152. Sharp Decline in Rates of Community Respiratory Viral Infections Among NIH Clinical Center Patients During the COVID-19 Pandemic

Abstract Background During the first year of the COVID-19 pandemic, nonpharmaceutical interventions had a broad impact on viral transmission apart from SARS-CoV-2. The NIH Clinical Center has used the BioFire FilmArray multiplex PCR respiratory pathogen panel (RPP) for evaluation of upper respiratory symptoms since 2014. Beginning in 3/20, respiratory samples from symptomatic patients were tested by SARS-CoV-2 PCR and the RPP. We performed a retrospective study comparing frequency and rates of community respiratory viruses detected by RPP from 1/14 through 3/21. Methods Results of RPPs from nasopharyngeal swabs/washes, bronchoalveolar lavages, and bronchial washes were included. Results from viral challenge studies were excluded. Charts were reviewed to determine whether repeat positives for the same virus within 12 months represented new infections; repeats from the same infection were excluded. A quantitative data analysis was completed using cross tabulations; comparisons were done using mixed models, applying Dunnett’s correction for multiplicity. Results A total of 3,329 patients underwent 8,122 RPPs from 1/14 through 3/21. Frequency of all respiratory pathogens declined from an annual range of 0.88-1.97% from 1/14-3/20 to 0.29% in 4/20-3/21 (p < 0.001). Individual viral pathogens declined sharply in frequency during the pandemic, with zero cases of influenza A/B, parainfluenza, or metapneumovirus detected from 4/20-3/21. One case each of adenovirus, RSV, CoV OC43, and CoV HKU1 were detected in 4/20-3/21. Rhino/enterovirus detection continued, but with a substantially lower frequency of 4.27% in 4/20-3/21, compared with an annual range of 8.65-18.28% from 1/14-3/20 (p < 0.001). Frequency of detection of all respiratory pathogens tested using the Biofire FilmArray multiplex PCR respiratory pathogen panel from January 2014 through March 2021. The frequency of pathogen detection from April 2020 through March 2021 declined substantially in comparison with previous years. Frequency of detection of influenza A, influenza B, rhinovirus/enterovirus, parainfluenza (1, 2, 3, 4), and respiratory syncytial virus from January 2014 through March 2021. The frequency of detection of these pathogens declined sharply starting in April 2020. Conclusion During the pandemic, the burden of viral respiratory infections detected among patients at the NIH Clinical Center improved considerably. This reprieve was likely thanks to the layered COVID-19 prevention and mitigation measures implemented in the community and the hospital: masking, distancing, symptom screening, isolation and testing symptomatic persons. As COVID-19 vaccination allows relaxation of masking, community transmission of respiratory viruses will likely resume; continued mask-wearing in the hospital may provide an enduring benefit by preventing nosocomial transmission. Disclosures Tara N. Palmore, MD, Nothing to disclose

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Epidemiology of Respiratory Pathogens among Elderly Nursing Home Residents with Acute Respiratory Infections in Corsica, France, 2013–2017

BioMed Research International ◽

10.1155/2017/1423718 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Shirley Masse ◽

Lisandru Capai ◽

Alessandra Falchi

Keyword(s):

Nursing Home ◽

Influenza A ◽

Respiratory Infections ◽

Nursing Home Residents ◽

Respiratory Viruses ◽

Sudden Onset ◽

Influenza Viruses ◽

Influenza B ◽

Acute Respiratory Infections ◽

Respiratory Pathogens

Background. The current study aims to describe the demographical and clinical characteristics of elderly nursing home (NH) residents with acute respiratory infections (ARIs) during four winter seasons (2013/2014–2016/2017), as well as the microbiological etiology of these infections. Methods. Seventeen NHs with at least one ARI resident in Corsica, France, were included. An ARI resident was defined as a resident developing a sudden onset of any constitutional symptoms in addition to any respiratory signs. Nasopharyngeal swabs from ARI residents were screened for the presence of 21 respiratory agents, including seasonal influenza viruses. Results. Of the 107 ARI residents enrolled from NHs, 61 (57%) were positive for at least one of the 21 respiratory pathogens. Forty-one (38.3%) of the 107 ARI residents had influenza: 38 (92%) were positive for influenza A (100% A(H3N2)) and three (8%) for influenza B/Victoria. Axillary fever (≥38°C) was significantly more common among patients infected with influenza A(H3N2). Conclusion. The circulation of seasonal respiratory viruses other than influenza A(H3N2) seems to be sporadic among elderly NH residents. Investigating the circulation of respiratory viruses in nonwinter seasons seems to be important in order to understand better the dynamic of their year-round circulation in NHs.

