The Interseasonal Resurgence of Respiratory Syncytial Virus in Australian Children Following the Reduction of Coronavirus Disease 2019–Related Public Health Measures

BackgroundFollowing a relative absence in winter 2020, a large resurgence of respiratory syncytial virus (RSV) detections occurred during the 2020/2021 summer in Western Australia. This seasonal shift was linked to SARS-CoV-2 public health measures. We examine the epidemiology and RSV testing of respiratory-coded admissions, and compare clinical phenotype of RSV-positive admissions between 2019 and 2020.MethodAt a single tertiary paediatric centre, International Classification of Diseases, 10th edition Australian Modification-coded respiratory admissions longer than 12 hours were combined with laboratory data from 1 January 2019 to 31 December 2020. Data were grouped into bronchiolitis, other acute lower respiratory infection (OALRI) and wheeze, to assess RSV testing practices. For RSV-positive admissions, demographics and clinical features were compared between 2019 and 2020.ResultsRSV-positive admissions peaked in early summer 2020, following an absent winter season. Testing was higher in 2020: bronchiolitis, 94.8% vs 89.2% (p=0.01); OALRI, 88.6% vs 82.6% (p=0.02); and wheeze, 62.8% vs 25.5% (p<0.001). The 2020 peak month, December, contributed almost 75% of RSV-positive admissions, 2.5 times the 2019 peak. The median age in 2020 was twice that observed in 2019 (16.4 vs 8.1 months, p<0.001). The proportion of RSV-positive OALRI admissions was greater in 2020 (32.6% vs 24.9%, p=0.01). There were no clinically meaningful differences in length of stay or disease severity.InterpretationThe 2020 RSV season was in summer, with a larger than expected peak. There was an increase in RSV-positive non-bronchiolitis admissions, consistent with infection in older RSV-naïve children. This resurgence raises concern for regions experiencing longer and more stringent SARS-CoV-2 public health measures.

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Effects of public health measures during the SARS‐CoV‐2 pandemic on the winter respiratory syncytial virus epidemic: An interrupted time series analysis

Paediatric and Perinatal Epidemiology ◽

10.1111/ppe.12829 ◽

2022 ◽

Author(s):

Ana Isabel Reyes Domínguez ◽

Svetlana Pavlovic Nesic ◽

Lourdes Urquía Martí ◽

María del Carmen Pérez González ◽

Desiderio Reyes Suárez ◽

...

Keyword(s):

Public Health ◽

Time Series ◽

Respiratory Syncytial Virus ◽

Time Series Analysis ◽

Interrupted Time Series ◽

Interrupted Time Series Analysis ◽

Health Measures ◽

Series Analysis ◽

Syncytial Virus

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COVID-19 public health measures and respiratory syncytial virus

The Lancet Child & Adolescent Health ◽

10.1016/s2352-4642(20)30307-2 ◽

2020 ◽

Vol 4 (11) ◽

pp. e42-e43 ◽

Cited By ~ 1

Author(s):

Philip N Britton ◽

Nan Hu ◽

Gemma Saravanos ◽

Jane Shrapnel ◽

Jake Davis ◽

...

Keyword(s):

Public Health ◽

Respiratory Syncytial Virus ◽

Health Measures ◽

Syncytial Virus

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Impact of Coronavirus Disease 2019 Public Health Measures on Detections of Influenza and Respiratory Syncytial Virus in Children During the 2020 Australian Winter

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1475 ◽

2020 ◽

Cited By ~ 8

Author(s):

Daniel K Yeoh ◽

David A Foley ◽

Cara A Minney-Smith ◽

Andrew C Martin ◽

Ariel O Mace ◽

...

Keyword(s):

Public Health ◽

Respiratory Syncytial Virus ◽

Respiratory Viruses ◽

Health Measures ◽

Syncytial Virus ◽

Western Australian

Abstract Public health measures targeting coronavirus disease 2019 have potential to impact transmission of other respiratory viruses. We found 98.0% and 99.4% reductions in respiratory syncytial virus and influenza detections, respectively, in Western Australian children through winter 2020 despite schools reopening. Border closures have likely been important in limiting external introductions.

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Use of Saliva Swab for Detection of Influenza Virus in Patients Admitted to an Emergency Department

Microbiology Spectrum ◽

10.1128/spectrum.00336-21 ◽

2021 ◽

Author(s):

Alicia Galar ◽

Pilar Catalán ◽

Lara Vesperinas ◽

Iria Miguens ◽

Ioana Muñoz ◽

...

