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Riccò M, Corrado S, Bottazzoli M, Marchesi F, Gili R, Bianchi FP, Frisicale EM, Guicciardi S, Fiacchini D, Tafuri S. RSV Infection in Refugees and Asylum Seekers: A Systematic Review and Meta-Analysis. EPIDEMIOLOGIA 2024; 5:221-249. [PMID: 38920751 PMCID: PMC11202732 DOI: 10.3390/epidemiologia5020016] [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: 04/02/2024] [Revised: 05/20/2024] [Accepted: 05/23/2024] [Indexed: 06/27/2024] Open
Abstract
Respiratory diseases, including respiratory syncytial virus (RSV) infections, are common reasons for seeking healthcare among refugees and asylum seekers. A systematic review with meta-analysis was designed to appraise all the available evidence on RSV infections among individuals in refugee camps. Three medical databases (PubMed, Embase, and Scopus) as well as the preprint repository medRxiv.org were searched for eligible observational studies, and the collected cases were pooled in a random-effects meta-analysis model. Heterogeneity was assessed using the I2 statistics. Funnel plots and a regression analysis were calculated for analyzing reporting bias. Eventually, six studies were retrieved from three areas (Bangladesh, Thailand, and Kenya), with pooled estimates of 129.704 cases per 1000 samples (95% CI 66.393 to 237.986) for RSV compared to 110.287 per 1000 people for influenza A (95% CI 73.186 to 162.889), 136.398 cases per 1000 people (95% CI 84.510 to 212.741) for human adenovirus (HAdV), 69.553 per 1000 people (95% CI 49.802 to 96.343) for parainfluenzavirus (PIFV), and 60.338 per 1000 people (95% CI 31.933 to 111.109) for human metapneumovirus (hMPV). Using influenza A as a reference group, the risk for a positive specimen was greater for RSV (relative risk [RR] 1.514, 95% CI 1.396 to 1.641) and HAdV (RR 1.984, 95% CI 1.834 to 2.146) and lower for influenza B (RR 0.276, 95% CI: 0.239 to 0.319), PIFV (RR: 0.889, 95% CI 0.806 to 0.981), and hMPV (RR 0.594, 95% CI 0.534 to 0.662). In summary, high rates of RSV infections were documented among individuals sheltered in refugee camps, stressing the importance of specifically designed preventive strategies.
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Affiliation(s)
- Matteo Riccò
- AUSL–IRCCS di Reggio Emilia, Servizio di Prevenzione e Sicurezza Negli Ambienti di Lavoro (SPSAL), Local Health Unit of Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Silvia Corrado
- ASST Rhodense, Dipartimento Della Donna e Area Materno-Infantile, UOC Pediatria, 20024 Garbagnate Milanese, Italy;
| | - Marco Bottazzoli
- Department of Otorhinolaryngology, APSS Trento, 38122 Trento, Italy
| | - Federico Marchesi
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy;
| | - Renata Gili
- Department of Prevention, Turin Local Health Authority, Via Silvio Pellico 19, 10125 Turin, Italy
| | | | | | - Stefano Guicciardi
- Health Directorate, Local Health Authority of Bologna, 40127 Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40127 Bologna, Italy
| | - Daniel Fiacchini
- AST Ancona, Prevention Department, UOC Sorveglianza e Prevenzione Malattie Infettive e Cronico Degenerative, 60127 Ancona, Italy
| | - Silvio Tafuri
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, 70121 Bari, Italy
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Yoon Y, Lee HS, Yang J, Gwack J, Kim BI, Cha JO, Min KH, Kim YK, Shim JJ, Lee YS. Impact of Nonpharmacological Interventions on Severe Acute Respiratory Infections in Children: From the National Surveillance Database. J Korean Med Sci 2023; 38:e311. [PMID: 37846785 PMCID: PMC10578990 DOI: 10.3346/jkms.2023.38.e311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/21/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Nonpharmacological interventions (NPIs) reduce the incidence of respiratory infections. After NPIs imposed during the coronavirus disease 2019 pandemic ceased, respiratory infections gradually increased worldwide. However, few studies have been conducted on severe respiratory infections requiring hospitalization in pediatric patients. This study compares epidemiological changes in severe respiratory infections during pre-NPI, NPI, and post-NPI periods in order to evaluate the effect of that NPI on severe respiratory infections in children. METHODS We retrospectively studied data collected at 13 Korean sentinel sites from January 2018 to October 2022 that were lodged in the national Severe Acute Respiratory Infections (SARIs) surveillance database. RESULTS A total of 9,631 pediatric patients were admitted with SARIs during the pre-NPI period, 579 during the NPI period, and 1,580 during the post-NPI period. During the NPI period, the number of pediatric patients hospitalized with severe respiratory infections decreased dramatically, thus from 72.1 per 1,000 to 6.6 per 1,000. However, after NPIs ceased, the number increased to 22.8 per 1,000. During the post-NPI period, the positive test rate increased to the level noted before the pandemic. CONCLUSION Strict NPIs including school and daycare center closures effectively reduced severe respiratory infections requiring hospitalization of children. However, childcare was severely compromised. To prepare for future respiratory infections, there is a need to develop a social consensus on NPIs that are appropriate for children.