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Epidemiology of Respiratory Pathogens in Children with Severe Acute Respiratory Infection and Impact of the Multiplex PCR Film Array Respiratory Panel: A 2-Year Study

International Journal of Microbiology ◽

10.1155/2021/2276261 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Asmae Lamrani Hanchi ◽

Morad Guennouni ◽

Meriem Rachidi ◽

Toufik Benhoumich ◽

Hind Bennani ◽

...

Keyword(s):

Multiplex Pcr ◽

Real Time ◽

Bordetella Pertussis ◽

Influenza A ◽

Respiratory Infections ◽

Respiratory Viruses ◽

Public Health Issue ◽

Respiratory Pathogens ◽

Severe Acute Respiratory Infection ◽

Wide Range

Sever acute respiratory infections (SARIs) are a public health issue that are common in children and are associated with an important morbidity and mortality rate worldwide. Although SARI are mainly caused by viruses, they are still a cause of antibiotic overuse. The use of molecular methods especially real-time multiplex PCR allowed to detect a wide range of respiratory viruses and their subtype as well as some atypical bacteria. The aim of this study was to investigate the epidemiology of respiratory pathogens detected in children admitted with SARI and to highlight the role of real-time multiplex PCR in the rapid diagnosis of viral and bacterial SARI. This work is a descriptive observational study from January 2018 to December 2019 including nasopharyngeal secretions collected from 534 children hospitalised in paediatric department. The detection of respiratory viruses and bacteria was performed by the FilmArray® Respiratory Panel. A total of 387 (72.5%) children were tested positive for at least one respiratory pathogen, and 23.3% of them were coinfected with more than one pathogen. Viral aetiology was found in 91.2% (n = 340). The most common viruses detected were HRV (n = 201) and RSV (n = 124), followed by PIV (n = 35) influenza A (n = 29) and human metapneumovirus (n = 27). Bacteria was found in 8.8% (n = 47), and Bordetella pertussis was the most detected. Respiratory syncytial virus and Bordetella pertussis were significantly higher in infants less than 6 months old. The detection of RSV and influenza A presented a pic in winter, and HMPV was statistically significant in spring ( p < 0.01 ). This study described the epidemiology of respiratory pathogens involved in severe respiratory infections in children that were affected by several factors such as season and age group. It also highlighted the importance of multiplex PCR in confirming viral origin, thus avoiding irrational prescription of antibiotics in paediatric settings.

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Mortality Following Isolation of Various Respiratory Viruses in Nursing Home Residents

Infection Control and Hospital Epidemiology ◽

10.1086/501589 ◽

1999 ◽

Vol 20 (12) ◽

pp. 812-815 ◽

Cited By ~ 33

Author(s):

Paul J. Drinka ◽

Stefan Gravenstein ◽

Elizabeth Langer ◽

Peggy Krause ◽

Peter Shult

Keyword(s):

Nursing Home ◽

Influenza A ◽

Skilled Nursing Facility ◽

Nursing Home Residents ◽

Respiratory Illness ◽

Respiratory Viruses ◽

Influenza B ◽

Respiratory Pathogens ◽

Syncytial Virus ◽

Viral Respiratory

AbstractObjective:To compare mortality following isolation of influenza A to mortality following isolation of other respiratory viruses in a nursing home.Setting:The Wisconsin Veterans Home, a 688-bed skilled nursing facility for veterans and their spouses.Participants:All residents with respiratory viral isolates obtained between 1988 and 1999.Design:Thirty-day mortality was determined following each culture-proven illness.Results:Thirty-day mortality following isolation of viral respiratory pathogens was 4.7% (15/322) for influenza A 5.4% (7/129) for influenza B; 6.1% (3/49) for parainfluenza type 1; 0% (0/26) for parainfluenza types 2,3, and 4; 0% (0/26) for respiratory syncytial virus (RSV); and 1.6% (1/61) for rhinovirus.Conclusions:Mortality following isolation of certain other respiratory viruses may be comparable to that following influenza A (although influenza A mortality might be higher without vaccination and antiviral agents). The use of uniform secretion precautions for all viral respiratory illness deserves consideration in nursing homes.

