liebigstrasse 20a, 04103 Leipzig, Germany
| | - Armin Frille
- Department of Respiratory Medicine, University of Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany
| | - Tillmann Wallborn
- Department of Pediatrics, Klinikum St. Georg, Delitzscher Strasse 141, 04129 Leipzig, Germany
| | - Melanie Maier
- Virology Department, Institute of Medical Microbiology and Virology, University of Leipzig, Johannisallee 30, 04103 Leipzig, Germany
| | - Corinna Pietsch
- Virology Department, Institute of Medical Microbiology and Virology, University of Leipzig, Johannisallee 30, 04103 Leipzig, Germany
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22
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Billard MN, Bont L. RSV immunisation: lessons from the COVID-19 pandemic. Lancet Child Adolesc Health 2023; 7:147-149. [PMID: 36634693 DOI: 10.1016/s2352-4642(22)00377-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 01/11/2023]
Affiliation(s)
- Marie-Noëlle Billard
- Department of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht 3584EA, Netherlands
| | - Louis Bont
- Department of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht 3584EA, Netherlands; ReSViNET Foundation, Julius Clinical, Zeist, Netherlands.
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23
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Nygaard U, Hartling UB, Nielsen J, Vestergaard LS, Dungu KHS, Nielsen JSA, Sellmer A, Matthesen AT, Kristensen K, Holm M. Hospital admissions and need for mechanical ventilation in children with respiratory syncytial virus before and during the COVID-19 pandemic: a Danish nationwide cohort study. Lancet Child Adolesc Health 2023; 7:171-9. [PMID: 36634692 DOI: 10.1016/S2352-4642(22)00371-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND The incidence of respiratory syncytial virus (RSV) increased in several countries after the relaxation of COVID-19 restrictions. We aimed to investigate the age-related risk of RSV-associated hospital admissions and need for mechanical ventilation during the RSV resurgence in summer and autumn 2021 compared with the four RSV seasons preceding the COVID-19 pandemic. We also aimed to describe the clinical complications necessitating mechanical ventilation. METHODS This population-based cohort study included patients aged 0-17 years admitted to hospital with RSV in Denmark during the RSV resurgence in summer and autumn 2021, and the four pre-COVID-19 RSV seasons (2016-17, 2017-18, 2018-19, and 2019-20). We retrieved data on RSV-associated hospital admissions from the Danish National Patient Registry and demographic and clinical details of children who received mechanical ventilation through prospective real-time data collection in 2021-22 and retrospective data collection for the 2016-17 to 2019-20 RSV seasons from all eight paediatric and neonatal intensive care units in Denmark. Risk factors for severe RSV disease were as defined as age younger than 3 months or severe comorbidities. We calculated the risk of RSV-associated hospital admissions per 100 000 population in each RSV season from week 21 to week 20 of the following year. We also calculated the risk rate of receiving mechanical ventilation per 100 000 population and 1000 RSV-associated hospital admissions during each RSV season from week 21 to week 20 of the following year. We calculated risk ratios (RRs) for hospital admission and mechanical ventilation by dividing the risk rate of hospital admission and mechanical ventilation in 2021-22 by annual mean risk rates in the four pre-COVID-19 RSV epidemics (2016-17 to 2019-20). We compared RRs using Fisher's exact test. We compared complications leading to intubation between children with and without risk factors for severe RSV disease. The study is registered at ClinicalTrials.gov, NCT05186597. FINDINGS Among 310 423 Danish children aged younger than 5 years, the mean number of RSV-associated hospital admissions increased from 1477 (SD 226) in the 2016-17 to 2019-20 RSV seasons to 3000 in the 2021-22 RSV season (RR 2·0 [95% CI 1·9-2·1]). 54 children with RSV received mechanical ventilation in 2021-22 compared with 15-28 annually in the 2016-17 to 2019-20 RSV seasons (2·3 [1·6-3·3]). The highest increase in hospital admissions and need for mechanical ventilation occurred among children aged 24-59 months (4·1 [3·6-4·7] for hospital admission; 4·6 [1·7-12·6] for mechanical ventilation). Among children admitted to hospital, the risk of mechanical ventilation was similar in 2021-22 and the four pre-COVID-19 seasons (risk rate 14·3 per 1000 RSV-associated hospital admissions [95% CI 10·4-19·3] vs 12·9 [10·1-16·1]; RR 1·1 [95% CI 0·8-1·6]). Across all RSV seasons studied, among children younger than 3 months or those with severe comorbidities, respiratory failure due to bronchiolitis led to mechanical ventilation in 69 (79%) of 87 children. Of 46 children with no risk factors for severe RSV, 40 (87%) received mechanical ventilation due to additional complications, including neurological (n=16; 35%), cardiac (n=1; 2%), and pulmonary complications (n=23; 50%; eg, wheeze responsive to bronchodilator therapy, severe bacterial co-infections, and pneumothorax). INTERPRETATION In Denmark, RSV disease did not seem to be more severe for the individual child during the RSV resurgence in 2021 following relaxation of COVID-19 restrictions. However, hospital admissions were higher among older children, possibly due to a postponed first RSV infection or no recent reinfection. Older children without risk factors for severe RSV disease had atypical complications that led to intubation. If new RSV-preventive interventions for healthy infants delay first RSV infection, a higher number of older children might be admitted to hospital due to atypical clinical phenotypes, rather than classical bronchiolitis. FUNDING National Ministry of Higher Education and Science and the Innovation Fund Denmark.
