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Käding N, Waldeck F, Meier B, Boutin S, Borsche M, Balck A, Föh B, Kramer J, Klein C, Katalinic A, Rupp J. Influence of non-pharmaceutical interventions during the COVID-19 pandemic on respiratory viral infections - a prospective population-based cohort study. Front Public Health 2024; 12:1415778. [PMID: 38979040 PMCID: PMC11228307 DOI: 10.3389/fpubh.2024.1415778] [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: 04/11/2024] [Accepted: 06/10/2024] [Indexed: 07/10/2024] Open
Abstract
Non-pharmaceutical interventions (NPI) have been proven successful in a population-based approach to protect from SARS-CoV-2 transmission during the COVID-19 pandemic. As a consequential-effect, a reduction in the spread of all respiratory viruses has been observed, but the primary factors behind this phenomenon have yet to be identified. We conducted a subgroup analysis of participants from the ELISA study, a prospective longitudinal cohort study on SARS-CoV-2 transmission, at four timepoints from November 2020 - September 2022. The aim was to provide a detailed overview of the circulation of respiratory viruses over 2 years and to identify potential personal risk factors of virus distribution. All participants were screened using qPCR for respiratory viral infections from nasopharyngeal swabs and answered a questionnaire regarding behavioral factors. Several categories of risk factors for the transmission of respiratory viruses were evaluated using a scoring system. In total, 1,124 participants were included in the study, showing high adherence to governmental-introduced NPI. The overall number of respiratory virus infections was low (0-4.9% of participants), with adenovirus (1.7%), rhino-/enterovirus (3.2%) and SARS-CoV-2 (1.2%) being the most abundant. We detected an inverse correlation between the number and intensity of NPI and the number of detected respiratory viruses. More precisely, the attendance of social events and household size was associated with rhino-/enterovirus infection while social contacts were associated with being positive for any virus. NPI introduced during the COVID-19 pandemic reduced the occurrence of seasonal respiratory viruses in our study, showing different risk-factors for enhanced transmission between viruses. Trial registration DRKS.de, German Clinical Trials Register (DRKS), Identifier: DRKS00023418, Registered on 28 October 2020.
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Affiliation(s)
- Nadja Käding
- Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Frederike Waldeck
- Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Bjarne Meier
- Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Sébastien Boutin
- Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein, Lübeck, Germany
- Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Lübeck, Germany
| | - Max Borsche
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Alexander Balck
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Bandik Föh
- Department of Medicine I, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Jan Kramer
- LADR Laboratory Group Dr. Kramer and Colleagues, Geesthacht, Germany
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Alexander Katalinic
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Jan Rupp
- Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein, Lübeck, Germany
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Ruuskanen O, Dollner H, Luoto R, Valtonen M, Heinonen OJ, Waris M. Contraction of Respiratory Viral Infection During air Travel: An Under-Recognized Health Risk for Athletes. SPORTS MEDICINE - OPEN 2024; 10:60. [PMID: 38776030 PMCID: PMC11111432 DOI: 10.1186/s40798-024-00725-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 05/09/2024] [Indexed: 05/25/2024]
Abstract
Air travel has an important role in the spread of viral acute respiratory infections (ARIs). Aircraft offer an ideal setting for the transmission of ARI because of a closed environment, crowded conditions, and close-contact setting. Numerous studies have shown that influenza and COVID-19 spread readily in an aircraft with one virus-positive symptomatic or asymptomatic index case. The numbers of secondary cases differ markedly in different studies most probably because of the wide variation of the infectiousness of the infector as well as the susceptibility of the infectees. The primary risk factor is sitting within two rows of an infectious passenger. Elite athletes travel frequently and are thus prone to contracting an ARI during travel. It is anecdotally known in the sport and exercise medicine community that athletes often contract ARI during air travel. The degree to which athletes are infected in an aircraft by respiratory viruses is unclear. Two recent studies suggest that 8% of Team Finland members traveling to major winter sports events contracted the common cold most probably during air travel. Further prospective clinical studies with viral diagnostics are needed to understand the transmission dynamics and to develop effective and socially acceptable preventive measures during air travel.