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Magnetofluidic platform for rapid multiplexed screening of SARS-CoV-2 variants and respiratory pathogens

10.1101/2021.05.10.21256995 ◽

2021 ◽

Author(s):

Alexander Y Trick ◽

Fan-En Chen ◽

Liben Chen ◽

Pei-Wei Lee ◽

Alexander C Hasnain ◽

...

Keyword(s):

Influenza A ◽

Respiratory Symptoms ◽

Limit Of Detection ◽

Respiratory Viruses ◽

Nasopharyngeal Swab ◽

Influenza B ◽

Respiratory Pathogens ◽

Multiplexed Detection ◽

New Challenges ◽

Sensitivity Specificity

The rise of highly transmissible SARS-CoV-2 variants brings new challenges and concerns with vaccine efficacy, diagnostic sensitivity, and public health responses in the fight to end the pandemic. Widespread detection of variant strains will be critical to inform policy decisions to mitigate further spread, and post-pandemic multiplexed screening of respiratory viruses will be necessary to properly manage patients presenting with similar respiratory symptoms. In this work, we have developed a portable, magnetofluidic cartridge platform for automated PCR testing in <30 min. Cartridges were designed for multiplexed detection of SARS-CoV-2 with either distinctive variant mutations or with Influenza A and B. The platform demonstrated a limit of detection down to 2 copies/μL SARS-CoV-2 RNA with successful identification of B.1.1.7 and B.1.351 variants. The multiplexed SARS-CoV-2/Flu assay was validated using archived clinical nasopharyngeal swab eluates (n = 116) with an overall sensitivity/specificity of 98.1%/95.2%, 85.7%/100%, 100%/98.2%, respectively, for SARS-CoV-2, Influenza A, and Influenza B. Further testing with saliva (n = 14) demonstrated successful detection of all SARS-CoV-2 positive samples with no false-positives.

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Coinfections with Respiratory Pathogens among COVID-19 Patients in Korea

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2021/6651045 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Kyoung Ho Roh ◽

Yu Kyung Kim ◽

Shin-Woo Kim ◽

Eun-Rim Kang ◽

Yong-Jin Yang ◽

...

Keyword(s):

Influenza A ◽

Pathogen Detection ◽

Respiratory Virus ◽

Respiratory Viruses ◽

Diagnostic Value ◽

Respiratory Pathogen ◽

Nasopharyngeal Swab ◽

Respiratory Pathogens ◽

Oropharyngeal Swab ◽

Syncytial Virus

The detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in upper and lower respiratory specimens and coinfection with other respiratory pathogens in patients with coronavirus disease 2019 (COVID-19) was investigated. Study subjects (N = 342) were retrospectively enrolled after being confirmed as SARS-CoV-2 positive, and their nasopharyngeal swab (NPS), oropharyngeal swab (OPS), and sputum specimens were restored for SARS-CoV-2 retesting and respiratory pathogen detection. The majority of the subjects (96.5%, N = 330) were confirmed as SARS-CoV-2 positive using NPS/OPS specimens. Among the COVID-19 patients (N = 342), 7.9% (N = 27) and 0.9% (N = 3) were coinfected with respiratory viruses and Mycoplasma pneumoniae, respectively, yielding an 8.8% (N = 30) overall respiratory pathogen coinfection rate. Of the respiratory virus coinfection cases (N = 27), 92.6% (N = 25) were coinfected with a single respiratory virus and 7.4% (N = 2) with two viruses (metapneumovirus/adenovirus and rhinovirus/bocavirus). No triple coinfections of other respiratory viruses or bacteria with SARS-CoV-2 were detected. Respiratory viruses coinfected in the patients with COVID-19 were as follows: rhinovirus (N = 7, 2.1%), respiratory syncytial virus A and B (N = 6, 1.8%), non-SARS-CoV-2 coronaviruses (229E, NL63, and OC43, N = 5, 1.5%), metapneumovirus (N = 4, 1.2%), influenza A (N = 3, 0.9%), adenovirus (N = 3, 0.9%), and bocavirus (N = 1, 0.3%). In conclusion, the diagnostic value of utilizing NPS/OPS specimens is excellent, and, as the first report in Korea, coinfection with respiratory pathogens was detected at a rate of 8.8% in patients with COVID-19.

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153. Gone Are the Other Respiratory Viruses During COVID…but the Rhinovirus/Enterovirus “Cockroach” Persists!

