Mahbubur Rahman, Timothy M. Uyeki, Malik Peiris, Jacqueline M. Cardwell, Patrick Nguipdop-Djomo, Min Kim, A. S. M. Alamgir, A. K. M. Muraduzzaman, Sudipta Sarkar, Md Giasuddin, Md Ahasanul Hoque, Montse Torremorell, Mahmudur Rahman, Guillaume Fournié, Dirk U. Pfeiffer, Meerjady Sabrina Flora, Punam Mangtani
Background
Avian influenza A viruses (AIVs) are endemic among poultry in Bangladesh sold at live bird markets (LBMs). We assessed virologic and serologic evidence of exposure to AIVs among LBM workers.
Methods
A cross-sectional study recruited 702 randomly sampled workers from 42 LBMs in Dhaka, Bangladesh, during 2017. Nasal and throat swabs collected from workers and air samples from LBMs were tested for influenza A virus by RT-PCR with positives subtyped for A(H5), A(H7), and A(H9). Baseline sera from 695 workers and follow-up sera from 89 workers with influenza A positive respiratory specimens were tested by microneutralization assay for antibodies to A(H5N1) clade 2.3.2.1a and A(H9N2) G1 lineage viruses circulating in poultry. A seropositive result was defined as a neutralizing antibody titer ≥ 1:40.
Results
Most LBM workers reported slaughtering (93.3%) and defeathering (84.5%) poultry. Ninety-nine (14.1%) had ≥ 1 respiratory specimen that tested influenza A positive but negative for A(H1) and A(H3). Of these 99, subtyping identified 28 (28.3%) A(H9), 2 (2%) A(H5), 3 (3%) both A(H5) and A(H9), and 66 (66.7%) A (nonsubtypeable). Influenza A viruses were detected in air samples at 25 LBMs (59.5%), including A(H9) only in 10 LBMs (40%), A(H5) only in one (4%), both A(H5) and A(H9) in 13 (52%), and one A (nonsubtypeable) (4%). None of the participants were seropositive for AIVs.
Conclusions
LBM workers had extensive exposure to AIVs, but none had serologic evidence of infection with A(H5N1) or A(H9N2) viruses circulating among poultry in Bangladesh. Ongoing surveillance of AIVs in LBMs and poultry workers is needed.
{"title":"A Cross-Sectional Virological and Sero-Epidemiological Study of Exposures to Avian Influenza A(H5N1) and A(H9N2) Viruses in Live Bird Market Workers in Dhaka, Bangladesh","authors":"Mahbubur Rahman, Timothy M. Uyeki, Malik Peiris, Jacqueline M. Cardwell, Patrick Nguipdop-Djomo, Min Kim, A. S. M. Alamgir, A. K. M. Muraduzzaman, Sudipta Sarkar, Md Giasuddin, Md Ahasanul Hoque, Montse Torremorell, Mahmudur Rahman, Guillaume Fournié, Dirk U. Pfeiffer, Meerjady Sabrina Flora, Punam Mangtani","doi":"10.1111/irv.70189","DOIUrl":"10.1111/irv.70189","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Avian influenza A viruses (AIVs) are endemic among poultry in Bangladesh sold at live bird markets (LBMs). We assessed virologic and serologic evidence of exposure to AIVs among LBM workers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study recruited 702 randomly sampled workers from 42 LBMs in Dhaka, Bangladesh, during 2017. Nasal and throat swabs collected from workers and air samples from LBMs were tested for influenza A virus by RT-PCR with positives subtyped for A(H5), A(H7), and A(H9). Baseline sera from 695 workers and follow-up sera from 89 workers with influenza A positive respiratory specimens were tested by microneutralization assay for antibodies to A(H5N1) clade 2.3.2.1a and A(H9N2) G1 lineage viruses circulating in poultry. A seropositive result was defined as a neutralizing antibody titer ≥ 1:40.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Most LBM workers reported slaughtering (93.3%) and defeathering (84.5%) poultry. Ninety-nine (14.1%) had ≥ 1 respiratory specimen that tested influenza A positive but negative for A(H1) and A(H3). Of these 99, subtyping identified 28 (28.3%) A(H9), 2 (2%) A(H5), 3 (3%) both A(H5) and A(H9), and 66 (66.7%) A (nonsubtypeable). Influenza A viruses were detected in air samples at 25 LBMs (59.5%), including A(H9) only in 10 LBMs (40%), A(H5) only in one (4%), both A(H5) and A(H9) in 13 (52%), and one A (nonsubtypeable) (4%). None of the participants were seropositive for AIVs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>LBM workers had extensive exposure to AIVs, but none had serologic evidence of infection with A(H5N1) or A(H9N2) viruses circulating among poultry in Bangladesh. Ongoing surveillance of AIVs in LBMs and poultry workers is needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 11","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12620130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534432","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}
Influenza B viruses are important contributors to seasonal influenza epidemics. Two antigenically distinct lineages, B/Victoria and B/Yamagata, have been circulating since the late 1980s. However, the B/Yamagata lineage has not been detected in most countries since 2020, potentially resulting in waning immunity that may leave people vulnerable to B/Yamagata virus infections, should this lineage reemerge.
