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}
Hamidou Lazoumar Ramatoulaye, Aliou Sanda Abdal-Kader, Adamou Lagare, Mahamadou Almahamoudou Maiga, Fakani Aboutalib Aliane, François Comlan Aida Sylviane, Idi Issa, Bibata Abdou Sidikou, Garda Idé Oumarou, Ali Sidiki, Zeinabou Abdou Aouta, Amina Moussa, Zeinabou Dioffo Alassan, Ibrahim Karidio, Goni Alhassan Maman Bachir, Issifou Djibo, Salia Moussa, Ibrahim Maman Laminou, Ronan Jambou, Vincent Richard
Background
In 2020, the new pathogen SARS-CoV-2 spread fast, causing a pandemic. Health care workers on the frontline were of course highly exposed. This study aims to analyze the risk factors of SARS-CoV-2 infection in HCWs who have been in contact with positive patients in Niger.
Methods
A prospective cohort was conducted among HCWs from March 2020 to June 2020 in health facilities in Niamey. A questionnaire was administered at inclusion; RT-PCR testing was performed if clinical signs were present. Serological testing was performed at baseline, Days 15 and 30. Univariate analysis and Cox regression were used.
Results
Regarding inclusion criteria, 129 health care workers were included. The sex ratio (male/female) was 0.82. The participants were mainly physicians (45.7%) and nurses (34.1%). At inclusion, the prevalence of COVID-19 was 34.9%. Only seronegative (n = 84) were followed up; the attack incidence rate for the first month was 440 per 1000 person*month. Regarding the Cox model, the use of alcohol-based hand washing was a protective factor (RR = 0.28, p = 0.01). Furthermore, females were more at risk than males (RR = 2, p-value = 0.049).
Conclusions
HCWs in Niger were faced with high infection risk; this should lead decision-makers to (i) enhance training on preventive measures and (ii) boost access to personal protective equipment in emergency and infectious disease wards.
{"title":"High Infection Risk Among Health Care Workers During the First SARS-CoV-2 Wave in Niamey, Niger","authors":"Hamidou Lazoumar Ramatoulaye, Aliou Sanda Abdal-Kader, Adamou Lagare, Mahamadou Almahamoudou Maiga, Fakani Aboutalib Aliane, François Comlan Aida Sylviane, Idi Issa, Bibata Abdou Sidikou, Garda Idé Oumarou, Ali Sidiki, Zeinabou Abdou Aouta, Amina Moussa, Zeinabou Dioffo Alassan, Ibrahim Karidio, Goni Alhassan Maman Bachir, Issifou Djibo, Salia Moussa, Ibrahim Maman Laminou, Ronan Jambou, Vincent Richard","doi":"10.1111/irv.70177","DOIUrl":"https://doi.org/10.1111/irv.70177","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In 2020, the new pathogen SARS-CoV-2 spread fast, causing a pandemic. Health care workers on the frontline were of course highly exposed. This study aims to analyze the risk factors of SARS-CoV-2 infection in HCWs who have been in contact with positive patients in Niger.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective cohort was conducted among HCWs from March 2020 to June 2020 in health facilities in Niamey. A questionnaire was administered at inclusion; RT-PCR testing was performed if clinical signs were present. Serological testing was performed at baseline, Days 15 and 30. Univariate analysis and Cox regression were used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Regarding inclusion criteria, 129 health care workers were included. The sex ratio (male/female) was 0.82. The participants were mainly physicians (45.7%) and nurses (34.1%). At inclusion, the prevalence of COVID-19 was 34.9%. Only seronegative (<i>n</i> = 84) were followed up; the attack incidence rate for the first month was 440 per 1000 person*month. Regarding the Cox model, the use of alcohol-based hand washing was a protective factor (RR = 0.28, <i>p</i> = 0.01). Furthermore, females were more at risk than males (RR = 2, <i>p</i>-value = 0.049).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>HCWs in Niger were faced with high infection risk; this should lead decision-makers to (i) enhance training on preventive measures and (ii) boost access to personal protective equipment in emergency and infectious disease wards.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 10","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.70177","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145366924","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}
William H. Elson, Anna Forbes, Gavin Jamie, Rashmi Wimalaratna, Roger Morbey, F. D. Richard Hobbs, Simon de Lusignan, Jamie Lopez Bernal
Background
Primary care computerised medical records (CMR) are used to report the incidence of acute respiratory infections (ARI) for public health surveillance. These systems could increase their utility by also reporting population-level severity of ARI; however, this is rarely done.