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Pruccoli G, Castagno E, Raffaldi I, Denina M, Barisone E, Baroero L, Timeus F, Rabbone I, Monzani A, Terragni GM, Lovera C, Brach del Prever A, Manzoni P, Barbaglia M, Roasio L, De Franco S, Calitri C, Lupica M, Felici E, Marciano C, Santovito S, Militerno G, Abrigo E, Curtoni A, Quarello P, Bondone C, Garazzino S. The Importance of RSV Epidemiological Surveillance: A Multicenter Observational Study of RSV Infection during the COVID-19 Pandemic. Viruses 2023; 15:v15020280. [PMID: 36851494 PMCID: PMC9963567 DOI: 10.3390/v15020280] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/12/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
The restrictive measures adopted worldwide against SARS-CoV-2 produced a drastic reduction in respiratory pathogens, including RSV, but a dramatic rebound was thereafter reported. In this multicenter retrospective observational study in 15 Pediatric Emergency Departments, all children <3 years old with RSV infection admitted between 1 September and 31 December 2021 were included and compared to those admitted in the same period of 2020 and 2019. The primary aim was to evaluate RSV epidemiology during and after the COVID-19 pandemic peak. The secondary aims were to evaluate the clinical features of children with RSV infection. Overall, 1015 children were enrolled: 100 in 2019, 3 in 2020 and 912 in 2021. In 2019, the peak was recorded in December, and in 2021, it was recorded in November. Comparing 2019 to 2021, in 2021 the median age was significantly higher and the age group 2-3 years was more affected. Admissions were significantly higher in 2021 than in 2020 and 2019, and the per-year hospitalization rate was lower in 2021 (84% vs. 93% in 2019), while the duration of admissions was similar. No difference was found in severity between 2019-2020-2021. In conclusion, after the COVID-19 pandemic, an increase in RSV cases in 2021 exceeding the median seasonal peak was detected, with the involvement of older children, while no difference was found in severity.
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Affiliation(s)
- Giulia Pruccoli
- Infectious Diseases Unit, Department of Pediatrics, University of Turin, Regina Margherita Children’s Hospital, A.O.U. Città Della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Emanuele Castagno
- Department of Pediatric Emergency, Regina Margherita Children’s Hospital, A.O.U. Città Della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Irene Raffaldi
- Department of Pediatric Emergency, Regina Margherita Children’s Hospital, A.O.U. Città Della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Marco Denina
- Department of Pediatric Emergency, Regina Margherita Children’s Hospital, A.O.U. Città Della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Elisa Barisone
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
- Correspondence: ; Tel.: +39-0113135396
| | - Luca Baroero
- Department of Pediatrics, Martini Hospital, 10141 Turin, Italy
| | - Fabio Timeus
- Pediatrics Department, Chivasso Hospital, 10034 Chivasso (TO), Italy
| | - Ivana Rabbone
- Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy
| | - Alice Monzani
- Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy
| | | | - Cristina Lovera
- Department of Pediatrics, A.O. S.Croce e Carle, 12100 Cuneo, Italy
| | | | - Paolo Manzoni
- Department of Pediatrics, Ospedale Degli Infermi di Ponderano, University of Turin, 13900 Biella, Italy
| | | | - Luca Roasio
- Department of Pediatrics, Edoardo Agnelli Hospital, 10064 Pinerolo (TO), Italy
| | - Simona De Franco
- Department of Pediatrics, Ospedale di Borgomanero, 28021 Borgomanero (NO), Italy
| | - Carmelina Calitri
- Department of Pediatrics, Ospedale di Rivoli, 10098 Rivoli (TO), Italy
| | - Maddalena Lupica
- Department of Pediatrics, Ospedale di Rivoli, 10098 Rivoli (TO), Italy
| | - Enrico Felici
- Pediatric and Pediatric Emergency Unit, Children’s Hospital, AO SS Antonio e Biagio e C. Arrigo, 15121 Alessandria, Italy
| | - Cinzia Marciano
- Pediatric and Pediatric Emergency Unit, Children’s Hospital, AO SS Antonio e Biagio e C. Arrigo, 15121 Alessandria, Italy
| | - Savino Santovito
- Department of Pediatrics, Ospedale Maria Vittoria, ASL Città di Torino, 10143 Turin, Italy
| | - Gaia Militerno
- Department of Pediatrics, Ospedale Cardinal Massaia, 14100 Asti, Italy
| | - Enrica Abrigo
- Department of Pediatrics, Ospedale Cardinal Massaia, 14100 Asti, Italy
| | - Antonio Curtoni
- Microbiology and Virology Unit, Molinette Hospital, A.O.U. Città della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Paola Quarello
- Department of Pediatric Onco-Hematology, University of Turin, Regina Margherita Children’s Hospital, A.O.U. Città Della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Claudia Bondone