Methods
We investigated the impact of the recent lack of B/Yamagata virus circulation on immunity in adults by analyzing the hemagglutination-inhibition (HI) titers of serum samples (n = 504) collected from 2013 through 2024 against influenza B viruses circulating from 1958 to 2019.
Results
Human serum HI titers to B/Yamagata viruses have not markedly declined since B/Yamagata viruses were last detected in the US in 2020. Human serum HI titers were highest against the first encountered B/Victoria- and B/Yamagata–lineage viruses, respectively, revealing imprinting effects.
Conclusions
The recent disappearance of the B/Yamagata lineage has not led to a substantial decline in antibody levels against this lineage.
{"title":"Immunity to Influenza B/Yamagata-Lineage Viruses Has Not Waned Since the Disappearance of This Virus Lineage","authors":"Hassanein H. Abozeid, Chunyang Gu, Sanja Trifkovic, Gabriele Neumann, Yoshihiro Kawaoka","doi":"10.1111/irv.70188","DOIUrl":"10.1111/irv.70188","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Influenza B viruses are important contributors to seasonal influenza epidemics. Two antigenically distinct lineages, B/Victoria and B/Yamagata, have been circulating since the late 1980s. However, the B/Yamagata lineage has not been detected in most countries since 2020, potentially resulting in waning immunity that may leave people vulnerable to B/Yamagata virus infections, should this lineage reemerge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We investigated the impact of the recent lack of B/Yamagata virus circulation on immunity in adults by analyzing the hemagglutination-inhibition (HI) titers of serum samples (<i>n</i> = 504) collected from 2013 through 2024 against influenza B viruses circulating from 1958 to 2019.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Human serum HI titers to B/Yamagata viruses have not markedly declined since B/Yamagata viruses were last detected in the US in 2020. Human serum HI titers were highest against the first encountered B/Victoria- and B/Yamagata–lineage viruses, respectively, revealing imprinting effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The recent disappearance of the B/Yamagata lineage has not led to a substantial decline in antibody levels against this lineage.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 11","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12620126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534420","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}
Hélène Bricout, Marie-Cécile Levant, Pascal Crépey, Gaëtan Gavazzi, Jacques Gaillat, Marine Dufournet, Nada Assi, Benjamin Grenier, Fanny Raguideau, Fabienne Péretz, Camille Salamand, Anne Mosnier, Laurence Watier, Odile Launay, Matthew M. Loiacono
Background
A French cohort study (2021/2022 influenza season) found the high-dose influenza vaccine (HD) more effective than standard-dose vaccines (SDs) in preventing influenza-related hospitalizations in the elderly. The study continued to refine results and validate these findings.
Methods
Data from community-dwelling 65+ adults who received HD or SD during the 2022/2023 vaccination campaign were extracted from the National Health database. Hospitalizations were recorded from 14 days postvaccination until June 30, 2023. HD and SD recipients were matched using a propensity score. Associations between vaccines and hospitalizations were assessed by estimating incidence rate ratios and converting them to HD vs. SD vaccine relative effectiveness (rVE).
Results
A total of 675,412 HD recipients were matched to 2,701,648 SD recipients. The rVE for influenza-related hospitalizations was 27.4% [95% CI: 19.8; 34.3]. It ranged from 22.7% [9.8; 33.6] to 33.6% [21.2; 44.0] across age groups, indicating that HD consistently outperformed SDs in preventing influenza-related hospitalizations, with the highest effect observed in 85+.
Conclusions
Our study is the first to publish rVE data comparing HD and SDs in a real-world setting in France for the 2022/2023 influenza season. Its findings reaffirm the benefit of HD vs. SDs. HD could help reduce the burden of severe respiratory infections in the elderly.
