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Zhao P, Zhang Y, Wang J, Li Y, Wang Y, Gao Y, Zhao M, Zhao M, Tan H, Tie Y, Feng Z. Epidemiology of respiratory pathogens in patients with acute respiratory infections during the COVID-19 pandemic and after easing of COVID-19 restrictions. Microbiol Spectr 2024:e0116124. [PMID: 39320069 DOI: 10.1128/spectrum.01161-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Accepted: 08/19/2024] [Indexed: 09/26/2024] Open
Abstract
We aimed to investigate the epidemiological characteristics of non-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) respiratory pathogens among patients with acute respiratory infections (ARIs) in Shijiazhuang, China, during the coronavirus disease 2019 (COVID-19) pandemic (January 2021--December 2022) and after the relaxation of COVID-19 restrictive measures (January 2022--December 2023). This retrospective study enrolled 6,633 ARIs patients who visited the Hebei General Hospital between 2021- and 2023. Nasopharyngeal swabs samples were collected for multiplex PCR detection of 13 common respiratory pathogens. Respiratory pathogens were detected in 31.58% of individuals diagnosed with ARIs, whileereas a co-infection with multiple pathogens was observed in 8.5% of the ARI patients. In the years 2021 and 2022, 326 (27.63%) and 283 (24.38%) respiratory pathogens were found to be positive, respectively, during the COVID-19 pandemic. However, in 2023, subsequent to the easing of COVID-19 restrictions, the positivity rate significantly rose to 34.62%, with 4,292 cases identified. The majority of positive cases over the last three3 years were concentrated in patients under 14 years old. The predominant pathogens identified were human rhinovirus (HRVs) (15.08%) in 2021, mycoplasma pneumonia (MP) (6.46%) in 2022, and influenza A virus (FluA) (11.35%) in 2023. Seasonal prevalence patterns of most pathogens were affected, except for parainfluenza virus (PIV). There was a simultaneous increase in the positive cases and positivity rates of FluA and adenovirus (ADV) Iin 2023, compared to 2021 and 2022. Additionally, the infection rates of respiratory syncytial virus (RSV), MP, and coronavirus (CoV) in 2023 either exceeded or were comparable to those in 2021 and 2022. Conversely, the positivity rates of PIV, RVs, metapneumovirus (MPV), and influenza B virus (FluB) were lower in 2023 compared to 2021 or 2022. IMPORTANCE The implementation of strict non-pharmaceutical interventions (NPIs) during the coronavirus disease 2019 (COVID-19) pandemic may lead to changes in the epidemiological features of respiratory pathogens, as well as the occurrence of immune debt, potentially causing a resurgence in respiratory pathogen activity following the easing of strict NPIs measures. There are limited reports on the epidemiological characteristics of respiratory pathogens among patients of all ages with acute respiratory infections (ARIs) during the COVID-19 pandemic and after the easing of COVID-19 restrictions. Our study investigated the epidemiology of 13 respiratory pathogens in Shijiazhuang, China, from January 2021 to December 2023. Thisese data isare crucial for the ongoing surveillance of epidemiological shifts in respiratory pathogens during and post the -COVID-19 pandemic, and serves as a scientific foundation for the prevention and management of ARIs.
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Affiliation(s)
- Pei Zhao
- Department of Clinical Laboratory Diagnosis, Hebei Medical University, Shijiazhuang, Hebei, China
- Department of Clinical Laboratory, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Yu Zhang
- Department of Clinical Laboratory, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Jie Wang
- Department of Clinical Laboratory, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Yonghui Li
- Hebei Center for Disease Control and Prevention, Shijiazhuang, China
| | - Yuxin Wang
- Graduate School, Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yuan Gao
- Department of Clinical Laboratory, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Mengchuan Zhao
- Department of Clinical Laboratory, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Ming Zhao
- Department of Clinical Laboratory, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - He Tan
- Department of Clinical Laboratory, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Yanqing Tie
- Department of Clinical Laboratory, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - ZhiShan Feng
- Department of Clinical Laboratory Diagnosis, Hebei Medical University, Shijiazhuang, Hebei, China
- Department of Clinical Laboratory, Hebei General Hospital, Shijiazhuang, Hebei, China
- Hebei Key Laboratory of Molecular Medicine, Shijiazhuang, China
- Hebei Clinical Research Center for Laboratory Medicine, Shijiazhuang, China
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Gibbons AB, Elsafy R, Campbell A, Li E. Trends in orbital cellulitis severity and management: 2016 through 2022. Orbit 2024:1-8. [PMID: 39288096 DOI: 10.1080/01676830.2024.2397027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 08/21/2024] [Indexed: 09/19/2024]
Abstract
PURPOSE To characterize trends in orbital cellulitis (OC) severity and management from 2016 through 2022, including assessment of effects from the COVID-19 pandemic. METHODS A retrospective chart review was conducted at a tertiary care center using an electronic medical record search of OC from January 1 2016 to January 1 2023. Radiography was used to categorize patients into three cohorts - OC without abscess, OC with subperiosteal abscess (SPA), and OC with orbital abscess (OA). Infection cohort and age group [pediatric (<9 years old), adolescent (9-18 years), adult (>18 years)] were compared across years. Subgroup analysis was performed in the SPA cohort. Comparisons were made between the time periods prior to and after the start of the COVID-19 pandemic. RESULTS From 2016-2022, there were 247 (67.3%) cases of OC, 103 (28.1%) SPA, and 17 (4.6%) OA. The year 2022 incurred higher rates of SPA and OA (p = 0.035), pediatric infections (p = 0.008), and co-morbid sinusitis (p = 0.005) compared to all preceding years. Rates were similar from 2016 through 2021. Within the SPA cohort, rates of surgical intervention and outcomes were similar across all years. Rate of abscess formation was significantly higher during the COVID-19 pandemic compared to the pre-pandemic era (p = 0.033). CONCLUSION The severity of OC leading up to the COVID-19 pandemic appeared steady. After pandemic onset, a delayed increase in abscess formation, predominantly affecting pediatric patients and correlating with a greater rate of sinusitis, was observed in 2022.
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Affiliation(s)
- Alison B Gibbons
- School of Medicine, The Johns Hopkins University, Baltimore, Maryland, USA
| | - Ramy Elsafy
- School of Medicine, The Johns Hopkins University, Baltimore, Maryland, USA
| | - Ashley Campbell
- School of Medicine, The Johns Hopkins University, Baltimore, Maryland, USA
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA
| | - Emily Li
- School of Medicine, The Johns Hopkins University, Baltimore, Maryland, USA
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA
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Ammar S, Anglemyer A, Bennett J, Lees J, Addidle M, Morgan J, DuBray K, Galloway Y, Grey C, Duff P. Post-pandemic increase in invasive group A strep infections in New Zealand. J Infect Public Health 2024; 17:102545. [PMID: 39303459 DOI: 10.1016/j.jiph.2024.102545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 09/11/2024] [Accepted: 09/12/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND Since October 2022, multiple high-income countries have reported an increase in invasive group A streptococcal (iGAS) infections. This study describes trends in iGAS infections in Aotearoa New Zealand (NZ) between 2017 and 2023, and examines associations of iGAS incidence, COVID-19 eras, and acute respiratory infections (ARI). METHODS Analyses include national-level surveillance data on iGAS and ARI. Multivariable Poisson regression was used to examine relationships between COVID-19 era and iGAS incidence, and Pearson pairwise correlations were calculated to examine trends between ARI and iGAS. FINDINGS A sharp increase in iGAS was observed in 2023, with notable increases among children aged under ten years. Indigenous Māori and Pacific peoples were disproportionately affected. emm1 and emm12 were commonly reported in 2022-2023. Compared to pre-pandemic, iGAS decreased significantly during the COVID-19 restrictions era and increased once COVID-19 restrictions were relaxed, after adjusting for ethnicity, sex, and age. ARI was moderately correlated with iGAS (r = 0∙55) in 2022-2023. INTERPRETATION Though delayed, NZ's recent iGAS trends mirror those seen in the 2022/2023 multi-country iGAS surge. These findings expand existing research, suggesting a link between the easing of COVID-19 measures, increased ARI circulation, and the rise in iGAS. Continued and improved iGAS surveillance, is needed to better understand iGAS epidemiology and support public health response. iGAS in NZ will become notifiable in late 2024, which should help improve iGAS monitoring and support public health response. FUNDING This research received no specific funding, though iGAS surveillance and typing in NZ is funded by the Ministry of Health, which was not involved in the analysis, interpretation, design, or any aspect of this study. No authors were paid to write this manuscript.
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Affiliation(s)
- Sherif Ammar
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Andrew Anglemyer
- Institute of Environmental Science and Research, Wellington, New Zealand; Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
| | - Julie Bennett
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Julianna Lees
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Michael Addidle
- Institute of Environmental Science and Research, Wellington, New Zealand; Pathlab, Tauranga, New Zealand
| | - Julie Morgan
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Kara DuBray
- Department of Paediatrics, Dunedin Hospital, Dunedin, New Zealand
| | - Yvonne Galloway
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Corina Grey
- Pacific Health Data and Insights, Auckland District Health Board, Auckland, New Zealand
| | - Putu Duff
- Institute of Environmental Science and Research, Wellington, New Zealand
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Li T, Li X, Liu X, Dong L, Fu H, Lin F, Tang Y, Jin Z. Epidemiological trends in respiratory pathogens infections among children post-COVID-19: A cross-sectional study. Heliyon 2024; 10:e36809. [PMID: 39263168 PMCID: PMC11387333 DOI: 10.1016/j.heliyon.2024.e36809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Revised: 08/12/2024] [Accepted: 08/22/2024] [Indexed: 09/13/2024] Open
Abstract
Objective The aim of this study was to investigate the epidemiological trend of respiratory pathogens infections among children after the Coronavirus Disease 2019 (COVID-19) pandemic. Methods This study enrolled 575,373 children who came to our hospital for relevant respiratory pathogen antigen/antibody testing due to respiratory symptoms such as fever and cough. The demographic and laboratory data, including age, gender, testing time, and influenza A virus (IAV), influenza B virus (IBV), respiratory syncytial virus (RSV), adenovirus (ADV), and Mycoplasma pneumonia (MP) results, were collected from electronic medical records. SPSS (version 21.0) and GraphPad Prism 9 software were used for statistical analysis and figure creation. Results 79,746 children tested positive for IAV IgM, and 3196 children tested positive for IBV IgM, with an overall positive rate of 28.5 % for IAV and 1.1 % for IBV. IAV infections peaked at 21,502 cases in March 2023. 80,699 children underwent RSV IgM testing from April to October 2023, with 5726 (7.1 %) testing positive. The apex of RSV infections occurred in May 2023, with 2140 cases. Regarding ADV, 100,460 children underwent testing from April to October 2023, with 1981 (11.9 %) testing positive. The pinnacle of ADV infections reached 4546 cases in November 2023. Concerning MP, 474,913 children underwent MP testing, with 73,833 (15.5 %) testing positive. The zenith of MP infections occurred in November 2023, with 25,291 cases. Further analysis revealed that the outbreaks of these pathogens are occurring earlier than in previous years. Additionally, our data showed that children aged >3 years accounted for 79.6 %, 87.8 %, 88.6 %, and 77.8 % of the total IAV-positive, IBV-positive, ADV-positive, and MP-positive children, respectively. Conversely, RSV primarily infected children <6 years. Conclusion Various respiratory pathogens showed an epidemic trend in children among children post-COVID-19. These results indicated that we should pay timely attention to the epidemiological trends and characteristics of respiratory pathogens in children after the COVID-19 pandemic and provide relevant information for society and clinical practice.
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Affiliation(s)
- Tiewei Li
- Department of Clinical Laboratory, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou Key Laboratory of Children's Infection and Immunity, Zhengzhou, China
| | - Xiaojuan Li
- Department of Clinical Laboratory, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou Key Laboratory of Children's Infection and Immunity, Zhengzhou, China
| | - Xinrui Liu
- Department of Clinical Laboratory, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou Key Laboratory of Children's Infection and Immunity, Zhengzhou, China
| | - Lili Dong
- Department of Respiratory Medicine, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
| | - Hui Fu
- Department of Neonatal Medicine, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
| | - Fatao Lin
- Department of Neonatal Medicine, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
| | - Yu Tang
- Department of Respiratory Medicine, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
| | - Zhipeng Jin
- Pediatric Intensive Care Unit, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
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Li J, Yang J, Ding X, Zhou H, Han N, Wu A. The spatiotemporal analysis of SARS-CoV-2 transmission in China since the termination of the dynamic zero-COVID policy. Virol Sin 2024:S1995-820X(24)00142-1. [PMID: 39270985 DOI: 10.1016/j.virs.2024.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 09/09/2024] [Indexed: 09/15/2024] Open
Abstract
China's dynamic zero-COVID policy has effectively curbed the spread of SARS-CoV-2, while inadvertently creating immunity gaps within its population. Subsequent surges in COVID-19 cases linked to various SARS-CoV-2 lineages post-policy termination necessitate a thorough investigation into the epidemiological landscape. This study addresses this issue by analyzing a comprehensive dataset of 39,456 high-quality genomes collected nationwide over an 11-month period since policy termination. Through lineage assignment, phylogenetic analysis, pandemic pattern comparison, phylodynamic reconstruction, and recombination detection, we found that China's post-epidemic period could be divided into three stages, along with dynamic changes in dominant lineages. Geographical clustering of similar lineages implies the importance of cross-border cooperation among neighboring regions. Compared to the USA, UK, and Japan, China exhibits unique trajectories of lineage epidemics, characterized by initial lagging followed by subsequent advancement, indicating the potential influence of diverse prevention and control policies on lineage epidemic patterns. Hong Kong, Shanghai, and Hubei emerge as pivotal nodes in the nationwide spread, marking a shift in the transmission center from east to central regions of China. Although China hasn't experienced significant variant emergence, the detection and validation of the novel recombination event, XCN lineage, underscore the ongoing virus evolution. Overall, this study systematically analyzes the spatiotemporal transmission of SARS-CoV-2 virus in China since the termination of the dynamic zero-COVID policy, offering valuable insights for regional surveillance and evidence-based public health policymaking.
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Affiliation(s)
- Jiaying Li
- State Key Laboratory of Common Mechanism Research for Major Diseases, Suzhou Institute of Systems Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Suzhou 215123, Jiangsu, China
| | - Jingqi Yang
- State Key Laboratory of Common Mechanism Research for Major Diseases, Suzhou Institute of Systems Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Suzhou 215123, Jiangsu, China
| | - Xiao Ding
- State Key Laboratory of Common Mechanism Research for Major Diseases, Suzhou Institute of Systems Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Suzhou 215123, Jiangsu, China
| | - Hangyu Zhou
- State Key Laboratory of Common Mechanism Research for Major Diseases, Suzhou Institute of Systems Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Suzhou 215123, Jiangsu, China
| | - Na Han
- State Key Laboratory of Common Mechanism Research for Major Diseases, Suzhou Institute of Systems Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Suzhou 215123, Jiangsu, China
| | - Aiping Wu
- State Key Laboratory of Common Mechanism Research for Major Diseases, Suzhou Institute of Systems Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Suzhou 215123, Jiangsu, China.