- Department of Pediatric Emergency, Regina Margherita Children’s Hospital, A.O.U. Città Della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Silvia Garazzino
- Infectious Diseases Unit, Department of Pediatrics, University of Turin, Regina Margherita Children’s Hospital, A.O.U. Città Della Salute e della Scienza di Torino, 10126 Turin, Italy
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Nguyen E, Saw C, Morkos M, Abass F, Foley D, Bulsara M. Unusual local epidemic of paediatric respiratory syncytial virus during a time of global pandemic. J Paediatr Child Health 2023; 59:464-469. [PMID: 36625316 DOI: 10.1111/jpc.16326] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 12/19/2022] [Accepted: 12/23/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Western Australia (WA) public health measures to eradicate SARS-CoV-2 resulted in a secondary reduction in paediatric respiratory syncytial virus (RSV) admissions. Following an absent expected 2020 winter peak, RSV-positive admissions surged during the summer of 2020. AIM This report examines the number of RSV-positive admissions and severities across 36 months to better understand this out-of-season epidemic. METHODS A retrospective observational study was performed assessing the number and severity of RSV-related respiratory hospitalisations at a peripheral paediatric centre from March 2018 to February 2021. Data were extracted from the hospital clinical database. RESULTS The total number of included participants was n = 294. The total number of RSV hospitalisations in SY (study year) 2018 (March 2018 to February 2019), SY 2019 (March 2019 to February 2020) and SY 2020 (March 2020 to February 2021) was 67, 98 and 129, respectively. Prior to SARS-CoV-2, RSV hospitalisations were highest during the winter months. In SY 2020, there were 0 RSV hospitalisations during winter, while 101 admissions in the following summer season. The proportion of admissions requiring respiratory support was significantly reduced in SY 2020 (34.1%) compared to SY 2018 (46.9%, P = 0.050) and SY 2019 (55.2%, P = 0.004). The median length of stay (LOS) in 2020 was 2.0 which was significantly reduced from 2018 and 2019 which was 3.0, P = 0.001; and 3.0, P < 0.001, respectively. CONCLUSION Following a period of RSV absence, there was an unprecedented surge in admission, however, with lower severity and shorter LOS.
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Affiliation(s)
- Edward Nguyen
- Paediatric Department, SJOG Midland Public Hospital, Perth, Western Australia, Australia
| | - Chia Saw
- Paediatric Department, SJOG Midland Public Hospital, Perth, Western Australia, Australia
| | - Michael Morkos
- Paediatric Department, SJOG Midland Public Hospital, Perth, Western Australia, Australia
| | - Fuad Abass
- Paediatric Department, SJOG Midland Public Hospital, Perth, Western Australia, Australia
| | - David Foley
- Microbiology, PathWest Reference Laboratory, Perth, Western Australia, Australia
| | - Max Bulsara
- UWA School of Population Health, Perth, Western Australia, Australia
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26
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Bozzola E, Barni S, Villani A. Respiratory Syncytial Virus Pediatric Hospitalization in the COVID-19 Era. Int J Environ Res Public Health 2022; 19:ijerph192315455. [PMID: 36497528 PMCID: PMC9738890 DOI: 10.3390/ijerph192315455] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/12/2022] [Accepted: 11/19/2022] [Indexed: 05/29/2023]
Abstract
Respiratory syncytial virus (RSV) globally affects the population, mainly young children, potentially causing hospitalization. During the COVID-19 pandemic, non-pharmacological measures interfered with the circulation of most respiratory viruses. Then, with the discontinuation of restrictive measures, a new scenario appeared. With this scoping review, we want to globally explore whether the RSV paediatric hospitalization rate was influenced by COVID-19. This scoping review was performed according to PRISMA guidelines on PubMed using the Mesh terms "Respiratory Syncytial Viruses"[Mesh] AND "COVID-19"[Mesh] OR "SARS-CoV-2"[Mesh]. Among them, we identified studies pertaining to children and adolescents up to 18 years old hospitalized for RSV, including 18 records in the revision. With the onset of the COVID-19 pandemic, a drastic reduction in RSV hospitalization among the pediatric population in 2020-2021 season has been observed in the Northern and Southern hemispheres. After the relaxing of restrictive measures, unexpected outbreaks happened, leading to increased hospitalization and occupation of pediatric intensive care units.
