Respiratory viruses are major contributors to morbidity and mortality worldwide, with their circulation influenced by seasonal patterns and pandemic-related interventions. This study analyzed detection trends of non-SARS-CoV-2 respiratory viruses in a large Italian hospital over a 7-year period, focusing on variations across COVID-19–related periods and patient age groups.
Methods
We retrospectively analyzed multiplex PCR-based laboratory results of 8836 nasopharyngeal samples collected between September 2016 and August 2023. Viral detection rates were stratified by season, COVID-19–related periods (pre-pandemic, pandemic, post-pandemic), and age groups.
Results
Of the 8836 nasopharyngeal samples analyzed, 2795 (31.6%) tested positive for at least one respiratory virus. Rhinovirus/enterovirus (RV/EV) was the most frequently detected virus (37.6%), followed by influenza A virus (IAV, 17.9%) and respiratory syncytial virus (RSV, 17.2%). The 2020–2021 season had the lowest positivity rate (p < 0.001), with marked declines in IAV and RSV detections, likely because of COVID-19 mitigation measures. Conversely, detections of RV/EV and human coronaviruses increased. Postpandemic data suggested a return to prepandemic patterns, though overall positivity rates remained altered. Age-stratified analysis revealed RSV predominance in infants (p < 0.001), emphasizing its clinical relevance in pediatric populations.
Conclusions
Our findings highlight the dynamic nature of respiratory virus epidemiology and the persistent impact of the COVID-19 pandemic on viral circulation. Continuous surveillance and adaptive public health strategies are essential for managing future outbreaks and mitigating the burden of respiratory viral infections.
{"title":"Detection of Respiratory Viruses Other Than SARS-CoV-2 in a Large Hospital Laboratory in Rome, Italy, During the Seasons 2016–2017 to 2022–2023","authors":"Flora Marzia Liotti, Simona Marchetti, Sara D'Onghia, Maurizio Sanguinetti, Rosaria Santangelo, Brunella Posteraro","doi":"10.1111/irv.70079","DOIUrl":"https://doi.org/10.1111/irv.70079","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objective</h3>\u0000 \u0000 <p>Respiratory viruses are major contributors to morbidity and mortality worldwide, with their circulation influenced by seasonal patterns and pandemic-related interventions. This study analyzed detection trends of non-SARS-CoV-2 respiratory viruses in a large Italian hospital over a 7-year period, focusing on variations across COVID-19–related periods and patient age groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed multiplex PCR-based laboratory results of 8836 nasopharyngeal samples collected between September 2016 and August 2023. Viral detection rates were stratified by season, COVID-19–related periods (pre-pandemic, pandemic, post-pandemic), and age groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 8836 nasopharyngeal samples analyzed, 2795 (31.6%) tested positive for at least one respiratory virus. Rhinovirus/enterovirus (RV/EV) was the most frequently detected virus (37.6%), followed by influenza A virus (IAV, 17.9%) and respiratory syncytial virus (RSV, 17.2%). The 2020–2021 season had the lowest positivity rate (<i>p</i> < 0.001), with marked declines in IAV and RSV detections, likely because of COVID-19 mitigation measures. Conversely, detections of RV/EV and human coronaviruses increased. Postpandemic data suggested a return to prepandemic patterns, though overall positivity rates remained altered. Age-stratified analysis revealed RSV predominance in infants (<i>p</i> < 0.001), emphasizing its clinical relevance in pediatric populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings highlight the dynamic nature of respiratory virus epidemiology and the persistent impact of the COVID-19 pandemic on viral circulation. Continuous surveillance and adaptive public health strategies are essential for managing future outbreaks and mitigating the burden of respiratory viral infections.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.70079","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Julia Wangui, George Gachara, Victor Mobegi, Charles Agoti, James Otieno, Silvanos Opanda, Benjamin Opot, Joseph N. Ngeranwa, Regina Njeru, Wallace Bulimo
Background
We conducted a retrospective study to explore molecular insights into human respiratory syncytial virus (HRSV) group B strains among patients attending outpatient clinics at government medical facilities both prior and during the onset of Influenza A/H1N1/2009 pandemic outbreak.
Methods
We screened 2300 nasopharyngeal swabs using multiplex real time reverse transcriptase polymerase chain reaction. We amplified a segment of the first and second hypervariable regions, as well as the conserved portion of the third domain of the G-gene using HRSV-B specific primers, sequenced by Sanger di-deoxy chain termination method and thereafter analyzed the sequences.
Results
We characterized the circulating strains into three known genotypes: SAB4 (1.4%), BA7 (1.4%), and multiple variants of BA9 (97.2%). The majority of BA9 viruses were uniquely Kenyan with only 4% aligning with BA9 lineages found elsewhere. The mean evolutionary rate of the HRSV-B was estimated to be 3.08 × 10−3 substitutions per site per year.