Keyword(s):

Public Health ◽

Emergency Department ◽

Influenza Virus ◽

Respiratory Syncytial Virus ◽

Early Detection ◽

Infection Control ◽

High Sensitivity ◽

Antibacterial Treatment ◽

Health Measures ◽

Syncytial Virus

Early detection of influenza virus is important for guiding antiviral and antibacterial treatment for infection control and public health measures. We have observed that saliva swab specimens have high sensitivity and specificity for the detection of influenza by the Xpert Xpress flu/respiratory syncytial virus (RSV) test and high overall agreement and C T correlation with nasopharyngeal specimens.

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1719. Respiratory Syncytial Virus-Associated Hospitalization Rates among US Infants: A Systematic Review and Meta-Analysis

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1897 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S843-S843

Author(s):

John M McLaughlin ◽

Farid L Khan ◽

Heinz-Josef Schmitt ◽

Yasmeen Agosti ◽

Luis Jodar ◽

...

Keyword(s):

Public Health ◽

Respiratory Syncytial Virus ◽

Active Surveillance ◽

Meta Analysis ◽

The United States ◽

Administrative Claims ◽

Prevention Strategies ◽

Hospitalization Rates ◽

Syncytial Virus ◽

The Impact

Abstract Background Understanding the true magnitude of infant respiratory syncytial virus (RSV) burden is critical for determining the potential public-health benefit of RSV prevention strategies. Although global reviews of infant RSV burden exist, none have summarized data from the United States or evaluated how RSV burden estimates are influenced by variations in study design. Methods We performed a systematic literature review and meta-analysis of studies describing RSV-associated hospitalization rates among US infants. We also examined the impact of key study characteristics on these estimates. Results After review of 3058 articles through January 2020, we identified 25 studies with 31 unique estimates of RSV-associated hospitalization rates. Among US infants < 1 year of age, annual rates ranged from 8.4 to 40.8 per 1000 with a pooled rate= 19.4 (95%CI= 17.9–20.9). Study type was associated with RSV hospitalization rates (P =.003), with active surveillance studies having pooled rates per 1000 (11.1; 95%CI: 9.8–12.3) that were half that of studies based on administrative claims (21.4; 95%CI: 19.5–23.3) or modeling approaches (23.2; 95%CI: 20.2–26.2). Conclusion Applying the pooled rates identified in our review to the 2020 US birth cohort suggests that 73,680 to 86,020 RSV-associated infant hospitalizations occur each year. To date, public-health officials have used conservative estimates from active surveillance as the basis for defining US infant RSV burden. The full range of RSV-associated hospitalization rates identified in our review better characterizes the true RSV burden in infants and can better inform future evaluations of RSV prevention strategies. Disclosures John M. McLaughlin, PhD, Pfizer (Employee, Shareholder) Farid L. Khan, MPH, Pfizer (Employee, Shareholder) Heinz-Josef Schmitt, MD, Pfizer (Employee, Shareholder) Yasmeen Agosti, MD, Pfizer (Employee, Shareholder) Luis Jodar, PhD, Pfizer (Employee, Shareholder) Eric Simões, MD, Pfizer (Consultant, Research Grant or Support) David L. Swerdlow, MD, Pfizer (Employee, Shareholder)

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Rapid disappearance of influenza following the implementation of COVID-19 mitigation measures in Hamilton, Ontario

Canada Communicable Disease Report ◽

10.14745/ccdr.v47i04a04 ◽

2021 ◽

Vol 47 (04) ◽

pp. 202-208

Author(s):

Kevin Zhang ◽

Avika Misra ◽

Patrick J Kim ◽

Seyed M Moghadas ◽

Joanne M Langley ◽

...

Keyword(s):

Public Health ◽

Influenza A ◽

Respiratory Virus ◽

Respiratory Viruses ◽

Mitigation Measures ◽

Nasopharyngeal Swab ◽

Health Measures ◽

Bayesian Linear Regression ◽

Syncytial Virus ◽

The Impact

Background: Public health measures, such as physical distancing and closure of schools and non-essential services, were rapidly implemented in Canada to interrupt the spread of the coronavirus disease 2019 (COVID-19). We sought to investigate the impact of mitigation measures during the spring wave of COVID-19 on the incidence of other laboratory-confirmed respiratory viruses in Hamilton, Ontario. Methods: All nasopharyngeal swab specimens (n=57,503) submitted for routine respiratory virus testing at a regional laboratory serving all acute-care hospitals in Hamilton between January 2010 and June 2020 were reviewed. Testing for influenza A and B, respiratory syncytial virus, human metapneumovirus, parainfluenza I–III, adenovirus, and rhinovirus/enterovirus was done routinely using a laboratory-developed polymerase chain reaction multiplex respiratory viral panel. A Bayesian linear regression model was used to determine the trend of positivity rates of all influenza samples for the first 26 weeks of each year from 2010 to 2019. The mean positivity rate of Bayesian inference was compared with the weekly reported positivity rate of influenza samples in 2020. Results: The positivity rate of influenza in 2020 diminished sharply following the population-wide implementation of COVID-19 interventions. Weeks 12–26 reported 0% positivity for influenza, with the exception of 0.1% reported in week 13. Conclusion: Public health measures implemented during the COVID-19 pandemic were associated with a reduced incidence of other respiratory viruses and should be considered to mitigate severe seasonal influenza and other respiratory virus pandemics.