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Messacar K, Baker RE, Park SW, Nguyen-Tran H, Cataldi JR, Grenfell B. Preparing for uncertainty: endemic paediatric viral illnesses after COVID-19 pandemic disruption. Lancet 2022; 400:1663-1665. [PMID: 35843260 PMCID: PMC9282759 DOI: 10.1016/s0140-6736(22)01277-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 07/01/2022] [Indexed: 02/06/2023]
Affiliation(s)
- Kevin Messacar
- Department of Pediatrics, Section of Infectious Diseases, University of Colorado School of Medicine, Aurora, CO, USA; Children's Hospital Colorado Aurora, CO 80045, USA.
| | - Rachel E Baker
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA
| | - Sang Woo Park
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA
| | - Hai Nguyen-Tran
- Department of Pediatrics, Section of Infectious Diseases, University of Colorado School of Medicine, Aurora, CO, USA
| | - Jessica R Cataldi
- Department of Pediatrics, Section of Infectious Diseases, University of Colorado School of Medicine, Aurora, CO, USA; Children's Hospital Colorado Aurora, CO 80045, USA
| | - Bryan Grenfell
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA; Princeton School of Public and International Affairs, Princeton University, Princeton, NJ, USA
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28
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Foley DA, Sikazwe CT, Minney-Smith CA, Ernst T, Moore HC, Nicol MP, Smith DW, Levy A, Blyth CC. An Unusual Resurgence of Human Metapneumovirus in Western Australia Following the Reduction of Non-Pharmaceutical Interventions to Prevent SARS-CoV-2 Transmission. Viruses 2022; 14:2135. [PMID: 36298690 PMCID: PMC9612024 DOI: 10.3390/v14102135] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/25/2022] [Accepted: 09/26/2022] [Indexed: 09/25/2023] Open
Abstract
Non-pharmaceutical interventions (NPIs) to reduce SARS-CoV-2 transmission disrupted respiratory virus seasonality. We examined the unusual return of human metapneumovirus (hMPV) in Western Australia following a period of absence in 2020. We analysed hMPV laboratory testing data from 1 January 2017 to 31 December 2021. Whole-genome sequencing of selected hMPV-positive samples was performed using a tiled-amplicon approach. Following an absence in spring 2020, an unusual hMPV surge was observed during the wet summer season in the tropical Northern region in late 2020. Following a six-month delay, an intense winter season occurred in the subtropical/temperate Southern and Metropolitan regions. Compared to 2017-2019, hMPV incidence in 2021 increased by 3-fold, with a greater than 4-fold increase in children aged 1-4 years. There was a collapse in hMPV diversity in 2020, with the emergence of a single subtype. NPIs contributed to an absent 2020 season and a clonal hMPV resurgence. The summer surge and delayed winter season suggest that prevailing temperature and humidity are keys determinant of hMPV transmission. The increased incidence in 2021 was linked to an expanded cohort of hMPV-naïve 1-4-year-old children and waning population immunity. Further intense and unusual respiratory virus seasons are expected as COVID-19 associated NPIs are removed.
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Affiliation(s)
- David Anthony Foley
- Department of Microbiology, PathWest Laboratory Medicine, Perth 6009, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- School of Medicine, University of Western Australia, Perth 6009, Australia
| | - Chisha T. Sikazwe
- Department of Microbiology, PathWest Laboratory Medicine, Perth 6009, Australia
- Infection and Immunity, School of Biomedical Sciences, University of Western Australia, Perth 6009, Australia
| | | | - Timo Ernst
- Infection and Immunity, School of Biomedical Sciences, University of Western Australia, Perth 6009, Australia
| | - Hannah C. Moore
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- Faculty of Health Sciences, School of Population Health, Curtin University, Perth 6102, Australia
| | - Mark P. Nicol
- Infection and Immunity, School of Biomedical Sciences, University of Western Australia, Perth 6009, Australia
| | - David W. Smith
- Department of Microbiology, PathWest Laboratory Medicine, Perth 6009, Australia
- School of Medicine, University of Western Australia, Perth 6009, Australia
| | - Avram Levy
- Department of Microbiology, PathWest Laboratory Medicine, Perth 6009, Australia
- Infection and Immunity, School of Biomedical Sciences, University of Western Australia, Perth 6009, Australia
| | - Christopher C. Blyth
- Department of Microbiology, PathWest Laboratory Medicine, Perth 6009, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- School of Medicine, University of Western Australia, Perth 6009, Australia
- Department of Infectious Diseases, Perth Children’s Hospital, Perth 6009, Australia
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29
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Pérez-López A, Al Mana H, Iqbal M, Suleiman M, Hasan MR, Tang P. Variations in respiratory syncytial virus activity following the relaxation of COVID-19 restrictions in Qatar. J Travel Med 2022; 29:6590686. [PMID: 35608003 PMCID: PMC9384098 DOI: 10.1093/jtm/taac065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/16/2022] [Accepted: 05/16/2022] [Indexed: 11/24/2022]
Affiliation(s)
