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Dovizio M, Veronesi C, Bartolini F, Cavaliere A, Grego S, Pagliaro R, Procacci C, Ubertazzo L, Bertizzolo L, Muzii B, Parisi S, Perrone V, Baraldi E, Bozzola E, Mosca F, Esposti LD. Clinical and economic burden of respiratory syncytial virus in children aged 0-5 years in Italy. Ital J Pediatr 2024; 50:57. [PMID: 38528616 DOI: 10.1186/s13052-024-01628-7] [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: 09/19/2023] [Accepted: 03/13/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is among the leading causes of hospitalization due to lower respiratory tract infections (LRTIs) in children younger than 5 years worldwide and the second cause of infant death after malaria. RSV infection occurs in almost all the infants before the second year of life with variable clinical severity, often requiring medical assistance. This analysis investigated patients aged 0-5 years with RSV infection focusing on epidemiology, clinical features, and economic burden of RSV-associated hospitalizations in a setting of Italian real clinical practice. METHODS An observational retrospective analysis was conducted on administrative databases of healthcare entities covering around 2.6 million residents of whom 120,000 health-assisted infants aged < 5 years. From 2010 to 2018, pediatric patients were included in the presence of hospitalization discharge diagnosis for RSV infections, and RSV-related acute bronchiolitis or pneumonia. Epidemiology, demographics, clinical picture and costs were evaluated in RSV-infected patients, overall and stratified by age ranges (0-1, 1-2, 2-5 years) and compared with an age-matched general population. RESULTS Overall 1378 RSV-infected children aged 0-5 years were included. Among them, the annual incidence rate of RSV-related hospitalizations was 175-195/100,000 people, with a peak in neonates aged < 1 year (689-806/100,000). While nearly 85% of infected infants were healthy, the remaining 15% presented previous hospitalization for known RSV risk factors, like preterm birth, or congenital heart, lung, and immune diseases. The economic analysis revealed that direct healthcare costs per patient/year were markedly higher in RSV patients than in the general population (3605€ vs 344€). CONCLUSIONS These findings derived from the real clinical practice in Italy confirmed that RSV has an important epidemiological, clinical, and economic burden among children aged 0-5 years. While the complex management of at-risk infants was confirmed, our data also highlighted the significant impact of RSV infection in infants born at term or otherwise healthy, demonstrating that all infants need protection against RSV disease, reducing then the risk of medium and long-term complications, such as wheezing and asthma.
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Affiliation(s)
- Melania Dovizio
- CliCon Società Benefit S.r.l., Health, Economics & Outcomes Research, Via Murri 9, Bologna, 40137, Italy
| | - Chiara Veronesi
- CliCon Società Benefit S.r.l., Health, Economics & Outcomes Research, Via Murri 9, Bologna, 40137, Italy
| | | | | | - Stefano Grego
- Dipartimento Tecnico-Amministrativo, ASL 3 Genovese, Genova, Italy
| | - Romina Pagliaro
- UOC Farmaceutica Territoriale, Azienda Sanitaria Locale Roma 5, Rome, Italy
| | - Cataldo Procacci
- Dipartimento Farmaceutico, ASL BAT (Barletta-Trani-Andria), Trani, Italy
| | | | | | | | | | - Valentina Perrone
- CliCon Società Benefit S.r.l., Health, Economics & Outcomes Research, Via Murri 9, Bologna, 40137, Italy
| | - Eugenio Baraldi
- Neonatal Intensive Care Unit, Department of Woman's and Child's Health, Padova University Hospital, Padova, Italy
| | - Elena Bozzola
- Pediatric Disease Unit, Bambino Gesù Children Hospital IRCCS, Rome, Italy
| | - Fabio Mosca
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Luca Degli Esposti
- CliCon Società Benefit S.r.l., Health, Economics & Outcomes Research, Via Murri 9, Bologna, 40137, Italy.
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Deng S, Guo L, Cohen C, Meijer A, Moyes J, Pasittungkul S, Poovorawan Y, Teirlinck A, van Boven M, Wanlapakorn N, Wolter N, Paget J, Nair H, Li Y. Impact of Subgroup Distribution on Seasonality of Human Respiratory Syncytial Virus: A Global Systematic Analysis. J Infect Dis 2024; 229:S25-S33. [PMID: 37249267 DOI: 10.1093/infdis/jiad192] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/18/2023] [Accepted: 05/29/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND Previous studies reported inconsistent findings regarding the association between respiratory syncytial virus (RSV) subgroup distribution and timing of RSV season. We aimed to further understand the association by conducting a global-level systematic analysis. METHODS We compiled published data on RSV seasonality through a systematic literature review, and unpublished data shared by international collaborators. Using annual cumulative proportion (ACP) of RSV-positive cases, we defined RSV season onset and offset as ACP reaching 10% and 90%, respectively. Linear regression models accounting for meteorological factors were constructed to analyze the association of proportion of RSV-A with the corresponding RSV season onset and offset. RESULTS We included 36 study sites from 20 countries, providing data for 179 study-years in 1995-2019. Globally, RSV subgroup distribution was not significantly associated with RSV season onset or offset globally, except for RSV season offset in the tropics in 1 model, possibly by chance. Models that included RSV subgroup distribution and meteorological factors explained only 2%-4% of the variations in timing of RSV season. CONCLUSIONS Year-on-year variations in RSV season onset and offset are not well explained by RSV subgroup distribution or meteorological factors. Factors including population susceptibility, mobility, and viral interference should be examined in future studies.