{"title":"Relative Effectiveness of High-Dose vs. Standard-Dose Influenza Vaccines in Preventing Hospitalizations: A National Retrospective Cohort Study in France, 2022/2023 Season","authors":"Hélène Bricout, Marie-Cécile Levant, Pascal Crépey, Gaëtan Gavazzi, Jacques Gaillat, Marine Dufournet, Nada Assi, Benjamin Grenier, Fanny Raguideau, Fabienne Péretz, Camille Salamand, Anne Mosnier, Laurence Watier, Odile Launay, Matthew M. Loiacono","doi":"10.1111/irv.70193","DOIUrl":"10.1111/irv.70193","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>A French cohort study (2021/2022 influenza season) found the high-dose influenza vaccine (HD) more effective than standard-dose vaccines (SDs) in preventing influenza-related hospitalizations in the elderly. The study continued to refine results and validate these findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from community-dwelling 65+ adults who received HD or SD during the 2022/2023 vaccination campaign were extracted from the National Health database. Hospitalizations were recorded from 14 days postvaccination until June 30, 2023. HD and SD recipients were matched using a propensity score. Associations between vaccines and hospitalizations were assessed by estimating incidence rate ratios and converting them to HD vs. SD vaccine relative effectiveness (rVE).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 675,412 HD recipients were matched to 2,701,648 SD recipients. The rVE for influenza-related hospitalizations was 27.4% [95% CI: 19.8; 34.3]. It ranged from 22.7% [9.8; 33.6] to 33.6% [21.2; 44.0] across age groups, indicating that HD consistently outperformed SDs in preventing influenza-related hospitalizations, with the highest effect observed in 85+.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study is the first to publish rVE data comparing HD and SDs in a real-world setting in France for the 2022/2023 influenza season. Its findings reaffirm the benefit of HD vs. SDs. HD could help reduce the burden of severe respiratory infections in the elderly.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 11","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12620122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534440","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}
Oanh Ngoc Nguyen, Nathaly Garzón-Orjuela, Alike W. van der Velden, Christopher C. Butler, Akke Vellinga
Background
Results from observational studies have shown that obesity has a mild to moderate association with influenza-like illness (ILI) severity and hospitalization risk. Using data from the ALIC4E Randomized Clinical Trial (RCT), this study investigated the relationship between obesity and ILI severity, time to recovery, and oseltamivir effectiveness in the obese population.
Methods
A total of 2622 adults (≥ 18 years old) from the ALIC4E RCT were categorized by body mass index (BMI) into under/normal weight (BMI < 25 kg/m2), overweight (BMI ≥ 25 kg/m2 and < 30 kg/m2), and obesity (BMI ≥ 30 kg/m2). ILI symptom severity, time to recovery, and oseltamivir effectiveness were assessed across these weight groups.
Results
At presentation, ILI symptom severity was not different between weight groups. However, time to recovery was longer for obese patients compared to under/normal weight patients, with adjusted HR 0.88 (95% CI 0.79–0.99). The mean time to recovery was 6.6 days (95% CI 6.0–7.1) for obese patients, 6.2 days (95% CI 5.8–6.6) for overweight, and 5.7 days (95% CI 5.4–6.1) for under/normal weight patients. Obese patients had similar benefits from oseltamivir treatment compared to under/normal weight patients, with an average of 0.8 days gained from oseltamivir (95% CI 0.7–1) and 0.5 days (95% CI 0.4–0.7), respectively.
Conclusions
ILI symptom severity at presentation was equally distributed between the three weight groups. However, their time to recovery was approximately 1 day longer compared to under/normal weight patients. The effectiveness of oseltamivir appears to be similar between the two groups.
背景：观察性研究结果表明，肥胖与流感样疾病（ILI）严重程度和住院风险有轻度至中度关联。本研究使用ALIC4E随机临床试验（RCT）的数据，调查肥胖人群中肥胖与ILI严重程度、恢复时间和奥司他韦有效性之间的关系。方法：根据体重指数（BMI）将来自ALIC4E RCT的2622名成年人（≥18岁）分为体重不足/正常（BMI 2）、超重（BMI≥25 kg/m2和2）和肥胖（BMI≥30 kg/m2）。对这些体重组的ILI症状严重程度、恢复时间和奥司他韦有效性进行评估。结果：发病时，体重组间ILI症状严重程度无显著差异。然而，与体重不足/正常的患者相比，肥胖患者的恢复时间更长，调整后风险比为0.88 （95% CI 0.79-0.99）。肥胖患者平均恢复时间为6.6天（95% CI 6.0-7.1），超重患者为6.2天（95% CI 5.8-6.6），体重不足/正常患者为5.7天（95% CI 5.4-6.1）。与体重不足/正常的患者相比，肥胖患者从奥司他韦治疗中获得的益处相似，从奥司他韦治疗中获得的益处平均分别为0.8天（95% CI 0.7-1）和0.5天（95% CI 0.4-0.7）。结论：三个体重组患者出现ILI症状时的严重程度分布均匀。然而，与体重不足/正常的患者相比，他们的恢复时间大约要长1天。奥司他韦的有效性在两组之间似乎是相似的。