- Andrés Pérez-López
- Division of Microbiology, Sidra Medicine, Doha, Qatar.,Weill Cornell Medicine in Qatar, Qatar Foundation - Education City, P.O. Box 24144, Doha, Qatar
| | - Hassan Al Mana
- Biomedical Research Centre, Microbiology Department, Qatar University, Doha Qatar
| | | | | | - Mohammad Rubayet Hasan
- Medical Scientific Department, LifeLabs, Toronto, Canada.,Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Canada
| | - Patrick Tang
- Division of Microbiology, Sidra Medicine, Doha, Qatar.,Weill Cornell Medicine in Qatar, Qatar Foundation - Education City, P.O. Box 24144, Doha, Qatar
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30
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Affiliation(s)
- Darren Tan
- Department of General Paediatrics, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Zoy Goff
- Department of Infectious Diseases, Perth Children's Hospital, Perth, Western Australia, Australia
- Department of Pharmacy, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Bradley MacDonald
- Department of General Paediatrics, Perth Children's Hospital, Perth, Western Australia, Australia
- Strep A. and Rheumatic Heart Disease, Telethon Kids Institute, Perth, Western Australia, Australia
- School of Population and Global Health, University of Western Australia, Crawley, Western Australia, Australia
| | - Christopher C Blyth
- Microbiology, PathWest Laboratory Medicine, Perth, Western Australia, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, University of Western Australia, Telethon Kids Institute, Perth, Western Australia, Australia
- School of Medicine, University of Western Australia, Crawley, Western Australia, Australia
- Infectious Diseases Department, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - David A Foley
- Microbiology, PathWest Laboratory Medicine, Perth, Western Australia, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, University of Western Australia, Telethon Kids Institute, Perth, Western Australia, Australia
- School of Medicine, University of Western Australia, Crawley, Western Australia, Australia
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31
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Schuurman GS, Bont L. SOCIAL LISTENING AND GOOGLE TRENDS AS TOOLS FOR ESTIMATING PUBLIC AWARENESS OF RESPIRATORY SYNCYTIAL VIRUS. Pediatr Infect Dis J 2022; 41:e292-e295. [PMID: 35675527 DOI: 10.1097/inf.0000000000003538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Respiratory Syncytial Virus (RSV) imposes a large disease burden on a global level. Public awareness of RSV is important to support preventive interventions. In this study, Google Trends and a social listening tool, Brand24, were compared for measuring changes in public awareness levels of RSV. Google Trends is recommended for future research, as it is more sensitive, cost-free and open access.
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Affiliation(s)
| | - Louis Bont
- Division of Paediatric Infectious Diseases, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands, ReSViNET Foundation, Zeist, The Netherlands
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32
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Loconsole D, Centrone F, Rizzo C, Caselli D, Orlandi A, Cardinale F, Serio C, Giordano P, Lassandro G, Milella L, Ficarella MT, Baldassarre ME, Laforgia N, Chironna M. Out-of-Season Epidemic of Respiratory Syncytial Virus during the COVID-19 Pandemic: The High Burden of Child Hospitalization in an Academic Hospital in Southern Italy in 2021. Children (Basel) 2022; 9. [PMID: 35740785 DOI: 10.3390/children9060848] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/01/2022] [Accepted: 06/07/2022] [Indexed: 11/17/2022]
Abstract
Respiratory syncytial virus (RSV) infection is the most common cause of hospitalization in young children. In the last 2 years, public health measures aimed at controlling the spread of SARS-CoV-2 have affected the epidemiology and seasonality of RSV worldwide. The aim of this descriptive retrospective observational study was to describe the characteristics of children hospitalized with RSV in an academic tertiary care hospital in Southern Italy in 2021. We also investigate the seasonal trends of RSV from 2017 to 2021. The demographic characteristics, comorbidities, clinical data, and coinfections were retrospectively evaluated. Compared with previous seasons, the 2021 outbreak of RSV was characterized by an increased number of patients, with a delayed peak observed in November. Overall, 179 children, including 128 (71.5%) aged <12 months, were hospitalized for RSV infection between August and December 2021. Ten children (5.6%) were admitted to the intensive care unit (ICU), all aged <5 months. One patient (0.5%) aged <1 month with severe comorbidities died. The severity of symptoms was significantly associated with younger age, underlying chronic disease, and the length of hospital stay (p < 0.05 each). History of prematurity was not significantly associated with the presence of coinfections. Because of the high burden of RSV infection and the expected larger RSV epidemics resulting from a greater number of RSV-naïve children, systematic epidemiological and virological surveillance is needed. Appropriate pathways for access to RSV prevention in all infants should also be introduced.