Objectives
To identify candidate markers of ARI severity suitable for use in primary care CMR-based surveillance.
Methods
We undertook a systematic review of bibliographic databases and grey literature. Eligible studies reported characteristics for > 500 patients with ARI, severe ARI, influenza-like illness or suspected COVID-19. Studies had to report at least one potential marker of severity. A panel of clinical primary care informaticians reviewed candidate severity markers and assessed each for severity, specificity, relevance to primary care and whether it was likely to be recorded in a CMR.
Results
We included 126 studies from 84 countries. Seventy-seven candidate severity markers were identified across 11 groups. These included four outcome groups (complications, hospital events, intensive care events and death) and seven predictor groups (symptoms, signs, scores, investigations, treatments, absenteeism and treatment-seeking behaviour). Thirty markers were considered most suitable for primary care CMR-based ARI surveillance: 7 outcomes (such as hospital admission, attendance and death) and 23 predictors (such as shortness of breath, oxygen levels, work absence and antibiotics). Predictors were generally considered more timely, as they are likely recorded during the consultation.
Conclusions
This review provides a list of severity markers that could support the development of population-level severity indicators for ARI surveillance in primary care. This could improve real-time situational awareness during respiratory outbreaks.
{"title":"A Systematic Review of the Markers of Severity in Acute Respiratory Infections to Inform Primary Care Surveillance","authors":"William H. Elson, Anna Forbes, Gavin Jamie, Rashmi Wimalaratna, Roger Morbey, F. D. Richard Hobbs, Simon de Lusignan, Jamie Lopez Bernal","doi":"10.1111/irv.70172","DOIUrl":"10.1111/irv.70172","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Primary care computerised medical records (CMR) are used to report the incidence of acute respiratory infections (ARI) for public health surveillance. These systems could increase their utility by also reporting population-level severity of ARI; however, this is rarely done.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To identify candidate markers of ARI severity suitable for use in primary care CMR-based surveillance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We undertook a systematic review of bibliographic databases and grey literature. Eligible studies reported characteristics for > 500 patients with ARI, severe ARI, influenza-like illness or suspected COVID-19. Studies had to report at least one potential marker of severity. A panel of clinical primary care informaticians reviewed candidate severity markers and assessed each for severity, specificity, relevance to primary care and whether it was likely to be recorded in a CMR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 126 studies from 84 countries. Seventy-seven candidate severity markers were identified across 11 groups. These included four outcome groups (complications, hospital events, intensive care events and death) and seven predictor groups (symptoms, signs, scores, investigations, treatments, absenteeism and treatment-seeking behaviour). Thirty markers were considered most suitable for primary care CMR-based ARI surveillance: 7 outcomes (such as hospital admission, attendance and death) and 23 predictors (such as shortness of breath, oxygen levels, work absence and antibiotics). Predictors were generally considered more timely, as they are likely recorded during the consultation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This review provides a list of severity markers that could support the development of population-level severity indicators for ARI surveillance in primary care. This could improve real-time situational awareness during respiratory outbreaks.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 10","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.70172","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145354676","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}
Danilo Franco, Stephanie Goya, Alexander Martínez, Vicente Mas, Brechla Moreno, Elimelec Valdespino, Melissa Gaitán, Lisseth Sáenz, Claudia González, Ambar Moreno, Zeuz Capitan-Barrios, Jean Paul Carrera, Sandra López-Vergès, Juan Miguel Pascale, Yadira Moltó, Lourdes Moreno, Belmaris Rizo, Enrique Urriola, Teresa Delgado, María Iglesias-Caballero, Inmaculada Casas, Suman R. Das, Juan Arbiza, Adriana Delfraro, Leyda Ábrego
Background
Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract infections and hospitalization in infants and children. Whole genome sequencing (WGS) plays a critical role in understanding the evolution and epidemiology of RSV. Limited studies have been conducted in Central America and the Caribbean, and none have specifically focused on lineages involved in recent outbreaks. Furthermore, no assays currently exist to evaluate the sensitivity of the RSV fusion protein to monoclonal antibodies.