Conclusion
Our findings indicate that the circulating HRSV-B viruses in Kenya underwent a slower evolution during the period of 2007–2010. Additionally, our findings reveal the existence of a unique lineage as well as new variants that have not been reported elsewhere to date.
{"title":"Molecular Analysis of Human Respiratory Syncytial Virus Group B Strains Isolated in Kenya Before and During the Emergence of Pandemic Influenza A/H1N1","authors":"Julia Wangui, George Gachara, Victor Mobegi, Charles Agoti, James Otieno, Silvanos Opanda, Benjamin Opot, Joseph N. Ngeranwa, Regina Njeru, Wallace Bulimo","doi":"10.1111/irv.70082","DOIUrl":"https://doi.org/10.1111/irv.70082","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We conducted a retrospective study to explore molecular insights into human respiratory syncytial virus (HRSV) group B strains among patients attending outpatient clinics at government medical facilities both prior and during the onset of Influenza A/H1N1/2009 pandemic outbreak.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We screened 2300 nasopharyngeal swabs using multiplex real time reverse transcriptase polymerase chain reaction. We amplified a segment of the first and second hypervariable regions, as well as the conserved portion of the third domain of the G-gene using HRSV-B specific primers, sequenced by Sanger di-deoxy chain termination method and thereafter analyzed the sequences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We characterized the circulating strains into three known genotypes: SAB4 (1.4%), BA7 (1.4%), and multiple variants of BA9 (97.2%). The majority of BA9 viruses were uniquely Kenyan with only 4% aligning with BA9 lineages found elsewhere. The mean evolutionary rate of the HRSV-B was estimated to be 3.08 × 10<sup>−3</sup> substitutions per site per year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings indicate that the circulating HRSV-B viruses in Kenya underwent a slower evolution during the period of 2007–2010. Additionally, our findings reveal the existence of a unique lineage as well as new variants that have not been reported elsewhere to date.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.70082","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kristoffer Grundtvig Skaarup, Filip Soeskov Davidovski, Emil Durukan, Daniel Modin, Mats Christian Højbjerg Lassen, Maria Dons, Anne Marie Reimer Jensen, Niklas Dyrby Johansen, Morten Sengeløv, Frederikke Vyff, Nino Emanuel Landler, Gorm Boje Jensen, Anne Bjerg Nielsen, Jacob Christensen, Raphael Hauser, Peter Schnohr, Rasmus Møgelvang, Lene Nielsen, Jens-Ulrik Stæhr Jensen, Tor Biering-Sørensen
Background
Influenza infection has been associated with multiple cardiac complications including acute heart failure and myocardial infarction. The FluHeart study aims to uncover the potential effect of influenza infection on cardiac structure and function as assessed by echocardiography during hospitalization.
Methods
This prospective cohort study included hospitalized influenza patients of the 2021–2022 influenza season. Participants underwent echocardiography using a prespecified protocol. Participants were successfully matched 1:1:1 on age, sex, and heart failure status with controls from the general population and controls hospitalized with COVID-19.
Results
This interim analysis involved 108 participants (36 influenza patients, 36 general population controls, and 36 COVID-19 patients). Mean age was 72 ± 18 years and 58% were male. Median time from admission to echocardiography was 1 day (IQI: 1:1) for influenza patients. The prevalence of left ventricular (LV) dysfunction was 75%, and right ventricular (RV) dysfunction was observed in 20% of influenza patients. N-terminal pro-brain natriuretic peptide levels were elevated ≥ 300 pg/mL in 62%, and 19% exhibited myocardial injury with elevated high-sensitivity troponin I levels. RV tricuspid annular plane systolic excursion and LV early diastolic peak mitral inflow to early diastolic tissue velocity were significantly worse in influenza patients compared to general population controls. Echocardiographic measures did not significantly differ between patients hospitalized with influenza and COVID-19.
Conclusion
In this interim analysis of the FluHeart study, both RV and LV function measures were significantly impaired in hospitalized influenza patients compared with matched general population controls. The extent of impairment resembled that observed in hospitalized COVID-19 patients.