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33
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Storch GA. Respiratory syncytial virus (RSV) around the globe: data to help guide wise use of vaccines and anti-virals. J Infect Dis 2022; 226:367-369. [PMID: 35668709 DOI: 10.1093/infdis/jiac228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 06/01/2022] [Indexed: 11/14/2022] Open
Affiliation(s)
- Gregory A Storch
- Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri, USA
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34
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Li Y, Wang X, Blau DM, Caballero MT, Feikin DR, Gill CJ, Madhi SA, Omer SB, Simões EAF, Campbell H, Pariente AB, Bardach D, Bassat Q, Casalegno JS, Chakhunashvili G, Crawford N, Danilenko D, Do LAH, Echavarria M, Gentile A, Gordon A, Heikkinen T, Huang QS, Jullien S, Krishnan A, Lopez EL, Markić J, Mira-Iglesias A, Moore HC, Moyes J, Mwananyanda L, Nokes DJ, Noordeen F, Obodai E, Palani N, Romero C, Salimi V, Satav A, Seo E, Shchomak Z, Singleton R, Stolyarov K, Stoszek SK, von Gottberg A, Wurzel D, Yoshida LM, Yung CF, Zar HJ, Nair H. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019: a systematic analysis. Lancet 2022; 399:2047-2064. [PMID: 35598608 PMCID: PMC7613574 DOI: 10.1016/s0140-6736(22)00478-0] [Citation(s) in RCA: 405] [Impact Index Per Article: 202.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/21/2022] [Accepted: 03/08/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is the most common cause of acute lower respiratory infection in young children. We previously estimated that in 2015, 33·1 million episodes of RSV-associated acute lower respiratory infection occurred in children aged 0-60 months, resulting in a total of 118 200 deaths worldwide. Since then, several community surveillance studies have been done to obtain a more precise estimation of RSV associated community deaths. We aimed to update RSV-associated acute lower respiratory infection morbidity and mortality at global, regional, and national levels in children aged 0-60 months for 2019, with focus on overall mortality and narrower infant age groups that are targeted by RSV prophylactics in development. METHODS In this systematic analysis, we expanded our global RSV disease burden dataset by obtaining new data from an updated search for papers published between Jan 1, 2017, and Dec 31, 2020, from MEDLINE, Embase, Global Health, CINAHL, Web of Science, LILACS, OpenGrey, CNKI, Wanfang, and ChongqingVIP. We also included unpublished data from RSV GEN collaborators. Eligible studies reported data for children aged 0-60 months with RSV as primary infection with acute lower respiratory infection in community settings, or acute lower respiratory infection necessitating hospital admission; reported data for at least 12 consecutive months, except for in-hospital case fatality ratio (CFR) or for where RSV seasonality is well-defined; and reported incidence rate, hospital admission rate, RSV positive proportion in acute lower respiratory infection hospital admission, or in-hospital CFR. Studies were excluded if case definition was not clearly defined or not consistently applied, RSV infection was not laboratory confirmed or based on serology alone, or if the report included fewer than 50 cases of acute lower respiratory infection. We applied a generalised linear mixed-effects model (GLMM) to estimate RSV-associated acute lower respiratory infection incidence, hospital admission, and in-hospital mortality both globally and regionally (by country development status and by World Bank Income Classification) in 2019. We estimated country-level RSV-associated acute lower respiratory infection incidence through a risk-factor based model. We developed new models (through GLMM) that incorporated the latest RSV community mortality data for estimating overall RSV mortality. This review was registered in PROSPERO (CRD42021252400). FINDINGS In addition to 317 studies included in our previous review, we identified and included 113 new eligible studies and unpublished data from 51 studies, for a total of 481 studies. We estimated that globally in 2019, there were 33·0 million RSV-associated acute lower respiratory infection episodes (uncertainty range [UR] 25·4-44·6 million), 3·6 million RSV-associated acute lower respiratory infection hospital admissions (2·9-4·6 million), 26 300 RSV-associated acute lower respiratory infection in-hospital deaths (15 100-49 100), and 101 400 RSV-attributable overall deaths (84 500-125 200) in children aged 0-60 months. In infants aged 0-6 months, we estimated that there were 6·6 million RSV-associated acute lower respiratory infection episodes (4·6-9·7 million), 1·4 million RSV-associated acute lower respiratory infection hospital admissions (1·0-2·0 million), 13 300 RSV-associated acute lower respiratory infection in-hospital deaths (6800-28 100), and 45 700 RSV-attributable overall deaths (38 400-55 900). 2·0% of deaths in children aged 0-60 months (UR 1·6-2·4) and 3·6% of deaths in children aged 28 days to 6 months (3·0-4·4) were attributable to RSV. More than 95% of RSV-associated acute lower respiratory infection episodes and more than 97% of RSV-attributable deaths across all age bands were in low-income and middle-income countries (LMICs). INTERPRETATION RSV contributes substantially to morbidity and mortality burden globally in children aged 0-60 months, especially during the first 6 months of life and in LMICs. We highlight the striking overall mortality burden of RSV disease worldwide, with one in every 50 deaths in children aged 0-60 months and one in every 28 deaths in children aged 28 days to 6 months attributable to RSV. For every RSV-associated acute lower respiratory infection in-hospital death, we estimate approximately three more deaths attributable to RSV in the community. RSV passive immunisation programmes targeting protection during the first 6 months of life could have a substantial effect on reducing RSV disease burden, although more data are needed to understand the implications of the potential age-shifts in peak RSV burden to older age when these are implemented. FUNDING EU Innovative Medicines Initiative Respiratory Syncytial Virus Consortium in Europe (RESCEU).