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Nakata F, Matsubara K, Hamahata K, Miyakoshi C, Minamikawa S, Ota K, Okutani T, Yamaoka R, Eguchi J, Ueda I, Yokoyama N, Horinouchi T, Nukina S. Resurgence of Kawasaki Disease Following Relaxation of Coronavirus Disease 2019 Pandemic Restrictions in Japan. J Pediatr 2024; 275:114251. [PMID: 39181319 DOI: 10.1016/j.jpeds.2024.114251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 07/30/2024] [Accepted: 08/18/2024] [Indexed: 08/27/2024]
Abstract
OBJECTIVE To compare the number and incidence of Kawasaki disease (KD) patients in years 2 through 4 of the coronavirus disease 2019 pandemic, and determine the impact of 3 years of implementation of infection control measures and their subsequent relaxation on the epidemiology of KD in Japan. STUDY DESIGN We conducted a population-based, cohort study including consecutive KD patients in Kobe City between 2021 and 2023. We compared the incidence of KD cases, in relation to timing of infection control measures, as well as infectious disease cases based on a regional surveillance system. Data from a previous 2016 through 2020 study were used for comparison. RESULTS A total of 566 children with KD were identified during the study period. During the infection control period in 2021 to 2022, the incidence of KD remained low compared with the prepandemic level (281.3 and 327.5/100 000 children aged 0-4 years in 2021 to 2022 and 2016 through 2019, respectively), but a recovery trend began in the 0-1-year age group. During the relaxation period in 2023, the incidence of KD increased across a wide-age range, reaching the highest recorded in Japan (426.7/100 000 children aged 0-4 years), and the median age of onset increased to age 30 months. The resurgence of KD coincided with the epidemic patterns for multiple infectious diseases in 2023. The seasonality of KD observed before the pandemic was altered. CONCLUSIONS KD resurged in 2023 after relaxation of the prolonged coronavirus disease 2019 pandemic restrictions in Japan. This phenomenon coincided with the rise of multiple infectious diseases, and supports the pathogenesis of KD being triggered by infectious agents.
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Affiliation(s)
- Fumio Nakata
- Department of Pediatrics, Kobe City Nishi-Kobe Medical Center, Kobe, Japan
| | - Kousaku Matsubara
- Department of Pediatrics, Kobe City Nishi-Kobe Medical Center, Kobe, Japan.
| | - Keigo Hamahata
- Department of Pediatrics, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Chisato Miyakoshi
- Department of Research Support, Center for Clinical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Shogo Minamikawa
- Department of General Pediatrics, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Kunitaka Ota
- Department of Pediatrics, Konan Medical Center, Kobe, Japan
| | - Takahiro Okutani
- Department of Pediatrics, Saiseikai Hyogo-ken Hospital, Kobe, Japan
| | - Rika Yamaoka
- Department of Pediatrics, National Hospital Organization Kobe Medical Center, Kobe, Japan
| | - Junji Eguchi
- Department of Pediatrics, Kobe City Medical Center West Hospital, Kobe, Japan
| | - Ikuyo Ueda
- Department of Pediatrics, Japan Community Health Care Organization Kobe Central Hospital, Kobe, Japan
| | - Naoki Yokoyama
- Department of Pediatrics, Akashi Medical Center, Akashi, Japan
| | - Tomoko Horinouchi
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Sadayuki Nukina
- Department of Pediatrics, Akashi City Hospital, Akashi, Japan
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Zhang L. From imprecise "immune debt" to nuanced "immune shortage"? Infect Dis Now 2024; 54:104894. [PMID: 38548017 DOI: 10.1016/j.idnow.2024.104894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 03/25/2024] [Indexed: 04/01/2024]
Affiliation(s)
- Luwen Zhang
- School of Biological Sciences, Nebraska Center for Virology, University of Nebraska, Lincoln, NE 68583, USA.
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Boccard V, Prevost B, Denamur S, Peulier-Maitre E, Nathan N, Corvol H. Bronchiolitis: Increased severity in the post-COVID-19 era. Pediatr Pulmonol 2024. [PMID: 38990099 DOI: 10.1002/ppul.27172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 06/18/2024] [Accepted: 07/03/2024] [Indexed: 07/12/2024]
Abstract
INTRODUCTION Acute bronchiolitis is a pressing public health concern, leading to numerous infant hospitalizations worldwide annually. The notable decrease in bronchiolitis hospitalizations during the COVID-19 pandemic sparked concerns about a potential resurgence post-pandemic. Questions also arose about the severity of post-pandemic cases compared to prepandemic ones. This study aimed to compare bronchiolitis severity before and after the COVID-19 pandemic, alongside changes in the epidemiology of bronchiolitis viral agents. MATERIAL AND METHODS We conducted a retrospective analysis of medical records concerning infants under 12 months hospitalized for acute bronchiolitis in our pediatric pulmonology department over a period of 5 years: 2 pre-COVID years (2018-2020), the COVID year (2020), and 2 post-COVID years (2021-2023). Clinical and laboratory data were collected using standardized forms. RESULTS Hospital admissions exhibited comparable rates pre- and post-COVID but witnessed a decline during the COVID period. Post-COVID, bronchiolitis severity increased, with longer hospitalization durations (p < 0.001) and increased oxygen therapy (p = 0.04), coinciding with a surge in the prevalence of RSV infections (p = 0.01). Patients testing positive for RSV were significantly younger (p = 0.005) and exhibited more severe symptoms. DISCUSSION AND CONCLUSION This study reveals a significant increase in bronchiolitis severity and a rise in RSV cases following the COVID pandemic. The implementation of preventive measures such as nirsevimab is crucial to alleviate the burden of respiratory illnesses in vulnerable populations. Continued vigilance and research are needed to address the evolving challenges of bronchiolitis in the post-COVID era.
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Affiliation(s)
- Victorine Boccard
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Trousseau, Service de Pneumologie Pédiatrique, Centre de Référence des Maladies Respiratoires Rares RespiRare, Paris, France
- Sorbonne Université, Centre de Recherche Saint-Antoine (CRSA), Inserm UMR_S938, Paris, France
| | - Blandine Prevost
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Trousseau, Service de Pneumologie Pédiatrique, Centre de Référence des Maladies Respiratoires Rares RespiRare, Paris, France
- Sorbonne Université, Centre de Recherche Saint-Antoine (CRSA), Inserm UMR_S938, Paris, France
| | - Sophie Denamur
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Trousseau, Service de Pneumologie Pédiatrique, Centre de Référence des Maladies Respiratoires Rares RespiRare, Paris, France
- Sorbonne Université, Centre de Recherche Saint-Antoine (CRSA), Inserm UMR_S938, Paris, France
| | - Elora Peulier-Maitre
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Trousseau, Service de Pneumologie Pédiatrique, Centre de Référence des Maladies Respiratoires Rares RespiRare, Paris, France
- Sorbonne Université, Centre de Recherche Saint-Antoine (CRSA), Inserm UMR_S938, Paris, France
| | - Nadia Nathan
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Trousseau, Service de Pneumologie Pédiatrique, Centre de Référence des Maladies Respiratoires Rares RespiRare, Paris, France
- Sorbonne Université, Laboratory of Childhood Genetic Diseases, Inserm UMR_S933, Paris, France
| | - Harriet Corvol
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Trousseau, Service de Pneumologie Pédiatrique, Centre de Référence des Maladies Respiratoires Rares RespiRare, Paris, France
- Sorbonne Université, Centre de Recherche Saint-Antoine (CRSA), Inserm UMR_S938, Paris, France
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Martignoni MM, Raulo A, Linkovski O, Kolodny O. SIR+ models: accounting for interaction-dependent disease susceptibility in the planning of public health interventions. Sci Rep 2024; 14:12908. [PMID: 38839831 PMCID: PMC11153654 DOI: 10.1038/s41598-024-63008-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 05/23/2024] [Indexed: 06/07/2024] Open
Abstract
Avoiding physical contact is regarded as one of the safest and most advisable strategies to follow to reduce pathogen spread. The flip side of this approach is that a lack of social interactions may negatively affect other dimensions of health, like induction of immunosuppressive anxiety and depression or preventing interactions of importance with a diversity of microbes, which may be necessary to train our immune system or to maintain its normal levels of activity. These may in turn negatively affect a population's susceptibility to infection and the incidence of severe disease. We suggest that future pandemic modelling may benefit from relying on 'SIR+ models': epidemiological models extended to account for the benefits of social interactions that affect immune resilience. We develop an SIR+ model and discuss which specific interventions may be more effective in balancing the trade-off between minimizing pathogen spread and maximizing other interaction-dependent health benefits. Our SIR+ model reflects the idea that health is not just the mere absence of disease, but rather a state of physical, mental and social well-being that can also be dependent on the same social connections that allow pathogen spread, and the modelling of public health interventions for future pandemics should account for this multidimensionality.
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Affiliation(s)
- Maria M Martignoni
- Department of Ecology, Evolution and Behavior, Faculty of Sciences, A. Silberman Institute of Life Sciences, Hebrew University of Jerusalem, Jerusalem, Israel.
| | - Aura Raulo
- Department of Biology, University of Oxford, Oxford, UK
- Department of Computing, University of Turku, Turku, Finland
| | - Omer Linkovski
- Department of Psychology and The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat-Gan, Israel
| | - Oren Kolodny
- Department of Ecology, Evolution and Behavior, Faculty of Sciences, A. Silberman Institute of Life Sciences, Hebrew University of Jerusalem, Jerusalem, Israel
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Fitzpatrick T, Buchan SA, Mahant S, Fu L, Kwong JC, Stukel TA, Guttmann A. Pediatric Respiratory Syncytial Virus Hospitalizations, 2017-2023. JAMA Netw Open 2024; 7:e2416077. [PMID: 38861259 PMCID: PMC11167505 DOI: 10.1001/jamanetworkopen.2024.16077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 03/29/2024] [Indexed: 06/12/2024] Open
Abstract
Importance Respiratory syncytial virus (RSV) transmission was disrupted worldwide following the COVID-19 pandemic, and further study is required to better understand these changes. Objective To compare observed and expected RSV hospital and intensive care unit (ICU) admission rates and characteristics of admitted children during the 2021-2022 and 2022-2023 seasons. Design, Setting, and Participants A population-based cohort study of all children aged younger than 5 years in Ontario, Canada, July 1, 2017, through March 31, 2023, was conducted. Exposures Individual and neighborhood-level sociodemographic and clinical characteristics were identified from administrative data, including age, palivizumab eligibility, complex medical conditions, rurality, and living in a marginalized neighborhood. Main Outcomes and Measures The main outcome was RSV-associated hospitalization. Secondary outcomes included ICU admissions, mechanical ventilation, extracorporeal membrane oxygenation, and in-hospital death. Poisson generalized estimating equations were used to model weekly age- and sex-specific hospitalization rates and estimate expected rates in the postpandemic era; adjusted rate ratios (RRs) and 95% CIs are reported. Results This cohort study included approximately 700 000 children per study year. Compared with prepandemic years (2017-2018, 2018-2019, and 2019-2020), the 2021-2022 RSV season peaked slightly earlier, but overall admission rates were comparable (289.1 vs 281.4-334.6 per 100 000, or approximately 2000 admissions). The 2022-2023 season peaked a month earlier and resulted in more than twice as many hospitalizations (770.0 per 100 000; n = 4977 admissions). The proportion of children admitted to an ICU in 2022-2023 (13.9%) was slightly higher than prepandemic (9.6%-11.4%); however, the population-based rate was triple the prepandemic levels (106.9 vs 27.6-36.6 per 100 000 children in Ontario). With the exception of palivizumab-eligible children, all sociodemographic and health status characteristics were associated with lower-than-expected RSV hospitalization rates in 2021-2022. In contrast, older age of patients was associated with higher-than-expected rates in 2022-2023 (ie, 24-59 months: RR, 1.90; 95% CI, 1.35-2.66). Conclusions and Relevance There were notable differences in RSV epidemiologic characteristics in Ontario following the COVID-19 pandemic. It is not yet clear whether and how long atypical RSV epidemics may persist. Clinicians and program planners should consider the potential for ongoing impacts to health care capacity and RSV immunization programs.
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Affiliation(s)
- Tiffany Fitzpatrick
- Public Health Ontario, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | - Sarah A. Buchan
- Public Health Ontario, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Sanjay Mahant
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Jeffrey C. Kwong
- Public Health Ontario, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- University Health Network, Toronto, Ontario, Canada
| | - Therese A. Stukel
- ICES, Toronto, Ontario, Canada
- Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Astrid Guttmann
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
- Edwin S. H. Leong Centre for Healthy Children, University of Toronto, Toronto, Ontario, Canada
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11
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Winthrop ZA, Perez JM, Staffa SJ, McManus ML, Duvall MG. Pediatric Respiratory Syncytial Virus Hospitalizations and Respiratory Support After the COVID-19 Pandemic. JAMA Netw Open 2024; 7:e2416852. [PMID: 38869896 PMCID: PMC11177168 DOI: 10.1001/jamanetworkopen.2024.16852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 04/15/2024] [Indexed: 06/14/2024] Open
Abstract
Importance After the COVID-19 pandemic, there was a surge of pediatric respiratory syncytial virus (RSV) infections, but national data on hospitalization and intensive care unit use and advanced respiratory support modalities have not been reported. Objective To analyze demographics, respiratory support modes, and clinical outcomes of children with RSV infections at tertiary pediatric hospitals from 2017 to 2023. Design, Setting, and Participants This cross-sectional study evaluated children from 48 freestanding US children's hospitals registered in the Pediatric Health Information System (PHIS) database. Patients 5 years or younger with RSV from July 1, 2017, to June 30, 2023, were included. Each season was defined from July 1 to June 30. Prepandemic RSV seasons included 2017 to 2018, 2018 to 2019, and 2019 to 2020. The postpandemic season was delineated as 2022 to 2023. Exposure Hospital presentation with RSV infection. Main Outcomes and Measures Data on emergency department presentations, hospital or intensive care unit admission and length of stay, demographics, respiratory support use, mortality, and cardiopulmonary resuscitation were analyzed. Postpandemic season data were compared with prepandemic seasonal averages. Results A total of 288 816 children aged 5 years or younger (median [IQR] age, 8.9 [3.3-21.5] months; 159 348 [55.2%] male) presented to 48 US children's hospitals with RSV from July 1, 2017, to June 30, 2023. Respiratory syncytial virus hospital presentations increased from 39 698 before the COVID-19 pandemic to 94 347 after the pandemic (P < .001), with 86.7% more hospitalizations than before the pandemic (50 619 vs 27 114; P < .001). In 2022 to 2023, children were older (median [IQR] age, 11.3 [4.1-26.6] months vs 6.8 [2.6-16.8] months; P < .001) and had fewer comorbidities (17.6% vs 21.8% of hospitalized patients; P < .001) than during prepandemic seasons. Advanced respiratory support use increased 70.1% in 2022 to 2023 (9094 vs 5340; P < .001), and children requiring high-flow nasal cannula (HFNC) or noninvasive ventilation (NIV) were older than during prepandemic seasons (median [IQR] age for HFNC, 6.9 [2.7-16.0] months vs 4.6 [2.0-11.7] months; for NIV, 6.0 [2.1-16.5] months vs 4.3 [1.9-11.9] months). Comorbid conditions were less frequent after the pandemic across all respiratory support modalities (HFNC, 14.9% vs 19.1%, NIV, 22.0% vs 28.5%, invasive mechanical ventilation, 30.5% vs 38.0%; P < .001). Conclusions and Relevance This cross-sectional study identified a postpandemic pediatric RSV surge that resulted in markedly increased hospital volumes and advanced respiratory support needs in older children with fewer comorbidities than prepandemic seasons. These clinical trends may inform novel vaccine allocation to reduce the overall burden during future RSV seasons.