{"title":"Cardiac Characteristics of Hospitalized Influenza Patients: An Interim Analysis From the FluHeart Study","authors":"Kristoffer Grundtvig Skaarup, Filip Soeskov Davidovski, Emil Durukan, Daniel Modin, Mats Christian Højbjerg Lassen, Maria Dons, Anne Marie Reimer Jensen, Niklas Dyrby Johansen, Morten Sengeløv, Frederikke Vyff, Nino Emanuel Landler, Gorm Boje Jensen, Anne Bjerg Nielsen, Jacob Christensen, Raphael Hauser, Peter Schnohr, Rasmus Møgelvang, Lene Nielsen, Jens-Ulrik Stæhr Jensen, Tor Biering-Sørensen","doi":"10.1111/irv.70067","DOIUrl":"https://doi.org/10.1111/irv.70067","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Influenza infection has been associated with multiple cardiac complications including acute heart failure and myocardial infarction. The FluHeart study aims to uncover the potential effect of influenza infection on cardiac structure and function as assessed by echocardiography during hospitalization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective cohort study included hospitalized influenza patients of the 2021–2022 influenza season. Participants underwent echocardiography using a prespecified protocol. Participants were successfully matched 1:1:1 on age, sex, and heart failure status with controls from the general population and controls hospitalized with COVID-19.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This interim analysis involved 108 participants (36 influenza patients, 36 general population controls, and 36 COVID-19 patients). Mean age was 72 ± 18 years and 58% were male. Median time from admission to echocardiography was 1 day (IQI: 1:1) for influenza patients. The prevalence of left ventricular (LV) dysfunction was 75%, and right ventricular (RV) dysfunction was observed in 20% of influenza patients. N-terminal pro-brain natriuretic peptide levels were elevated ≥ 300 pg/mL in 62%, and 19% exhibited myocardial injury with elevated high-sensitivity troponin I levels. RV tricuspid annular plane systolic excursion and LV early diastolic peak mitral inflow to early diastolic tissue velocity were significantly worse in influenza patients compared to general population controls. Echocardiographic measures did not significantly differ between patients hospitalized with influenza and COVID-19.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this interim analysis of the FluHeart study, both RV and LV function measures were significantly impaired in hospitalized influenza patients compared with matched general population controls. The extent of impairment resembled that observed in hospitalized COVID-19 patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.70067","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Angela Gentile, María del Valle Juárez, Gabriela Ensinck, Oscar Lopez, Pablo Melonari, Tatiana Fernández, Andrés Gioiosa, Gustavo Lazarte, Silvina Lobertti, María Florencia Lucion, Natalia Pejito, Camila Racana, Leandro López, Gabriela Gregorio
Introduction
The COVID-19 pandemic altered the epidemiology of respiratory viruses other than SARS-CoV-2. This study investigated the clinical-epidemiological pattern of hospitalized pediatric patients with acute lower respiratory tract infections (ALRI) and influenza in Argentina, comparing prepandemic and postpandemic periods.
Materials and Methods
This multicenter, cross-sectional study included patients under 18 years old admitted for ALRIs in five tertiary centers of Argentina before (2018 and 2019) and after (2022 and 2023) COVID-19. Changes in viral detection rates, seasonality, and case fatality rate (CFR), along with epidemiological and clinical characteristics, were analyzed. Indirect immunofluorescence assay (IFA) or RT-PCR was used for virological diagnosis pre-pandemic, and only RT-PCR in post-pandemic. Epi Info 7 and SPSS 15.0 was used for data analysis.
Results
A total of 5838 cases of ALRI were included (mean age: 9.5 months; IQR: 4–22 months); 96.6% were tested for viral detection, and 66.4% were positive (3877 cases). Respiratory syncytial virus (RSV) was the most prevalent. Influenza showed typical winter seasonality in 2018, 2019, and 2023. However, 2022 exhibited a bimodal pattern: late summer and spring, with co-circulation of influenza A and B in the second peak. CFR varied by viral diagnosis; influenza showed the highest CFR, all deaths related to influenza A. Among 354 influenza cases, 81% were < 5 years old, 53% were male, 63% had comorbidities, and 14.1% required intensive care. Mean of influenza vaccine coverage (6–24 months) was 21.4%. In both periods, patients with influenza were more likely to have pneumonia. Additionally, in the postpandemic period, malnourishment or being 3 years of age or older was also associated with a higher likelihood of influenza infection compared with infection with other respiratory viruses.
Conclusions
Influenza primarily affected children under 5 years old. Postpandemic cases involved older individuals, and increased circulation of influenza A H3N2 was observed. Vaccination coverage was notably low. Influenza returned to its usual seasonal pattern in 2023.