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Affiliation(s)
- Shuyu Deng
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Ling Guo
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Cheryl Cohen
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Adam Meijer
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, The Netherlands
| | - Jocelyn Moyes
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Siripat Pasittungkul
- Centre of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Yong Poovorawan
- Centre of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Anne Teirlinck
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, The Netherlands
| | - Michiel van Boven
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, The Netherlands
| | - Nasamon Wanlapakorn
- Centre of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nicole Wolter
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - John Paget
- Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Harish Nair
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - You Li
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
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Chan CM, Wahab AA, Ali A. Assessing the impact of COVID-19 on epidemiological changes of severe pediatric respiratory syncytial virus infections in Malaysia. Front Public Health 2024; 12:1246921. [PMID: 38356949 PMCID: PMC10866006 DOI: 10.3389/fpubh.2024.1246921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 01/19/2024] [Indexed: 02/16/2024] Open
Abstract
Introduction Respiratory syncytial virus (RSV) is one of the leading causes of hospitalization and mortality among children with respiratory tract infections. The non-pharmaceutical preventive measures against severe acute respiratory syndrome coronavirus (COVID-19) may have reduced the transmission of RSV, altering its tropical epidemiological seasonality. Thus, this study represents the first attempt to evaluate changes in RSV epidemiology in the context of COVID-19 pandemic in Malaysia. Methods Conducted at a tertiary hospital in Kuala Lumpur, Malaysia, this retrospective study analyzed collated data of children aged <12 years who were admitted for severe respiratory infections from 2017 to 2022. Time series models were used to predict the differences between actual and forecasted RSV cases, while logistic regression assessed the statistical association between RSV and COVID-19. Results Among the 4,084 children analyzed, we reported a significant inverse relationship between RSV and COVID-19 infections during the pandemic (2020-2021) (p < 0.05). In 2020, the RSV positivity rate sharply declined to 8.3 and 5.9%, respectively, in the two prominent seasons. Time series analysis showed a tremendous decrease in cases compared to the expected values, with reductions of 98.3% in the first season and 95.7% in the second season. However, following the lifting of the restriction order in 2022, RSV infections rose sharply with a positivity rate of 36.3%, higher than pre-COVID-19 pandemic levels. Conclusion This study provides evidence of increasing RSV cases post-COVID-19 pandemic, due to immunity debt. Hence, the healthcare system must be prepared to address future RSV outbreaks with the appropriate implementation of prophylaxis and public health measures.
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Affiliation(s)
- Chee Mun Chan
- Department of Pediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Research Center, Hospital Tunku Ampuan Besar Tuanku Aishah Rohani, UKM Specialist Children’s Hospital, Kuala Lumpur, Malaysia
| | - Asrul Abdul Wahab
- Department of Microbiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Adli Ali
- Department of Pediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Research Center, Hospital Tunku Ampuan Besar Tuanku Aishah Rohani, UKM Specialist Children’s Hospital, Kuala Lumpur, Malaysia
- Institute of IR4.0, Universiti Kebangsaan Malaysia, Bangi, Malaysia
- Infection and Immunology Health and Advanced Medicine Cluster, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Rice E, Oakes DB, Holland C, Moore HC, Blyth CC. Respiratory syncytial virus in children: epidemiology and clinical impact post-COVID-19. Curr Opin Infect Dis 2023; 36:522-528. [PMID: 37830952 DOI: 10.1097/qco.0000000000000967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
PURPOSE OF REVIEW Respiratory syncytial virus (RSV) remains a leading cause of mortality and morbidity worldwide. RSV seasonality was disrupted by COVID-19-associated nonpharmaceutical interventions (NPIs). We review RSV seasonality, molecular epidemiology, clinical manifestations, and community awareness to inform future prevention strategies. RECENT FINDINGS An initial reduction of RSV disease observed with NPIs, and subsequent global resurgence was associated with a collapse in genetic diversity. A lack of immunity is suggested to have contributed to the resurgence of RSV cases experienced post COVID-19. The median age of children admitted with RSV increased during the resurgence, likely secondary to the expanded cohort of RSV-immune naive children. The pandemic also played a role in increased community awareness, which can be utilized as part of a coordinated public health effort to introduce prevention strategies. Further education on signs and symptoms of RSV is still required. SUMMARY mAbs and maternal vaccines targeting RSV have the potential to reduce paediatric morbidity, however this new era of RSV prevention will require ongoing research to facilitate community awareness and engagement, and better respiratory surveillance. Tackling the global burden of RSV will require a coordinated effort and measures to ensure access and affordability of new prevention strategies.
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Affiliation(s)
- Emily Rice
- Department of General Paediatrics, Perth Children's Hospital, Hospital Avenue
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia
| | - Daniel B Oakes
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia
| | - Charlie Holland
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia
- School of Population Health, Curtin University
| | - Hannah C Moore
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia
- School of Population Health, Curtin University
| | - Christopher C Blyth
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia
- Department of Infectious Diseases, Perth Children's Hospital, Hospital Avenue
- School of Medicine, University of Western Australia
- Department of Microbiology, PathWest Laboratory Medicine, QEII Medical Centre, Perth, Western Australia
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Trang UTH, Phuong HVM, Hoang NH, Son NV, Thanh LT, Hang NLK, Cuong VD, Huong TTT, Hien NT, Anh NP, Mai LQ. Circulation of human respiratory syncytial virus and new ON1 genotype in northern Viet Nam, 2017-2020. Western Pac Surveill Response J 2023; 14:1-9. [PMID: 38021214 PMCID: PMC10646430 DOI: 10.5365/wpsar.2023.14.4.990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
Objective Human respiratory syncytial virus (RSV) is a primary cause of paediatric severe acute respiratory infection (SARI) worldwide, especially in developing countries. We investigated the genetic characteristics of RSV in northern Viet Nam to determine the prevalence and distribution of subtypes as well as the diversity and transmission patterns of genotypes. Methods In two facilities, from January 2017 to December 2020, 1563 clinical specimens were collected from paediatric patients hospitalized with SARI and tested for RSV. Selected positive samples underwent sequencing analysis targeting the second hypervariable region of the G gene using next-generation sequencing. Results The RSV positivity rate was 28.02% (438/1563 samples), and prevalence was highest in children aged < 1 year (43.84%; 192/438). Subtype RSV-A accounted for 53.42% (234/438) of cases, RSV-B for 45.89% (201/438), and there was coinfection in 0.68% (3/438). Both subtypes cocirculated and peaked during August-September in each year of the study. Phylogenetic analysis showed that RSV-A samples belonged to the ON1 genotype, which has three subgenotypes: ON1.1, ON1.2 and ON1.3. However, we did not find the 72-nucleotide duplication in the second hypervariable region of the G gene, a characteristic of genotype ON1, in any RSV-A samples. RSV-B samples belonged to genotype BA9. Discussion Our results provide additional molecular characterization of RSV infections in Viet Nam. Specially, our study is the first to report the absence of the 72-nucleotide duplication in the G gene of RSV-A genotype ON1 in Viet Nam, which may help in understanding the genetic evolution of RSV and be useful for vaccine development in the future.