{"title":"Obesity in Recovery From Influenza-Like Illness and Effectiveness of Oseltamivir","authors":"Oanh Ngoc Nguyen, Nathaly Garzón-Orjuela, Alike W. van der Velden, Christopher C. Butler, Akke Vellinga","doi":"10.1111/irv.70185","DOIUrl":"10.1111/irv.70185","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Results from observational studies have shown that obesity has a mild to moderate association with influenza-like illness (ILI) severity and hospitalization risk. Using data from the ALIC<sup>4</sup>E Randomized Clinical Trial (RCT), this study investigated the relationship between obesity and ILI severity, time to recovery, and oseltamivir effectiveness in the obese population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 2622 adults (≥ 18 years old) from the ALIC<sup>4</sup>E RCT were categorized by body mass index (BMI) into under/normal weight (BMI < 25 kg/m<sup>2</sup>), overweight (BMI ≥ 25 kg/m<sup>2</sup> and < 30 kg/m<sup>2</sup>), and obesity (BMI ≥ 30 kg/m<sup>2</sup>). ILI symptom severity, time to recovery, and oseltamivir effectiveness were assessed across these weight groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At presentation, ILI symptom severity was not different between weight groups. However, time to recovery was longer for obese patients compared to under/normal weight patients, with adjusted HR 0.88 (95% CI 0.79–0.99). The mean time to recovery was 6.6 days (95% CI 6.0–7.1) for obese patients, 6.2 days (95% CI 5.8–6.6) for overweight, and 5.7 days (95% CI 5.4–6.1) for under/normal weight patients. Obese patients had similar benefits from oseltamivir treatment compared to under/normal weight patients, with an average of 0.8 days gained from oseltamivir (95% CI 0.7–1) and 0.5 days (95% CI 0.4–0.7), respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ILI symptom severity at presentation was equally distributed between the three weight groups. However, their time to recovery was approximately 1 day longer compared to under/normal weight patients. The effectiveness of oseltamivir appears to be similar between the two groups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 11","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12598495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145482077","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}
Rebecca Badra, Wenqing Zhang, John S. L. Tam, Richard Webby, Sylvie Van Der Werf, Sergejs Nikisins, Ann Cullinane, Saad Gharaibeh, Richard Njouom, Malik Peiris, Ghazi Kayali, Jean-Michel Heraud
In 2009, the World Health Organization (WHO) developed a public health research agenda for influenza to guide researchers and outline directions and priority areas for research on influenza aiming at reducing the burden of seasonal epidemic influenza and the risk and impact of pandemic influenza. The agenda was updated in 2017, but since then, important research has been conducted, and major changes have occurred to the global health landscape impacted mainly by the COVID-19 pandemic. Therefore, there is a need to assess advances in zoonotic influenza surveillance methods reported between 2017 and 2024 in order to highlight key achievements and identify remaining gaps that limit their broader implementation, hence informing an update of the research agenda. We conducted a comprehensive literature review of zoonotic influenza surveillance and monitoring, focusing on novel and enhanced methodologies reported globally between 2017 and 2024. A systematic analysis was performed following PRISMA guidelines on 7490 peer-reviewed manuscripts from 2017 to 2024 retrieved from PubMed, of which 164 records were included in this review. Analysis of the information collected indicated several advances and gaps at different levels of surveillance and unmet public health needs. Most countries do not have active and comprehensive surveillance programs for zoonotic influenza at the human–animal interface, which underestimates the true burden of zoonotic influenza diseases. The review concludes with a set of high-priority research recommendations focused on filling gaps in One Health data integration, validation, and field deployment of novel diagnostic technologies, wider adoption of noninvasive and environmental surveillance approaches, and stronger linkage of methodological innovations to risk assessment and policy action. In light of the recent upsurge in H5N1 activity and cross-species transmission, the WHO has convened multiple R&D Blueprint consultations over the past year to prioritize research and development for H5N1 candidate vaccines, diagnostics, and pandemic preparedness. These ongoing initiatives underscore the critical importance of strengthening surveillance at the human–animal interface.