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Affiliation(s)
- Yoonsun Yoon
- Department of Pediatrics, Korea University Guro Hospital, Seoul, Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea
| | - Juyeon Yang
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea
| | - Jin Gwack
- Division of Infectious Disease Control, Bureau of Infectious Disease Policy, Korea Disease Control and Prevention Agency (KDCA), Cheongju, Korea
| | - Bryan Inho Kim
- Division of Infectious Disease Control, Bureau of Infectious Disease Policy, Korea Disease Control and Prevention Agency (KDCA), Cheongju, Korea
| | - Jeong-Ok Cha
- Division of Infectious Disease Control, Bureau of Infectious Disease Policy, Korea Disease Control and Prevention Agency (KDCA), Cheongju, Korea
| | - Kyung Hoon Min
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Yun-Kyung Kim
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Jae Jeong Shim
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Young Seok Lee
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea.
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Infodemiology of RSV in Italy (2017-2022): An Alternative Option for the Surveillance of Incident Cases in Pediatric Age? CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121984. [PMID: 36553427 PMCID: PMC9777371 DOI: 10.3390/children9121984] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022]
Abstract
The aim of this study was to evaluate whether or not online queries for Respiratory Syncytial Virus (RSV) retrieved by means of Google Trends™ and the Italian Wikipedia analysis program mirror the occurrence of influenza-like illnesses (ILI), as reported by the Italian Influenza Surveillance network (InfluNet). Estimated rates for ILI in the general population and in the age groups 0−4 years and 5−14 years were obtained for the influenza seasons 2017−2018 to 2020−2021. Similarly, a weekly fraction of online searches was retrieved for a series of terms associated with Respiratory Syncytial Virus. Next, trends for daily visualization of Italian Wikipedia Pages for Human Respiratory Syncytial Virus, Pneumonia, Bronchiolitis, Influenza, and Respiratory Failure were similarly retrieved. The correlation of all search terms with ILI was analyzed by means of Spearman’s rank correlation analysis. Among search terms associated with the clinical diagnosis of Respiratory Syncytial Virus infections, the occurrence of ILI was highly correlated only with Bronchiolitis in the age group 0−4 years (β 0.210, p = 0.028), while more generic search terms, such as Bronchitis, fever, influenza, and Pneumonia, were identified as effective predictors of ILI, in general and by age groups. In a regression analysis modeled with ILIs as the outcome variable, daily visualizations for the Wikipedia pages on Bronchiolitis were identified as negative predictors for ILI in general (β = −0.152, p = 0.032), ILI in age group 0−4 years (β = −0.264, p = 0.001) and 5−14 years (β = −0.202, p = 0.006), while Influenza was characterized as a positive effector for ILIs in the age group 5−14 years (β = 0.245, p = 0.001). Interestingly, not only were the search terms extensively correlated with one another, but all of them were also characterized by autocorrelation through a Durbin-Watson test (all estimates DW < 2.0) In summary, our study identified a complicated pattern of data visualization as no clear association between rates of ILI in pediatric age group 0−4 and 5 to 14 years was actually found. Finally, our data stress that the infodemiology option may be quite problematic for assessing the time trend of RSV infections in Italy until more appropriate reporting will be made available, by sharing estimates of Lower Respiratory Tract Infections, and through a more accurate characterization of younger age groups.