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Affiliation(s)
- Zachary A. Winthrop
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - Jennifer M. Perez
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - Steven J. Staffa
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - Michael L. McManus
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - Melody G. Duvall
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts
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12
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d'Humières C, Fouillet A, Verdurme L, Lakoussan SB, Gallien Y, Coignard C, Hervo M, Ebel A, Soares A, Visseaux B, Maire B, Juan PH, Parent du Châtelet I, Guthmann JP, Durand J. An unusual outbreak of parvovirus B19 infections, France, 2023 to 2024. Euro Surveill 2024; 29:2400339. [PMID: 38904112 PMCID: PMC11191415 DOI: 10.2807/1560-7917.es.2024.29.25.2400339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 06/20/2024] [Indexed: 06/22/2024] Open
Abstract
From April 2023 to May 2024, an unusual epidemic of parvovirus B19 (B19V) infections occurred in France. The number of B19V IgM-positive serologies was four times higher than in the previous epidemic in 2019. Clinical data from emergency networks corroborated this observation. Morbidity and mortality consequences were observed in children through all data sources. In adults, the increase was only observed in laboratory-confirmed data. Physicians and decisionmakers should be informed in order to better prevent, diagnose and manage at-risk patients.
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Affiliation(s)
- Camille d'Humières
- These authors contributed equally to this work and share first authorship
- Laboratoire Cerba, Frépillon, France
| | - Anne Fouillet
- These authors contributed equally to this work and share first authorship
- Santé Publique France, Saint Maurice, France
| | | | | | | | | | | | - Anne Ebel
- Laboratoire Eurofins Biomnis, Ivry sur Seine, France
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13
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Poague KIHM, Blanford JI, Martínez JA, Anthonj C. Preparing schools for future pandemics: Insights on water, sanitation and hygiene solutions from the Brazilian school reopening policies. Int J Hyg Environ Health 2024; 257:114325. [PMID: 38330729 DOI: 10.1016/j.ijheh.2024.114325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/04/2024] [Accepted: 01/25/2024] [Indexed: 02/10/2024]
Abstract
Post-COVID-19, schools urgently need to enhance infection control and prevention (IPC) measures, including water, sanitation, and hygiene (WASH), to prepare for future outbreaks and pandemics. Particularly in Brazil, that is of particular concern, as students are still recovering from the 20th longest school closure in the world. Hence, the current study had two goals: (i) to describe WASH solutions outlined in policies released at the federal, state, and capital city levels in Brazil during the COVID-19 pandemic for the safe reopening of schools and (ii) to discuss their potential to enhance school's capacity to remain operational during a new pandemic or outbreak. With a qualitative exploratory approach, we performed content analysis to discuss the direction (what, where, how and for whom?) of 66 public policies by integrating four frameworks. Solutions were discussed in the light of the principles of human rights and the human rights to water and sanitation, international guidelines for WASH and IPC in schools and the Sphere minimum standards for humanitarian aid. One hundred and fifty-nine solutions, spanning five thematic areas and five population groups, including software and hardware interventions, were compiled for potential use in Brazil and beyond. While suggested solutions have the potential to provide a cleaner and safer learning environment, it is essential to exercise caution when implementing these measures and adapt them to the specific circumstances of each school.
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Affiliation(s)
- Kasandra I H M Poague
- Faculty of Geo-Information Science and Earth Observation-ITC, University of Twente, Enschede, the Netherlands.
| | - Justine I Blanford
- Faculty of Geo-Information Science and Earth Observation-ITC, University of Twente, Enschede, the Netherlands
| | - Javier A Martínez
- Faculty of Geo-Information Science and Earth Observation-ITC, University of Twente, Enschede, the Netherlands
| | - Carmen Anthonj
- Faculty of Geo-Information Science and Earth Observation-ITC, University of Twente, Enschede, the Netherlands
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14
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Wolters M, Berinson B, Degel-Brossmann N, Hoffmann A, Bluszis R, Aepfelbacher M, Rohde H, Christner M. Population of invasive group A streptococci isolates from a German tertiary care center is dominated by the hypertoxigenic virulent M1 UK genotype. Infection 2024; 52:667-671. [PMID: 38064158 PMCID: PMC10954911 DOI: 10.1007/s15010-023-02137-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 11/04/2023] [Indexed: 03/21/2024]
Abstract
PURPOSE Hypertoxigenic Streptococcus pyogenes emm1 lineage M1UK has recently been associated with upsurges of invasive infections and scarlet fever in several countries, but whole-genome sequencing surveillance data of lineages circulating in Germany is lacking. In this study, we investigated recent iGAS isolates from our laboratory at a German tertiary care center for the presence of the M1UK lineage. METHODS Whole-genome sequencing was employed to characterize a collection of 47 consecutive non-copy isolates recovered from blood cultures (21) and tissue samples (26) in our laboratory between October 2022 and April 2023. RESULTS M protein gene (emm) typing distinguished 14 different emm types, with emm1 (17) being the dominant type. Single-nucleotide polymorphism (SNP) analysis confirmed the presence of all 27 SNPs characteristic for the M1UK lineage in 14 of 17 emm1 isolates. CONCLUSION This study has shown for the first time that M1UK is present in Germany and might constitute a driving force in the observed surge of GAS infections. This observation mirrors developments in the UK and other countries and underscores the importance of WGS surveillance to understand the epidemiology of GAS.
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Affiliation(s)
- Manuel Wolters
- Institut für Medizinische Mikrobiologie, Virologie und Hygiene, Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistrasse 52, 20246, Hamburg, Germany
| | - Benjamin Berinson
- Institut für Medizinische Mikrobiologie, Virologie und Hygiene, Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistrasse 52, 20246, Hamburg, Germany
| | - Nicole Degel-Brossmann
- Institut für Medizinische Mikrobiologie, Virologie und Hygiene, Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistrasse 52, 20246, Hamburg, Germany
| | - Armin Hoffmann
- Institut für Medizinische Mikrobiologie, Virologie und Hygiene, Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistrasse 52, 20246, Hamburg, Germany
| | - Rico Bluszis
- Institut für Medizinische Mikrobiologie, Virologie und Hygiene, Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistrasse 52, 20246, Hamburg, Germany
| | - Martin Aepfelbacher
- Institut für Medizinische Mikrobiologie, Virologie und Hygiene, Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistrasse 52, 20246, Hamburg, Germany
| | - Holger Rohde
- Institut für Medizinische Mikrobiologie, Virologie und Hygiene, Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistrasse 52, 20246, Hamburg, Germany.
| | - Martin Christner
- Institut für Medizinische Mikrobiologie, Virologie und Hygiene, Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistrasse 52, 20246, Hamburg, Germany
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15
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Suss RJ, Simões EAF. Respiratory Syncytial Virus Hospital-Based Burden of Disease in Children Younger Than 5 Years, 2015-2022. JAMA Netw Open 2024; 7:e247125. [PMID: 38635270 DOI: 10.1001/jamanetworkopen.2024.7125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2024] Open
Abstract
Importance Respiratory syncytial virus (RSV) resurgences have been noted following the COVID-19 pandemic in many countries. Recent findings suggest that the 2021 and 2022 RSV seasons were more severe than in past seasons, and age distribution may have shifted toward older children in the younger than 5 years age group. Objectives To estimate age-specific changes in RSV hospital-based burden of disease before and after the COVID-19 pandemic and to compare incidence by Medicaid use. Design, Setting, and Participants This retrospective cohort study included children younger than 5 years diagnosed with RSV and bronchiolitis at 50 US children's hospitals in 10 US geographic regions. The included participants had an encounter in intensive care, inpatient, emergency, or observational units, between June 1, 2015, and March 31, 2023. Exposures Diagnosis of RSV, bronchiolitis, or both at encounter. Main Outcome and Measures Incidence rate ratio of hospital use within each care unit before vs after the COVID-19 pandemic. It was hypothesized a priori that incidence of hospital use would increase overall in 2021 and 2022 compared with 2015 to 2019 and that the increase would be greater among children 12 months and older. Results Of 924 061 study participants (median [IQR] age, 8 (5-16) months; 535 619 [58.0%] male), 348 077 (37.7%) were diagnosed with RSV. Of these, 187 850 (54.0%) were hospitalized. Incidence rate ratios of hospitalization increased for all ages in 2021 and 2022 compared with 2015 to 2019. Children aged 24 to 59 months were 4.86 (95% CI, 4.75-4.98) times as likely to be hospitalized in 2022 compared with 2015 to 2019, whereas infants aged 0 to 5 months were 1.77 (95% CI, 1.74-1.80) times as likely. Medicaid patients were more likely to be hospitalized than non-Medicaid patients regardless of year. Conclusions and Relevance Hospitalizations for RSV and bronchiolitis demonstrated atypical seasonality in 2021 and 2022, with an overall increase in RSV encounters. Postpandemic RSV hospitalization increased for all ages, but especially among older children, whereas bronchiolitis hospitalization was decreased or unchanged compared with earlier seasons. These findings suggest some of the observed increase in RSV hospital use may be due to increased testing.
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Affiliation(s)
- Robert J Suss
- Department of Pediatric Infectious Diseases, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora
| | - Eric A F Simões
- Department of Pediatric Infectious Diseases, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora
- Center for Global Health, Department of Epidemiology, Colorado School of Public Health, Aurora
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16
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Ferrari ACF, Giani E, Scaramuzza AE, Cutuli V, Giambarda M, Rota F, Verderio C, Cimardi L, Fumagalli G, Soliani M, Drera BA, Testa S, Cavalli C. The risk of hospitalisation from RSV is not increased by co-infection in children under 24-months-of-age. Eur J Pediatr 2024; 183:1943-1945. [PMID: 38244041 DOI: 10.1007/s00431-024-05440-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/12/2024] [Accepted: 01/15/2024] [Indexed: 01/22/2024]
Abstract
The recent pandemic prompted renewed interest in paediatric respiratory infections, including whether co-infections - particularly with RSV - have an adverse prognostic impact. We evaluated the charts of all children presenting with respiratory symptoms to our unit between October 2022 and April 2023, each of whom was subjected to a multiplex PCR assay to detect eight viral targets and one bacterial target and examine the relationships between mono- and co-infections and hospitalization outcomes. We observed that younger age and RSV infection were both associated with the need for hospitalisation and the duration of hospitalisation after adjusting for confounders. Co-infection was, however, not associated with these outcomes. Conclusion: This real-world data add to a growing consensus that RSV increases the risk of hospitalisation, while other co-infections, except for co-infection with SARS-CoV-2, do not. Given the timeframe over which our study was conducted, only a few children had SARS-CoV-2 co-infection, so we could not confirm any significant effect from this interaction. What is Known: • RSV increases the risk of hospitalisation and the need tor ventilatory support, especially in very young children. What is New: • Younger age and RSV infection were both associated with the need for hospitalisation and the duration of hospitalisation after adjusting for confounders. • Co-infection was, however, not associated with these outcomes.
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Affiliation(s)
| | - Elisa Giani
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Andrea Enzo Scaramuzza
- Department of Paediatrics, ASST Cremona, Maggiore Hospital, Ospedale Maggiore, Viale Concordia 1, 26100, Cremona, Italy.
| | - Vera Cutuli
- Postgraduate School of Paediatrics, University of Brescia, Brescia, Italy
| | - Martina Giambarda
- Postgraduate School of Paediatrics, University of Brescia, Brescia, Italy
| | - Francesca Rota
- Postgraduate School of Paediatrics, University of Brescia, Brescia, Italy
| | - Cecilia Verderio
- Postgraduate School of Paediatrics, University of Brescia, Brescia, Italy
| | - Leonardo Cimardi
- Department of Laboratory Medicine-Haemostasis and Thrombosis Centre, ASST Cremona, Maggiore Hospital, Cremona, Italy
| | - Gloria Fumagalli
- Department of Paediatrics, ASST Cremona, Maggiore Hospital, Ospedale Maggiore, Viale Concordia 1, 26100, Cremona, Italy
| | - Martina Soliani
- Department of Paediatrics, ASST Cremona, Maggiore Hospital, Ospedale Maggiore, Viale Concordia 1, 26100, Cremona, Italy
| | - Bruno Angelo Drera
- Department of Neonatal Intensive Care Unit, ASST Cremona, Maggiore Hospital, Cremona, Italy
| | - Sophie Testa
- Department of Laboratory Medicine-Haemostasis and Thrombosis Centre, ASST Cremona, Maggiore Hospital, Cremona, Italy
| | - Claudio Cavalli
- Department of Paediatrics, ASST Cremona, Maggiore Hospital, Ospedale Maggiore, Viale Concordia 1, 26100, Cremona, Italy
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Messacar K, Matzinger S, Berg K, Weisbeck K, Butler M, Pysnack N, Nguyen-Tran H, Davizon ES, Bankers L, Jung SA, Birkholz M, Wheeler A, Dominguez SR. Multimodal Surveillance Model for Enterovirus D68 Respiratory Disease and Acute Flaccid Myelitis among Children in Colorado, USA, 2022. Emerg Infect Dis 2024; 30:423-431. [PMID: 38407198 PMCID: PMC10902548 DOI: 10.3201/eid3003.231223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Abstract
Surveillance for emerging pathogens is critical for developing early warning systems to guide preparedness efforts for future outbreaks of associated disease. To better define the epidemiology and burden of associated respiratory disease and acute flaccid myelitis (AFM), as well as to provide actionable data for public health interventions, we developed a multimodal surveillance program in Colorado, USA, for enterovirus D68 (EV-D68). Timely local, state, and national public health outreach was possible because prospective syndromic surveillance for AFM and asthma-like respiratory illness, prospective clinical laboratory surveillance for EV-D68 among children hospitalized with respiratory illness, and retrospective wastewater surveillance led to early detection of the 2022 outbreak of EV-D68 among Colorado children. The lessons learned from developing the individual layers of this multimodal surveillance program and how they complemented and informed the other layers of surveillance for EV-D68 and AFM could be applied to other emerging pathogens and their associated diseases.
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18
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Li Y, Wu Z, Yan Y, Shi Y, Huang J, Du H, Du Q, Li Y, Lin Y, Liu D, Lu X. Prevalence of respiratory viruses among hospitalized children with lower respiratory tract infections during the COVID-19 pandemic in Wuhan, China. Int J Infect Dis 2024; 139:6-12. [PMID: 37984762 DOI: 10.1016/j.ijid.2023.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 11/14/2023] [Accepted: 11/15/2023] [Indexed: 11/22/2023] Open
Abstract
OBJECTIVES We aimed to investigate the continuous changes in respiratory virus epidemics in hospitalized children with lower respiratory tract infections (LRTIs) persisting from January 2019 to December 2022 in Wuhan, China. METHODS We retrospectively enrolled children with LRTIs admitted to the Wuhan Children's Hospital. Specimens were nasopharyngeal aspirates which had been collected and detected the following microorganisms with direct immunofluorescence: influenza virus types A and B, respiratory syncytial virus, parainfluenza virus types 1-3, and adenovirus. We also analyzed demographic data and laboratory test results. RESULTS A total of 22,660 patients were enrolled. The total virus detection rate in 2019, 2021, and 2022 significantly declined gradually (36.96% vs 29.47% vs 22.62%, P value < 0.001). All the detected viruses did not follow previously observed seasonal patterns during the COVID-19 pandemic. Children hospitalized for LRTIs were older during the COVID-19 pandemic in contrast to the pre-period, particularly notable in cases attributed to respiratory syncytial virus and parainfluenza virus type 3 infections. CONCLUSIONS This work adds to our knowledge of the epidemiology characteristics of respiratory viruses spanning the COVID-19 pandemic among children with LRTIs. The circulation of respiratory viruses changed consistently, and active LRTI surveillance in children remains critical for defining the healthcare burden of respiratory viruses.