{"title":"Comparative Analysis of Influenza Epidemiology Before and After the COVID-19 Pandemic in Argentina (2018–2019 vs. 2022–2023)","authors":"Angela Gentile, María del Valle Juárez, Gabriela Ensinck, Oscar Lopez, Pablo Melonari, Tatiana Fernández, Andrés Gioiosa, Gustavo Lazarte, Silvina Lobertti, María Florencia Lucion, Natalia Pejito, Camila Racana, Leandro López, Gabriela Gregorio","doi":"10.1111/irv.70078","DOIUrl":"https://doi.org/10.1111/irv.70078","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The COVID-19 pandemic altered the epidemiology of respiratory viruses other than SARS-CoV-2. This study investigated the clinical-epidemiological pattern of hospitalized pediatric patients with acute lower respiratory tract infections (ALRI) and influenza in Argentina, comparing prepandemic and postpandemic periods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This multicenter, cross-sectional study included patients under 18 years old admitted for ALRIs in five tertiary centers of Argentina before (2018 and 2019) and after (2022 and 2023) COVID-19. Changes in viral detection rates, seasonality, and case fatality rate (CFR), along with epidemiological and clinical characteristics, were analyzed. Indirect immunofluorescence assay (IFA) or RT-PCR was used for virological diagnosis pre-pandemic, and only RT-PCR in post-pandemic. Epi Info 7 and SPSS 15.0 was used for data analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 5838 cases of ALRI were included (mean age: 9.5 months; IQR: 4–22 months); 96.6% were tested for viral detection, and 66.4% were positive (3877 cases). Respiratory syncytial virus (RSV) was the most prevalent. Influenza showed typical winter seasonality in 2018, 2019, and 2023. However, 2022 exhibited a bimodal pattern: late summer and spring, with co-circulation of influenza A and B in the second peak. CFR varied by viral diagnosis; influenza showed the highest CFR, all deaths related to influenza A. Among 354 influenza cases, 81% were < 5 years old, 53% were male, 63% had comorbidities, and 14.1% required intensive care. Mean of influenza vaccine coverage (6–24 months) was 21.4%. In both periods, patients with influenza were more likely to have pneumonia. Additionally, in the postpandemic period, malnourishment or being 3 years of age or older was also associated with a higher likelihood of influenza infection compared with infection with other respiratory viruses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Influenza primarily affected children under 5 years old. Postpandemic cases involved older individuals, and increased circulation of influenza A H3N2 was observed. Vaccination coverage was notably low. Influenza returned to its usual seasonal pattern in 2023.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.70078","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In 2021, the Norwegian Institute of Public Health established temporary registry-based surveillance of severe acute respiratory infections (SARI). We aimed to describe the surveillance system and evaluate selected attributes to inform the establishment of a permanent SARI surveillance system.
Methods
SARI cases were defined using ICD-10 discharge codes from national health and administrative registries, including codes for acute upper or lower respiratory infection (URI and LRI), COVID-19, acute respiratory distress syndrome, pertussis or otitis media. Data from polymerase chain reaction (PCR) analyses were available for 10 respiratory pathogens including SARS-CoV-2, influenza virus and respiratory syncytial virus (RSV). We included data from 28 September 2020 to 31 March 2024 and calculated the following parameters: the proportion of cases tested for SARS-CoV-2, influenza virus and/or RSV; time between admission and registration of a SARI-related ICD-10 code; and proportion of cases with URI, LRI and COVID-19.
Results
We identified 214,730 SARI cases, of whom 82%, 73% and 53% were tested for SARS-CoV-2, influenza virus and RSV. Case peaks were predominantly driven by one or a combination of these pathogens. Median time between admission and a registered SARI diagnostic code was 5 (lower–upper quartile 3–10) days. Nowcasting and alternative case definitions for SARI with COVID-19, influenza and RSV improved the timeliness. The ICD-10 codes for LRIs and COVID-19 captured only ~55% of the cases in the age group of 0–29 years compared to the routine case definition, where URIs were included.
Conclusions
Registry-based SARI surveillance provides timely data for handling epidemics of respiratory infections in Norway. We recommend establishing a permanent SARI surveillance system.
{"title":"Registry-Based Surveillance of Severe Acute Respiratory Infections in Norway During 2021–2024","authors":"Elina Seppälä, Håkon Bøås, Jesper Dahl, Jeanette Stålcrantz, Melanie Stecher, Ragnhild Tønnessen, Gunnar Øyvind Isaksson Rø, Hilde Kløvstad, Trine Hessevik Paulsen","doi":"10.1111/irv.70080","DOIUrl":"https://doi.org/10.1111/irv.70080","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In 2021, the Norwegian Institute of Public Health established temporary registry-based surveillance of severe acute respiratory infections (SARI). We aimed to describe the surveillance system and evaluate selected attributes to inform the establishment of a permanent SARI surveillance system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>SARI cases were defined using ICD-10 discharge codes from national health and administrative registries, including codes for acute upper or lower respiratory infection (URI and LRI), COVID-19, acute respiratory distress syndrome, pertussis or otitis media. Data from polymerase chain reaction (PCR) analyses were available for 10 respiratory pathogens including SARS-CoV-2, influenza virus and respiratory syncytial virus (RSV). We included data from 28 September 2020 to 31 March 2024 and calculated the following parameters: the proportion of cases tested for SARS-CoV-2, influenza virus and/or RSV; time between admission and registration of a SARI-related ICD-10 code; and proportion of cases with URI, LRI and COVID-19.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 214,730 SARI cases, of whom 82%, 73% and 53% were tested for SARS-CoV-2, influenza virus and RSV. Case peaks were predominantly driven by one or a combination of these pathogens. Median time between admission and a registered SARI diagnostic code was 5 (lower–upper quartile 3–10) days. Nowcasting and alternative case definitions for SARI with COVID-19, influenza and RSV improved the timeliness. The ICD-10 codes for LRIs and COVID-19 captured only ~55% of the cases in the age group of 0–29 years compared to the routine case definition, where URIs were included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Registry-based SARI surveillance provides timely data for handling epidemics of respiratory infections in Norway. We recommend establishing a permanent SARI surveillance system.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.70080","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143404633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sangshin Park, Hyelan Lee, Jung Yoon Park, Sujin Choi, Hyun Jung Kim, Lorenzo Bertizzolo, Young Hwa Lee, Young June Choe
Background
Respiratory syncytial virus (RSV) is an important cause of bronchiolitis and pneumonia in children globally. This study aimed to incorporate new data to update estimates of RSV burden in children through 5 years of age in Western Pacific and Southeast Asia Regions.