Methods
In Panama, an epidemiological surveillance system tracks RSV activity through the collection of nasopharyngeal samples from patients with acute respiratory infections. Between January 2018 and July 2024, 303 RSV-positive samples were analyzed by RT-qPCR. RSV-B was the dominant subgroup in 2018, but following years had alternating dominance between RSV-A and RSV-B. Of the 303 samples, 115 underwent WGS. Additionally, neutralization assays were done using different Anti-F Monoclonal Antibodies.
Results
In RSV-A, 11 lineages were identified, with 3 to 5 cocirculating during each annual outbreak, and a shift in predominance from A.D.1 (2019) to A.D.5.2 (2023–2024). In RSV-B, two lineages circulated: B.D.4.1.1 (2018–2020) and its descendant B.D.E.1, which predominated from 2021 onward. Several monoclonal antibodies, including nirsevimab's precursor MEDI8897*, effectively neutralized the RSV strains in neutralization assays.
Conclusions
Although Panama has not yet implemented a preventive therapy for RSV, this step could modify outbreak dynamics. The findings from this study provide a baseline reference prior to the implementation of preventive therapies against RSV in Panama and the region, facilitating the assessment of potential changes in the evolutionary dynamics of the virus.
{"title":"Genomic Insights Into Respiratory Syncytial Virus Circulation Patterns and Neutralization by Anti-F Monoclonal Antibodies in Panama (2018–2024)","authors":"Danilo Franco, Stephanie Goya, Alexander Martínez, Vicente Mas, Brechla Moreno, Elimelec Valdespino, Melissa Gaitán, Lisseth Sáenz, Claudia González, Ambar Moreno, Zeuz Capitan-Barrios, Jean Paul Carrera, Sandra López-Vergès, Juan Miguel Pascale, Yadira Moltó, Lourdes Moreno, Belmaris Rizo, Enrique Urriola, Teresa Delgado, María Iglesias-Caballero, Inmaculada Casas, Suman R. Das, Juan Arbiza, Adriana Delfraro, Leyda Ábrego","doi":"10.1111/irv.70173","DOIUrl":"10.1111/irv.70173","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract infections and hospitalization in infants and children. Whole genome sequencing (WGS) plays a critical role in understanding the evolution and epidemiology of RSV. Limited studies have been conducted in Central America and the Caribbean, and none have specifically focused on lineages involved in recent outbreaks. Furthermore, no assays currently exist to evaluate the sensitivity of the RSV fusion protein to monoclonal antibodies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In Panama, an epidemiological surveillance system tracks RSV activity through the collection of nasopharyngeal samples from patients with acute respiratory infections. Between January 2018 and July 2024, 303 RSV-positive samples were analyzed by RT-qPCR. RSV-B was the dominant subgroup in 2018, but following years had alternating dominance between RSV-A and RSV-B. Of the 303 samples, 115 underwent WGS. Additionally, neutralization assays were done using different Anti-F Monoclonal Antibodies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In RSV-A, 11 lineages were identified, with 3 to 5 cocirculating during each annual outbreak, and a shift in predominance from <span>A.D</span>.1 (2019) to <span>A.D</span>.5.2 (2023–2024). In RSV-B, two lineages circulated: B.D.4.1.1 (2018–2020) and its descendant B.D.E.1, which predominated from 2021 onward. Several monoclonal antibodies, including nirsevimab's precursor MEDI8897*, effectively neutralized the RSV strains in neutralization assays.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although Panama has not yet implemented a preventive therapy for RSV, this step could modify outbreak dynamics. The findings from this study provide a baseline reference prior to the implementation of preventive therapies against RSV in Panama and the region, facilitating the assessment of potential changes in the evolutionary dynamics of the virus.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 10","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.70173","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145344875","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 surveillance and drug resistance testing have always been central to clinical efforts. Therefore, researching the virus characteristics and antiviral drugs is essential.