{"title":"A Systematic Review of New, Enhanced Surveillance Systems and Methodologies for Zoonotic Influenza Viruses in Animals and Human–Animal Interface","authors":"Rebecca Badra, Wenqing Zhang, John S. L. Tam, Richard Webby, Sylvie Van Der Werf, Sergejs Nikisins, Ann Cullinane, Saad Gharaibeh, Richard Njouom, Malik Peiris, Ghazi Kayali, Jean-Michel Heraud","doi":"10.1111/irv.70178","DOIUrl":"10.1111/irv.70178","url":null,"abstract":"<p>In 2009, the World Health Organization (WHO) developed a public health research agenda for influenza to guide researchers and outline directions and priority areas for research on influenza aiming at reducing the burden of seasonal epidemic influenza and the risk and impact of pandemic influenza. The agenda was updated in 2017, but since then, important research has been conducted, and major changes have occurred to the global health landscape impacted mainly by the COVID-19 pandemic. Therefore, there is a need to assess advances in zoonotic influenza surveillance methods reported between 2017 and 2024 in order to highlight key achievements and identify remaining gaps that limit their broader implementation, hence informing an update of the research agenda. We conducted a comprehensive literature review of zoonotic influenza surveillance and monitoring, focusing on novel and enhanced methodologies reported globally between 2017 and 2024. A systematic analysis was performed following PRISMA guidelines on 7490 peer-reviewed manuscripts from 2017 to 2024 retrieved from PubMed, of which 164 records were included in this review. Analysis of the information collected indicated several advances and gaps at different levels of surveillance and unmet public health needs. Most countries do not have active and comprehensive surveillance programs for zoonotic influenza at the human–animal interface, which underestimates the true burden of zoonotic influenza diseases. The review concludes with a set of high-priority research recommendations focused on filling gaps in One Health data integration, validation, and field deployment of novel diagnostic technologies, wider adoption of noninvasive and environmental surveillance approaches, and stronger linkage of methodological innovations to risk assessment and policy action. In light of the recent upsurge in H5N1 activity and cross-species transmission, the WHO has convened multiple R&D Blueprint consultations over the past year to prioritize research and development for H5N1 candidate vaccines, diagnostics, and pandemic preparedness. These ongoing initiatives underscore the critical importance of strengthening surveillance at the human–animal interface.</p>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 11","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12602164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145488598","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}
Alicia N. Stein, Anusorn Thanataveerat, Kimberly W. McDermott, Alex Dean, Stephanie Wall, Cory Pack, Sheena G. Sullivan, Ian McGovern, Mendel D. M. Haag
Background
Egg adaptation can reduce the effectiveness of egg-based influenza vaccines. Previous studies have demonstrated improved effectiveness of cell versus egg-based quadrivalent influenza vaccines (QIVc and QIVe, respectively) during the 2017–2020 influenza seasons among persons aged ≥ 4 years. Here we evaluate the relative vaccine effectiveness (rVE) of QIVc versus QIVe in preventing test-confirmed influenza among persons aged 6 months to 64 years during the US 2022–2023 influenza season, along with the potential impact on influenza burden averted.
Methods
A retrospective test-negative design was applied to linked electronic health records and claims data from QIVc or QIVe recipients who were tested for influenza in routine outpatient care within 7 days of an acute respiratory or febrile illness. rVE was estimated by comparing the odds of testing positive among QIVc versus QIVe recipients, adjusted using doubly robust methodology. The influenza burden additionally averted by vaccination with QIVc versus QIVe was estimated using a published model.
Results
Of 43,086 patients included, 18.6% received QIVc and 81.4% received QIVe. The rVE of QIVc versus QIVe was 7.7% (95% CI, 0.9%–13.9%). Use of QIVc instead of QIVe during the 2022–23 influenza season would have prevented an additional 636,209 symptomatic cases of influenza, 314,130 outpatient visits, and 3759 hospitalizations.
Conclusions
QIVc was superior to QIVe in the prevention of test-confirmed influenza among persons aged 6 months to 64 years during the US 2022–2023 influenza season. The rVE of 7.7% would translate to a substantially reduced influenza burden if QIVc were used over QIVe.
{"title":"Estimated Relative Effectiveness and Public Health Impact of Cell-Based Versus Egg-Based Influenza Vaccines During the 2022–2023 Season in the United States","authors":"Alicia N. Stein, Anusorn Thanataveerat, Kimberly W. McDermott, Alex Dean, Stephanie Wall, Cory Pack, Sheena G. Sullivan, Ian McGovern, Mendel D. M. Haag","doi":"10.1111/irv.70180","DOIUrl":"10.1111/irv.70180","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Egg adaptation can reduce the effectiveness of egg-based influenza vaccines. Previous studies have demonstrated improved effectiveness of cell versus egg-based quadrivalent influenza vaccines (QIVc and QIVe, respectively) during the 2017–2020 influenza seasons among persons aged ≥ 4 years. Here we evaluate the relative vaccine effectiveness (rVE) of QIVc versus QIVe in preventing test-confirmed influenza among persons aged 6 months to 64 years during the US 2022–2023 influenza season, along with the potential impact on influenza burden averted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective test-negative design was applied to linked electronic health records and claims data from QIVc or QIVe recipients who were tested for influenza in routine outpatient care within 7 days of an acute respiratory or febrile illness. rVE was estimated by comparing the odds of testing positive among QIVc versus QIVe recipients, adjusted using doubly robust methodology. The influenza burden additionally averted by vaccination with QIVc versus QIVe was estimated using a published model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 43,086 patients included, 18.6% received QIVc and 81.4% received QIVe. The rVE of QIVc versus QIVe was 7.7% (95% CI, 0.9%–13.9%). Use of QIVc instead of QIVe during the 2022–23 influenza season would have prevented an additional 636,209 symptomatic cases of influenza, 314,130 outpatient visits, and 3759 hospitalizations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>QIVc was superior to QIVe in the prevention of test-confirmed influenza among persons aged 6 months to 64 years during the US 2022–2023 influenza season. The rVE of 7.7% would translate to a substantially reduced influenza burden if QIVc were used over QIVe.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 11","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12583930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145437898","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}
Sook-San Wong, Mark Zanin, Min-Suk Song, Cristina Contreras, Thomas P. Fabrizio, Eun-Kyo Hong, Hye Kwon Kim, Woonsung Na, Richard J. Webby, Sun-Woo Yoon
Background
Although influenza A viruses (IAVs) are respiratory pathogens, infections may occur via nonrespiratory routes. However, the effects of different routes of exposure on the course of infection and disease are not well characterized.