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Koltai M, Krauer F, Hodgson D, van Leeuwen E, Treskova-Schwarzbach M, Jit M, Flasche S. Determinants of RSV epidemiology following suppression through pandemic contact restrictions. Epidemics 2022; 40:100614. [PMID: 35901639 PMCID: PMC9301974 DOI: 10.1016/j.epidem.2022.100614] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 06/26/2022] [Accepted: 07/20/2022] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION COVID-19 related non-pharmaceutical interventions (NPIs) led to a suppression of RSV circulation in winter 2020/21 in the UK and an off-season resurgence in Summer 2021. We explore how the parameters of RSV epidemiology shape the size and dynamics of post-suppression resurgence and what we can learn about them from the resurgence patterns observed so far. METHODS We developed an age-structured dynamic transmission model of RSV and sampled the parameters governing RSV seasonality, infection susceptibility and post-infection immunity, retaining simulations fitting the UK's pre-pandemic epidemiology by a set of global criteria consistent with likelihood calculations. From Spring 2020 to Summer 2021 we assumed a reduced contact frequency, returning to pre-pandemic levels from Spring 2021. We simulated transmission forwards until 2023 and evaluated the impact of the sampled parameters on the projected trajectories of RSV hospitalisations and compared these to the observed resurgence. RESULTS Simulations replicated an out-of-season resurgence of RSV in 2021. If unmitigated, paediatric RSV hospitalisation incidence in the 2021/22 season was projected to increase by 30-60% compared to pre-pandemic levels. The increase was larger if infection risk was primarily determined by immunity acquired from previous exposure rather than age-dependent factors, exceeding 90 % and 130 % in 1-2 and 2-5 year old children, respectively. Analysing the simulations replicating the observed early outbreak in 2021 in addition to pre-pandemic RSV data, we found they were characterised by weaker seasonal forcing, stronger age-dependence of infection susceptibility and higher baseline transmissibility. CONCLUSION COVID-19 mitigation measures in the UK stopped RSV circulation in the 2020/21 season and generated immunity debt leading to an early off-season RSV epidemic in 2021. A stronger dependence of infection susceptibility on immunity from previous exposure increases the size of the resurgent season. The early onset of the RSV resurgence in 2021, its marginally increased size relative to previous seasons and its decline by January 2022 suggest a stronger dependence of infection susceptibility on age-related factors, as well as a weaker effect of seasonality and a higher baseline transmissibility. The pattern of resurgence has been complicated by contact levels still not back to pre-pandemic levels. Further fitting of RSV resurgence in multiple countries incorporating data on contact patterns will be needed to further narrow down these parameters and to better predict the pathogen's future trajectory, planning for a potential expansion of new immunisation products against RSV in the coming years.
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Affiliation(s)
- Mihaly Koltai
- Department for Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK.
| | - Fabienne Krauer
- Department for Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - David Hodgson
- Department for Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Edwin van Leeuwen
- Department for Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK; Statistics, Modelling and Economics Department, UK Health Security Agency, London, UK
| | | | - Mark Jit
- Department for Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Stefan Flasche
- Department for Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
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Baraldi E, Checcucci Lisi G, Costantino C, Heinrichs JH, Manzoni P, Riccò M, Roberts M, Vassilouthis N. RSV disease in infants and young children: Can we see a brighter future? Hum Vaccin Immunother 2022; 18:2079322. [PMID: 35724340 DOI: 10.1080/21645515.2022.2079322] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Respiratory syncytial virus (RSV) is a highly contagious seasonal virus and the leading cause of Lower Respiratory Tract Infections (LRTI), including pneumonia and bronchiolitis in children. RSV-related LRTI cause approximately 3 million hospitalizations and 120,000 deaths annually among children <5 years of age. The majority of the burden of RSV occurs in previously healthy infants. Only a monoclonal antibody (mAb) has been approved against RSV infections in a restricted group, leaving an urgent unmet need for a large number of children potentially benefiting from preventive measures. Approaches under development include maternal vaccines to protect newborns, extended half-life monoclonal antibodies to provide rapid long-lasting protection, and pediatric vaccines. RSV has been identified as a major global priority but a solution to tackle this unmet need for all children has yet to be implemented. New technologies represent the avenue for effectively addressing the leading-cause of hospitalization in children <1 years old.
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Affiliation(s)
- Eugenio Baraldi
- Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy
| | | | - Claudio Costantino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro", University of Palermo, Palermo, Italy
| | | | - Paolo Manzoni
- Department of Pediatrics and Neonatology, University Hospital Degli Infermi, Biella, Italy
| | - Matteo Riccò
- Dipartimento di Sanità Pubblica, Servizio di Prevenzione e Sicurezza Negli Ambienti di Lavoro (SPSAL), AUSL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Increased transmission of SARS-CoV-2 in Denmark during UEFA European championships. Epidemiol Infect 2022; 150:e123. [PMID: 35317884 PMCID: PMC9254153 DOI: 10.1017/s095026882200019x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Denmark hosted four games during the 2020 UEFA European championships (EC2020). After declining positive SARS-CoV-2 test rates in Denmark, a rise occurred during and after the tournament, concomitant with the replacement of the dominant Alpha lineage (B.1.1.7) by the Delta lineage (B.1.617.2), increasing vaccination rates and cessation of several restrictions. A cohort study including 33 227 cases was conducted from 30 May to 25 July 2021, 14 days before and after the EC2020. Included was a nested cohort with event information from big-screen events and matches at the Danish national stadium, Parken (DNSP) in Copenhagen, held from 12 June to 28 June 2021. Information from whole-genome sequencing, contact tracing and Danish registries was collected. Case–case connections were used to establish transmission trees. Cases infected on match days were compared to cases not infected on match days as a reference. The crude incidence rate ratio (IRR) of transmissions was 1.55, corresponding to 584 (1.76%) cases attributable to EC2020 celebrations. The IRR adjusted for covariates was lower (IRR 1.41) but still significant, and also pointed to a reduced number of transmissions from fully vaccinated cases (IRR 0.59). These data support the hypothesis that the EC2020 celebrations contributed to the rise of cases in Denmark in the early summer of 2021.