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Affiliation(s)
- You Li
- School of Public Health, Nanjing Medical University, Nanjing, China; Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Xin Wang
- School of Public Health, Nanjing Medical University, Nanjing, China; Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Dianna M Blau
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mauricio T Caballero
- Fundacion INFANT, Buenos Aires, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
| | - Daniel R Feikin
- Department of Immunizations, Vaccines, and Biologicals, WHO, Geneva, Switzerland
| | - Christopher J Gill
- Boston University School of Public Health, Department of Global Health, Boston, Massachusetts, USA
| | - Shabir A Madhi
- South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa; African Leadership Initiative in Vaccinology Expertise, University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa
| | - Saad B Omer
- Yale Institute for Global Health, New Haven, CT, USA
| | - Eric A F Simões
- Department of Pediatrics, Section of Infectious Diseases, University of Colorado, School of Medicine, Aurora, CO, USA; Department of Epidemiology and Center for Global Health, Colorado School of Public Health, Aurora, CO, USA
| | - Harry Campbell
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Ana Bermejo Pariente
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Darmaa Bardach
- National Center for Communicable Diseases (Mongolia), Ulaanbaatar, Mongolia
| | - Quique Bassat
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique; Catalan Institution for Research and Advanced Studies, Barcelona, Spain
| | - Jean-Sebastien Casalegno
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Centre de Biologie Nord, Institut des Agents Infectieux, Laboratoire de Virologie, Lyon, France
| | | | - Nigel Crawford
- The Royal Children's Hospital, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Daria Danilenko
- Smorodintsev Research Institute of Influenza, Saint Petersburg, Russia
| | - Lien Anh Ha Do
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Marcela Echavarria
- Clinical Virology Unit, Centro de Educación Médica e Investigaciones Clínicas, Buenos Aires, Argentina
| | - Angela Gentile
- Ricardo Gutierrez Children Hospital, Buenos Aires, Argentina
| | - Aubree Gordon
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - Terho Heikkinen
- Department of Pediatrics, University of Turku and Turku University Hospital, Turku, Finland
| | - Q Sue Huang
- WHO National Influenza Centre, Institute of Environmental Science and Research, Wellington, New Zealand
| | - Sophie Jullien
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Jigme Dorji Wangchuck National Referral Hospital, Gongphel Lam, Thimphu, Bhutan
| | - Anand Krishnan
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Eduardo Luis Lopez
- Hospital de Niños Dr. Ricardo Gutiérrez, Department of Medicine, Pediatric Infectious Diseases Program, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Joško Markić
- Department of Pediatrics, University Hospital Split, Split, Croatia; University of Split, School of Medicine, Split, Croatia
| | - Ainara Mira-Iglesias
- Área de Investigación en Vacunas, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, Salud Pública, Valencia, Spain
| | - Hannah C Moore
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Jocelyn Moyes
- National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Lawrence Mwananyanda
- Boston University School of Public Health, Department of Global Health, Boston, Massachusetts, USA
| | - D James Nokes
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya; School of Life Sciences, University of Warwick, Coventry, UK
| | - Faseeha Noordeen
- Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Evangeline Obodai
- Virology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Nandhini Palani
- Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
| | | | - Vahid Salimi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ashish Satav
- MAHAN Trust Mahatma Gandhi Tribal Hospital, Karmgram, Utavali, Tahsil, Dharni, India
| | - Euri Seo
- Department of Pediatrics, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, South Korea
| | - Zakhar Shchomak
- Department of Pediatrics, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | | | - Kirill Stolyarov
- Smorodintsev Research Institute of Influenza, Saint Petersburg, Russia
| | | | - Anne von Gottberg
- School of Pathology, University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa; National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Danielle Wurzel
- Murdoch Children's Research Institute, Melbourne, Australia; Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Lay-Myint Yoshida
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Chee Fu Yung
- Infectious Diseases Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore; Duke-NUS Medical School, Singapore; Lee Kong Chian School of Medicine, Imperial College, Nanyang Technological University, Singapore
| | - Heather J Zar
- Department of Paediatrics and Child Health, and South African Medical Research Council Unit on Child & Adolescent Health, University of Cape Town and Red Cross War Memorial Children's Hospital, Cape Town, South Africa
| | - Harish Nair
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK; Respiratory Syncytial Virus Network Foundation, Zeist, Netherlands, on behalf of the Respiratory Virus Global Epidemiology Network, and the RESCEU investigators.