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Affiliation(s)
- Ung Thi Hong Trang
- Graduate University of Science and Technology, Vietnam Academy of Science and Technology, Hanoi, Viet Nam
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
| | | | - Nguyen Huy Hoang
- Graduate University of Science and Technology, Vietnam Academy of Science and Technology, Hanoi, Viet Nam
- Institute of Genome Research, Vietnam Academy of Science and Technology, Hanoi, Viet Nam
| | - Nguyen Vu Son
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
| | - Le Thi Thanh
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
| | | | - Vuong Duc Cuong
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
| | | | - Nguyen Thi Hien
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
| | | | - Le Quynh Mai
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
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Wagatsuma K, Koolhof IS, Saito R. Nonlinear and Multidelayed Effects of Meteorological Drivers on Human Respiratory Syncytial Virus Infection in Japan. Viruses 2023; 15:1914. [PMID: 37766320 PMCID: PMC10535838 DOI: 10.3390/v15091914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/07/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
In this study, we aimed to characterize the nonlinear and multidelayed effects of multiple meteorological drivers on human respiratory syncytial virus (HRSV) infection epidemics in Japan. The prefecture-specific weekly time-series of the number of newly confirmed HRSV infection cases and multiple meteorological variables were collected for 47 Japanese prefectures from 1 January 2014 to 31 December 2019. We combined standard time-series generalized linear models with distributed lag nonlinear models to determine the exposure-lag-response association between the incidence relative risks (IRRs) of HRSV infection and its meteorological drivers. Pooling the 2-week cumulative estimates showed that overall high ambient temperatures (22.7 °C at the 75th percentile compared to 16.3 °C) and high relative humidity (76.4% at the 75th percentile compared to 70.4%) were associated with higher HRSV infection incidence (IRR for ambient temperature 1.068, 95% confidence interval [CI], 1.056-1.079; IRR for relative humidity 1.045, 95% CI, 1.032-1.059). Precipitation revealed a positive association trend, and for wind speed, clear evidence of a negative association was found. Our findings provide a basic picture of the seasonality of HRSV transmission and its nonlinear association with multiple meteorological drivers in the pre-HRSV-vaccination and pre-coronavirus disease 2019 (COVID-19) era in Japan.
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Affiliation(s)
- Keita Wagatsuma
- Division of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan;
- Japan Society for the Promotion of Science, Tokyo 102-0083, Japan
| | - Iain S. Koolhof
- College of Health and Medicine, School of Medicine, University of Tasmania, Hobart 7000, Australia;
| | - Reiko Saito
- Division of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan;
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Divarathna MVM, Rafeek RAM, Morel AJ, Aththanayake C, Noordeen F. Epidemiology and risk factors of respiratory syncytial virus associated acute respiratory tract infection in hospitalized children younger than 5 years from Sri Lanka. Front Microbiol 2023; 14:1173842. [PMID: 37434712 PMCID: PMC10330818 DOI: 10.3389/fmicb.2023.1173842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 06/09/2023] [Indexed: 07/13/2023] Open
Abstract
Background Respiratory syncytial virus (RSV) is the leading cause of acute respiratory tract infections (ARTI) and a major cause of morbidity and mortality in children worldwide. Aim This study aimed to describe the prevalence and seasonal patterns of RSV and to determine the actual and predictive association of RSV-associated ARTI and clinical, socio-demographic, and climatic risk factors in children < 5 years. Methods Nasopharyngeal aspirates were collected from 500 children < 5 years admitted to the Kegalle General Hospital, Sri Lanka between May 2016 to July 2018. RSV and RSV subtypes were detected using immunofluorescence assay and real time RT-PCR, respectively. Descriptive and inferential statistics were done for the data analysis using Chi-square, Fisher's exact, Kruskal-Wallis test, and multiple binary logistic regression in the statistical package for social sciences (SPSS), version 16.0. Results Prevalence of RSV-associated ARTI was 28% in children < 5 years. Both RSV subtypes were detected throughout the study period. RSV-B was the dominant subtype detected with a prevalence of 72.14%. RSV infection in general caused severe respiratory disease leading to hypoxemia. Compared to RSV-B, RSV-A infection had more symptoms leading to hypoxemia. Factors increasing the risk of contracting RSV infection included number of people living (n > 6), having pets at home and inhaling toxic fumes. The inferential analysis predicts RSV infection in children < 5 years with ARTI, with a 75.4% probability with clinical and socio-demographic characteristics like age < 1 year, fever for > 4 days, cough, conjunctivitis, stuffiness, fatigue, six or more people at home, having pets at home and inhaling toxic fumes. Climatic factors like increases in temperature (°C), wind speed (Km/h), wind gust (Km/h), rainfall (mm) and atmospheric pressure (mb) showed a strong correlation with the RSV infection in children.
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Affiliation(s)
- Maduja V. M. Divarathna
- Department of Microbiology, Faculty of Medicine, Diagnostic and Research Virology Laboratory, University of Peradeniya, Peradeniya, Sri Lanka
| | - Rukshan A. M. Rafeek
- Department of Microbiology, Faculty of Medicine, Diagnostic and Research Virology Laboratory, University of Peradeniya, Peradeniya, Sri Lanka
| | | | | | - Faseeha Noordeen
- Department of Microbiology, Faculty of Medicine, Diagnostic and Research Virology Laboratory, University of Peradeniya, Peradeniya, Sri Lanka
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Chan CM, Wahab AA, Ali A. Determining the Relationship of Meteorological Factors and Severe Pediatric Respiratory Syncytial Virus (RSV) Infection in Central Peninsular Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1848. [PMID: 36767211 PMCID: PMC9914795 DOI: 10.3390/ijerph20031848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/13/2023] [Accepted: 01/14/2023] [Indexed: 06/18/2023]
Abstract
Respiratory syncytial virus (RSV) is the most common pathogen causing viral respiratory tract infections among younger children worldwide. The influence of meteorological factors on RSV seasonal activity is well-established for temperate countries; however, in subtropical countries such as Malaysia, relatively stable temperate climates do not clearly support this trend, and the available data are contradictory. Better understanding of meteorological factors and seasonality of RSV will allow effective strategic health management relating to RSV infection, particularly immunoprophylaxis of high-risk infants with palivizumab. Retrospectively, from 2017 to 2021, we examined the association between various meteorological factors (rainfall, rainy days, temperature, and relative humidity) and the incidence of RSV in children aged less than 12 years in Kuala Lumpur, Malaysia. RSV activity peaked in two periods (July to August and October to December), which was significantly correlated with the lowest rainfall (p < 0.007) and number of rainy days (p < 0.005). RSV prevalence was also positively associated with temperature (p < 0.006) and inversely associated with relative humidity (p < 0.006). Based on our findings, we recommend that immunoprophylaxis with palivizumab be administered in children aged less than 2 years where transmission of RSV is postulated to be the highest after the end of two monsoon seasons.