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.153 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S92-S93

Author(s):

Jasjit Singh ◽

Beth Huff ◽

Delma Nieves ◽

Wendi Gornick

Keyword(s):

Influenza A ◽

Viral Infections ◽

Respiratory Viruses ◽

Return To School ◽

Influenza B ◽

Respiratory Pathogens ◽

Free Standing ◽

California Department ◽

Syncytial Virus ◽

Healthcare Associated

Abstract Background In a typical winter respiratory season, Influenza A, Influenza B, Respiratory Syncytial Virus (RSV) and human Metapneumovirus (hMPV) infections are common in pediatrics. During the COVID-19 pandemic, we noted a marked decrease in all except for Rhinovirus/Enterovirus at our free-standing quaternary level children’s hospital. Methods We prospectively reviewed all patients with positive testing for viral respiratory pathogens from October 1, 2018 through May 29, 2021. Testing was done by polymerase chain reaction (PCR) (BioFire® FilmArray® Respiratory 2 Panel, UT) and by SARS-CoV-2 PCR testing (Cepheid®, CA). The latter may have been done for pre-procedure or admission screening. We submitted 74 specimens to the California Department Public Health (CDPH) for definitive identification and serotyping analysis. Results The number of Rhinovirus/Enterovirus (RV/EV) infections was compared with Influenza A & B, RSV, and hMPV over the past 3 years. There was a 152% increase in RV/EV from 2018-2019 to 2020-2021 with near absence of other respiratory viruses (Figure 1). In 2020-2021, RV/EV (N=877, 84%) made up a larger percentage of all viral etiologies compared to 2018-2019 (N=348, 11%) (Figure 2). Healthcare acquired infections (HAI) due to respiratory viruses decreased in 2020-2021 compared to both of the prior seasons, though all cases were due to RV/EV (Figure 3). There were no RV/EV associated deaths. Of 74 submitted, CDPH did typing on 24 samples; all were found to be rhinovirus (RV). Figure 1. High-Risk Winter Viral Infections 2019-2021. Figure 2. Distribution of Winter Viral Pathogens 2018-2019 Compared to 2020-2021 Season. Figure 3. Winter Viral Healthcare Associated Infections 2019-2021. Conclusion We experienced a marked increase in RV/EV during COVID precautions, despite a near absence of other common respiratory viruses. This was reflected in both our community data and HAI due to respiratory viruses. There was a marked increase in RV/EV starting with week 18 (Figure 4). We hypothesize this is due to schools’ re-opening. Understanding RV epidemiology and transmission is important, as it may inform return to school and work protocols for the upcoming respiratory viral season. Figure 4. Rhinovirus/Enterovirus by Week for the 2020-2021 Season. Disclosures All Authors: No reported disclosures

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Bioaerosol Sampling in Clinical Settings: A Promising, Noninvasive Approach for Detecting Respiratory Viruses

Open Forum Infectious Diseases ◽

10.1093/ofid/ofw259 ◽

2016 ◽

Vol 4 (1) ◽

Cited By ~ 14

Author(s):

Tham T. Nguyen ◽

Mee K. Poh ◽

Jenny Low ◽

Shirin Kalimuddin ◽

Koh C. Thoon ◽

...

Keyword(s):

Influenza A Virus ◽

Influenza A ◽

Respiratory Viruses ◽

Respiratory Pathogen ◽

Influenza B Virus ◽

Influenza B ◽

Clinical Settings ◽

Noninvasive Method ◽

Molecular Assays ◽

B Virus

Abstract Background Seeking a noninvasive method to conduct surveillance for respiratory pathogens, we sought to examine the usefulness of 2 types of off-the-shelf aerosol samplers to detect respiratory viruses in Singapore. Methods In this pilot study, we ran the aerosol samplers several times each week with patients present in the patient waiting areas at 3 primary health clinics during the months of April and May 2016. We used a SKC BioSampler with a BioLite Air Sampling Pump (run for 60 min at 8 L/min) and SKC AirChek TOUCH personal air samplers with polytetrafluoroethylene Teflon filter cassettes (run for 180 min at 5 L/min). The aerosol specimens and controls were studied with molecular assays for influenza A virus, influenza B virus, adenoviruses, and coronaviruses. Results Overall, 16 (33.3%) of the 48 specimens indicated evidence of at least 1 respiratory pathogen, with 1 (2%) positive for influenza A virus, 3 (6%) positive for influenza B virus, and 12 (25%) positive for adenovirus. Conclusions Although we were not able to correlate molecular detection with individual patient illness, patients with common acute respiratory illnesses were present during the samplings. Combined with molecular assays, it would suggest that aerosol sampling has potential as a noninvasive method for novel respiratory virus detection in clinical settings.