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Gatti L, Koenen MH, Zhang JD, Anisimova M, Verhagen LM, Schutten M, Osterhaus A, van der Vries E. Cross-reactive immunity potentially drives global oscillation and opposed alternation patterns of seasonal influenza A viruses. Sci Rep 2022; 12:8883. [PMID: 35614123 DOI: 10.1038/s41598-022-08233-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 03/02/2022] [Indexed: 11/08/2022] Open
Abstract
Several human pathogens exhibit distinct patterns of seasonality and circulate as pairs. For instance, influenza A virus subtypes oscillate and peak during winter seasons of the world’s temperate climate zones. Alternation of dominant strains in successive influenza seasons makes epidemic forecasting a major challenge. From the start of the 2009 influenza pandemic we enrolled influenza A virus infected patients (n = 2980) in a global prospective clinical study. Complete hemagglutinin sequences were obtained from 1078 A/H1N1 and 1033 A/H3N2 viruses. We used phylodynamics to construct high resolution spatio-temporal phylogenetic hemagglutinin trees and estimated global influenza A effective reproductive numbers (R) over time (2009–2013). We demonstrate that R oscillates around R = 1 with a clear opposed alternation pattern between phases of the A/H1N1 and A/H3N2 subtypes. Moreover, we find a similar alternation pattern for the number of global viral spread between the sampled geographical locations. Both observations suggest a between-strain competition for susceptible hosts on a global level. Extrinsic factors that affect person-to-person transmission are a major driver of influenza seasonality. The data presented here indicate that cross-reactive host immunity is also a key intrinsic driver of influenza seasonality, which determines the influenza A virus strain at the onset of each epidemic season.
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Foley DA, Phuong LK, Peplinski J, Lim SMJ, Lee WH, Keane A, Wong JWS, Minney-Smith CA, Martin AC, Mace AO, Sikazwe CT, Le H, Levy A, Borland M, Hazelton B, Moore HC, Blyth C, Yeoh D, Bowen AC. Examining the entire delayed respiratory syncytial virus season in Western Australia. Arch Dis Child 2022; 107:517-519. [PMID: 34930725 DOI: 10.1136/archdischild-2021-323375] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/08/2021] [Indexed: 11/03/2022]
Affiliation(s)
- David Anthony Foley
- Microbiology, PathWest Laboratory Medicine Western Australia, Perth, Western Australia, Australia .,Wesfarmers Centre of Vaccines and Infecitous Diseases, University of Western Australia, Telethon Kids Institute, Perth, Western Australia, Australia
| | - Linny Kimly Phuong
- Infection and Immunity, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Joseph Peplinski
- Department of General Paediatrics, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Selina Mei Jy Lim
- Infectious Diseases Department, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Wei Hao Lee
- Department of General Paediatrics, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Aoife Keane
- Department of General Paediatrics, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Jessica Win See Wong
- Department of General Paediatrics, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Cara A Minney-Smith
- Microbiology, PathWest Laboratory Medicine Western Australia, Perth, Western Australia, Australia
| | - Andrew C Martin
- Department of General Paediatrics, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Ariel O Mace
- Department of General Paediatrics, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Chisha T Sikazwe
- Microbiology, PathWest Laboratory Medicine Western Australia, Perth, Western Australia, Australia.,Infection and Immunity, Biomedical Science, University of Western Australia, Perth, Western Australia, Australia
| | - Huong Le
- Wesfarmers Centre of Vaccines and Infecitous Diseases, University of Western Australia, Telethon Kids Institute, Perth, Western Australia, Australia
| | - Avram Levy
- Microbiology, PathWest Laboratory Medicine Western Australia, Perth, Western Australia, Australia.,Infection and Immunity, Biomedical Science, University of Western Australia, Perth, Western Australia, Australia
| | - Meredith Borland
- Emergency Medicine, Perth Children's Hospital, Nedlands, Western Australia, Australia.,Divisions of Paediatrics and Emergency Medicine, University of Western Australia, Crawley, Western Australia, Australia
| | - Briony Hazelton
- Microbiology, PathWest Laboratory Medicine Western Australia, Perth, Western Australia, Australia.,Infectious Diseases Department, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Hannah C Moore
- Wesfarmers Centre of Vaccines and Infecitous Diseases, University of Western Australia, Telethon Kids Institute, Perth, Western Australia, Australia
| | - Christopher Blyth
- Microbiology, PathWest Laboratory Medicine Western Australia, Perth, Western Australia, Australia.,Wesfarmers Centre of Vaccines and Infecitous Diseases, University of Western Australia, Telethon Kids Institute, Perth, Western Australia, Australia.,Infectious Diseases Department, Perth Children's Hospital, Perth, Western Australia, Australia.,School of Paediatrics and Child Health, University of Western Australia, Subiaco, Western Australia, Australia
| | - Daniel Yeoh
- Infectious Diseases Department, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Asha C Bowen
- Wesfarmers Centre of Vaccines and Infecitous Diseases, University of Western Australia, Telethon Kids Institute, Perth, Western Australia, Australia.,Infectious Diseases Department, Perth Children's Hospital, Perth, Western Australia, Australia
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Affiliation(s)
- M Ricco
- AUSL - IRCCS di Reggio Emilia, Servizio di Prevenzione e Sicurezza negli ambienti di Lavoro (SPSAL), Via Amendola n.2, Reggio Emilia (RE), Italy.
| | - M Valente
- University of Parma, Department of Medicine and Surgery, Via Gramsci n.14, 43123; Parma (PR), Italy
| | - F Marchesi
- University of Parma, Department of Medicine and Surgery, Via Gramsci n.14, 43123; Parma (PR), Italy
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