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Affiliation(s)
- Chee Mun Chan
- Department of Pediatric, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Kuala Lumpur 56000, Malaysia
| | - Asrul Abdul Wahab
- Department of Microbiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Kuala Lumpur 56000, Malaysia
| | - Adli Ali
- Department of Pediatric, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Kuala Lumpur 56000, Malaysia
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Garba MA, Giwa FJ, Adelaiye H, Olorukooba AA, Abdullahi F, Makarfi H, Löwensteyn Y, Bont L, Abdurraheem F, Uudu E, Mudasir H, Mazur NI. Epidemiology of Respiratory Syncytial Virus-Associated Acute Lower Respiratory Tract Infection among Hospitalized Under-5s in Northwestern Nigeria. J PEDIAT INF DIS-GER 2023. [DOI: 10.1055/s-0042-1760446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Abstract
Objective Globally, 33 million cases of respiratory syncytial virus (RSV) infections occur annually among under-fives (5s). Ninety-nine percent of deaths from RSV occur in low- and middle-income countries. Under-five pneumonia mortality in Nigeria was estimated at 140,520 in 2017, but RSV epidemiological data are scant due to poor awareness and limited testing. Vaccines for RSV are currently under development and RSV mortality data from this high mortality, low resource setting are essential to maximizing the potential benefit of vaccination as well as promoting vaccine uptake. This study aimed to describe the epidemiology of RSV-associated acute lower respiratory tract infection (ALRTI) in children younger than 5 years in Zaria, Northwestern Nigeria.
Methods A prospective cohort study was conducted among children aged 1 month to 5 years who were hospitalized with ALRTI in the Emergency Pediatric Unit of a tertiary hospital in Zaria from November 2018 to October 2019. Naso-pharyngeal swabs were obtained for RSV testing using a point-of-care immunoassay technique.
Results Thirty-three percent (35/106) of the children had RSV-related ALRTI. The median age of RSV-positive cases was 8 months (IQR 3–14). Two-thirds of children (68.6%, 24/35) were below 12 months. The RSV mortality rate was 5.7% (2/35). RSV occurred in 10 months of the year with peaks in March and July.
Conclusion A third of admitted children with ALRTI were positive for RSV. Therefore RSV significantly contributes to childhood pneumonia and the dual seasonal peak observed in our study may have implications for vaccine implementation.
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Affiliation(s)
- Maria Ahuoiza Garba
- Department of Paediatrics, Faculty of Clinical Sciences, College of Medical Sciences, Ahmadu Bello University, Zaria, Kaduna State, Nigeria
| | - Fatima Jummai Giwa
- Department of Medical Microbiology, Faculty of Basic Clinical Sciences, College of Medical Sciences, Ahmadu Bello University, Zaria, Kaduna State, Nigeria
| | - Hamdala Adelaiye
- Department of Paediatrics, Ahmadu Bello University Teaching Hospital, Shika, Zaria, Kaduna State, Nigeria
| | - Abiola Aira Olorukooba
- Department of Paediatrics, Faculty of Clinical Sciences, College of Medical Sciences, Ahmadu Bello University, Zaria, Kaduna State, Nigeria
| | - Fatima Abdullahi
- Department of Paediatrics, Faculty of Clinical Sciences, College of Medical Sciences, Ahmadu Bello University, Zaria, Kaduna State, Nigeria
| | - Hauwa Makarfi
- Department of Paediatrics, Faculty of Clinical Sciences, College of Medical Sciences, Ahmadu Bello University, Zaria, Kaduna State, Nigeria
| | - Yvette Löwensteyn
- Department of Pediatric Infectious Diseases, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Louis Bont
- Department of Pediatric Infectious Diseases, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Fadlullah Abdurraheem
- Department of Paediatrics, Ahmadu Bello University Teaching Hospital, Shika, Zaria, Kaduna State, Nigeria
| | - Ehi Uudu
- Department of Paediatrics, Ahmadu Bello University Teaching Hospital, Shika, Zaria, Kaduna State, Nigeria
| | - Halima Mudasir
- Department of Paediatrics, Ahmadu Bello University Teaching Hospital, Shika, Zaria, Kaduna State, Nigeria
| | - Natalie I Mazur
- Department of Pediatric Infectious Diseases, University Medical Centre Utrecht, Utrecht, The Netherlands
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Sim JY, Chen YC, Hsu WY, Chen WY, Chou Y, Chow JC, Lai YC, Tang HJ, Chen CC, Ho CH, Chang TH. Circulating pediatric respiratory pathogens in Taiwan during 2020: Dynamic change under low COVID-19 incidence. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2022; 55:1151-1158. [PMID: 35450828 PMCID: PMC9767794 DOI: 10.1016/j.jmii.2022.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 02/16/2022] [Accepted: 03/24/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND In Taiwan, there were only 799 confirmed COVID-19 cases in 2020. The unique backdrop amidst a pandemic and promotion of nonpharmaceutical interventions generated some distinct changes in the epidemiology of common respiratory pathogens. In this study, we aimed to investigate the dynamic changes in respiratory pathogens in children during 2020. METHODS We performed a retrospective cohort study at a tertiary hospital in southern Taiwan during 2020. Patients aged 0-18 years who visited the pediatric emergency department were enrolled. Children who presented with clinical symptoms (fever or respiratory illness) and received nasopharyngeal swabs for multiplex polymerase chain reaction (PCR) were included in our analysis. We also compared respiratory syncytial virus (RSV) trends from previous years by PCR and lateral flow immunochromatographic assays from 2017 to 2020. RESULTS A total of 120 children were tested. The overall detection rate was 55%. With strengthened restrictions, the detection rate dropped from 70% to 30%. However, non-enveloped viruses (rhinovirus/enterovirus and adenovirus) were in constant circulation. Upon easing prevention measures, the detection rate remained above 60%, and an outbreak of an enveloped virus (RSV and parainfluenza virus) was noted. Compared with 2017-2019, the cyclical RSV epidemic was delayed, with a large surge in late 2020. CONCLUSIONS We observed a constant circulation of non-enveloped viruses when strict nonpharmaceutical interventions were employed and a delayed surge of enveloped viruses during the easing of restrictions. Continuous surveillance and monitoring of the evolutionary dynamics of respiratory viruses is important, while easing restrictions requires balanced judgment.
