Assessing the impact of SARS-CoV-2 on influenza-like illness surveillance trends in the community during the 2023/2024 winter in England.

IF 4.8 2区 医学 Q1 INFECTIOUS DISEASES International Journal of Infectious Diseases Pub Date : 2025-01-01 Epub Date: 2024-11-16 DOI:10.1016/j.ijid.2024.107307
Jonathon Mellor, Martyn Fyles, Robert S Paton, Alexander Phillips, Christopher E Overton, Thomas Ward
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Abstract

Objectives: Influenza-like-illness (ILI) is a commonly used symptom categorization in seasonal disease surveillance focusing on influenza in community and clinical settings. However, SARS-CoV-2 often causes presentation with a similar symptom profile. We explore how SARS-CoV-2-positive individuals can influence surveillance trends for the World Health Organization, the United States Centre for Disease Control, and the European Centre for Disease Control (ECDC) ILI criteria.

Methods: Harnessing the Winter COVID-19 Infection Study in England, a cohort study, the prevalence of different ILI definitions is modeled using multilevel regression and poststratification using age and spatial stratifications with temporal smoothing. Trends over time across stratifications were compared for SARS-CoV-2 positive and negative individuals to understand differences in ILI trends. Symptom presentation across positive and negative SARS-CoV-2 cases were compared.

Results: SARS-CoV-2 symptom profiles are shown to overlap with the ILI case definitions, particularly for "cough" and "fever", causing SARS-CoV-2 positive individuals to be frequently detected as ILI cases. The trend of SARS-CoV-2 positives is a substantial component of the ILI-modeled trend, driving an earlier perceived peak in prevalence. The ECDC symptom definition was most influenced by SARS-CoV-2 positive individuals.

Conclusions: Using a large community cohort we show how SARS-CoV-2 can impact ILI surveillance trends. SARS-CoV-2 makes up a substantial part of the community ILI burden and public health messaging should reflect this when discussing ILI. We show ILI is no longer a strong proxy for influenza activity alone.

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评估 SARS-CoV-2 对英格兰 2023/2024 年冬季社区流感样疾病监测趋势的影响。
背景:流感样病症是季节性疾病监测中常用的症状分类,主要针对社区和临床环境中的流感。然而,SARS-CoV-2 通常会导致类似症状的表现。我们探讨了 SARS-CoV-2 阳性个体如何影响世界卫生组织、中国疾病预防控制中心和欧洲疾病预防控制中心流感样病症标准的监测趋势。方法:利用英格兰冬季 COVID-19 感染研究(一项队列研究),使用多梯度回归和后分层法,对不同流感样病症定义的流行率进行建模,并使用年龄和空间分层法进行时间平滑。比较了 SARS-CoV-2 阳性和阴性个体不同分层的时间趋势,以了解流感样疾病趋势的差异。比较了 SARS-CoV-2 阳性和阴性病例的症状表现:结果:SARS-CoV-2 的症状特征与流感样病例的定义重叠,尤其是 "咳嗽 "和 "发热",导致 SARS-CoV-2 阳性者经常被检测为流感样病例。SARS-CoV-2 阳性病例的趋势是流感样病例模型趋势的重要组成部分,推动了流行高峰的提前到来。ECDC 的症状定义受 SARS-CoV-2 阳性者的影响最大:结论:通过一个大型社区队列,我们展示了 SARS-CoV-2 如何影响流感样病例监测趋势。SARS-CoV-2 在社区流感样病例中占很大比例,在讨论流感样病例时,公共卫生信息应反映这一点。我们的研究表明,流感样病例不再是流感活动的有力替代。
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来源期刊
CiteScore
18.90
自引率
2.40%
发文量
1020
审稿时长
30 days
期刊介绍: International Journal of Infectious Diseases (IJID) Publisher: International Society for Infectious Diseases Publication Frequency: Monthly Type: Peer-reviewed, Open Access Scope: Publishes original clinical and laboratory-based research. Reports clinical trials, reviews, and some case reports. Focuses on epidemiology, clinical diagnosis, treatment, and control of infectious diseases. Emphasizes diseases common in under-resourced countries.
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