Method
The HA and NA activities were assessed in influenza strains, and mutations were identified through gene sequencing. The effects of oseltamivir, molnupiravir, and baloxavir treatments were evaluated in vitro. The effectiveness of molnupiravir monotherapy and its combination with baloxavir was also evaluated in a mouse model. Changes in body weight and lung tissue were examined, including pathological changes, virus replication, and inflammation levels.
Results
Forty-one seasonal influenza H1N1 strains from 2023 were used. The EC50 of oseltamivir was significantly increased compared to the 2009 reference strain. Correlation analysis showed that the increase in EC50 was related to the HA and NA activities. The antiviral effects of molnupiravir and baloxavir significantly inhibited virus replication; the combination treatment of molnupiravir/baloxavir showed more potent and synergistic inhibitory effects in vitro. In the mouse model, molnupiravir treatment effectively inhibited virus replication and lung inflammation, but the treatment did not improve weight loss or reduce mortality. With the molnupiravir/baloxavir treatment, viral replication was significantly inhibited and proved to be more effective than either monotherapy. The combination therapy also showed the lowest inflammatory response along with a higher survival rate.
Conclusions
The increase in HA and NA activities of seasonal influenza reduced the efficacy of oseltamivir treatment, but the effectiveness of molnupiravir and baloxavir was retained. Combination therapy showed a significant antiviral effect, which provides a reference for the clinical treatment.
{"title":"Efficacy of Oseltamivir Against Seasonal Influenza H1N1 and the Efficacy of a Novel Combination Treatment In Vitro and In Vivo in Mouse Studies","authors":"Danlei Liu, Ka-Yi Leung, Ruiqi Zhang, Hoi-Yan Lam, Yujing Fan, Xiaochun Xie, Wan-Mui Chan, Kelvin Kai-Wang To, Kwok-Hung Chan, Ivan Fan-Ngai Hung","doi":"10.1111/irv.70176","DOIUrl":"10.1111/irv.70176","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Influenza surveillance and drug resistance testing have always been central to clinical efforts. Therefore, researching the virus characteristics and antiviral drugs is essential.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>The HA and NA activities were assessed in influenza strains, and mutations were identified through gene sequencing. The effects of oseltamivir, molnupiravir, and baloxavir treatments were evaluated in vitro. The effectiveness of molnupiravir monotherapy and its combination with baloxavir was also evaluated in a mouse model. Changes in body weight and lung tissue were examined, including pathological changes, virus replication, and inflammation levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-one seasonal influenza H1N1 strains from 2023 were used. The EC<sub>50</sub> of oseltamivir was significantly increased compared to the 2009 reference strain. Correlation analysis showed that the increase in EC<sub>50</sub> was related to the HA and NA activities. The antiviral effects of molnupiravir and baloxavir significantly inhibited virus replication; the combination treatment of molnupiravir/baloxavir showed more potent and synergistic inhibitory effects in vitro. In the mouse model, molnupiravir treatment effectively inhibited virus replication and lung inflammation, but the treatment did not improve weight loss or reduce mortality. With the molnupiravir/baloxavir treatment, viral replication was significantly inhibited and proved to be more effective than either monotherapy. The combination therapy also showed the lowest inflammatory response along with a higher survival rate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The increase in HA and NA activities of seasonal influenza reduced the efficacy of oseltamivir treatment, but the effectiveness of molnupiravir and baloxavir was retained. Combination therapy showed a significant antiviral effect, which provides a reference for the clinical treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 10","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12537536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336925","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}
Nana Chang, Haiyang Wang, Kamila Aisaiti, Jingxia Guo, Tong Wu, Cheng Zhang, Han Du, Fei Du, Yuhai Bi, Zhenghai Ma
Background
H9N2 avian influenza viruses (AIVs) donate their genes to other subtype AIVs, posing significant threats to poultry industries and public health due to their endemicity and zoonotic potential. This study investigates the molecular evolution, reassortment, and mutations of the H9N2 isolates from the live poultry markets (LPMs) in Xinjiang, China.
Methods
AIVs were isolated from oropharyngeal and cloacal swabs, as well as environmental samples collected during the winter of 2017–2018. Full-genome sequencing and phylogenetic and molecular analysis were conducted to elucidate viral origins, reassortment patterns, and molecular characteristics.