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Gong L, Wu C, Lu M, Huang C, Chen Y, Li Z, Huang G, Liu D, Tang X. Analysis of Incidence and Clinical Characteristics of RSV Infection in Hospitalized Children: A Retrospective Study. Risk Manag Healthc Policy 2021; 14:1525-1531. [PMID: 33889036 PMCID: PMC8054821 DOI: 10.2147/rmhp.s305370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 03/29/2021] [Indexed: 12/12/2022] Open
Abstract
Objective To investigate the incidence and clinical characteristics of hospitalized children with respiratory syncytial virus (RSV) infection, and to provide evidence for the importance of preventive strategies and improvements in supportive care of RSV infection. Methods This retrospective study included children under 14 years who received throat swab test and were diagnosed with RSV infection from January 2019 to December 2020. Throat swabs and intravenous blood were the main sources of samples, which were obtained within 24 hours of hospitalization. Direct immunofluorescence assay was used to diagnose RSV infection. Results Among the 448 hospitalized children with RSV infection, males (71.9%) showed the highest proportion, the highest incidence was found in children<6 months old (45.3%), and 76.6% of them had pneumonia. Pharyngeal redness, cough, expectoration, and mental fatigue were the most common symptoms in hospitalized children of all ages. More than 60% of hospitalized children had increased lymphocyte count, aspartate aminotransferase, creatine kinase-MB form, lactate dehydrogenase, and α-HBDH levels. The rates of myocardial damage, respiratory failure, stay in the intensive care unit (ICU), use of mechanical ventilation, and absorption of oxygen were higher in children<6 months old. Except for children who were 37-60 months old, the percentage of length of hospital stay≥7 days in the other age groups was greater than 62.0%. Except for children who were 0-28 days old and>61 months old, the other age groups showed a re-hospitalization situation due to re-infection with RSV. In hospitalized children diagnosed with RSV infection from throat swabs, we also performed the RSV IgM test and found that 59.2% of them were positive, 8.0% of them were weakly positive, and 32.8% of them were negative. Conclusion This study analyzes the incidence and clinical characteristics of hospitalized children with RSV infection, which provides evidence for the importance of preventive strategies and improvements in supportive care of RSV infection.
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Affiliation(s)
- Ling Gong
- The First Clinical Medical College, Jinan University, Guangzhou, 510632, People's Republic of China.,Department of Respiratory Medicine, The First People's Hospital of Zunyi (The Third Affiliated Hospital of Zunyi Medical University), Zunyi, 563000, People's Republic of China
| | - Chunyan Wu
- Department of Respiratory Medicine, The First People's Hospital of Zunyi (The Third Affiliated Hospital of Zunyi Medical University), Zunyi, 563000, People's Republic of China
| | - Mingjie Lu
- Department of Respiratory Medicine, The First People's Hospital of Zunyi (The Third Affiliated Hospital of Zunyi Medical University), Zunyi, 563000, People's Republic of China
| | - Chengyan Huang
- Department of Respiratory Medicine, The First People's Hospital of Zunyi (The Third Affiliated Hospital of Zunyi Medical University), Zunyi, 563000, People's Republic of China
| | - Yongqian Chen
- Department of Respiratory Medicine, The First People's Hospital of Zunyi (The Third Affiliated Hospital of Zunyi Medical University), Zunyi, 563000, People's Republic of China
| | - Zhu Li
- Department of Respiratory Medicine, The First People's Hospital of Zunyi (The Third Affiliated Hospital of Zunyi Medical University), Zunyi, 563000, People's Republic of China
| | - Guichuan Huang
- Department of Respiratory Medicine, The First People's Hospital of Zunyi (The Third Affiliated Hospital of Zunyi Medical University), Zunyi, 563000, People's Republic of China
| | - Daishun Liu
- Department of Respiratory Medicine, The First People's Hospital of Zunyi (The Third Affiliated Hospital of Zunyi Medical University), Zunyi, 563000, People's Republic of China
| | - Xiaoping Tang
- The First Clinical Medical College, Jinan University, Guangzhou, 510632, People's Republic of China.,Infectious Disease Department, Guangzhou Eighth People's Hospital (the Affiliated Hospital ofGuangzhou Medical University), Guangzhou, 510060, People's Republic of China
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