Methods
This study assessed the pathogenicity and host responses in ferrets inoculated with the low pathogenic A/Anhui/1/2013 (H7N9) influenza A virus via different routes. Ferrets were inoculated through various routes, and viral replication in the respiratory tract was evaluated using nasal wash samples as well as respiratory and nonrespiratory tissues. Host immune responses were analyzed using peripheral blood collected from the virus-inoculated ferrets.
Results
Inoculation of ferrets with H7N9 via the intranasal (IN), intraocular (IO), or intraesophageal (IE) routes revealed that IN inoculation led to the greatest distribution of virus, whereas IO and IE inoculation led to more restricted viral spread. However, despite different routes, the respiratory tract remained the preferred site of IAV replication. IN- and IE-inoculation led to greater symptom severity compared to IO inoculation. Proinflammatory cytokine expression was highest in IN-inoculated ferrets and was not always associated with cumulative viral loads.
Conclusions
Overall, these results indicated that the route of inoculation can influence tissue distribution and disease outcomes, but the respiratory tract remains the primary site of viral replication.
{"title":"Route of Inoculation Determines Symptom Profile and Replication Dynamics After low Pathogenic Avian Influenza A(H7N9) Virus Infection in Ferrets","authors":"Sook-San Wong, Mark Zanin, Min-Suk Song, Cristina Contreras, Thomas P. Fabrizio, Eun-Kyo Hong, Hye Kwon Kim, Woonsung Na, Richard J. Webby, Sun-Woo Yoon","doi":"10.1111/irv.70183","DOIUrl":"10.1111/irv.70183","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although influenza A viruses (IAVs) are respiratory pathogens, infections may occur via nonrespiratory routes. However, the effects of different routes of exposure on the course of infection and disease are not well characterized.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study assessed the pathogenicity and host responses in ferrets inoculated with the low pathogenic A/Anhui/1/2013 (H7N9) influenza A virus via different routes. Ferrets were inoculated through various routes, and viral replication in the respiratory tract was evaluated using nasal wash samples as well as respiratory and nonrespiratory tissues. Host immune responses were analyzed using peripheral blood collected from the virus-inoculated ferrets.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Inoculation of ferrets with H7N9 via the intranasal (IN), intraocular (IO), or intraesophageal (IE) routes revealed that IN inoculation led to the greatest distribution of virus, whereas IO and IE inoculation led to more restricted viral spread. However, despite different routes, the respiratory tract remained the preferred site of IAV replication. IN- and IE-inoculation led to greater symptom severity compared to IO inoculation. Proinflammatory cytokine expression was highest in IN-inoculated ferrets and was not always associated with cumulative viral loads.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Overall, these results indicated that the route of inoculation can influence tissue distribution and disease outcomes, but the respiratory tract remains the primary site of viral replication.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 11","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12579965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145431361","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}
Jing Fan, Ran Zhang, Qianyue Zhang, Shu Cong, Ying Song, W. William Schluter, Suizan Zhou, Xuping Song, Wenjing Wang, Liwen Fang
Background
The proportion of healthcare workers (HCWs) who receive and recommend seasonal influenza vaccination to their patients remains low in China. This study aims to understand why HCWs infrequently use and recommend the influenza vaccine and how to improve utilization.
Methods
A cross-sectional questionnaire survey and a focus group interview were conducted among primary HCWs in Hubei Province in September 2018 and May 2019. We analyzed qualitative data using descriptive methods and a general inductive approach following a quantitative analysis. In addition, we used the Health Belief Model (HBM) framework to summarize predictors of HCW vaccination and recommendation.
Results
Primary HCWs acquired basic knowledge about influenza infection and vaccination and were less likely to receive and recommend influenza vaccination. However, from the focus group, HCWs reported influenza was a mild disease and would not recommend vaccination for patients who looked healthy. HCWs raised concerns about adverse events, cost-effectiveness, and contraindications to influenza vaccination. HCWs reported, “I would be more likely to recommend vaccination if my employer required that I do so.”