Results
Thirty H9N2 isolates were obtained, all belonging to the G57 genotype. Phylogenetic analysis revealed three distinct Eurasian lineages: BJ/94-like (HA, NA), G1-like (PB2, MP), and F98-like. Notably, viral genes diverged into two major branches (A/B), with the A branches of HA, PB2, PA, and NS further subdivided into A1/A2 sublineages. In addition to the A and B branches, the viral genes of several isolates formed independent phylogenetic branches. Some of the viral genes clustered together with H9N2 viruses from the poultry/environmental strains in China and Japan, and some viral genes (e.g., PB2, PB1, MP, and NS) showed close phylogenetic relationships with human-infecting H9N2/H7N9 viruses. The multiple mutations detected in the isolates were associated with viral virulence, mammalian adaptation, and transmission.
Conclusion
Xinjiang H9N2 viruses display complex reassortment dynamics involving multiple geographic lineages. Their genetic connection to human-infecting strains underscores the risk of zoonotic spillover. Enhanced surveillance in LPMs is crucial for pandemic preparedness.
{"title":"Complex Reassortment Dynamics of H9N2 Avian Influenza Viruses in Xinjiang, China: Implications for Zoonotic Spillover","authors":"Nana Chang, Haiyang Wang, Kamila Aisaiti, Jingxia Guo, Tong Wu, Cheng Zhang, Han Du, Fei Du, Yuhai Bi, Zhenghai Ma","doi":"10.1111/irv.70170","DOIUrl":"10.1111/irv.70170","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>H9N2 avian influenza viruses (AIVs) donate their genes to other subtype AIVs, posing significant threats to poultry industries and public health due to their endemicity and zoonotic potential. This study investigates the molecular evolution, reassortment, and mutations of the H9N2 isolates from the live poultry markets (LPMs) in Xinjiang, China.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>AIVs were isolated from oropharyngeal and cloacal swabs, as well as environmental samples collected during the winter of 2017–2018. Full-genome sequencing and phylogenetic and molecular analysis were conducted to elucidate viral origins, reassortment patterns, and molecular characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty H9N2 isolates were obtained, all belonging to the G57 genotype. Phylogenetic analysis revealed three distinct Eurasian lineages: BJ/94-like (HA, NA), G1-like (PB2, MP), and F98-like. Notably, viral genes diverged into two major branches (A/B), with the A branches of HA, PB2, PA, and NS further subdivided into A1/A2 sublineages. In addition to the A and B branches, the viral genes of several isolates formed independent phylogenetic branches. Some of the viral genes clustered together with H9N2 viruses from the poultry/environmental strains in China and Japan, and some viral genes (e.g., <i>PB2</i>, <i>PB1</i>, <i>MP</i>, and <i>NS</i>) showed close phylogenetic relationships with human-infecting H9N2/H7N9 viruses. The multiple mutations detected in the isolates were associated with viral virulence, mammalian adaptation, and transmission.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Xinjiang H9N2 viruses display complex reassortment dynamics involving multiple geographic lineages. Their genetic connection to human-infecting strains underscores the risk of zoonotic spillover. Enhanced surveillance in LPMs is crucial for pandemic preparedness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 10","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12537064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336887","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}
Alexander Domnich, Donatella Panatto, Vincenzo Paolozzi, Matilde Ogliastro, Valentina Ricucci, Giancarlo Icardi, Andrea Orsi
Background
Human metapneumovirus (hMPV) has been increasingly recognized as a major contributor to respiratory infections in all age groups. Owing to its recent discovery, available data on the burden of hMPV in adults are still scant and heterogeneous. Here, we aimed to explore the epidemiology, symptomatic profile, and mortality related to hMPV among Italian adults.
Methods
We performed an integrated analysis of several community-based and hospital-based studies conducted in Genoa (Italy) between 2014 and 2025. Adults aged ≥ 18 years prescribed with ≥ 1 molecular test for hMPV were eligible.