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Affiliation(s)
- Ying Li
- Department of Respiratory Medicine, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Pediatric Respiratory Disease Laboratory, Institute of Maternal and Child Health, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; CAS Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan China; Computational Virology Group, Center for Bacteria and Viruses Resources and Bioinformation, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan China; University of Chinese Academy of Sciences, Beijing, 101409, China
| | - Zhiyong Wu
- CAS Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan China; Computational Virology Group, Center for Bacteria and Viruses Resources and Bioinformation, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan China; University of Chinese Academy of Sciences, Beijing, 101409, China
| | - Yi Yan
- CAS Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan China; Computational Virology Group, Center for Bacteria and Viruses Resources and Bioinformation, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan China
| | - Yue Shi
- CAS Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan China; Computational Virology Group, Center for Bacteria and Viruses Resources and Bioinformation, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan China
| | - Jiaming Huang
- CAS Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan China; Computational Virology Group, Center for Bacteria and Viruses Resources and Bioinformation, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan China; University of Chinese Academy of Sciences, Beijing, 101409, China
| | - Hui Du
- Department of Respiratory Medicine, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Pediatric Respiratory Disease Laboratory, Institute of Maternal and Child Health, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qing Du
- Department of Respiratory Medicine, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Pediatric Respiratory Disease Laboratory, Institute of Maternal and Child Health, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yang Li
- Department of Respiratory Medicine, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Pediatric Respiratory Disease Laboratory, Institute of Maternal and Child Health, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yaxin Lin
- Department of Respiratory Medicine, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Pediatric Respiratory Disease Laboratory, Institute of Maternal and Child Health, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Di Liu
- CAS Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan China; Computational Virology Group, Center for Bacteria and Viruses Resources and Bioinformation, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan China; University of Chinese Academy of Sciences, Beijing, 101409, China
| | - Xiaoxia Lu
- Department of Respiratory Medicine, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Pediatric Respiratory Disease Laboratory, Institute of Maternal and Child Health, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Salem Y, Jakob J, Steinberg R, Gorlanova O, Fuchs O, Müller L, Usemann J, Frey U, Latzin P, Yammine S. Cohort Profile Update: The Bern Basel Infant Lung Development Cohort. Int J Epidemiol 2024; 53:dyad164. [PMID: 38061036 DOI: 10.1093/ije/dyad164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 12/05/2023] [Indexed: 02/12/2024] Open
Affiliation(s)
- Yasmin Salem
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Julian Jakob
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Ruth Steinberg
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Graduate School for Biomedical Science, University of Bern, Bern, Switzerland
| | - Olga Gorlanova
- University Children's Hospital Basel (UKBB), Basel, Switzerland
| | - Oliver Fuchs
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Allergology, Department of Medicine, Lucerne Cantonal Hospital and University of Lucerne, Lucerne, Switzerland
| | - Loretta Müller
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Jakob Usemann
- University Children's Hospital Basel (UKBB), Basel, Switzerland
| | - Urs Frey
- University Children's Hospital Basel (UKBB), Basel, Switzerland
| | - Philipp Latzin
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sophie Yammine
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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20
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Li T, Chu C, Wei B, Lu H. Immunity debt: Hospitals need to be prepared in advance for multiple respiratory diseases that tend to co-occur. Biosci Trends 2024; 17:499-502. [PMID: 38072445 DOI: 10.5582/bst.2023.01303] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
As SARS-CoV-2 transitions from a pandemic to an endemic presence, a significant rise in respiratory diseases such as influenza and Mycoplasma pneumonia is challenging healthcare systems weakened by the impact of COVID-19. This commentary examines the global resurgence of respiratory pathogens, heightened by the post-pandemic "immunity debt", through an analysis of WHO surveillance data and national health reports. Findings reveal a substantial increase in respiratory illnesses, notably among children, compounded by a shortage of pediatricians and growing antimicrobial resistance. This underscores the need to improve hospital preparedness, optimize clinical responses, and enhance public health strategies to effectively navigate the impending peak of concurrent respiratory infections.
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Affiliation(s)
- Ting Li
- Department of Infectious Diseases, National Clinical Research Center for Infectious Diseases, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong, China
- Centre for Environment and Population Health, School of Medicine and Dentistry, Griffith University, Brisbane, Australia
| | - Cordia Chu
- Centre for Environment and Population Health, School of Medicine and Dentistry, Griffith University, Brisbane, Australia
| | - Biying Wei
- Department of Infectious Diseases, National Clinical Research Center for Infectious Diseases, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong, China
| | - Hongzhou Lu
- Department of Infectious Diseases, National Clinical Research Center for Infectious Diseases, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong, China
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21
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Timbrook TT, Glancey M, Noble BA, Eng S, Heins Z, Hommel B, Tessonneau M, Galvin BW, Macalino G. The epidemiology of pediatric outpatient acute respiratory tract infections in the US: a multi-facility analysis of multiplex PCR testing from 2018 to 2023. Microbiol Spectr 2024; 12:e0342323. [PMID: 38095469 PMCID: PMC10782947 DOI: 10.1128/spectrum.03423-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 11/20/2023] [Indexed: 01/13/2024] Open
Abstract
IMPORTANCE Post-pandemic, it is essential to understand the epidemiology of pediatric acute respiratory tract infections (ARTIs). Our multi-facility study elucidates the outpatient epidemiology of pediatric ARTI using highly multiplexed PCR testing, providing critical insights into the evolving landscape of the etiological agents with a particular focus on the years following the emergence of SARS-CoV-2. Utilizing data from two different multiplex PCR panels, our research provides a comprehensive analysis of respiratory pathogen positivity from 2018 to 2023. Our findings indicate that over half of the annual test results identified at least one pathogen, primarily of viral origin. Intriguingly, despite the surge in testing during the COVID-19 pandemic, pathogen detection rates remain similar to the pre-pandemic era. These data hold significant implications for directing antimicrobial stewardship strategies, curbing unnecessary antibiotic use in pediatric respiratory diseases, and the value of multiplex PCR testing in the outpatient setting among pediatrics.
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Affiliation(s)
- Tristan T. Timbrook
- Global Medical Affairs, bioMérieux, Salt Lake City, Utah, USA
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, Utah, USA
| | | | | | - Stephen Eng
- Baker Tilly US, LLP, New York, New York, USA
| | - Zoe Heins
- Global Medical Affairs, bioMérieux, Salt Lake City, Utah, USA
| | | | - Marie Tessonneau
- Baker Tilly US, LLP, New York, New York, USA
- Global Medical Affairs, bioMérieux, Marcy l'Étoile, France
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22
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AlBahrani S, Al Otaibi TO, Alqahtani JS, AlZahrani SJ, Sharbini DA, AlMuyidi FW, Alotaibi AO, Olayan OAA, AlMasoud SF, Bo Obaid MAH, Altawfiq KJA, Jebakumar AZ, Al-Tawfiq JA. The impact of non-pharmacologic interventions on respiratory syncytial virus hospitalization during the COVID-19 pandemic: A retrospective study from Saudi Arabia. J Infect Public Health 2024; 17:96-101. [PMID: 37992439 DOI: 10.1016/j.jiph.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 10/27/2023] [Accepted: 11/06/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Acute respiratory tract infections (ARTIs) are frequently observed in infants and young children. The dynamics and transmission of ARTIs have been significantly impacted by the global COVID-19 pandemic. This study investigates the change in admission rates of Respiratory Syncytial virus (RSV) in a hospital in Saudi Arabia. METHODS The study included hospitalized pediatric patients who underwent RSV testing in three periods: pre-pandemic (2019), during the pandemic (2020-2021), and the immediate post-pandemic (2022). RSV testing was conducted using either PCR or antigen tests. RESULTS Between January 2019 to December 2022, out of 927 tested patients, 173 (18.7%) were positive for RSV. The yearly positivity rates were as follows: 42 (35.6%) of 118, 24 (33.3%) of 72, 15 (18.5%) of 81, and 92 (14%) of 656, yearly from 2019 to 2022, respectively (P < 0.00001). Among all cases, 150 (16.2%) required hospitalization, including 94 (62.7%) males and 56 (37.3%) females. The admission rate to the intensive care unit (ICU) was 25 (16.7%), and mechanical ventilation was required for 10 (6.6%) patients. The overall case fatality rate was 0.7%. A Binary logistic regression analysis showed upper respiratory tract symptoms were more common in patients admitted in 2019 compared to 2022 (odd ratio:20.9, 95% CI: 4.2-104.1, P value < 0.0001). CONCLUSION The study showed that there were differences in RSV infection before and after COVID-19. Understanding how COVID-19 mitigation measures affect RSV transmission can aid in the development of effective prevention and control strategies.
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Affiliation(s)
- Salma AlBahrani
- Infectious Disease Unit, Specialty Internal Medicine, King Fahd Military Medical Complex, Dhahran, College of medicine-Imam Abdulrahaman Bin Faisal University, Dammam, Saudi Arabia
| | | | - Jaber S Alqahtani
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | | | - Dalal Ahmad Sharbini
- Immunology and serology Department, King Fahd Military Medical Complex, Dhahran, Saudi Arabia
| | | | | | | | - Suliman Fahad AlMasoud
- Molecular laboratory department, King Fahd Military Medical Complex, Dhahran, Saudi Arabia
| | | | | | | | - Jaffar A Al-Tawfiq
- Infectious Disease Unit, Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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23
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Wiemer DF, Halfter M, Müseler U, Schawaller M, Frickmann H. Effects of COVID-19-Associated Infection Control on the Pattern of Infections Imported by German Soldiers and Police Officers Returning from Predominantly Tropical Deployment Sites. Infect Dis Rep 2023; 15:778-794. [PMID: 38131883 PMCID: PMC10743252 DOI: 10.3390/idr15060070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/23/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023] Open
Abstract
In response to the COVID-19 pandemic, German public health authorities launched various infection control procedures. In line with this, anti-pandemic infection control was also implemented for German military and police deployments. The presented study assessed the impact of this increased infection control effort on deployment-associated infections in a holistic approach. To do so, the results of post-deployment assessments offered to German soldiers and police officers at the Department of Tropical Medicine and Infectious Diseases of the Bundeswehr Hospital Hamburg obtained during the pandemic period were compared to the results recorded during the pre-pandemic period in an exploratory, hypothesis-forming comparative study. In total, data from 1010 military deployments and 134 police deployments, predominantly to the African or the Eastern Mediterranean WHO regions, were included in the analyses. In the main results, a significant decrease in gastroenteritis in deployed soldiers (20.1% versus 61.3%, p < 0.0001) and at least a trend in the same direction in deployed police officers (25.7% versus 35.4%, p = 0.4026) were shown for the pandemic period, while no consistent tendency into the one or the other direction was detectable for febrile illness on deployment. In contrast to the finding of less frequently reported deployment-associated gastroenteritis, the detection rates of enteric microorganisms after deployment, including poor hygiene-related colonization with apathogenic protozoa, remained unchanged. Regarding non-enteric infections, the numbers of serologically confirmed malaria cases on deployment and as expected, due to increased airway protection, Mycobacterium tuberculosis-specific immune-conversion dropped significantly with p = 0.0037 and p = 0.009, respectively. As a side finding, soldiers and police officers with post-deployment medical assessments were more likely to be older and male during the pandemic compared to the pre-pandemic period. In summary, only minor changes in deployment-associated infection and colonization rates were seen in response to the increased infection control procedures during the pandemic period, apart from respiratory infections. In particular, the clinical finding of less gastroenteritis on deployment was not matched by a concordant decline in poor hygiene-related enteric colonization with apathogenic protozoa in the soldiers' guts, indicating that the fecal-oral transmission risk remained basically the same.
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Affiliation(s)
- Dorothea Franziska Wiemer
- Tropical Medicine and Infectious Disease Unit, Medical Department, Bundeswehr Hospital Hamburg, 20359 Hamburg, Germany; (D.F.W.); (M.H.)
| | - Matthias Halfter
- Tropical Medicine and Infectious Disease Unit, Medical Department, Bundeswehr Hospital Hamburg, 20359 Hamburg, Germany; (D.F.W.); (M.H.)
| | - Ulrich Müseler
- Medical Service, German Federal Police, 14473 Potsdam, Germany;
| | | | - Hagen Frickmann
- Department of Microbiology and Hospital Hygiene, Bundeswehr Hospital Hamburg, 20359 Hamburg, Germany
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, 18057 Rostock, Germany
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24
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Parums DV. Editorial: Outbreaks of Post-Pandemic Childhood Pneumonia and the Re-Emergence of Endemic Respiratory Infections. Med Sci Monit 2023; 29:e943312. [PMID: 38037346 PMCID: PMC10702145 DOI: 10.12659/msm.943312] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 11/27/2023] [Indexed: 12/02/2023] Open
Abstract
In October and November 2023, hospitals in the major cities of Beijing and Liaoning in northern China reported a surge in cases of pneumonia in children, with some hospitals being overwhelmed by pediatric emergency admissions. Similar outbreaks of childhood pneumonia had been reported in the autumn of 2022 in Europe and North America. Therefore, increased reports of childhood pneumonia could be driven by post-pandemic changes in the pathogenesis of endemic respiratory infections other than COVID-19, including Mycoplasma pneumoniae, respiratory syncytial virus (RSV), and influenza, rather than emerging novel pathogens. However, the recent reports of increased hospitalizations for children with pneumonia warrant continued infection surveillance and monitoring to exclude new respiratory pathogens or more virulent variants of known pathogens, including SARS-CoV-2. This editorial aims to present what is known about the re-emergence of endemic respiratory infections, which may be the cause of the recently reported outbreaks of childhood pneumonia.
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Affiliation(s)
- Dinah V Parums
- Science Editor, Medical Science Monitor, International Scientific Information, Inc., Melville, NY, USA
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25
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Grand RJ. Pathogenicity and virulence of human adenovirus F41: Possible links to severe hepatitis in children. Virulence 2023; 14:2242544. [PMID: 37543996 PMCID: PMC10405776 DOI: 10.1080/21505594.2023.2242544] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 08/08/2023] Open
Abstract
Over 100 human adenoviruses (HAdVs) have been isolated and allocated to seven species, A-G. Species F comprises two members-HAdV-F40 and HAdV-F41. As their primary site of infection is the gastrointestinal tract they have been termed, with species A, enteric adenoviruses. HAdV-F40 and HAdV-F41 are a common cause of gastroenteritis and diarrhoea in children. Partly because of difficulties in propagating the viruses in the laboratory, due to their restrictions on growth in many cell lines, our knowledge of the properties of individual viral proteins is limited. However, the structure of HAdV-F41 has recently been determined by cryo-electron microscopy. The overall structure is similar to those of HAdV-C5 and HAdV-D26 although with some differences. The sequence and arrangement of the hexon hypervariable region 1 (HVR1) and the arrangement of the C-terminal region of protein IX differ. Variations in the penton base and hexon HVR1 may play a role in facilitating infection of intestinal cells by HAdV-F41. A unique feature of HAdV-F40 and F41, among human adenoviruses, is the presence and expression of two fibre genes, giving long and short fibre proteins. This may also contribute to the tropism of these viruses. HAdV-F41 has been linked to a recent outbreak of severe acute hepatitis "of unknown origin" in young children. Further investigation has shown a very high prevalence of adeno-associated virus-2 in the liver and/or plasma of some cohorts of patients. These observations have proved controversial as HAdV-F41 had not been reported to infect the liver and AAV-2 has generally been considered harmless.