Conclusions
Health education materials for HCWs could be improved by providing scientific evidence on the burden of influenza disease, the benefits of vaccination, and national and international policies on influenza vaccination. In addition, interventions that may improve influenza vaccination coverage include workplace requirements for influenza vaccination of HCWs and requirements for HCWs to recommend influenza vaccination to high-risk groups in addition to providing no-cost and on-site vaccination.
{"title":"Healthcare Workers From Two Sites in China in 2018–2019 Unlikely to Receive and Recommend Influenza Vaccination: A Qualitative Study Following a Quantitative Analysis to Improve Future Interventions","authors":"Jing Fan, Ran Zhang, Qianyue Zhang, Shu Cong, Ying Song, W. William Schluter, Suizan Zhou, Xuping Song, Wenjing Wang, Liwen Fang","doi":"10.1111/irv.70157","DOIUrl":"10.1111/irv.70157","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The proportion of healthcare workers (HCWs) who receive and recommend seasonal influenza vaccination to their patients remains low in China. This study aims to understand why HCWs infrequently use and recommend the influenza vaccine and how to improve utilization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional questionnaire survey and a focus group interview were conducted among primary HCWs in Hubei Province in September 2018 and May 2019. We analyzed qualitative data using descriptive methods and a general inductive approach following a quantitative analysis. In addition, we used the Health Belief Model (HBM) framework to summarize predictors of HCW vaccination and recommendation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Primary HCWs acquired basic knowledge about influenza infection and vaccination and were less likely to receive and recommend influenza vaccination. However, from the focus group, HCWs reported influenza was a mild disease and would not recommend vaccination for patients who looked healthy. HCWs raised concerns about adverse events, cost-effectiveness, and contraindications to influenza vaccination. HCWs reported, “I would be more likely to recommend vaccination if my employer required that I do so.”</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Health education materials for HCWs could be improved by providing scientific evidence on the burden of influenza disease, the benefits of vaccination, and national and international policies on influenza vaccination. In addition, interventions that may improve influenza vaccination coverage include workplace requirements for influenza vaccination of HCWs and requirements for HCWs to recommend influenza vaccination to high-risk groups in addition to providing no-cost and on-site vaccination.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 11","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12580223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145431404","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}
Andrei R. Akhmetzhanov, Hao-Yuan Cheng, Gillian Cheng, Jonathan Dushoff
Background
The COVID-19 pandemic was characterized by waves driven by distinct viral variants, including the Omicron variant, which emerged in October 2021. To formulate effective public health strategies and understand disease spread, accurate estimates of the incubation periods of these variants are important. Existing estimates often conflict due to biases caused by epidemic dynamics and selective inclusion of cases. Using data from Taiwan, where disease incidence remained low and contact tracing was comprehensive during the first months of the Omicron outbreak, this study aims to accurately estimate the incubation period of the Omicron (BA.1) variant incubation period.
Methods
We reviewed the first 100 Omicron BA.1 symptomatic cases reported in Taiwan's contact-tracing records (between December 2021 and January 2022). Of these, 69 had usable information. Data on exposure and symptom onset dates were fitted with the generalized gamma. A systematic search and meta-analysis on incubation periods for Omicron BA.1/2/4/5 subvariants was then conducted to derive pooled mean estimates for the incubation periods of each subvariant.
Results
The mean incubation period was estimated at 3.5 days (95% credible interval: 3.0–4.0 days), with no clear differences based on vaccination status or age. This estimate aligned closely with the pooled mean of 3.7 days (3.3–4.0 days) for Omicron BA.1 and of 3.7 days (2.3–5.1 days) for all considered Omicron variants BA.1/2 and BA.5.
Conclusions
Omicron subvariants have a relatively shorter incubation period compared to previous SARS-CoV-2 variants. A continuous update of incubation period estimates, based on available data, is necessary to develop guidelines that can reduce the socioeconomic costs associated with COVID-19.