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Affiliation(s)
- Jun Yi Sim
- Department of Pediatrics, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taiwan
| | - Yu-Chin Chen
- Department of Pediatrics, Chi Mei Medical Center, Chiali, Tainan, Taiwan
| | - Wei-Yun Hsu
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan
| | - Wei-Yu Chen
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan
| | - Yun Chou
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan
| | - Julie Chi Chow
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan
| | - Yi-Ching Lai
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan
| | - Hung-Jen Tang
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Chi-Chung Chen
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan,Department of Food Science, National Chiayi University, Chiayi, Taiwan
| | - Chung-Han Ho
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan,Department of Information Management, Southern Taiwan University of Science and Technology, Tainan, Taiwan
| | - Tu-Hsuan Chang
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan,Corresponding author. Department of Pediatrics, Chi Mei Medical Center No.901, Zhonghua Rd., Yongkang Dist., Tainan City, 710, Taiwan. Fax: +886 6 220 370
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Low YL, Wong SY, Lee EKH, Muhammed MH. Prevalence of respiratory viruses among paediatric patients in acute respiratory illnesses in Malaysia. PLoS One 2022; 17:e0265288. [PMID: 35921317 PMCID: PMC9348681 DOI: 10.1371/journal.pone.0265288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 07/06/2022] [Indexed: 11/18/2022] Open
Abstract
Objectives
Acute respiratory infections (ARIs) are one of the leading causes of childhood morbidity and mortality worldwide. However, there is limited surveillance data on the epidemiological burden of respiratory pathogens in tropical countries like Malaysia. This study aims to estimate the prevalence of respiratory pathogens causing ARIs among children aged <18 years old in Malaysia and their epidemiological characteristics.
Methods
Nasopharyngeal swab specimens received at 12 laboratories located in different states of Malaysia from 2015–2019 were studied. Detection of 18 respiratory pathogens were performed using multiplex PCR.
Results
Data from a total of 23,306 paediatric patients who presented with ARI over a five-year period was studied. Of these, 18538 (79.5%) were tested positive. The most prevalent respiratory pathogens detected in this study were enterovirus/ rhinovirus (6837/ 23000; 29.7%), influenza virus (5176/ 23000; 22.5%) and respiratory syncytial virus (RSV) (3652/ 23000; 15.9%). Throughout the study period, RSV demonstrated the most pronounce seasonality; peak infection occurred during July to September. Whereas the influenza virus was detected year-round in Malaysia. No seasonal variation was noted in other respiratory pathogens. The risk of RSV hospitalisation was found to be significantly higher in children aged less than two years old, whereas hospitalisation rates for the influenza virus peaked at children aged between 3–6 years old.
Conclusion
This study provides insight into the epidemiology and the seasonality of the causative pathogens of ARI among the paediatric population in Malaysia. Knowledge of seasonal respiratory pathogens epidemiological dynamics will facilitate the identification of a target window for vaccination.
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Affiliation(s)
- Yoke Lee Low
- Pantai Premier Pathology Sdn Bhd, Kuala Lumpur, Malaysia
- * E-mail:
| | - Shin Yee Wong
- Pantai Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
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12
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Waterlow NR, Toizumi M, van Leeuwen E, Thi Nguyen HA, Myint-Yoshida L, Eggo RM, Flasche S. Evidence for influenza and RSV interaction from 10 years of enhanced surveillance in Nha Trang, Vietnam, a modelling study. PLoS Comput Biol 2022; 18:e1010234. [PMID: 35749561 PMCID: PMC9262224 DOI: 10.1371/journal.pcbi.1010234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 07/07/2022] [Accepted: 05/20/2022] [Indexed: 11/19/2022] Open
Abstract
Influenza and Respiratory Syncytial Virus (RSV) interact within their host posing the concern for impacts on heterologous viruses following vaccination. We aimed to estimate the population level impact of their interaction. We developed a dynamic age-stratified two-pathogen mathematical model that includes pathogen interaction through competition for infection and enhanced severity of dual infections. We used parallel tempering to fit its parameters to 11 years of enhanced hospital-based surveillance for acute respiratory illnesses (ARI) in children under 5 years old in Nha Trang, Vietnam. The data supported either a 41% (95%CrI: 36–54) reduction in susceptibility following infection and for 10.0 days (95%CrI 7.1–12.8) thereafter, or no change in susceptibility following infection. We estimate that co-infection increased the probability for an infection in <2y old children to be reported 7.2 fold (95%CrI 5.0–11.4); or 16.6 fold (95%CrI 14.5–18.4) in the moderate or low interaction scenarios. Absence of either pathogen was not to the detriment of the other. We find stronger evidence for severity enhancing than for acquisition limiting interaction. In this setting vaccination against either pathogen is unlikely to have a major detrimental effect on the burden of disease caused by the other. Influenza and Respiratory Syncytial Virus (RSV) cause large burdens of disease. Instead of acting independently, there may be short term cross-protection between them. The evidence of this to date comes from ecological studies which are unable to test the mechanism, or biological studies that are unable to determine the population level impacts of such cross-protection. We create a mathematical model that simulates the circulation of these two viruses, and allows for cross-protection between them. We then fit this model to hospital reported cases of confirmed infection from Nha Trang, Vietnam in order to estimate whether any cross-protection exists in this setting. We show that there are two possibilities—either no interaction or moderate interaction that can result in the observed circulation patterns. However, we further show that co-infection results in an increased reporting rate, presumably due to increased severity.