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Affiliation(s)
- Roger J. Grand
- Institute for Cancer and Genomic Science, the Medical School, University of Birmingham, Birmingham, UK
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26
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Patalon T, Saciuk Y, Trotzky D, Pachys G, Ben-Tov A, Segal Y, Gazit S. An Outbreak of Parvovirus B19 in Israel. Viruses 2023; 15:2261. [PMID: 38005937 PMCID: PMC10674631 DOI: 10.3390/v15112261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 11/12/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023] Open
Abstract
Human parvovirus B19 (B19V) has a wide clinical spectrum, ranging from an asymptomatic infection to a life threatening one. During pregnancy, it can lead to fetal loss and hydrops fetalis. This retrospective study examined the incidence rates of B19V in Israel, analyzing anonymized electronic medical records of 2.7 million individuals between January 2015 and September 2023. A generalized linear model with a Poisson distribution was fit to the data, adjusting for potential confounders. A marked increase in B19V was observed in 2023, with an adjusted incidence rate ratio (IRR) of 6.6 (95% CI 6.33-6.89) when comparing 2023 to previous years. When specifically comparing 2023 to COVID-19 years (2020-2022), adjusted IRR climbs to 9.21 (8.66-9.80). Moreover, in 2023, previously existing seasonality has largely disappeared. High SES characterized most infected individuals with a marked discrepancy in social sectors; the Arab population was significantly less likely to be found B19V positive, even when adjusting for SES. Most infections occurred in school-aged children (6-11 years old). Pregnant women experienced the most significant rise in B19V, with an adjusted IRR of 11.47 (9.44-13.97) in 2023 compared to previous years; most cases were diagnosed in the first trimester. This study demonstrates that Israel is currently experiencing the largest and longest reported outbreak of B19V to date. Policymakers should consider setting screening policies in place, at least for populations at risk, while specifically studying and potentially targeting low socioeconomic populations and specific social sectors to avoid health inequalities.
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Affiliation(s)
- Tal Patalon
- Kahn Sagol Maccabi (KSM) Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv 68125, Israel
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv 68125, Israel
| | - Yaki Saciuk
- Kahn Sagol Maccabi (KSM) Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv 68125, Israel
| | - Daniel Trotzky
- Shamir Medical Center (Assaf Harofeh Medical Center), Zerifin 70300, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Gal Pachys
- Shamir Medical Center (Assaf Harofeh Medical Center), Zerifin 70300, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Amir Ben-Tov
- Kahn Sagol Maccabi (KSM) Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv 68125, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Yaakov Segal
- Maccabi Healthcare Services, Tel Aviv 68125, Israel
| | - Sivan Gazit
- Kahn Sagol Maccabi (KSM) Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv 68125, Israel
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv 68125, Israel
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27
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Harrison R, Mubareka S, Papenburg J, Schober T, Allen UD, Hatchette TF, Evans GA. AMMI Canada 2023 update on influenza: Management and emerging issues. JOURNAL OF THE ASSOCIATION OF MEDICAL MICROBIOLOGY AND INFECTIOUS DISEASE CANADA = JOURNAL OFFICIEL DE L'ASSOCIATION POUR LA MICROBIOLOGIE MEDICALE ET L'INFECTIOLOGIE CANADA 2023; 8:176-185. [PMID: 38058499 PMCID: PMC10697102 DOI: 10.3138/jammi-2023-07-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Affiliation(s)
- Robyn Harrison
- University of Alberta, Alberta Health Services, Edmonton, Alberta, Canada
| | - Samira Mubareka
- Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Jesse Papenburg
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Montreal Children’s Hospital, McGill University Health Centre, Montreal, Quebec, Canada
- Division of Microbiology, Department of Clinical Laboratory Medicine, Montreal Children’s Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | | | - Upton D Allen
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Division of Infectious Diseases, Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Todd F Hatchette
- Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Gerald A Evans
- Division of Infectious Diseases, Department of Medicine, Kingston Health Sciences Centre, Queen’s University, Kingston, Ontario, Canada
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28
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Ho EC, Cataldi JR, Silveira LJ, Birkholz M, Loi MM, Osborne CM, Dominguez SR. Outbreak of Invasive Group A Streptococcus in Children-Colorado, October 2022-April 2023. J Pediatric Infect Dis Soc 2023; 12:540-548. [PMID: 37792995 DOI: 10.1093/jpids/piad080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 10/03/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND In the fall of 2022, we observed a sharp rise in pediatric Invasive Group A Streptococcus (iGAS) hospitalizations in Colorado. We compared the epidemiology, clinical features, and patient outcomes in this outbreak to prior years. METHODS Between October 2022 and April 2023, we prospectively identified and reviewed iGAS cases in hospitalized pediatric patients at Children's Hospital Colorado. Using laboratory specimen records, we also retrospectively compared the number of patients with sterile site GAS-positive cultures across three time periods: pre-COVID-19 (January 2015-March 2020), height of COVID-19 pandemic (April 2020-September 2022), and outbreak (October 2022-April 2023). RESULTS Among 96 prospectively identified iGAS cases, median age was 5.7 years old; 66% were male, 70% previously healthy, 39% required critical care, and four patients died. Almost 60% had associated respiratory viral symptoms, 10% had toxic shock syndrome, and 4% had necrotizing fasciitis. Leukopenia, bandemia, and higher C-reactive protein values were laboratory findings associated with need for critical care. There were significantly more cases during the outbreak (9.9/month outbreak vs 3.9/month pre-pandemic vs 1.3/month pandemic), including more cases with pneumonia (28% outbreak vs 15% pre-pandemic vs 0% pandemic) and multifocal disease (17% outbreak vs 3% pre-pandemic vs 0% pandemic), P < .001 for all. CONCLUSIONS Outbreak case numbers were almost triple the pre-pandemic baseline. The high percentage of cases with associated viral symptoms suggests a link to coinciding surges in respiratory viruses during this time. Invasive GAS can be severe and evolve rapidly; clinical and laboratory features may help in earlier identification of critically ill children.
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Affiliation(s)
- Erin C Ho
- Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA
- Section of Infectious Diseases, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA
| | - Jessica R Cataldi
- Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA
- Section of Infectious Diseases, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA
| | - Lori J Silveira
- Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA
| | - Meghan Birkholz
- Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA
| | - Michele M Loi
- Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA
- Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA
| | - Christina M Osborne
- Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA and
- Department of Pediatrics, Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Samuel R Dominguez
- Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA
- Section of Infectious Diseases, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA
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29
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Remien KA, Amarin JZ, Horvat CM, Nofziger RA, Page-Goertz CK, Besunder JB, Potts BK, Forbes ML, Halasa N, Pelletier JH. Admissions for Bronchiolitis at Children's Hospitals Before and During the COVID-19 Pandemic. JAMA Netw Open 2023; 6:e2339884. [PMID: 37883085 PMCID: PMC10603547 DOI: 10.1001/jamanetworkopen.2023.39884] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/12/2023] [Indexed: 10/27/2023] Open
Abstract
Importance The COVID-19 pandemic has been associated with a transient decrease in bronchiolitis hospitalizations compared with prepandemic patterns, but current effects remain unknown. Objective To analyze changes in patterns of bronchiolitis admissions at US children's hospitals during the 2020-2023 bronchiolitis seasons compared with the 2010-2019 seasons. Design, Setting, and Participants This retrospective cross-sectional study used data from 41 US children's hospitals in the Pediatric Health Information System database. Bronchiolitis has winter-predominant seasonality, so hospitalizations were grouped according to bronchiolitis season (from July through June). This study included all patients aged younger than 2 years admitted with a diagnosis of bronchiolitis between July 1, 2010, and June 30, 2023. Bronchiolitis seasons from July through June between 2010-2011 and 2019-2020 were classified as the prepandemic era, and seasons between 2020-2021 and 2022-2023 were classified as the pandemic era. Data analysis was performed from July 1, 2010, through June 30, 2023. Exposures Admission date. Main Outcomes and Measures The primary outcome was number of hospitalizations for bronchiolitis by season and month. Monthly admission counts from the prepandemic era were transformed into time series and used to train seasonal ensemble forecasting models. Forecasts were compared to monthly admissions during the pandemic era. Results In this study, there were 400 801 bronchiolitis admissions among 349 609 patients between July 1, 2010, and June 30, 2023. The median patient age was 6 (IQR, 2-12) months; 58.7% were boys and 43.7% were White. Hospitalizations increased gradually during the prepandemic era (median, 29 309 [IQR, 26 196-34 157]), decreased 69.2% (n = 9030) in the 2020-2021 season, and increased 75.3% (n = 51 397) in the 2022-2023 season. Patients in the pandemic era were older than those in the prepandemic era (median, 7 [IQR, 3-14] vs 6 [2-12] months; P < .001). Intensive care unit (ICU) admissions increased from 32.2% (96 245 of 298 535) in the prepandemic era to 36.7% (37 516 of 102 266) in the pandemic era (P < .001). The seasonality of bronchiolitis admissions changed during the pandemic era. Admissions peaked in August 2021 (actual 5036 vs 943 [95% CI, 0-2491] forecasted) and November 2022 (actual 10 120 vs 5268 [95% CI, 3425-7419] forecasted). These findings were unchanged in sensitivity analyses excluding children with complex chronic conditions and excluding repeat admissions. In a sensitivity analysis including all viral lower respiratory tract infections in children aged younger than 5 years, there were 66 767 admissions in 2022-2023 vs 35 623 (31 301-41 002) in the prepandemic era, with the largest increase in children aged 24 to 59 months. Conclusions and Relevance The findings of this cross-sectional study suggest that bronchiolitis hospitalizations decreased transiently and then increased markedly during the COVID-19 pandemic era. Patients admitted during the pandemic era were older and were more likely to be admitted to an ICU. These findings suggest that bronchiolitis seasonality has not yet returned to prepandemic patterns, and US hospitals should prepare for the possibility of atypical timing again in 2023.
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Affiliation(s)
- Kailey A. Remien
- Department of Medical Education, Akron Children’s Hospital, Akron, Ohio
| | - Justin Z. Amarin
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Christopher M. Horvat
- Division of Pediatric Critical Care Medicine, Department of Critical Care Medicine, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Ryan A. Nofziger
- Division of Critical Care Medicine, Department of Pediatrics, Akron Children’s Hospital, Akron, Ohio
- Department of Pediatrics, College of Medicine, Northeast Ohio Medical University, Rootstown, Ohio
| | - Christopher K. Page-Goertz
- Division of Critical Care Medicine, Department of Pediatrics, Akron Children’s Hospital, Akron, Ohio
- Department of Pediatrics, College of Medicine, Northeast Ohio Medical University, Rootstown, Ohio
| | - James B. Besunder
- Division of Critical Care Medicine, Department of Pediatrics, Akron Children’s Hospital, Akron, Ohio
- Department of Pediatrics, College of Medicine, Northeast Ohio Medical University, Rootstown, Ohio
| | - Brittany K. Potts
- Department of Pediatrics, College of Medicine, Northeast Ohio Medical University, Rootstown, Ohio
- Division of Hospital Medicine, Department of Pediatrics, Akron Children’s Hospital, Akron, Ohio
| | - Michael L. Forbes
- Division of Critical Care Medicine, Department of Pediatrics, Akron Children’s Hospital, Akron, Ohio
- Department of Pediatrics, College of Medicine, Northeast Ohio Medical University, Rootstown, Ohio
- Rebecca D. Considine Research Institute, Akron Children’s Hospital, Akron, Ohio
| | - Natasha Halasa
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jonathan H. Pelletier
- Division of Critical Care Medicine, Department of Pediatrics, Akron Children’s Hospital, Akron, Ohio
- Department of Pediatrics, College of Medicine, Northeast Ohio Medical University, Rootstown, Ohio
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Wang L, Davis PB, Berger N, Kaelber DC, Volkow N, Xu R. Association of COVID-19 with respiratory syncytial virus (RSV) infections in children aged 0-5 years in the USA in 2022: a multicentre retrospective cohort study. Fam Med Community Health 2023; 11:e002456. [PMID: 37832975 PMCID: PMC10582888 DOI: 10.1136/fmch-2023-002456] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2023] Open
Abstract
OBJECTIVE To investigate whether COVID-19 infection was associated with increased risk for incident respiratory syncytial virus (RSV) infections and associated diseases among young children that might have contributed to the 2022 surge of severe paediatric RSV cases in the USA. DESIGN This is a retrospective population-based cohort study. Five outcomes were examined, including overall RSV infection, positive lab test-confirmed RSV infection, clinically diagnosed RSV diseases, RSV-associated bronchiolitis and unspecified bronchiolitis. Risk ratio (RR) and 95% CI of the outcomes that occurred during the 2022 and 2021 RSV seasons were calculated by comparing propensity-score matched cohorts. SETTING Nationwide multicentre database of electronic health records (EHRs) of 61.4 million patients in the USA including 1.7 million children 0-5 years of age, which was accessed through TriNetX Analytics that provides web-based and secure access to patient EHR data from hospitals, primary care and specialty treatment providers. PARTICIPANTS The study population consisted of 228 940 children of 0-5 years with no prior RSV infection who had medical encounters in October 2022. Findings were replicated in a separate study population of 370 919 children of 0-5 years with no prior RSV infection who had medical encounters in July 2021-August 2021 during a non-overlapping time period. RESULTS For the 2022 study population (average age 2.4 years, 46.8% girls, 61% white, 16% black), the risk for incident RSV infection during October 2022-December 2022 was 6.40% for children with prior COVID-19 infection, higher than 4.30% for the matched children without COVID-19 (RR 1.40, 95% CI 1.27 to 1.55); and among children aged 0-1 year, the overall risk was 7.90% for those with prior COVID-19 infection, higher than 5.64% for matched children without (RR 1.40, 95% CI 1.21 to 1.62). For the 2021 study population (average age 2.2 years, 46% girls, 57% white, 20% black), the risk for incident RSV infection during July 2021-December 2021 was 4.85% for children with prior COVID-19 infection, higher than 3.68% for the matched children without COVID-19 (RR 1.32, 95% CI 1.12 to 1.56); and 7.30% for children aged 0-1 year with prior COVID-19 infection, higher than 4.98% for matched children without (RR 1.47, 95% CI 1.18 to 1.82). CONCLUSION COVID-19 was associated with a significantly increased risk for RSV infections among children aged 0-5 years in 2022. Similar findings were replicated for a study population of children aged 0-5 years in 2021. Our findings suggest that COVID-19 contributed to the 2022 surge of RSV cases in young children through the large buildup of COVID-19-infected children and the potential long-term adverse effects of COVID-19 on the immune and respiratory system.