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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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Circulation of Respiratory Viruses in Hospitalized Adults before and during the COVID-19 Pandemic in Brescia, Italy: A Retrospective Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18189525 ◽

2021 ◽

Vol 18 (18) ◽

pp. 9525

Author(s):

Maria Antonia De Francesco ◽

Caterina Pollara ◽

Franco Gargiulo ◽

Mauro Giacomelli ◽

Arnaldo Caruso

Keyword(s):

Respiratory Syncytial Virus ◽

Influenza A ◽

Statistical Significance ◽

Respiratory Viruses ◽

Influenza Viruses ◽

Contact Tracing ◽

Nucleic Acid Detection ◽

Respiratory Pathogens ◽

Syncytial Virus ◽

Human Coronaviruses

Different preventive public health measures were adopted globally to limit the spread of SARS-CoV-2, such as hand hygiene and the use of masks, travel restrictions, social distance actions such as the closure of schools and workplaces, case and contact tracing, quarantine and lockdown. These measures, in particular physical distancing and the use of masks, might have contributed to containing the spread of other respiratory viruses that occurs principally by contact and droplet routes. The aim of this study was to evaluate the prevalence of different respiratory viruses (influenza viruses A and B, respiratory syncytial virus, parainfluenza viruses 1, 2, 3 and 4, rhinovirus, adenovirus, metapneumovirus and human coronaviruses) after one year of the pandemic. Furthermore, another aim was to evaluate the possible impact of these non-pharmaceutical measures on the circulation of seasonal respiratory viruses. This single center study was conducted between January 2017–February 2020 (pre-pandemic period) and March 2020–May 2021 (pandemic period). All adults >18 years with respiratory symptoms and tested for respiratory pathogens were included in the study. Nucleic acid detection of all respiratory viruses was performed by multiplex real time PCR. Our results show that the test positivity for influenza A and B, metapneumovirus, parainfluenza virus, respiratory syncytial virus and human coronaviruses decreased with statistical significance during the pandemic. Contrary to this, for adenovirus the decrease was not statistically significant. Conversely, a statistically significant increase was detected for rhinovirus. Coinfections between different respiratory viruses were observed during the pre-pandemic period, while the only coinfection detected during pandemic was between SARS-CoV-2 and rhinovirus. To understand how the preventive strategies against SARS-CoV-2 might alter the transmission dynamics and epidemic patterns of respiratory viruses is fundamental to guide future preventive recommendations.

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Influenza and RSV incidence during COVID-19 pandemic—an observational study from in-hospital point-of-care testing

Medical Microbiology and Immunology ◽

10.1007/s00430-021-00720-7 ◽

2021 ◽

Author(s):

Paul Stamm ◽

Ingo Sagoschen ◽

Kerstin Weise ◽

Bodo Plachter ◽

Thomas Münzel ◽

...

Keyword(s):

Emergency Room ◽

Influenza A ◽

Point Of Care ◽

Respiratory Viruses ◽

Pediatric Emergency ◽

Influenza B ◽

Complete Suppression ◽

Emergency Room Patients ◽

Syncytial Virus ◽

Point Of Care Tests

AbstractThe severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has forced the implementation of unprecedented public health measures strategies which might also have a significant impact on the spreading of other viral pathogens such as influenza and Respiratory Syncytial Virus (RSV) . The present study compares the incidences of the most relevant respiratory viruses before and during the SARS-CoV-2 pandemic in emergency room patients. We analyzed the results of in total 14,946 polymerase chain reaction point-of-care tests (POCT-PCR) for Influenza A, Influenza B, RSV and SARS-CoV-2 in an adult and a pediatric emergency room between December 1, 2018 and March 31, 2021. Despite a fivefold increase in the number of tests performed, the positivity rate for Influenza A dropped from 19.32% (165 positives of 854 tests in 2018/19), 14.57% (149 positives of 1023 in 2019–20) to 0% (0 positives of 4915 tests) in 2020/21. In analogy, the positivity rate for Influenza B and RSV dropped from 0.35 to 1.47%, respectively, 10.65–21.08% to 0% for both in 2020/21. The positivity rate for SARS-CoV2 reached 9.74% (110 of 1129 tests performed) during the so-called second wave in December 2020. Compared to the two previous years, seasonal influenza and RSV incidence was eliminated during the COVID-19 pandemic. Corona-related measures and human behavior patterns could lead to a significant decline or even complete suppression of other respiratory viruses such as influenza and RSV.

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