Results
Of 21,580 and 2671 adults included in the hospital-based and community-based studies, 376 and 117, respectively, tested positive for hMPV. Seasonal (November to April) hMPV detection rate was 4.4% (95% CI: 3.6%–5.2%) in the community-based and 2.4% (95% CI: 2.1%–2.6%) in the hospital-based studies. Most detections occurred during the spring months. Each 1-year increase in age was associated with a 1.1% increase in the odds of hMPV positivity (adjusted odds ratio [aOR] 1.011; 95% CI: 1.005–1.016). Clinical presentation of hMPV resembled that of the phylogenetically related respiratory syncytial virus. Among hMPV-positive inpatients, 7.3% (95% CI: 4.3%–11.5%) died during their hospital encounter. In-hospital mortality was associated with residency in long-term care facilities (aOR 8.73; 95% CI: 2.63–29.15) and cancer (aOR 4.51; 95% CI: 1.50–14.35).
Conclusions
hMPV is a common virological finding in outpatient and inpatient adults and is responsible for a measurable burden, especially among the most frail older adults.
{"title":"Epidemiology and Burden of Human Metapneumovirus Among Italian Adults in Outpatient and Inpatient Settings, 2014–2025","authors":"Alexander Domnich, Donatella Panatto, Vincenzo Paolozzi, Matilde Ogliastro, Valentina Ricucci, Giancarlo Icardi, Andrea Orsi","doi":"10.1111/irv.70175","DOIUrl":"10.1111/irv.70175","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Human metapneumovirus (hMPV) has been increasingly recognized as a major contributor to respiratory infections in all age groups. Owing to its recent discovery, available data on the burden of hMPV in adults are still scant and heterogeneous. Here, we aimed to explore the epidemiology, symptomatic profile, and mortality related to hMPV among Italian adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed an integrated analysis of several community-based and hospital-based studies conducted in Genoa (Italy) between 2014 and 2025. Adults aged ≥ 18 years prescribed with ≥ 1 molecular test for hMPV were eligible.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 21,580 and 2671 adults included in the hospital-based and community-based studies, 376 and 117, respectively, tested positive for hMPV. Seasonal (November to April) hMPV detection rate was 4.4% (95% CI: 3.6%–5.2%) in the community-based and 2.4% (95% CI: 2.1%–2.6%) in the hospital-based studies. Most detections occurred during the spring months. Each 1-year increase in age was associated with a 1.1% increase in the odds of hMPV positivity (adjusted odds ratio [aOR] 1.011; 95% CI: 1.005–1.016). Clinical presentation of hMPV resembled that of the phylogenetically related respiratory syncytial virus. Among hMPV-positive inpatients, 7.3% (95% CI: 4.3%–11.5%) died during their hospital encounter. In-hospital mortality was associated with residency in long-term care facilities (aOR 8.73; 95% CI: 2.63–29.15) and cancer (aOR 4.51; 95% CI: 1.50–14.35).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>hMPV is a common virological finding in outpatient and inpatient adults and is responsible for a measurable burden, especially among the most frail older adults.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 10","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12537271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336912","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}
B. Wahi-Singh, P. Wahi-Singh, C. Lau, A. Buckle, P. Manzoni, H. Nair
Background
Hospital-acquired respiratory syncytial virus (HA-RSV) infections pose a substantial risk to hospitalised children, previously described as composing a fifth of RSV-related deaths worldwide. Despite this, the epidemiology of HA-RSV remains under-characterised, with limited meta-analytical evidence quantifying its incidence, morbidity and mortality.
Methods
We conducted a systematic review and meta-analysis of English language papers published between January 1975 and March 2024 searching EMBASE, MEDLINE and CABI Global Health. We included studies with primary data on paediatric HA-RSV cases among either all patients, patients with RSV or patients with healthcare-acquired infections (HAIs). Outbreak reports were excluded for the purposes of this analysis. Using random-effects meta-analyses, we synthesised the HA-RSV incidence rate (IR) and mortality rate (MR) among patient groups, reported as cases and deaths per 1000 person-years respectively. HA-RSV cumulative incidence and case-fatality rate (CFR) are also reported as percentages. The Joanna-Briggs Institute critical appraisal tool was used for quality assessment.
Results
Twenty-seven studies from 11 countries were included. The pooled HA-RSV IR among all paediatric patients was 10.86 cases (95% confidence interval, 3.83–17.89) per 1000 person-years. The MR was 11.34 (5.57–17.11) deaths per 1000 person-years, and the pooled CFR was 13.30% (3.21%–23.40%). HA-RSV comprised 15.57% of RSV hospitalisations and 22.48% of all HAIs.