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Affiliation(s)
- Olli Ruuskanen
- Department of Paediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, PL 52, 20521, Turku, Finland
| | - Henrik Dollner
- Department of Clinical and Molecular Medicine, Children's Clinic, St. Olavs University Hospital, Norwegian University of Science and Technology, Trondheim, Norway
| | - Raakel Luoto
- Department of Paediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, PL 52, 20521, Turku, Finland
| | | | - Olli J Heinonen
- Paavo Nurmi Centre and Unit for Health and Physical Activity, University of Turku, Turku, Finland
| | - Matti Waris
- Institute of Biomedicine, University of Turku and Department of Clinical Virology, Turku University Hospital, Kiinamyllynkatu 10, 20520, Turku, Finland.
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Abdulkader RS, Potdar V, Mohd G, Chadwick J, Raju MK, Devika S, Bharadwaj SD, Aggarwal N, Vijay N, Sugumari C, Sundararajan T, Vasuki V, Bharathi Santhose N, Mohammed Razik CA, Madhavan V, Krupa NC, Prabakaran N, Murhekar MV, Gupta N. Protocol for establishing a model for integrated influenza surveillance in Tamil Nadu, India. Front Public Health 2023; 11:1236690. [PMID: 37663861 PMCID: PMC10469860 DOI: 10.3389/fpubh.2023.1236690] [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: 06/08/2023] [Accepted: 08/04/2023] [Indexed: 09/05/2023] Open
Abstract
The potential for influenza viruses to cause public health emergencies is great. The World Health Organisation (WHO) in 2005 concluded that the world was unprepared to respond to an influenza pandemic. Available surveillance guidelines for pandemic influenza lack the specificity that would enable many countries to establish operational surveillance plans. A well-designed epidemiological and virological surveillance is required to strengthen a country's capacity for seasonal, novel, and pandemic influenza detection and prevention. Here, we describe the protocol to establish a novel mechanism for influenza and SARS-CoV-2 surveillance in the four identified districts of Tamil Nadu, India. This project will be carried out as an implementation research. Each district will identify one medical college and two primary health centres (PHCs) as sentinel sites for collecting severe acute respiratory infections (SARI) and influenza like illness (ILI) related information, respectively. For virological testing, 15 ILI and 10 SARI cases will be sampled and tested for influenza A, influenza B, and SARS-CoV-2 every week. Situation analysis using the WHO situation analysis tool will be done to identify the gaps and needs in the existing surveillance systems. Training for staff involved in disease surveillance will be given periodically. To enhance the reporting of ILI/SARI for sentinel surveillance, trained project staff will collect information from all ILI/SARI patients attending the sentinel sites using pre-tested tools. Using time, place, and person analysis, alerts for abnormal increases in cases will be generated and communicated to health authorities to initiate response activities. Advanced epidemiological analysis will be used to model influenza trends over time. Integrating virological and epidemiological surveillance data with advanced analysis and timely communication can enhance local preparedness for public health emergencies. Good quality surveillance data will facilitate an understanding outbreak severity and disease seasonality. Real-time data will help provide early warning signals for prevention and control of influenza and COVID-19 outbreaks. The implementation strategies found to be effective in this project can be scaled up to other parts of the country for replication and integration.