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Affiliation(s)
- Naomi R. Waterlow
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom
- * E-mail:
| | - Michiko Toizumi
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Edwin van Leeuwen
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Statistics, Modelling and Economics Department, UKHSA, London, United Kingdom
| | | | - Lay Myint-Yoshida
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Rosalind M. Eggo
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Stefan Flasche
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Wang J, Zhang L, Lei R, Li P, Li S. Effects and Interaction of Meteorological Parameters on Influenza Incidence During 2010-2019 in Lanzhou, China. Front Public Health 2022; 10:833710. [PMID: 35273941 PMCID: PMC8902077 DOI: 10.3389/fpubh.2022.833710] [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: 12/12/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
Background Influenza is a seasonal infectious disease, and meteorological parameters critically influence the incidence of influenza. However, the meteorological parameters linked to influenza occurrence in semi-arid areas are not studied in detail. This study aimed to clarify the impact of meteorological parameters on influenza incidence during 2010-2019 in Lanzhou. The results are expected to facilitate the optimization of influenza-related public health policies by the local healthcare departments. Methods Descriptive data related to influenza incidence and meteorology during 2010-2019 in Lanzhou were analyzed. The exposure-response relationship between the risk of influenza occurrence and meteorological parameters was explored according to the distributed lag no-linear model (DLNM) with Poisson distribution. The response surface model and stratified model were used to estimate the interactive effect between relative humidity (RH) and other meteorological parameters on influenza incidence. Results A total of 6701 cases of influenza were reported during 2010-2019. DLNM results showed that the risk of influenza would gradually increase as the weekly mean average ambient temperature (AT), RH, and absolute humidity (AH) decrease at lag 3 weeks when they were lower than 12.16°C, 51.38%, and 5.24 g/m3, respectively. The low Tem (at 5th percentile, P5) had the greatest effect on influenza incidence; the greatest estimated relative risk (RR) was 4.54 (95%CI: 3.19-6.46) at cumulative lag 2 weeks. The largest estimates of RRs for low RH (P5) and AH (P5) were 4.81 (95%CI: 3.82-6.05) and 4.17 (95%CI: 3.30-5.28) at cumulative lag 3 weeks, respectively. An increase in AT by 1°C led to an estimates of percent change (95%CI) of 3.12% (-4.75% to -1.46%) decrease in the weekly influenza case counts in a low RH environment. In addition, RH showed significant interaction with AT and AP on influenza incidence but not with wind speed. Conclusion This study indicated that low AT, low humidity (RH and AH), and high air pressure (AP) increased the risk of influenza. Moreover, the interactive effect of low RH with low AT and high AP can aggravate the incidence of influenza.
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Affiliation(s)
- Jinyu Wang
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Ling Zhang
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, China
| | - Ruoyi Lei
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, China
| | - Pu Li
- The Second People's Hospital of Baiyin, Baiyin, China
| | - Sheng Li
- The First People's Hospital of Lanzhou, Lanzhou, China
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Noble M, Khan RA, Walker B, Bennett E, Gent N. Respiratory syncytial virus-associated hospitalisation in children aged ≤5 years: a scoping review of literature from 2009 to 2021. ERJ Open Res 2022; 8:00593-2021. [PMID: 35651366 PMCID: PMC9149382 DOI: 10.1183/23120541.00593-2021] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 03/22/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Following the easing of COVID-19 restrictions in many countries, a surge in respiratory syncytial virus (RSV) hospitalisations was reported, surpassing yearly trends pre-pandemic. The changes to RSV epidemiology may have unforeseen effects on healthcare systems and populations globally, adding to the burden generated during the pandemic and placing increased demand on resources. Here we aim to identify recent global trends of RSV hospitalisation amongst children aged ≤5 years, to help inform policy makers in the planning of preventative interventions. Methods We conducted a scoping review of published literature between January 2009 and May 2021. Using keywords “Hospital admissions, Respiratory syncytial virus, RSV, Bronchiolitis, Children” we located studies using Medline, EMCARE, CINAHL and HMIC. Studies were eligible if they reported on trends/data for RSV hospitalisation amongst children aged ≤5 years. The articles were reviewed by two independent reviewers. Findings We assessed 3310 abstracts, reviewed 70 studies and included 56 studies in the final review. Findings were categorised into themes. The review highlighted that, although RSV incidence has been steadily increasing since 2009, the number of reported RSV hospitalisations decreased during lockdown. The highest numbers of hospitalisations were reported in children <1 year of age, particularly 0–2-month-old infants. Globally, RSV hospitalisations tend to peak in the winter months; however, since COVID-19 restrictions have eased, countries are reporting incidence peaks at different times, in contrast to the trends of previous years. Conclusion With greater physical interactions due to the relaxation of COVID-19 restriction measures, RSV-related hospitalisations can be seen to increase amongst children aged ≤5 years, possibly surpassing the numbers reported in previous RSV seasons. With #COVID19 restriction measures being eased globally, #RSV-related hospitalisation among children will increase, possibly surpassing pre-pandemic levelshttps://bit.ly/35lg4Iv
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Abstract
In this paper, we study and present a mathematical modeling approach based on artificial neural networks to forecast the number of cases of respiratory syncytial virus (RSV). The number of RSV-positive cases in most of the countries around the world present a seasonal-type behavior. We constructed and developed several multilayer perceptron (MLP) models that intend to appropriately forecast the number of cases of RSV, based on previous history. We compared our mathematical modeling approach with a classical statistical technique for the time-series, and we concluded that our results are more accurate. The dataset collected during 2005 to 2010 consisting of 312 weeks belongs to Bogotá D.C., Colombia. The adjusted MLP network that we constructed has a fairly high forecast accuracy. Finally, based on these computations, we recommend training the selected MLP model using 70% of the historical data of RSV-positive cases for training and 20% for validation in order to obtain more accurate results. These results are useful and provide scientific information for health authorities of Colombia to design suitable public health policies related to RSV.