Methods
A systematic review and meta-analysis were conducted to examine the proportion of RSV among cases of respiratory tract infection (RTI) in children in Western Pacific and Southeast Asia Regions using random effects models. Studies were eligible if they met the following inclusion criteria: (1) observational studies such as cohort and cross-sectional studies; (2) studies on humans; (3) studies on patients with RTI or influenza-like illness (ILI); (4) studies reporting incidence or proportion of RSV infection among respiratory related illness; and (5) studies on children aged 5 years or less.
Findings
A total of 4403 studies were identified from an initial search. After screening titles, abstracts, and full-text review, a total of 173 studies that met predefined eligibility criteria were included in the analysis. The overall proportion of RSV infections among all ARTIs was 18.7% (95% CI: 16.0%–21.5%), whereas the proportion of RSV infections among LRTIs was 28.7% (95% CI: 2.6%–30.3%) in children in Western Pacific and Southeast Asia Regions between 1970 and 2020. The proportion of RSV infections peaked in the 1980s at 33.4% (95% CI: 19.8%–48.5%), having increased from 10.6% (95% CI: 2.9%–22.2%) in the 1970s. It then showed a decreasing trend, with 28.9% (95% CI: 18.8%–40.3%) in the 1990s, 24.5% (95% CI: 22.3%–26.8%) in the 2000s, and 20.1% (95% CI: 17.8%–22.5%) in the 2010s. By country, Myanmar (50.0%; 95% CI, 47.5%–52.4%) and New Zealand (45.3%; 95% CI, 37.1%–53.7%) had the highest proportion during the overall time period, followed by Bhutan (45.2%; 95% CI, 36.4%–54.3%), Lao PDR (41.0%; 95% CI, 36.2%–46.0%), and Vietnam (35.5%; 95% CI, 19.3%–53.6%).
Interpretation
Substantial RSV-associated disease burden occurs in children in Western Pacific and Southeast Asia Regions. Our findings provide new and important evidence of the need for RSV prevention in Western Pacific and Southeast Asia countries. They could inform future preventive policy.
{"title":"Trends in Proportions of Respiratory Syncytial Virus Infections Among Reported Respiratory Tract Infection Cases in Children Aged 0 to 5 Years in Western Pacific and Southeast Asia Regions: A Systematic Review and Meta-Analysis","authors":"Sangshin Park, Hyelan Lee, Jung Yoon Park, Sujin Choi, Hyun Jung Kim, Lorenzo Bertizzolo, Young Hwa Lee, Young June Choe","doi":"10.1111/irv.70077","DOIUrl":"https://doi.org/10.1111/irv.70077","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Respiratory syncytial virus (RSV) is an important cause of bronchiolitis and pneumonia in children globally. This study aimed to incorporate new data to update estimates of RSV burden in children through 5 years of age in Western Pacific and Southeast Asia Regions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review and meta-analysis were conducted to examine the proportion of RSV among cases of respiratory tract infection (RTI) in children in Western Pacific and Southeast Asia Regions using random effects models. Studies were eligible if they met the following inclusion criteria: (1) observational studies such as cohort and cross-sectional studies; (2) studies on humans; (3) studies on patients with RTI or influenza-like illness (ILI); (4) studies reporting incidence or proportion of RSV infection among respiratory related illness; and (5) studies on children aged 5 years or less.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>A total of 4403 studies were identified from an initial search. After screening titles, abstracts, and full-text review, a total of 173 studies that met predefined eligibility criteria were included in the analysis. The overall proportion of RSV infections among all ARTIs was 18.7% (95% CI: 16.0%–21.5%), whereas the proportion of RSV infections among LRTIs was 28.7% (95% CI: 2.6%–30.3%) in children in Western Pacific and Southeast Asia Regions between 1970 and 2020. The proportion of RSV infections peaked in the 1980s at 33.4% (95% CI: 19.8%–48.5%), having increased from 10.6% (95% CI: 2.9%–22.2%) in the 1970s. It then showed a decreasing trend, with 28.9% (95% CI: 18.8%–40.3%) in the 1990s, 24.5% (95% CI: 22.3%–26.8%) in the 2000s, and 20.1% (95% CI: 17.8%–22.5%) in the 2010s. By country, Myanmar (50.0%; 95% CI, 47.5%–52.4%) and New Zealand (45.3%; 95% CI, 37.1%–53.7%) had the highest proportion during the overall time period, followed by Bhutan (45.2%; 95% CI, 36.4%–54.3%), Lao PDR (41.0%; 95% CI, 36.2%–46.0%), and Vietnam (35.5%; 95% CI, 19.3%–53.6%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interpretation</h3>\u0000 \u0000 <p>Substantial RSV-associated disease burden occurs in children in Western Pacific and Southeast Asia Regions. Our findings provide new and important evidence of the need for RSV prevention in Western Pacific and Southeast Asia countries. They could inform future preventive policy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.70077","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ainara Mira-Iglesias, Mónica López-Lacort, Hélène Bricout, Matthew Loiacono, Mario Carballido-Fernández, Joan Mollar-Maseres, Miguel Tortajada-Girbés, Germán Schwarz-Chávarri, F. Xavier López-Labrador, Joan Puig-Barberà, Javier Díez-Domingo, Alejandro Orrico-Sánchez
Background
International Classification of Diseases (ICD) codes obtained from real-world data can be used to identify influenza cases for epidemiological research but, without validation, may introduce biases. The objective of this study was to validate ICD influenza discharge diagnoses using real-time reverse transcription-polymerase chain reaction (RT-PCR) laboratory-confirmed influenza (LCI) results.