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Affiliation(s)
- Lindsey Wang
- Center for Science, Health, and Society, Case Western Reserve University, Cleveland, Ohio, USA
| | - Pamela B Davis
- Center for Community Health Integration, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Nathan Berger
- Center for Science, Health, and Society, Case Western Reserve University, Cleveland, Ohio, USA
| | - David C Kaelber
- The Center for Clinical Informatics Research and Education and the Departments ofInternal Medicine, Pediatrics, and Population and Quantitative Health Sciences, MetroHealth Medical Center, Cleveland, Ohio, USA
| | - Nora Volkow
- National Institute on Drug Abuse, National Institute of Health, Bethesda, Maryland, USA
| | - Rong Xu
- Center for AI in Drug Discovery, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
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Fourgeaud J, Allali S, Toubiana J, Pinhas Y, Frange P, Leruez-Ville M, Cohen JF. Post-COVID-19 pandemic outbreak of severe Parvovirus B19 primary infections in Paris, France: 10-year interrupted time-series analysis (2012-2023). J Clin Virol 2023; 167:105576. [PMID: 37633184 DOI: 10.1016/j.jcv.2023.105576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 08/21/2023] [Indexed: 08/28/2023]
Affiliation(s)
- Jacques Fourgeaud
- Microbiology department, Necker-Enfants malades Hospital, AP-HP, Université Paris Cité, Paris, France; Université Paris Cité, URP 7328 FETUS, Paris, France
| | - Slimane Allali
- Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants malades Hospital, AP-HP, Université Paris Cité, Paris, France; Sickle Cell Center, Necker-Enfants malades Hospital, AP-HP, Université Paris Cité, Paris, France
| | - Julie Toubiana
- Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants malades Hospital, AP-HP, Université Paris Cité, Paris, France
| | - Yael Pinhas
- Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants malades Hospital, AP-HP, Université Paris Cité, Paris, France
| | - Pierre Frange
- Microbiology department, Necker-Enfants malades Hospital, AP-HP, Université Paris Cité, Paris, France; Université Paris Cité, URP 7328 FETUS, Paris, France
| | - Marianne Leruez-Ville
- Microbiology department, Necker-Enfants malades Hospital, AP-HP, Université Paris Cité, Paris, France; Université Paris Cité, URP 7328 FETUS, Paris, France
| | - Jérémie F Cohen
- Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants malades Hospital, AP-HP, Université Paris Cité, Paris, France.
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Wang L, Berger N, Davis PB, Kaelber DC, Volkow N, Xu R. Time trend and seasonality in medically attended respiratory syncytial virus (RSV) infections in US children aged 0-5 years, January 2010-January 2023. Fam Med Community Health 2023; 11:e002453. [PMID: 37844966 PMCID: PMC10582996 DOI: 10.1136/fmch-2023-002453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023] Open
Abstract
OBJECTIVE The long-term time trend and seasonality variations of first-time medically attended respiratory syncytial virus (RSV) infections among young children are unknown. We aim to examine the time trend of medically attended first-time RSV infections among young children in the USA from January 2010 through January 2023. DESIGN This is a population-based cohort study using electronic health records (EHRs). Monthly incidence rate of medically attended first-time RSV infection (cases per 10 000 000 person-days). A time-series regression model was used to model and predict time trends and seasonality. SETTING Multicenter and nationwide TriNetX Network in the USA. PARTICIPANTS The study population comprised children aged 0-5 years who had medical visits during the period of January 2010 to January 2023. RESULTS The data included 29 013 937 medical visits for children aged 0-5 years (46.5% girls and 53.5% boys) from January 2010 through January 2023. From 2010 through 2019, the monthly incidence rate of first-time medically attended RSV infection in children aged 0-5 years followed a consistent seasonal pattern. Seasonal patterns of medically attended RSV infections were significantly disrupted during the COVID-19 pandemic. In 2020, the seasonal variation disappeared with a peak incidence rate of 20 cases per 1 000 000 person-days, a decrease of 97.4% from the expected peak rate (rate ratio or RR: 0.026, 95% CI 0.017 to 0.040). In 2021, the seasonality returned but started 4 months earlier, lasted for 9 months, and peaked in August at a rate of 753 cases per 1 000 000 person-days, a decrease of 9.6% from the expected peak rate (RR: 0.90, 95% CI 0.82 to 0.99). In 2022, the seasonal pattern is similar to prepandemic years but reached a historically high rate of 2182 cases per 10 000 000 person-days in November, an increase of 143% from the expected peak rate (RR: 2.43, 95% CI 2.25 to 2.63). The time trend and seasonality of the EHR-based medically attended RSV infections are consistent with those of RSV-associated hospitalisations from the Centers for Disease Control and Prevention (CDC) survey-based surveillance system. CONCLUSION The findings show the disrupted seasonality during the COVID-19 pandemic and a historically high surge of paediatric RSV cases that required medical attention in 2022. Our study demonstrates the potential of EHRs as a cost-effective alternative for real-time pathogen and syndromic surveillance of unexpected disease patterns including RSV infection.
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Affiliation(s)
- Lindsey Wang
- Center for Science, Health, and Society, Case Western Reserve University, Cleveland, Ohio, USA
| | - Nathan Berger
- Center for Science, Health, and Society, Case Western Reserve University, Cleveland, Ohio, USA
| | - Pamela B Davis
- Center for Community Health Integration, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - David C Kaelber
- The Center for Clinical Informatics Research and Education and the Departments ofInternal Medicine, Pediatrics, and Population and Quantitative Health Sciences, MetroHealth Medical Center, Cleveland, Ohio, USA
| | - Nora Volkow
- National Institute on Drug Abuse, National Institute of Health, Bethesda, Maryland, USA
| | - Rong Xu
- Center for Artificial Intelligence in Drug Discovery, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
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Munro AP, Martinón-Torres F, Drysdale SB, Faust SN. The disease burden of respiratory syncytial virus in Infants. Curr Opin Infect Dis 2023; 36:379-384. [PMID: 37610444 PMCID: PMC10487373 DOI: 10.1097/qco.0000000000000952] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
PURPOSE OF REVIEW To describe the current global burden of respiratory syncytial virus (RSV) in infants and its implications for morbidity, health resources and economic costs. RECENT FINDINGS New prophylactic therapies are on the horizon for RSV in the form of long-acting monoclonal antibodies suitable for healthy infants and maternal immunizations. SUMMARY Despite being responsible for significant global infant morbidity and mortality, until recently there have been no effective therapeutics available for healthy infants to protect them from RSV. Several new drugs are likely to be available within the next few years which could help relieve a huge burden on healthcare systems over the coming winters.
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Affiliation(s)
- Alasdair P.S. Munro
- NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Federico Martinón-Torres
- Translational Paediatrics and Infectious Diseases, Hospital Clínico Universitario and Universidad de Santiago de Compostela
- Genetics, Vaccines and Paediatric Infectious Diseases Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago and Universidad de Santiago de Compostela (USC), Galicia
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Simon B. Drysdale
- Centre for Neonatal and Paediatric Infection, Institute for Infection and Immunity, St George's, University of London
- Department of Paediatrics, St George's University Hospital NHS Foundation Trust, London, UK
| | - Saul N. Faust
- NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
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Shaw D, Abad R, Amin-Chowdhury Z, Bautista A, Bennett D, Broughton K, Cao B, Casanova C, Choi EH, Chu YW, Claus H, Coelho J, Corcoran M, Cottrell S, Cunney R, Cuypers L, Dalby T, Davies H, de Gouveia L, Deghmane AE, Demczuk W, Desmet S, Domenech M, Drew R, du Plessis M, Duarte C, Erlendsdóttir H, Fry NK, Fuursted K, Hale T, Henares D, Henriques-Normark B, Hilty M, Hoffmann S, Humphreys H, Ip M, Jacobsson S, Johnson C, Johnston J, Jolley KA, Kawabata A, Kozakova J, Kristinsson KG, Krizova P, Kuch A, Ladhani S, Lâm TT, León ME, Lindholm L, Litt D, Maiden MCJ, Martin I, Martiny D, Mattheus W, McCarthy ND, Meehan M, Meiring S, Mölling P, Morfeldt E, Morgan J, Mulhall R, Muñoz-Almagro C, Murdoch D, Murphy J, Musilek M, Mzabi A, Novakova L, Oftadeh S, Perez-Argüello A, Pérez-Vázquez M, Perrin M, Perry M, Prevost B, Roberts M, Rokney A, Ron M, Sanabria OM, Scott KJ, Sheppard C, Siira L, Sintchenko V, Skoczyńska A, Sloan M, Slotved HC, Smith AJ, Steens A, Taha MK, Toropainen M, Tzanakaki G, Vainio A, van der Linden MPG, van Sorge NM, Varon E, Vohrnova S, von Gottberg A, Yuste J, Zanella R, Zhou F, Brueggemann AB. Trends in invasive bacterial diseases during the first 2 years of the COVID-19 pandemic: analyses of prospective surveillance data from 30 countries and territories in the IRIS Consortium. Lancet Digit Health 2023; 5:e582-e593. [PMID: 37516557 PMCID: PMC10914672 DOI: 10.1016/s2589-7500(23)00108-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/22/2023] [Accepted: 05/25/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND The Invasive Respiratory Infection Surveillance (IRIS) Consortium was established to assess the impact of the COVID-19 pandemic on invasive diseases caused by Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, and Streptococcus agalactiae. We aimed to analyse the incidence and distribution of these diseases during the first 2 years of the COVID-19 pandemic compared to the 2 years preceding the pandemic. METHODS For this prospective analysis, laboratories in 30 countries and territories representing five continents submitted surveillance data from Jan 1, 2018, to Jan 2, 2022, to private projects within databases in PubMLST. The impact of COVID-19 containment measures on the overall number of cases was analysed, and changes in disease distributions by patient age and serotype or group were examined. Interrupted time-series analyses were done to quantify the impact of pandemic response measures and their relaxation on disease rates, and autoregressive integrated moving average models were used to estimate effect sizes and forecast counterfactual trends by hemisphere. FINDINGS Overall, 116 841 cases were analysed: 76 481 in 2018-19, before the pandemic, and 40 360 in 2020-21, during the pandemic. During the pandemic there was a significant reduction in the risk of disease caused by S pneumoniae (risk ratio 0·47; 95% CI 0·40-0·55), H influenzae (0·51; 0·40-0·66) and N meningitidis (0·26; 0·21-0·31), while no significant changes were observed for S agalactiae (1·02; 0·75-1·40), which is not transmitted via the respiratory route. No major changes in the distribution of cases were observed when stratified by patient age or serotype or group. An estimated 36 289 (95% prediction interval 17 145-55 434) cases of invasive bacterial disease were averted during the first 2 years of the pandemic among IRIS-participating countries and territories. INTERPRETATION COVID-19 containment measures were associated with a sustained decrease in the incidence of invasive disease caused by S pneumoniae, H influenzae, and N meningitidis during the first 2 years of the pandemic, but cases began to increase in some countries towards the end of 2021 as pandemic restrictions were lifted. These IRIS data provide a better understanding of microbial transmission, will inform vaccine development and implementation, and can contribute to health-care service planning and provision of policies. FUNDING Wellcome Trust, NIHR Oxford Biomedical Research Centre, Spanish Ministry of Science and Innovation, Korea Disease Control and Prevention Agency, Torsten Söderberg Foundation, Stockholm County Council, Swedish Research Council, German Federal Ministry of Health, Robert Koch Institute, Pfizer, Merck, and the Greek National Public Health Organization.