Conclusions
HA-RSV is a serious and under-recognised cause of morbidity and mortality in hospitalised paediatric patients, with significantly higher mortality than community-acquired RSV. These findings underscore the need for strengthened infection control, standardised diagnostic criteria and targeted preventative strategies to mitigate its impact globally.
背景：医院获得性呼吸道合胞病毒（HA-RSV）感染对住院儿童构成重大风险，以前曾描述为占全球rsv相关死亡的五分之一。尽管如此，HA-RSV的流行病学特征仍然不足，量化其发病率、发病率和死亡率的荟萃分析证据有限。方法：我们对1975年1月至2024年3月间发表的英文论文进行了系统回顾和荟萃分析，检索了EMBASE、MEDLINE和CABI Global Health。我们纳入了在所有患者、RSV患者或卫生保健获得性感染（HAIs）患者中进行的具有儿科HA-RSV病例主要数据的研究。为进行此分析，不包括爆发报告。使用随机效应荟萃分析，我们综合了HA-RSV发病率（IR）和死亡率（MR），分别以每1000人年的病例和死亡报告。HA-RSV累计发病率和病死率（CFR）也以百分比报告。乔安娜-布里格斯研究所的关键评估工具被用于质量评估。结果：纳入了来自11个国家的27项研究。所有儿科患者的HA-RSV IR合计为10.86例（95%可信区间3.83-17.89）/ 1000人年。MR为每1000人年11.34例（5.57 ~ 17.11）例死亡，合并CFR为13.30%（3.21% ~ 23.40%）。呼吸道合胞病毒住院占呼吸道合胞病毒住院的15.57%，占所有呼吸道合胞病毒住院的22.48%。结论：HA-RSV是住院儿科患者发病率和死亡率的一个严重且未被充分认识的原因，其死亡率明显高于社区获得性RSV。这些发现强调需要加强感染控制、标准化诊断标准和有针对性的预防战略，以减轻其全球影响。
{"title":"The Epidemiology of Healthcare-Acquired Respiratory Syncytial Virus Infection Among Hospitalised Paediatric Patients: a Systematic Review and Meta-Analysis","authors":"B. Wahi-Singh, P. Wahi-Singh, C. Lau, A. Buckle, P. Manzoni, H. Nair","doi":"10.1111/irv.70169","DOIUrl":"10.1111/irv.70169","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hospital-acquired respiratory syncytial virus (HA-RSV) infections pose a substantial risk to hospitalised children, previously described as composing a fifth of RSV-related deaths worldwide. Despite this, the epidemiology of HA-RSV remains under-characterised, with limited meta-analytical evidence quantifying its incidence, morbidity and mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a systematic review and meta-analysis of English language papers published between January 1975 and March 2024 searching EMBASE, MEDLINE and CABI Global Health. We included studies with primary data on paediatric HA-RSV cases among either all patients, patients with RSV or patients with healthcare-acquired infections (HAIs). Outbreak reports were excluded for the purposes of this analysis. Using random-effects meta-analyses, we synthesised the HA-RSV incidence rate (IR) and mortality rate (MR) among patient groups, reported as cases and deaths per 1000 person-years respectively. HA-RSV cumulative incidence and case-fatality rate (CFR) are also reported as percentages. The Joanna-Briggs Institute critical appraisal tool was used for quality assessment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-seven studies from 11 countries were included. The pooled HA-RSV IR among all paediatric patients was 10.86 cases (95% confidence interval, 3.83–17.89) per 1000 person-years. The MR was 11.34 (5.57–17.11) deaths per 1000 person-years, and the pooled CFR was 13.30% (3.21%–23.40%). HA-RSV comprised 15.57% of RSV hospitalisations and 22.48% of all HAIs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>HA-RSV is a serious and under-recognised cause of morbidity and mortality in hospitalised paediatric patients, with significantly higher mortality than community-acquired RSV. These findings underscore the need for strengthened infection control, standardised diagnostic criteria and targeted preventative strategies to mitigate its impact globally.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 10","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12519416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285971","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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