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Risk factors for respiratory syncytial virus bronchiolitis hospital admission in New Zealand

Epidemiology and Infection ◽

10.1017/s0950268807000180 ◽

2008 ◽

Vol 136 (10) ◽

pp. 1333-1341 ◽

Cited By ~ 34

Author(s):

K. GRIMWOOD ◽

C. COHET ◽

F. J. RICH ◽

S. CHENG ◽

C. WOOD ◽

...

Keyword(s):

Risk Factors ◽

Respiratory Syncytial Virus ◽

New Zealand ◽

Adjusted Risk ◽

Health Measures ◽

Adjusted Risk Ratio ◽

Independent Risk Factors ◽

Syncytial Virus ◽

Hospital Births ◽

Hemisphere Winter

SUMMARYThis study assessed risk factors for respiratory syncytial virus (RSV) hospitalization and disease severity in Wellington, New Zealand. During the southern hemisphere winter months of 2003–2005, 230 infants aged <24 months hospitalized with bronchiolitis were recruited. RSV was identified in 141 (61%) infants. Comparison with data from all live hospital births from the same region (2003–2005) revealed three independent risk factors for RSV hospitalization: birth between February and July [adjusted risk ratio (aRR) 1·62, 95% confidence interval (CI) 1·15–2·29], gestation <37 weeks (aRR 2·29, 95% CI 1·48–3·56) and Māori ethnicity (aRR 3·64, 95% CI 2·27–5·85) or Pacific ethnicity (aRR 3·60, 95% CI 2·14–6·06). The high risk for Māori and Pacific infants was only partially accounted for by other known risk factors. This work highlights the importance of RSV disease in indigenous and minority populations, and identifies the need for further research to develop public health measures that can reduce health disparities.

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Insurance Status and the Risk of Severe Respiratory Syncytial Virus Disease in United States Preterm Infants Born at 32–35 Weeks Gestational Age

Open Forum Infectious Diseases ◽

10.1093/ofid/ofw163 ◽

2016 ◽

Vol 3 (3) ◽

Cited By ~ 5

Author(s):

Jeremy A. Franklin ◽

Evan J. Anderson ◽

Xionghua Wu ◽

Christopher S. Ambrose ◽

Eric A. F. Simões

Keyword(s):

Public Health ◽

Risk Factors ◽

Respiratory Syncytial Virus ◽

Preterm Infants ◽

Public Health Insurance ◽

Insurance Status ◽

Severe Respiratory Syncytial Virus ◽

Public Insurance ◽

Ed Visits ◽

Syncytial Virus

Abstract Background. Database studies have identified that public health insurance status is associated with an increased risk of severe respiratory syncytial virus (RSV) disease in US infants. However, these studies did not adjust for the presence of other risk factors and did not evaluate the risk in preterm infants. Methods. In this study, we evaluate the independent association between public insurance and severe RSV disease outcomes adjusting for other risk factors. The prospective, observational RSV Respiratory Events among Preterm Infants Outcomes and Risk Tracking (REPORT) study was conducted over 2 consecutive RSV seasons at 188 US clinical sites that enrolled preterm infants born at 32–35 wGA who had not received RSV immunoprophylaxis with palivizumab. Adjusted incidence rates per 100 infant-seasons of the RSV-associated endpoints of outpatient lower respiratory tract infection (LRI), emergency department (ED) visits, RSV hospitalizations (RSVHs), and intensive care unit admissions during peak RSV season (November–March) were compared for infants with private and public insurance. Results. Of 1642 evaluable infants enrolled in the REPORT study, 50.1% had private insurance and 49.9% had public health insurance. Adjusted rates of RSV outpatient LRIs were similar; however, rates of ED visits (hazard ratio [HR], 2.04; 95% confidence interval [CI], 1.20–3.45) were higher for subjects with public insurance, with a similar but nonsignificant trend observed for hospitalization (HR, 1.61; 95% CI, .93–2.78). Conclusions. Socioeconomic status, as evaluated by public versus private healthcare insurance, is a significant independent risk factor for ED use in US preterm infants and may contribute to increased RSVHs in this population.

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