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Affiliation(s)
- David Shaw
- Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK
| | - Raquel Abad
- National Reference Laboratory for Meningococci, National Center of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Zahin Amin-Chowdhury
- Immunisation and Countermeasures Division, UK Health Security Agency, London, UK
| | | | - Desiree Bennett
- Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland, Dublin, Ireland
| | - Karen Broughton
- Staphylococcus and Streptococcus Reference Section, AMRHAI, UK Health Security Agency, London, UK
| | - Bin Cao
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Carlo Casanova
- Swiss National Reference Center for Invasive Pneumococci, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Eun Hwa Choi
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Yiu-Wai Chu
- Department of Health, Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Hong Kong Special Administrative Region, China
| | - Heike Claus
- University of Würzburg, Institute for Hygiene and Microbiology, National Reference Centre for Meningococci and Haemophilus influenzae, Würzburg, Germany
| | - Juliana Coelho
- Staphylococcus and Streptococcus Reference Section, AMRHAI, UK Health Security Agency, London, UK
| | - Mary Corcoran
- Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland, Dublin, Ireland; Department of Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Robert Cunney
- Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland, Dublin, Ireland; Department of Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Lize Cuypers
- National Reference Centre for Streptococcus pneumoniae, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Tine Dalby
- Statens Serum Institut, Department of Infectious Disease Epidemiology & Prevention, Copenhagen, Denmark
| | - Heather Davies
- Meningococcal Reference Laboratory, Institute of Environmental Science and Research, Porirua, New Zealand
| | - Linda de Gouveia
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa
| | - Ala-Eddine Deghmane
- Institut Pasteur, Univeristé Paris Cité, Invasive Bacterial Infections Unit and National Reference Centre for Meningococci and Haemophilus influenzae, Paris, France
| | - Walter Demczuk
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Stefanie Desmet
- National Reference Centre for Streptococcus pneumoniae, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Mirian Domenech
- National Center for Microbiology and CIBER of Respiratory Research, Instituto de Salud Carlos III, Madrid, Spain
| | - Richard Drew
- Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland, Dublin, Ireland; Department of Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland; Clinical Innovation Unit, Rotunda, Dublin, Ireland
| | - Mignon du Plessis
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa
| | | | - Helga Erlendsdóttir
- Department of Clinical Microbiology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | - Norman K Fry
- Immunisation and Vaccine Preventable Diseases Division and Respiratory and Vaccine Preventable Bacteria Reference Unit, UK Health Security Agency, London, UK
| | - Kurt Fuursted
- Statens Serum Institut, Department of Bacteria, Parasites & Fungi, Copenhagen, Denmark
| | - Thomas Hale
- Blavatnik School of Government, University of Oxford, Oxford, UK
| | - Desiree Henares
- Microbiology Department, Institut Recerca Sant Joan de Déu, Hospital Sant Joan de Deu, Barcelona, Spain; CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Birgitta Henriques-Normark
- Karolinska Institutet, Karolinska University Hospital, Public Health Agency of Sweden, Stockholm, Sweden
| | - Markus Hilty
- Swiss National Reference Center for Invasive Pneumococci, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Steen Hoffmann
- Statens Serum Institut, Department of Bacteria, Parasites & Fungi, Copenhagen, Denmark
| | - Hilary Humphreys
- Department of Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland; Department of Clinical Microbiology, Beaumont Hospital, Dublin, Ireland
| | - Margaret Ip
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Susanne Jacobsson
- National Reference Laboratory for Neisseria meningitidis, Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | | | | | | | | | - Jana Kozakova
- National Reference Laboratory for Streptococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
| | - Karl G Kristinsson
- Department of Clinical Microbiology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | - Pavla Krizova
- National Reference Laboratory for Meningococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
| | - Alicja Kuch
- National Reference Centre for Bacterial Meningitis, Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Warsaw, Poland
| | - Shamez Ladhani
- Immunisation and Countermeasures Division, UK Health Security Agency, London, UK
| | - Thiên-Trí Lâm
- University of Würzburg, Institute for Hygiene and Microbiology, National Reference Centre for Meningococci and Haemophilus influenzae, Würzburg, Germany
| | | | - Laura Lindholm
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - David Litt
- Respiratory and Vaccine Preventable Bacteria Reference Unit, UK Health Security Agency, London, UK
| | | | - Irene Martin
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Delphine Martiny
- National Belgian Reference Centre for Haemophilus influenzae, Laboratoire des Hôpitaux Universitaires de Bruxelles-Universitair Laboratorium van Brussel, Brussels, Belgium; Faculty of Medicine and Pharmacy, University of Mons, Mons, Belgium
| | | | - Noel D McCarthy
- Population Health Medicine, Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland
| | - Mary Meehan
- Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland, Dublin, Ireland
| | - Susan Meiring
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa
| | - Paula Mölling
- National Reference Laboratory for Neisseria meningitidis, Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | | | - Julie Morgan
- Streptococcal Reference Laboratory, Institute of Environmental Science and Research Limited, Porirua, New Zealand
| | - Robert Mulhall
- Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland, Dublin, Ireland
| | - Carmen Muñoz-Almagro
- Microbiology Department, Institut Recerca Sant Joan de Déu, Hospital Sant Joan de Deu, Barcelona, Spain; CIBER of Epidemiology and Public Health, Madrid, Spain; Medicine Department, Universitat Internacional de Catalunya, Barcelona, Spain
| | | | | | - Martin Musilek
- National Reference Laboratory for Meningococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
| | - Alexandre Mzabi
- Ministère de la Santé - Direction de la santé, Luxembourg, Luxembourg
| | - Ludmila Novakova
- National Reference Laboratory for Haemophilus Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
| | - Shahin Oftadeh
- NSW Pneumococcal Reference Laboratory, Institute of Clinical Pathology and Medical Research - NSW Health Pathology, Sydney, NSW, Australia
| | - Amaresh Perez-Argüello
- Microbiology Department, Institut Recerca Sant Joan de Déu, Hospital Sant Joan de Deu, Barcelona, Spain
| | - Maria Pérez-Vázquez
- Laboratorio de Referencia e Investigación en Resistencia a Antibióticos e Infecciones Relacionadas con la Asistencia Sanitaria, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain; CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - Benoit Prevost
- National Belgian Reference Centre for Haemophilus influenzae, Laboratoire des Hôpitaux Universitaires de Bruxelles-Universitair Laboratorium van Brussel, Brussels, Belgium
| | | | - Assaf Rokney
- Public Health Laboratories-Jerusalem, Public Health Services, Ministry of Health, Jerusalem, Israel
| | - Merav Ron
- Public Health Laboratories-Jerusalem, Public Health Services, Ministry of Health, Jerusalem, Israel
| | | | - Kevin J Scott
- Bacterial Respiratory Infection Service, Scottish Microbiology Reference Laboratories, Glasgow Royal Infirmary, Glasgow, UK
| | - Carmen Sheppard
- Respiratory and Vaccine Preventable Bacteria Reference Unit, UK Health Security Agency, London, UK
| | - Lotta Siira
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Vitali Sintchenko
- NSW Pneumococcal Reference Laboratory, Institute of Clinical Pathology and Medical Research - NSW Health Pathology, Sydney, NSW, Australia; Sydney Institute for Infectious Diseases, University of Sydney, NSW, Australia
| | - Anna Skoczyńska
- National Reference Centre for Bacterial Meningitis, Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Warsaw, Poland
| | | | | | - Andrew J Smith
- Bacterial Respiratory Infection Service, Scottish Microbiology Reference Laboratories, Glasgow Royal Infirmary, Glasgow, UK; College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
| | - Anneke Steens
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Muhamed-Kheir Taha
- Institut Pasteur, Univeristé Paris Cité, Invasive Bacterial Infections Unit and National Reference Centre for Meningococci and Haemophilus influenzae, Paris, France
| | | | - Georgina Tzanakaki
- National Meningitis Reference Laboratory, Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece
| | - Anni Vainio
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Mark P G van der Linden
- Department of Medical Microbiology, German National Reference Centre for Streptococci, University Hospital RWTH Aachen, Aachen, Germany
| | - Nina M van Sorge
- Department of Medical Microbiology and Infection Prevention, and Netherlands Reference Laboratory for Bacterial Meningitis, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Emmanuelle Varon
- Laboratory of Medical Biology and National Reference Centre for Pneumococci, Intercommunal Hospital of Créteil, Créteil, France
| | - Sandra Vohrnova
- National Reference Laboratory for Streptococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
| | - Anne von Gottberg
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa
| | - Jose Yuste
- National Center for Microbiology and CIBER of Respiratory Research, Instituto de Salud Carlos III, Madrid, Spain
| | - Rosemeire Zanella
- National Laboratory for Meningitis and Pneumococcal Infections, Center of Bacteriology, Institute Adolfo Lutz, São Paulo, Brazil
| | - Fei Zhou
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Angela B Brueggemann
- Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK.
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Burrell R, Saravanos G, Britton PN. Unintended impacts of COVID-19 on the epidemiology and burden of paediatric respiratory infections. Paediatr Respir Rev 2023:S1526-0542(23)00044-1. [PMID: 37580220 DOI: 10.1016/j.prrv.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 07/25/2023] [Indexed: 08/16/2023]
Abstract
Acute respiratory infections (ARI), especially lower respiratory infections (LRI), are a leading cause of childhood morbidity and mortality globally. Non-pharmaceutical interventions (NPI) employed during the COVID-19 pandemic have impacted on the epidemiology and burden of paediatric ARI, although accurately describing the full nature of the impact is challenging. For most ARI pathogens, a reduction was observed in the early phase of the pandemic, correlating with the most stringent NPI. In later phases of the pandemic resurgence of disease was observed as NPI eased. This pattern was most striking for seasonal viruses, such as influenza and respiratory syncytial virus. The impact on ARI-associated bacterial disease varied; marked reductions in invasive Streptococcus pneumoniae and Streptococcus pyogenes were observed, followed by a resurgence that correlated with increases in respiratory viral infections. For Corynebacterium diphtheriae,Bordetella pertussis, andMycoplasma pneumoniae, a sustained reduction of disease was observed well into 2022 in most regions. Proposedmechanisms for the varied epidemiological disruption amongst ARI pathogens includedifferential effects of NPI on specific pathogens, population-level immunological effects, and ecological and genetic pathogen adaptations. Additionally, important indirect effects of pandemic restrictions on paediatric respiratory infections have been identified. These occurred as a result of disruptions to routine health services, reductions in vaccination coverage, and disruptions to respiratory infection research and surveillance activities. Impacts have been disproportionately borne by those in low resource settings. We discuss opportunities to leverage pandemic learnings to support improved understanding of the epidemiology of paediatric respiratory infections to inform future prevention and health system strengthening. Educational Aims. The reader will gain an improved understanding of.
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Affiliation(s)
- Rebecca Burrell
- Sydney Medical School, University of Sydney, Australia; Sydney Infectious Diseases Institute, University of Sydney, New South Wales, Australia
| | - Gemma Saravanos
- Susan Wakil School of Nursing and Midwifery, University of Sydney, Australia; Sydney Infectious Diseases Institute, University of Sydney, New South Wales, Australia
| | - Philip N Britton
- Sydney Medical School, University of Sydney, Australia; Department of Infectious Diseases & Microbiology, The Children's Hospital at Westmead, Westmead, Australia; Sydney Infectious Diseases Institute, University of Sydney, New South Wales, Australia.
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36
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De Maio F, Fiori B, Bianco DM, Sanguinetti M, Sali M. Respiratory viruses in the pre and post-pandemic periods in an Italian tertiary hospital. Immun Inflamm Dis 2023; 11:e909. [PMID: 37647421 PMCID: PMC10427785 DOI: 10.1002/iid3.909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/17/2023] [Accepted: 05/24/2023] [Indexed: 09/01/2023] Open
Abstract
We have appreciated the article published by Bardsley and colleagues describing the seasonal circulation of respiratory syncytial virus (RSV) in UK children, and we hope to contribute to increase information on this intriguing and elusive topic. We describe our epidemiological trend with the aim to add a small brick to the current knowledge regarding respiratory infections due to RSV and other respiratory viruses in an era that is changing due to a radical change in the evaluation of respiratory symptoms following the pandemic event.
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Affiliation(s)
- Flavio De Maio
- Dipartimento di Scienze di Laboratorio e InfettivologicheFondazione Policlinico Universitario “A. Gemelli”, IRCCSRomeItaly
| | - Barbara Fiori
- Dipartimento di Scienze di Laboratorio e InfettivologicheFondazione Policlinico Universitario “A. Gemelli”, IRCCSRomeItaly
| | - Delia M. Bianco
- Dipartimento di Scienze biotecnologiche di base, Cliniche intensivologiche e perioperatorie—Sezione di MicrobiologiaUniversità Cattolica del Sacro CuoreRomeItaly
| | - Maurizio Sanguinetti
- Dipartimento di Scienze di Laboratorio e InfettivologicheFondazione Policlinico Universitario “A. Gemelli”, IRCCSRomeItaly
- Dipartimento di Scienze biotecnologiche di base, Cliniche intensivologiche e perioperatorie—Sezione di MicrobiologiaUniversità Cattolica del Sacro CuoreRomeItaly
| | - Michela Sali
- Dipartimento di Scienze di Laboratorio e InfettivologicheFondazione Policlinico Universitario “A. Gemelli”, IRCCSRomeItaly
- Dipartimento di Scienze biotecnologiche di base, Cliniche intensivologiche e perioperatorie—Sezione di MicrobiologiaUniversità Cattolica del Sacro CuoreRomeItaly
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Rao S, Armistead I, Messacar K, Alden NB, Schmoll E, Austin E, Dominguez SR. Shifting Epidemiology and Severity of Respiratory Syncytial Virus in Children During the COVID-19 Pandemic. JAMA Pediatr 2023; 177:730-732. [PMID: 37184852 PMCID: PMC10186203 DOI: 10.1001/jamapediatrics.2023.1088] [Citation(s) in RCA: 38] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 02/14/2023] [Indexed: 05/16/2023]
Abstract
This cohort study examined changes in RSV age distribution and disease severity in Colorado children after the COVID-19 pandemic.
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Affiliation(s)
- Suchitra Rao
- Department of Pediatrics, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora
| | - Isaac Armistead
- Colorado Department of Public Health and Environment, Denver
| | - Kevin Messacar
- Department of Pediatrics, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora
| | - Nisha B. Alden
- Colorado Department of Public Health and Environment, Denver
| | - Emma Schmoll
- Colorado Department of Public Health and Environment, Denver
| | | | - Samuel R. Dominguez
- Department of Pediatrics, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora
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Wang L, Davis PB, Berger NA, Kaelber DC, Volkow ND, Xu R. Disrupted seasonality and association of COVID-19 with medically attended respiratory syncytial virus infections among young children in the US: January 2010-January 2023. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.12.23289898. [PMID: 37292931 PMCID: PMC10246033 DOI: 10.1101/2023.05.12.23289898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Respiratory syncytial virus (RSV) infections and hospitalizations surged sharply in 2022 among young children. To assess whether COVID-19 contributed to this surge, we leveraged a real-time nation-wide US database of electronic health records (EHRs) using time series analysis from January 1, 2010 through January 31, 2023, and propensity-score matched cohort comparisons for children aged 0-5 years with or without prior COVID-19 infection. Seasonal patterns of medically attended RSV infections were significantly disrupted during the COVID-19 pandemic. The monthly incidence rate for first-time medically attended cases, most of which were severe RSV-associated diseases, reached a historical high rate of 2,182 cases per 1,0000,000 person-days in November 2022, corresponding to a related increase of 143% compared to expected peak rate (rate ratio: 2.43, 95% CI: 2.25-2.63). Among 228,940 children aged 0-5 years, the risk for first-time medically attended RSV during 10/2022-12/2022 was 6.40% for children with prior COVID-19 infection, higher than 4.30% for the matched children without COVID-19 (risk ratio or RR: 1.40, 95% CI: 1.27-1.55); and among 99,105 children aged 0-1 year, the overall risk was 7.90% for those with prior COVID-19 infection, higher than 5.64% for matched children without (RR: 1.40, 95% CI: 1.21-1.62). These data provide evidence that COVID-19 contributed to the 2022 surge of severe pediatric RSV cases.
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Affiliation(s)
- Lindsey Wang
- Center for Science, Health, and Society, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Pamela B. Davis
- The Center for Community Health Integration, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Nathan A. Berger
- Center for Science, Health, and Society, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - David C. Kaelber
- Departments of Internal Medicine, Pediatrics, and Population and Quantitative Health Sciences and the Center for Clinical Informatics Research and Education, The MetroHealth System, Cleveland, OH, USA
| | - Nora D. Volkow
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Rong Xu
- Center for Artificial Intelligence in Drug Discovery, Case Western Reserve University School of Medicine, Cleveland, OH, USA
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Gutierrez-Tobar IF, Beltran-Arroyave C, Díaz A, Londoño JP, Jimenez KL, Zamora CG, Camacho-Moreno G, Alvarez-Olmos MI, Beltran-Higuera SJ, Alvarez-Moreno CA. Adenovirus Respiratory Infections Post Pandemic in Colombia: An Old Enemy With Increased Severity in Pediatric Population? Pediatr Infect Dis J 2023; 42:e133-e134. [PMID: 36728116 DOI: 10.1097/inf.0000000000003827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
| | | | - Alejandro Díaz
- Hospital Pablo Tobón Uribe, Hospital General de Medellin, Medellín, Colombia
| | | | | | - Carmen G Zamora
- Referente infancia, Líder Programa IRA Distrital, SDS, Bogotá, Colombia
| | - German Camacho-Moreno
- Universidad Nacional de Colombia, HOMI, Fundación Hospital pediatrico la Misericordia, Fundación Hospital Infantil Universitario de San José, Bogotá, Colombia
| | - Martha I Alvarez-Olmos
- Fundación Cardioinfantil Hospital Universitario, Universidad El Bosque, Bogotá, Colombia
| | | | - Carlos A Alvarez-Moreno
- Departamento Enfermedades Infecciosas, Clínica Colsanitas, Universidad Nacional de Colombia, Bogotá, Colombia
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Hönemann M, Thiem S, Bergs S, Berthold T, Propach C, Siekmeyer M, Frille A, Wallborn T, Maier M, Pietsch C. In-Depth Analysis of the Re-Emergence of Respiratory Syncytial Virus at a Tertiary Care Hospital in Germany in the Summer of 2021 after the Alleviation of Non-Pharmaceutical Interventions Due to the SARS-CoV-2 Pandemic. Viruses 2023; 15:877. [PMID: 37112857 PMCID: PMC10144477 DOI: 10.3390/v15040877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/24/2023] [Accepted: 03/28/2023] [Indexed: 04/29/2023] Open
Abstract
Following the extensive non-pharmaceutical interventions (NPIs) and behavioral changes in the wake of the SARS-CoV-2 pandemic, an interseasonal rise in respiratory syncytial virus (RSV) cases was observed in Germany in 2021. The aim of this study was to characterize the local molecular epidemiology of RSV infections in comparison to the three pre-pandemic seasons. Additionally, clinical data were retrieved from patient charts to determine the clinical significance of RSV infections. RSV detections peaked in calendar week 40 of 2021, 18 weeks earlier than the usual peak observed in the three pre-pandemic seasons. Sequence analysis revealed a close phylogenetic relatedness regardless of the season of origin. A significantly higher amount of pediatric cases (88.9% of all cases, p < 0.001) was observed for season 2021/2022. For the pediatric cases, significant differences were observed for an increased number of siblings in the household (p = 0.004), a lower rate of fever (p = 0.007), and a reduced amount of co-infections (p = 0.001). Although the mean age of the adult patients was significantly younger (47.1 vs. 64.7, p < 0.001), high rates of comorbidities, lower respiratory tract infections and intensive care unit admissions prevailed. The NPIs in the wake of the SARS-CoV-2 pandemic had a tremendous impact on the epidemiologic characteristics and seasonality of RSV and warrant further epidemiologic studies of this important pathogen.