Methods
The study was conducted during six influenza seasons (2012/2013–2017/2018) in the Valencia Hospital Surveillance Network for the Study of Influenza (VAHNSI). Patients aged 18+ years were identified via active-surveillance and had to meet an influenza-like illness (ILI) case definition to be included. All patients were tested for influenza by real-time RT-PCR. Main and secondary influenza discharge diagnosis codes were extracted from hospital discharge letters. Positive predictive values (PPVs) and the complementary of the sensitivities (1-Sensitivity) of ICD codes with corresponding 95% credible intervals (CrIs) were estimated via binomial Bayesian regression models.
Results
A total of 13,545 patients were included, with 2257 (17%) positive for influenza. Of 2257 LCI cases, 1385 (61%) were not ICD-coded as influenza. Overall, 74.73% (95% CrI: 63.24–84.44) of LCI were not-ICD coded as influenza (1-Sensitivity) after adjustment. Sensitivity improved across seasons and with increasing age. Average PPV was 74.02% (95% CrI: 68.58–79.17), ranging from 43.71% to 81.57% between seasons.
Conclusion
Using only main and secondary discharge diagnosis codes for influenza detection markedly underestimates the full burden of influenza in hospitalized patients. Future studies, including post-COVID context, using prospective surveillance for ILI are required to assess the validity of hospital discharge data as a tool for determining influenza-related burden of disease.
{"title":"Accuracy of ICD Influenza Discharge Diagnosis Codes in Hospitalized Adults From the Valencia Region, Spain, in the Pre-COVID-19 Period 2012/2013 to 2017/2018","authors":"Ainara Mira-Iglesias, Mónica López-Lacort, Hélène Bricout, Matthew Loiacono, Mario Carballido-Fernández, Joan Mollar-Maseres, Miguel Tortajada-Girbés, Germán Schwarz-Chávarri, F. Xavier López-Labrador, Joan Puig-Barberà, Javier Díez-Domingo, Alejandro Orrico-Sánchez","doi":"10.1111/irv.70069","DOIUrl":"https://doi.org/10.1111/irv.70069","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>International Classification of Diseases (ICD) codes obtained from real-world data can be used to identify influenza cases for epidemiological research but, without validation, may introduce biases. The objective of this study was to validate ICD influenza discharge diagnoses using real-time reverse transcription-polymerase chain reaction (RT-PCR) laboratory-confirmed influenza (LCI) results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study was conducted during six influenza seasons (2012/2013–2017/2018) in the Valencia Hospital Surveillance Network for the Study of Influenza (VAHNSI). Patients aged 18+ years were identified via active-surveillance and had to meet an influenza-like illness (ILI) case definition to be included. All patients were tested for influenza by real-time RT-PCR. Main and secondary influenza discharge diagnosis codes were extracted from hospital discharge letters. Positive predictive values (PPVs) and the complementary of the sensitivities (1-Sensitivity) of ICD codes with corresponding 95% credible intervals (CrIs) were estimated via binomial Bayesian regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 13,545 patients were included, with 2257 (17%) positive for influenza. Of 2257 LCI cases, 1385 (61%) were not ICD-coded as influenza. Overall, 74.73% (95% CrI: 63.24–84.44) of LCI were not-ICD coded as influenza (1-Sensitivity) after adjustment. Sensitivity improved across seasons and with increasing age. Average PPV was 74.02% (95% CrI: 68.58–79.17), ranging from 43.71% to 81.57% between seasons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Using only main and secondary discharge diagnosis codes for influenza detection markedly underestimates the full burden of influenza in hospitalized patients. Future studies, including post-COVID context, using prospective surveillance for ILI are required to assess the validity of hospital discharge data as a tool for determining influenza-related burden of disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.70069","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143248630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Valérie D. V. Sankatsing, Jojanneke van Summeren, Fasika Molla Abreha, Elisabetta Pandolfi, Maria Chironna, Daniela Loconsole, Rolf Kramer, John Paget, Caterina Rizzo
Background
Accurate cost estimates of respiratory syncytial virus (RSV) infections in primary care are limited, despite the majority of cases being managed in this setting. This study aims to estimate healthcare costs for children with RSV in primary care and the related costs of parental work absence.