{"title":"Consolidating Estimates of the Incubation Period for Omicron Subvariants From the Literature and Their Comparison to the Estimate From Taiwan: A Systematic Review and Meta-Analysis, September 2024","authors":"Andrei R. Akhmetzhanov, Hao-Yuan Cheng, Gillian Cheng, Jonathan Dushoff","doi":"10.1111/irv.70171","DOIUrl":"https://doi.org/10.1111/irv.70171","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The COVID-19 pandemic was characterized by waves driven by distinct viral variants, including the Omicron variant, which emerged in October 2021. To formulate effective public health strategies and understand disease spread, accurate estimates of the incubation periods of these variants are important. Existing estimates often conflict due to biases caused by epidemic dynamics and selective inclusion of cases. Using data from Taiwan, where disease incidence remained low and contact tracing was comprehensive during the first months of the Omicron outbreak, this study aims to accurately estimate the incubation period of the Omicron (BA.1) variant incubation period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We reviewed the first 100 Omicron BA.1 symptomatic cases reported in Taiwan's contact-tracing records (between December 2021 and January 2022). Of these, 69 had usable information. Data on exposure and symptom onset dates were fitted with the generalized gamma. A systematic search and meta-analysis on incubation periods for Omicron BA.1/2/4/5 subvariants was then conducted to derive pooled mean estimates for the incubation periods of each subvariant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean incubation period was estimated at 3.5 days (95% credible interval: 3.0–4.0 days), with no clear differences based on vaccination status or age. This estimate aligned closely with the pooled mean of 3.7 days (3.3–4.0 days) for Omicron BA.1 and of 3.7 days (2.3–5.1 days) for all considered Omicron variants BA.1/2 and BA.5.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Omicron subvariants have a relatively shorter incubation period compared to previous SARS-CoV-2 variants. A continuous update of incubation period estimates, based on available data, is necessary to develop guidelines that can reduce the socioeconomic costs associated with COVID-19.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 11","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.70171","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145399086","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, Lotte van Heuvel, Peter Spreeuwenberg, Louis J. Bont, Foekje F. Stelma, Saverio Caini, Jojanneke van Summeren
Background
Most respiratory syncytial virus (RSV) infections in children are managed in primary care settings, including ambulatory care and emergency departments (EDs). This study provides adjusted pooled RSV incidence estimates for children under 5 years in primary care settings in high-income countries (HICs).
Methods
We used population-based RSV incidence rates from 27 studies collected in a previous systematic review as input parameters. To adjust for heterogeneity in study design, we assessed the impact of four key factors: 1) age, 2) primary care setting (ambulatory care or EDs), 3) data collection period (year-round or seasonal), and 4) study methodology (cohort studies with laboratory-confirmed RSV, healthcare databases, surveillance data). In the final model, we corrected for age, primary care setting, and study methodology. Adjusted pooled RSV incidence estimates were calculated using a multilevel logit-logistic regression model.
Results
For children < 5 years, the adjusted pooled RSV incidence estimate in primary care settings was 62.8 per 1000 population (95% CI 45.3–86.6). Incidence was higher in ambulatory care (108.1 per 1000; 95% CI 78.0–148.0) compared to EDs (35.8 per 1000; 95% CI 25.3–50.3). Age-stratified incidence estimates declined with increasing age, showing 86.5 (95% CI 61.6–120.2), 80.3 (95% CI 57.1–111.8), 60.7 (95% CI 43.2–84.6), and 36.5 (95% CI 25.4–52.2) per 1000 for children aged < 6 months, 0–1 year, 0–2 years, and 0–5 years, respectively.
Conclusions
This is the first multilevel meta-analysis estimating the RSV-related burden in primary care settings, including both ambulatory and emergency care. These results can be used by decision makers for the introduction of RSV immunization programs.
{"title":"Burden of RSV in Young Children in High-Income Countries: Incidence Estimates From a Multilevel Meta-Analysis in Primary and Emergency Care","authors":"Susanne Heemskerk, Lotte van Heuvel, Peter Spreeuwenberg, Louis J. Bont, Foekje F. Stelma, Saverio Caini, Jojanneke van Summeren","doi":"10.1111/irv.70179","DOIUrl":"10.1111/irv.70179","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Most respiratory syncytial virus (RSV) infections in children are managed in primary care settings, including ambulatory care and emergency departments (EDs). This study provides adjusted pooled RSV incidence estimates for children under 5 years in primary care settings in high-income countries (HICs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used population-based RSV incidence rates from 27 studies collected in a previous systematic review as input parameters. To adjust for heterogeneity in study design, we assessed the impact of four key factors: 1) age, 2) primary care setting (ambulatory care or EDs), 3) data collection period (year-round or seasonal), and 4) study methodology (cohort studies with laboratory-confirmed RSV, healthcare databases, surveillance data). In the final model, we corrected for age, primary care setting, and study methodology. Adjusted pooled RSV incidence estimates were calculated using a multilevel logit-logistic regression model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For children < 5 years, the adjusted pooled RSV incidence estimate in primary care settings was 62.8 per 1000 population (95% CI 45.3–86.6). Incidence was higher in ambulatory care (108.1 per 1000; 95% CI 78.0–148.0) compared to EDs (35.8 per 1000; 95% CI 25.3–50.3). Age-stratified incidence estimates declined with increasing age, showing 86.5 (95% CI 61.6–120.2), 80.3 (95% CI 57.1–111.8), 60.7 (95% CI 43.2–84.6), and 36.5 (95% CI 25.4–52.2) per 1000 for children aged < 6 months, 0–1 year, 0–2 years, and 0–5 years, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This is the first multilevel meta-analysis estimating the RSV-related burden in primary care settings, including both ambulatory and emergency care. These results can be used by decision makers for the introduction of RSV immunization programs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 10","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12554624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145372653","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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