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Affiliation(s)
- Mario Hönemann
- Virology Department, Institute of Medical Microbiology and Virology, University of Leipzig, Johannisallee 30, 04103 Leipzig, Germany
| | - Stephanie Thiem
- Virology Department, Institute of Medical Microbiology and Virology, University of Leipzig, Johannisallee 30, 04103 Leipzig, Germany
| | - Sandra Bergs
- Virology Department, Institute of Medical Microbiology and Virology, University of Leipzig, Johannisallee 30, 04103 Leipzig, Germany
| | - Tom Berthold
- Virology Department, Institute of Medical Microbiology and Virology, University of Leipzig, Johannisallee 30, 04103 Leipzig, Germany
| | - Christian Propach
- Virology Department, Institute of Medical Microbiology and Virology, University of Leipzig, Johannisallee 30, 04103 Leipzig, Germany
| | - Manuela Siekmeyer
- Department of Pediatrics, University of Leipzig, Liebigstrasse 20a, 04103 Leipzig, Germany
| | - Armin Frille
- Department of Respiratory Medicine, University of Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany
| | - Tillmann Wallborn
- Department of Pediatrics, Klinikum St. Georg, Delitzscher Strasse 141, 04129 Leipzig, Germany
| | - Melanie Maier
- Virology Department, Institute of Medical Microbiology and Virology, University of Leipzig, Johannisallee 30, 04103 Leipzig, Germany
| | - Corinna Pietsch
- Virology Department, Institute of Medical Microbiology and Virology, University of Leipzig, Johannisallee 30, 04103 Leipzig, Germany
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Mandato C, Colucci A, Vajro P. Emerging, re-emerging and/or atypically behaving infectious diseases. Acta Paediatr 2023; 112:1145-1147. [PMID: 36944185 DOI: 10.1111/apa.16744] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 02/21/2023] [Accepted: 03/03/2023] [Indexed: 03/23/2023]
Affiliation(s)
- Claudia Mandato
- Dipartimento di Medicina, Chirurgia e Odontoiatria "Scuola Medica Salernitana", Section of Pediatrics, Baronissi, Italy
| | - Angelo Colucci
- Dipartimento di Medicina, Chirurgia e Odontoiatria "Scuola Medica Salernitana", Section of Pediatrics, Baronissi, Italy
| | - Pietro Vajro
- Dipartimento di Medicina, Chirurgia e Odontoiatria "Scuola Medica Salernitana", Section of Pediatrics, Baronissi, Italy
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Bonacina F, Boëlle PY, Colizza V, Lopez O, Thomas M, Poletto C. Global patterns and drivers of influenza decline during the COVID-19 pandemic. Int J Infect Dis 2023; 128:132-139. [PMID: 36608787 PMCID: PMC9809002 DOI: 10.1016/j.ijid.2022.12.042] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/02/2022] [Accepted: 12/27/2022] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES The influenza circulation reportedly declined during the COVID-19 pandemic in many countries. The occurrence of this change has not been studied worldwide nor its potential drivers. METHODS The change in the proportion of positive influenza samples reported by country and trimester was computed relative to the 2014-2019 period using the FluNet database. Random forests were used to determine predictors of change from demographical, weather, pandemic preparedness, COVID-19 incidence, and pandemic response characteristics. Regression trees were used to classify observations according to these predictors. RESULTS During the COVID-19 pandemic, the influenza decline relative to prepandemic levels was global but heterogeneous across space and time. It was more than 50% for 311 of 376 trimesters-countries and even more than 99% for 135. COVID-19 incidence and pandemic preparedness were the two most important predictors of the decline. Europe and North America initially showed limited decline despite high COVID-19 restrictions; however, there was a strong decline afterward in most temperate countries, where pandemic preparedness, COVID-19 incidence, and social restrictions were high; the decline was limited in countries where these factors were low. The "zero-COVID" countries experienced the greatest decline. CONCLUSION Our findings set the stage for interpreting the resurgence of influenza worldwide.
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Affiliation(s)
- Francesco Bonacina
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F75012 Paris, France; Sorbonne Université, CNRS, Laboratoire de Probabilités, Statistique et Modélisation, F-75013 Paris, France
| | - Pierre-Yves Boëlle
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F75012 Paris, France
| | - Vittoria Colizza
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F75012 Paris, France; Tokyo Tech World Research Hub Initiative (WRHI), Tokyo Institute of Technology, Tokyo, Japan
| | - Olivier Lopez
- Sorbonne Université, CNRS, Laboratoire de Probabilités, Statistique et Modélisation, F-75013 Paris, France
| | - Maud Thomas
- Sorbonne Université, CNRS, Laboratoire de Probabilités, Statistique et Modélisation, F-75013 Paris, France
| | - Chiara Poletto
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F75012 Paris, France; Department of Molecular Medicine, University of Padova, 35121 Padova, Italy.
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Cohen R, Levy C, Rybak A, Angoulvant F, Ouldali N, Grimprel E. Immune debt: Recrudescence of disease and confirmation of a contested concept. Infect Dis Now 2023; 53:104638. [PMID: 36535583 PMCID: PMC9756601 DOI: 10.1016/j.idnow.2022.12.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022]
Affiliation(s)
- Robert Cohen
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France; Université Paris Est, IMRB-GRC GEMINI, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France
| | - Corinne Levy
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France; Université Paris Est, IMRB-GRC GEMINI, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France.
| | - Alexis Rybak
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Department of Pediatric, Robert Debré Hospital, Paris University Hospital, Paris, France
| | - François Angoulvant
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Service de pédiatrie, Département femme-mère-enfant, CHU, Centre hospitalier universitaire vaudois, Lausanne, Suisse
| | - Naim Ouldali
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Department of Pediatric, Robert Debré Hospital, Paris University Hospital, Paris, France
| | - Emmanuel Grimprel
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Department of Pediatric, Trousseau Hospital, APHP Paris, France, Sorbonne University, France
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Zhang X, Du J, Li G, Chen T, Yang J, Yang J, Zhang T, Wang Q, Yang L, Lai S, Feng L, Yang W. Assessing the impact of COVID-19 interventions on influenza-like illness in Beijing and Hong Kong: an observational and modeling study. Infect Dis Poverty 2023; 12:11. [PMID: 36797765 PMCID: PMC9933034 DOI: 10.1186/s40249-023-01061-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 01/28/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND The impact of coronavirus diseases 2019 (COVID-19) related non-pharmaceutical interventions (NPIs) on influenza activity in the presence of other known seasonal driving factors is unclear, especially at the municipal scale. This study aimed to assess the impact of NPIs on outpatient influenza-like illness (ILI) consultations in Beijing and the Hong Kong Special Administrative Region (SAR) of China. METHODS We descriptively analyzed the temporal characteristics of the weekly ILI counts, nine NPI indicators, mean temperature, relative humidity, and absolute humidity from 2011 to 2021. Generalized additive models (GAM) using data in 2011-2019 were established to predict the weekly ILI counts under a counterfactual scenario of no COVID-19 interventions in Beijing and the Hong Kong SAR in 2020-2021, respectively. GAM models were further built to evaluate the potential impact of each individual or combined NPIs on weekly ILI counts in the presence of other seasonal driving factors in the above settings in 2020-2021. RESULTS The weekly ILI counts in Beijing and the Hong Kong SAR fluctuated across years and months in 2011-2019, with an obvious winter-spring seasonality in Beijing. During the 2020-2021 season, the observed weekly ILI counts in both Beijing and the Hong Kong SAR were much lower than those of the past 9 flu seasons, with a 47.5% [95% confidence interval (CI): 42.3%, 52.2%) and 60.0% (95% CI: 58.6%, 61.1%) reduction, respectively. The observed numbers for these two cities also accounted for only 40.2% (95% CI: 35.4%, 45.3%) and 58.0% (95% CI: 54.1%, 61.5%) of the GAM model estimates in the absence of COVID-19 NPIs, respectively. Our study revealed that, "Cancelling public events" and "Restrictions on internal travel" measures played an important role in the reduction of ILI in Beijing, while the "restrictions on international travel" was statistically most associated with ILI reductions in the Hong Kong SAR. CONCLUSIONS Our study suggests that COVID-19 NPIs had been reducing outpatient ILI consultations in the presence of other seasonal driving factors in Beijing and the Hong Kong SAR from 2020 to 2021. In cities with varying local circumstances, some NPIs with appropriate stringency may be tailored to reduce the burden of ILI caused by severe influenza strains or other respiratory infections in future.
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Affiliation(s)
- Xingxing Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100073, China
| | - Jing Du
- Beijing Centre for Disease Prevention and Control, Beijing, 100013, China
| | - Gang Li
- Beijing Centre for Disease Prevention and Control, Beijing, 100013, China
| | - Teng Chen
- Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY, 11794-3600, USA
| | - Jin Yang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100073, China
| | - Jiao Yang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100073, China
| | - Ting Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100073, China
| | - Qing Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100073, China
| | - Liuyang Yang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100073, China
- Department of Management Science and Information System, Faculty of Management and Economics, Kunming University of Science and Technology, Kunming, 650506, China
| | - Shengjie Lai
- WorldPop, School of Geography and Environmental Science, University of Southampton, Southampton, SO17 1BJ, UK.
| | - Luzhao Feng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100073, China.
| | - Weizhong Yang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100073, China.
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45
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Pettoello-Mantovani M, Pop TL, Giardino I, Vural M, Ferrara P, Somekh E. Epidemiologic Changes Caused by the Preventive Measures for the Coronavirus Disease 2019 Pandemic: An Additional Challenge for Pediatricians. J Pediatr 2023; 252:225-226.e1. [PMID: 36228682 PMCID: PMC9550291 DOI: 10.1016/j.jpeds.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Massimo Pettoello-Mantovani
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Association pour l'Activité et la Recherche Scìentifiques, Nouchatel, Switzerland; Italian Academy of Pediatrics, Milan, Italy.
| | - Tudor Lucian Pop
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Association pour l'Activité et la Recherche Scìentifiques, Nouchatel, Switzerland; Romania Society of Social Pediatrics, Cluj, Romania
| | - Ida Giardino
- Association pour l'Activité et la Recherche Scìentifiques, Nouchatel, Switzerland; Department of Biomedical Sciences, University of Foggia, Foggia, Italy
| | - Mehmet Vural
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Association pour l'Activité et la Recherche Scìentifiques, Nouchatel, Switzerland; Turkish Pediatric Association, Istanbul, Turkey
| | | | - Eli Somekh
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Association pour l'Activité et la Recherche Scìentifiques, Nouchatel, Switzerland; Department of Pediatrics, Mayanei Hayeshuah Medical Center, Bnei Brak, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Israel Pediatric Society, Tel Aviv, Israel
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46
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Martinez PP, Li J, Cortes CP, Baker RE, Mahmud AS. The Return of Wintertime Respiratory Virus Outbreaks and Shifts in the Age Structure of Incidence in the Southern Hemisphere. Open Forum Infect Dis 2022; 9:ofac650. [PMID: 36519120 PMCID: PMC9745764 DOI: 10.1093/ofid/ofac650] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 12/01/2022] [Indexed: 07/22/2023] Open
Affiliation(s)
- Pamela P Martinez
- Correspondence: Pamela P. Martinez, PhD, Department of Microbiology and Department of Statistics, University of Illinois at Urbana Champaign, Chemical and Life Sciences Laboratory, B103 CLSL, MC-110, S Goodwin Ave, Urbana, IL 61801 ()
| | - Junya Li
- Department of Microbiology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Claudia P Cortes
- Facultad de Medicina, Universidad de Chile, Santiago, Chile
- Fundacion Arriaran, Universidad de Chile, Santiago, Chile
- Clinica Santa Maria, Santiago, Chile
| | - Rachel E Baker
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey, USA
- Princeton High Meadows Environmental Institute, Princeton University, Princeton, New Jersey, USA
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island, USA
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Deng J, Heybati K, Garcia C, Huang E, Zhou F. The COVID-19 endemic: Calm before the storm of paediatric viral respiratory illnesses. QJM 2022; 116:329-331. [PMID: 36440950 DOI: 10.1093/qjmed/hcac264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 11/24/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Jiawen Deng
- Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, ON, Canada
| | - Kiyan Heybati
- Mayo Clinic Alix School of Medicine, Mayo Clinic (Rochester), 200 1st St SW, Rochester, MN, USA
| | - Cristian Garcia
- Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, ON, Canada
| | - Emma Huang
- Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON, Canada
| | - Fangwen Zhou
- Faculty of Health Sciences, McMaster University, 1280 Main St West, Hamilton, ON, Canada
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Buonsenso D, Morello R, Ferro V, Musolino AM, De Rose C, Inchingolo R, Valentini P. Are Lung Ultrasound Features More Severe in Children Diagnosed with Bronchiolitis after the COVID-19 Lockdown Period? J Clin Med 2022; 11:5294. [PMID: 36142940 PMCID: PMC9500987 DOI: 10.3390/jcm11185294] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/18/2022] [Accepted: 09/05/2022] [Indexed: 11/16/2022] Open
Abstract
The non-pharmacological measures implemented during the SARS-CoV-2 pandemic disrupted the usual bronchiolitis seasonality. Some authors have speculated that, after the lock down period, there would be an increase in the number and severity of respiratory infections due to the re-introduction of respiratory viruses. We collected clinical, microbiological and lung ultrasound data using the classification of the Italian Society of Thoracic Ultrasound (ADET) in children with bronchiolitis during the pandemic compared to the pre-pandemic period, with the aim of assessing whether the epidemic of bronchiolitis during the pandemic was characterized by a more severe lung involvement documented by lung ultrasound. We enrolled 108 children with bronchiolitis (52 pre-pandemic and 56 COVID-19 period), with a median age of 1.74 months (interquartile range, IQR 1-3.68) and 39.8% were females. Rhinovirus detection and high-flow nasal cannula usage were both increased during the COVID-19 period, although overall need of hospitalization and pediatric intensive care unit admissions did not change during the two periods. Lung ultrasound scores were similar in the two cohorts evaluated. Conclusions: our study suggests that, despite changes in microbiology and treatments performed, lung ultrasound severity scores were similar, suggesting that that bronchiolitis during the pandemic period was no more severe than pre-pandemic period, despite children diagnosed during the pandemic had a higher, but it was not statistically significant, probably, due to small sample size, probability of being admitted.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Centro di Salute Globale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Rosa Morello
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Valentina Ferro
- Dipartimento di Emergenza e Accettazione, Ospedale Pediatrico Bambino Gesù, 00165 Rome, Italy
| | - Anna Maria Musolino
- Dipartimento di Emergenza e Accettazione, Ospedale Pediatrico Bambino Gesù, 00165 Rome, Italy
| | - Cristina De Rose
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Riccardo Inchingolo
- Dipartimento Scienze Mediche e Chirurgiche, UOC Pneumologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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