Methods
Children < 5 years of age with symptoms of acute respiratory infections were recruited via primary care paediatricians in two Italian regions for a prospective cohort study on the RSV burden in primary care, during the 2019/2020 winter. Healthcare utilization, medication use and parental work absence were assessed during a 14-day follow-up period. Average costs were estimated per RSV episode for the overall study population, as well as per age group.
Results
Two hundred ninety three children were recruited, of which 119 tested RSV positive (41%) and 109 were included. In total, 89% of RSV-positive children (97/109) had ≥ 1 repeat paediatrician visit(s), and 10% (11/109) visited the ED. The mean number of repeat visits was 3.8 (SD: 4.0) and the mean duration of work absence 4.0 days (SD: 5.0). Average costs per RSV episode were €730 (95% CI: €691–€771), with direct medical costs accounting for 25% (€183 [95% CI: €174–€191]) and indirect costs related to work absence for 75% (€547 [95% CI: €509–€587]).
Conclusions
Costs associated with RSV infections in young children in primary care are considerable due to a substantial number of paediatrician visits and high rates of parental work absence. These costs are important to include in decision-making regarding the implementation of new RSV immunization strategies in national immunization programmes.
{"title":"Economic Impact of Respiratory Syncytial Virus Infections in Children Under 5 Years of Age Attending Primary Care in Italy: A Prospective Cohort Study in Two Regions","authors":"Valérie D. V. Sankatsing, Jojanneke van Summeren, Fasika Molla Abreha, Elisabetta Pandolfi, Maria Chironna, Daniela Loconsole, Rolf Kramer, John Paget, Caterina Rizzo","doi":"10.1111/irv.70074","DOIUrl":"10.1111/irv.70074","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Accurate cost estimates of respiratory syncytial virus (RSV) infections in primary care are limited, despite the majority of cases being managed in this setting. This study aims to estimate healthcare costs for children with RSV in primary care and the related costs of parental work absence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Children < 5 years of age with symptoms of acute respiratory infections were recruited via primary care paediatricians in two Italian regions for a prospective cohort study on the RSV burden in primary care, during the 2019/2020 winter. Healthcare utilization, medication use and parental work absence were assessed during a 14-day follow-up period. Average costs were estimated per RSV episode for the overall study population, as well as per age group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two hundred ninety three children were recruited, of which 119 tested RSV positive (41%) and 109 were included. In total, 89% of RSV-positive children (97/109) had ≥ 1 repeat paediatrician visit(s), and 10% (11/109) visited the ED. The mean number of repeat visits was 3.8 (SD: 4.0) and the mean duration of work absence 4.0 days (SD: 5.0). Average costs per RSV episode were €730 (95% CI: €691–€771), with direct medical costs accounting for 25% (€183 [95% CI: €174–€191]) and indirect costs related to work absence for 75% (€547 [95% CI: €509–€587]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Costs associated with RSV infections in young children in primary care are considerable due to a substantial number of paediatrician visits and high rates of parental work absence. These costs are important to include in decision-making regarding the implementation of new RSV immunization strategies in national immunization programmes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.70074","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
SARS-CoV-2, which originated in China in late 2019, quickly fueled the global COVID-19 pandemic, profoundly impacting health and the economy worldwide. A series of vaccines, mostly based on the full SARS-CoV-2 Spike protein, were rapidly developed, showing excellent humoral and cellular responses and high efficacy against both symptomatic infection and severe disease. However, viral evolution and the waning humoral neutralizing responses strongly challenged vaccine long term effectiveness, mainly against symptomatic infection, making necessary a strategy of repeated and updated booster shots. In this repeated vaccination context, antibody repertoire diversification was evidenced, although immune imprinting after booster doses or reinfection was also demonstrated and identified as a major determinant of immunological responses to repeated antigen exposures. Considering that a small domain of the SARS-CoV-2 Spike protein, the receptor binding domain (RBD), is the major target of neutralizing antibodies and concentrates most viral mutations, the following text aims to provide insights into the ongoing debate over the best strategies for vaccine boosters. We address the relevance of developing new booster vaccines that target the evolving RBD, thus focusing on the relevant antigenic sites of the SARS-CoV-2 new variants. A combination of this strategy with immunofusing and computerized approaches could minimize immune imprinting, therefore optimizing neutralizing immune responses and booster vaccine efficacy.