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Thongpan I, Vichaiwattana P, Vongpunsawad S, Poovorawan Y. Upsurge of human rhinovirus infection followed by a delayed seasonal respiratory syncytial virus infection in Thai children during the coronavirus pandemic. Influenza Other Respir Viruses 2021; 15:711-720. [PMID: 34350701 PMCID: PMC8542963 DOI: 10.1111/irv.12893] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 07/19/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) and human rhinovirus (HRV) commonly cause influenza-like illness in young children. The global coronavirus pandemic beginning in 2020 altered the seasonality and prevalence of these respiratory infections in Thailand. We aimed to characterize the upsurge of HRV and the subsequent RSV infection observed among young children who sought medical care at a hospital in Bangkok. METHODS From July to December 2020, nasopharyngeal swabs from children ≤5 years of age presented with influenza-like illness were tested for RSV and HRV using reverse-transcription polymerase chain reaction. Positive samples were Sanger sequenced. Genotyping was performed using sequence and phylogenetic analysis. RESULTS Upsurge of HRV infection began in July and was subsequently replaced by a surge of RSV infection from September onward. In 6 months, HRV was detected in 27.5% (158/574) of the samples, of which 44% (69/158) were HRV-A, 7% (11/158) were HRV-B, and 36% (57/158) were HRV-C. Meanwhile, RSV was detected in 40.4% (232/574) of the samples, of which 78% (181/232) were RSV-A and 6% (14/232) were RSV-B. RSV peaked in October 2020, approximately 2 months later than typically seen in previous years. All RSV-A were of subgenotype ON1. Codetection of HRV and RSV was found in 5.1% (29/574). CONCLUSIONS HRV and RSV infection among young children coincided with relaxed local coronavirus public health measures, including the return to in-class schooling. The delayed RSV season in 2020 was predominantly associated with RSV-A.
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Affiliation(s)
- Ilada Thongpan
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Preeyaporn Vichaiwattana
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Sompong Vongpunsawad
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Yong Poovorawan
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Wagatsuma K, Koolhof IS, Shobugawa Y, Saito R. Decreased human respiratory syncytial virus activity during the COVID-19 pandemic in Japan: an ecological time-series analysis. BMC Infect Dis 2021; 21:734. [PMID: 34344351 PMCID: PMC8329631 DOI: 10.1186/s12879-021-06461-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/21/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Non-pharmaceutical interventions (NPIs), such as sanitary measures and travel restrictions, aimed at controlling the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), may affect the transmission dynamics of human respiratory syncytial virus (HRSV). We aimed to quantify the contribution of the sales of hand hygiene products and the number of international and domestic airline passenger arrivals on HRSV epidemic in Japan. METHODS The monthly number of HRSV cases per sentinel site (HRSV activity) in 2020 was compared with the average of the corresponding period in the previous 6 years (from January 2014 to December 2020) using a monthly paired t-test. A generalized linear gamma regression model was used to regress the time-series of the monthly HRSV activity against NPI indicators, including sale of hand hygiene products and the number of domestic and international airline passengers, while controlling for meteorological conditions (monthly average temperature and relative humidity) and seasonal variations between years (2014-2020). RESULTS The average number of monthly HRSV case notifications in 2020 decreased by approximately 85% (p < 0.001) compared to those in the preceding 6 years (2014-2019). For every average ¥1 billion (approximately £680,000/$9,000,000) spent on hand hygiene products during the current month and 1 month before there was a 0.29% (p = 0.003) decrease in HRSV infections. An increase of average 1000 domestic and international airline passenger arrivals during the previous 1-2 months was associated with a 3.8 × 10- 4% (p < 0.001) and 1.2 × 10- 3% (p < 0.001) increase in the monthly number of HRSV infections, respectively. CONCLUSIONS This study suggests that there is an association between the decrease in the monthly number of HRSV cases and improved hygiene and sanitary measures and travel restrictions for COVID-19 in Japan, indicating that these public health interventions can contribute to the suppression of HRSV activity. These findings may help in public health policy and decision making.
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Affiliation(s)
- Keita Wagatsuma
- Division of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi dori, Chuo-ku, Niigata City, 951-8510, Japan.
| | - Iain S Koolhof
- College of Health and Medicine, School of Medicine, University of Tasmania, Hobart, Australia
| | - Yugo Shobugawa
- Department of Active Ageing (donated by Tokamachi city, Niigata, Japan), Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Reiko Saito
- Division of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi dori, Chuo-ku, Niigata City, 951-8510, Japan
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Chuaychoo B, Rattanasaengloet K, Banlengchit R, Horthongkham N, Athipanyasilp N, Totanarungroj K, Muangman N. Characteristics, complications, and mortality of respiratory syncytial virus compared with influenza infections in hospitalized adult patients in Thailand. Int J Infect Dis 2021; 110:237-246. [PMID: 34303842 DOI: 10.1016/j.ijid.2021.07.045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/14/2021] [Accepted: 07/18/2021] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION RSV is increasingly recognized in adults. An improved understanding of clinical manifestations and complications may facilitate diagnosis and management. METHODS This was a retrospective study of hospitalized patients aged ≥ 18 years with RSV or influenza infection at Siriraj hospital, Thailand between January 2014 and December 2017. RESULTS RSV and/or influenza were detected by RT-PCR in 570 (20.1%) of 2836 patients. After excluding patients coinfected with influenza A and B (n = 5), and with influenza and RSV (n = 3), 141 (5.0%) RSV and 421 (14.8%) influenza patients were analyzed. Over the study period, RSV circulated during the rainy season and peaked in September or October. Patients with RSV were older than patients with influenza and presented significantly less myalgia and fever, but more wheezing. Pneumonia was the most common complication, occurring in 110 (78.0%) of RSV cases and in 295 (70.1%) of influenza cases (p = 0.069). Cardiovascular complications were found in 30 (21.3%) RSV and 96 (22.8%) influenza (p = 0.707), and were reasons for admission in 15 (10.6%) RSV and 50 (11.9%) influenza. The in-hospital mortality rates for RSV (17; 12.1%) and influenza (60; 14.3%) were similar (p = 0.512). CONCLUSIONS In Thailand, RSV is a less common cause of adult hospitalization than influenza, but pulmonary and cardiovascular complications, and mortality are similar. Clinical manifestations cannot reliably distinguish between RSV and influenza infection; laboratory-confirmed diagnosis is needed.
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Affiliation(s)
- Benjamas Chuaychoo
- Division of Respiratory Disease and Tuberculosis, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
| | - Kanokwan Rattanasaengloet
- Division of Respiratory Disease and Tuberculosis, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | - Navin Horthongkham
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Niracha Athipanyasilp
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kanyarat Totanarungroj
- Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Nisa Muangman
- Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Paudel B, Chu T, Chen M, Sampath V, Prunicki M, Nadeau KC. Increased duration of pollen and mold exposure are linked to climate change. Sci Rep 2021; 11:12816. [PMID: 34140579 PMCID: PMC8211740 DOI: 10.1038/s41598-021-92178-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 06/07/2021] [Indexed: 11/12/2022] Open
Abstract
Pollen and molds are environmental allergens that are affected by climate change. As pollen and molds exhibit geographical variations, we sought to understand the impact of climate change (temperature, carbon dioxide (CO2), precipitation, smoke exposure) on common pollen and molds in the San Francisco Bay Area, one of the largest urban areas in the United States. When using time-series regression models between 2002 and 2019, the annual average number of weeks with pollen concentrations higher than zero increased over time. For tree pollens, the average increase in this duration was 0.47 weeks and 0.51 weeks for mold spores. Associations between mold, pollen and meteorological data (e.g., precipitation, temperature, atmospheric CO2, and area covered by wildfire smoke) were analyzed using the autoregressive integrated moving average model. We found that peak concentrations of weed and tree pollens were positively associated with temperature (p < 0.05 at lag 0–1, 0–4, and 0–12 weeks) and precipitation (p < 0.05 at lag 0–4, 0–12, and 0–24 weeks) changes, respectively. We did not find clear associations between pollen concentrations and CO2 levels or wildfire smoke exposure. This study’s findings suggest that spore and pollen activities are related to changes in observed climate change variables.
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Affiliation(s)
- Bibek Paudel
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine and Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Theodore Chu
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Meng Chen
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine and Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Vanitha Sampath
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine and Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Mary Prunicki
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine and Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Kari C Nadeau
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine and Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, USA.
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Linssen RS, den Hollander B, Bont L, van Woensel JBM, Bem RA. The Association between Weather Conditions and Admissions to the Paediatric Intensive Care Unit for Respiratory Syncytial Virus Bronchiolitis. Pathogens 2021; 10:pathogens10050567. [PMID: 34067031 PMCID: PMC8150834 DOI: 10.3390/pathogens10050567] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 04/21/2021] [Accepted: 05/05/2021] [Indexed: 12/01/2022] Open
Abstract
Respiratory syncytial virus (RSV) bronchiolitis is a leading cause of global child morbidity and mortality. Every year, seasonal RSV outbreaks put high pressure on paediatric intensive care units (PICUs) worldwide, including in the Netherlands, and this burden appears to be increasing. Weather conditions have a strong influence on RSV activity, and climate change has been proposed as a potential important determinant of future RSV-related health care utilisation. In this national study spanning a total of 13 years with 2161 PICU admissions for RSV bronchiolitis, we aimed (1) to identify meteorological variables that were associated with the number of PICU admissions for RSV bronchiolitis in the Netherlands and (2) to determine if longitudinal changes in these variables occurred over time as a possible explanation for the observed increase in PICU burden. Poisson regression modelling was used to identify weather variables (aggregated in months and weeks) that predicted PICU admissions, and linear regression analysis was used to assess changes in the weather over time. Maximum temperature and global radiation best predicted PICU admissions, with global radiation showing the most stable strength of effect in both month and week data. However, we did not observe a significant change in these weather variables over the 13-year time period. Based on our study, we could not identify changing weather conditions as a potential contributing factor to the increased RSV-related PICU burden in the Netherlands.
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Affiliation(s)
- Rosalie S. Linssen
- Paediatric Intensive Care Unit, Emma Children’s Hospital, Amsterdam University Medical Centers, Location AMC, 1105 AZ Amsterdam, The Netherlands; (B.d.H.); (J.B.M.v.W.); (R.A.B.)
- Amsterdam Reproduction & Development (AR&D) and the Amsterdam Infection & Immunity (AR&I) Research Institutes Medical Centers, Location AMC, 1105 AZ Amsterdam, The Netherlands
- Correspondence: ; Tel.: +31-20-56-62453-E
| | - Bibiche den Hollander
- Paediatric Intensive Care Unit, Emma Children’s Hospital, Amsterdam University Medical Centers, Location AMC, 1105 AZ Amsterdam, The Netherlands; (B.d.H.); (J.B.M.v.W.); (R.A.B.)
| | - Louis Bont
- UMCU Laboratory of Translational Immunology, University Medical Center Utrecht, Wilhelmina Children’s Hospital, 3584 EA Utrecht, The Netherlands;
- Respiratory Syncytial Virus Network (ReSViNET) Foundation, 3703 CD Zeist, The Netherlands
| | - Job B. M. van Woensel
- Paediatric Intensive Care Unit, Emma Children’s Hospital, Amsterdam University Medical Centers, Location AMC, 1105 AZ Amsterdam, The Netherlands; (B.d.H.); (J.B.M.v.W.); (R.A.B.)
| | - Reinout A. Bem
- Paediatric Intensive Care Unit, Emma Children’s Hospital, Amsterdam University Medical Centers, Location AMC, 1105 AZ Amsterdam, The Netherlands; (B.d.H.); (J.B.M.v.W.); (R.A.B.)
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Epidemiology and Seasonality of Childhood Respiratory Syncytial Virus Infections in the Tropics. Viruses 2021; 13:v13040696. [PMID: 33923823 PMCID: PMC8074094 DOI: 10.3390/v13040696] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/03/2021] [Accepted: 02/19/2021] [Indexed: 12/19/2022] Open
Abstract
Infections caused by respiratory syncytial virus (RSV) are a major cause of morbidity and mortality in young children worldwide. Understanding seasonal patterns of region-specific RSV activity is important to guide resource allocation for existing and future treatment and prevention strategies. The decades of excellent RSV surveillance data that are available from the developed countries of the world are incredibly instructive in advancing public health initiatives in those regions. With few exceptions, these developed nations are positioned geographically across temperate regions of the world. RSV surveillance across tropical regions of the world has improved in recent years, but remains spotty, and where available, still lacks the necessary longitudinal data to determine the amount of seasonal variation expected over time. However, existing and emerging data collected across tropical regions of the world do indicate that patterns of infection are often quite different from those so well described in temperate areas. Here, we provide a brief summary regarding what is known about general patterns of RSV disease activity across tropical Asia, Africa and South America, then offer additional country-specific details using examples where multiple reports and/or more robust surveillance data have become available.
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