{"title":"Rethinking Optimal Immunogens to Face SARS-CoV-2 Evolution Through Vaccination","authors":"Julià Blanco, Benjamin Trinité, Joan Puig-Barberà","doi":"10.1111/irv.70076","DOIUrl":"10.1111/irv.70076","url":null,"abstract":"<p>SARS-CoV-2, which originated in China in late 2019, quickly fueled the global COVID-19 pandemic, profoundly impacting health and the economy worldwide. A series of vaccines, mostly based on the full SARS-CoV-2 Spike protein, were rapidly developed, showing excellent humoral and cellular responses and high efficacy against both symptomatic infection and severe disease. However, viral evolution and the waning humoral neutralizing responses strongly challenged vaccine long term effectiveness, mainly against symptomatic infection, making necessary a strategy of repeated and updated booster shots. In this repeated vaccination context, antibody repertoire diversification was evidenced, although immune imprinting after booster doses or reinfection was also demonstrated and identified as a major determinant of immunological responses to repeated antigen exposures. Considering that a small domain of the SARS-CoV-2 Spike protein, the receptor binding domain (RBD), is the major target of neutralizing antibodies and concentrates most viral mutations, the following text aims to provide insights into the ongoing debate over the best strategies for vaccine boosters. We address the relevance of developing new booster vaccines that target the evolving RBD, thus focusing on the relevant antigenic sites of the SARS-CoV-2 new variants. A combination of this strategy with immunofusing and computerized approaches could minimize immune imprinting, therefore optimizing neutralizing immune responses and booster vaccine efficacy.</p>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Susanne Heemskerk, Christos Baliatsas, Foekje Stelma, Harish Nair, John Paget, Peter Spreeuwenberg
Background
During the COVID-19 pandemic, atypical respiratory syncytial virus (RSV) circulation patterns emerged, with the occurrence of RSV activity outside the typical winter season. This study investigates the impact of COVID-19 and associated non-pharmaceutical interventions (NPIs) on RSV seasonality.
Methods
The onset, offset and peak of RSV epidemics from 2018 to 2022 across 12 European countries were determined using the 3% positivity threshold method. A multilevel longitudinal logit regression model for proportions assessed the associations between five NPIs (school closures, mask use, workplace measures, public gathering restrictions and closure of public spaces) and RSV, utilising RSV surveillance data, two NPI databases (ECDC-JRC and Oxford) and COVID-19 surveillance data.
Results
Before 2020, consistent RSV seasonality patterns were observed, but the seasonal increase of RSV-positive cases in winter remained absent during the COVID-19 pandemic (2020–2022). Analysis revealed inconsistent associations between individual NPIs and RSV. The associations differed depending on the data source used (ECDC-JRC or Oxford), not only in magnitude but also in the direction of the coefficients. Public gathering restrictions and closure of public spaces exhibited significant negative associations with RSV incidence. However, this was only observed when using surveillance data for the entire epidemiological year and not when only examining weeks with increased RSV activity.
Conclusions
This study highlights the need for standardised international data collection and procedures for infectious disease modelling, as varying NPI implementations, NPI registration and RSV surveillance across countries complicate the understanding of RSV dynamics during the pandemic. Caution is recommended when interpreting the effects of NPIs on RSV circulation.
{"title":"Assessing the Impact of Non-Pharmaceutical Interventions During the COVID-19 Pandemic on RSV Seasonality in Europe","authors":"Susanne Heemskerk, Christos Baliatsas, Foekje Stelma, Harish Nair, John Paget, Peter Spreeuwenberg","doi":"10.1111/irv.70066","DOIUrl":"10.1111/irv.70066","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>During the COVID-19 pandemic, atypical respiratory syncytial virus (RSV) circulation patterns emerged, with the occurrence of RSV activity outside the typical winter season. This study investigates the impact of COVID-19 and associated non-pharmaceutical interventions (NPIs) on RSV seasonality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The onset, offset and peak of RSV epidemics from 2018 to 2022 across 12 European countries were determined using the 3% positivity threshold method. A multilevel longitudinal logit regression model for proportions assessed the associations between five NPIs (school closures, mask use, workplace measures, public gathering restrictions and closure of public spaces) and RSV, utilising RSV surveillance data, two NPI databases (ECDC-JRC and Oxford) and COVID-19 surveillance data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Before 2020, consistent RSV seasonality patterns were observed, but the seasonal increase of RSV-positive cases in winter remained absent during the COVID-19 pandemic (2020–2022). Analysis revealed inconsistent associations between individual NPIs and RSV. The associations differed depending on the data source used (ECDC-JRC or Oxford), not only in magnitude but also in the direction of the coefficients. Public gathering restrictions and closure of public spaces exhibited significant negative associations with RSV incidence. However, this was only observed when using surveillance data for the entire epidemiological year and not when only examining weeks with increased RSV activity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study highlights the need for standardised international data collection and procedures for infectious disease modelling, as varying NPI implementations, NPI registration and RSV surveillance across countries complicate the understanding of RSV dynamics during the pandemic. Caution is recommended when interpreting the effects of NPIs on RSV circulation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11750802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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