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Affiliation(s)
| | | | - Gulam Mohd
- National Institute of Epidemiology, Chennai, India
| | | | | | - S. Devika
- National Institute of Epidemiology, Chennai, India
| | | | | | - Neetu Vijay
- Indian Council of Medical Research, New Delhi, India
| | | | - T. Sundararajan
- Government Mohan Kumaramangalam Medical College, Salem, India
| | - V. Vasuki
- Tiruvarur Medical College Hospital, Tiruvarur, India
| | | | | | | | - N. C. Krupa
- National Institute of Epidemiology, Chennai, India
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Thind P, Vargas CY, Reed C, Wang L, Alba LR, Larson EL, Saiman L, Stockwell MS. Acceptability, Feasibility, and Validity of Detecting Respiratory Pathogens During Acute Respiratory Illness in Participant-Collected Swabs in a Low-Income, Community Sample. Open Forum Infect Dis 2023; 10:ofad068. [PMID: 36879622 PMCID: PMC9985149 DOI: 10.1093/ofid/ofad068] [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: 10/23/2022] [Indexed: 02/18/2023] Open
Abstract
Background Community surveillance for acute respiratory illness (ARI) can include unsupervised participant-collected nasal swabs. Little is known about use of self-swabs in low-income populations or among households including extended family members and the validity of self-collected swabs. We assessed the acceptability, feasibility, and validity of unsupervised participant-collected nasal swabs in a low-income, community sample. Methods This was a substudy of a larger prospective community-based ARI surveillance study in 405 households in New York City. Participating household members self-collected swabs on the day of a research home visit for an index case, and for 3-6 subsequent days. Demographics associated with agreement to participate and swab collection were assessed, and index case self-collected versus research staff-collected swab results were compared. Results Most households (n = 292 [89.6%]) agreed to participate, including 1310 members. Being <18 years old, female, and the household reporter or member of the nuclear family (parents and children) were associated with both agreement to participate and self-swab collection. Being born in the United States or immigrating ≥10 years ago was associated with participation, and being Spanish-speaking and having less than a high school education were associated with swab collection. In all, 84.4% collected at least 1 self-swabbed specimen; self-swabbing rates were highest during the first 4 collection days. Concordance between research staff-collected swabs and self-swabs was 88.4% for negative swabs, 75.0% for influenza, and 69.4% for noninfluenza pathogens. Conclusions Self-swabbing was acceptable, feasible, and valid in this low-income, minoritized population. Some differences in participation and swab collection were identified that could be noted by future researchers and modelers.
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Affiliation(s)
- Priyam Thind
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Celibell Y Vargas
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Carrie Reed
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Liqun Wang
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Luis R Alba
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Elaine L Larson
- School of Nursing, Columbia University Irving Medical Center, New York, New York, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York, USA
| | - Lisa Saiman
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
- Department of Infection Prevention and Control, New York–Presbyterian Hospital, New York, New York, USA
| | - Melissa S Stockwell
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
- Department of Population and Family Health, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York, USA
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Huang AH, Hsu WT, Lee CC. Respiratory Virus Burden in the Community: More Than What Meets the Eye. Clin Infect Dis 2022; 75:551. [PMID: 35148382 DOI: 10.1093/cid/ciac132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Amy Huaishiuan Huang
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Wan Ting Hsu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Chien Chang Lee
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Halabi KC, Stockwell MS, Alba L, Vargas C, Reed C, Saiman L. Clinical and socioeconomic burden of rhinoviruses/enteroviruses in the community. Influenza Other Respir Viruses 2022; 16:891-896. [PMID: 35485187 PMCID: PMC9343330 DOI: 10.1111/irv.12989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 03/13/2022] [Indexed: 11/26/2022] Open
Abstract
Background The epidemiology, clinical features, and socioeconomic burden associated with detection of rhinoviruses (RV)/enteroviruses (EV) from individuals in the community with acute respiratory infections (ARIs) are not fully understood. Methods To assess the clinical and socioeconomic burden associated with RV/EV, a secondary analysis of data collected during a prospective, community‐based ARI surveillance study was performed. From December 2012 to September 2017, adult and pediatric participants with ARIs had nasopharyngeal specimens obtained and tested by multiplex polymerase chain reaction assay. Characteristics and socioeconomic burden including missed school or work and/or antibiotic use among participants who did and did not seek medical care and among participants with and without co‐detection of another respiratory pathogen with RV/EV were compared. Results Throughout the study period, RV/EV was detected in 54.7% (885/1617) of ARIs with a respiratory pathogen detected. Most ARI episodes associated with RV/EV occurred in females (59.1%) and children ≤17 years old (64.2%). Those ≤17 years were more likely to seek medical care. Compared to those not seeking medical care (n = 686), those seeking medical care (n = 199) had a longer duration of illness (5 vs. 7 days) and were more likely to miss work/school (16.4% vs. 47.7%) and/or use antibiotics (3.6% vs. 34.2%). Co‐detection occurred in 8% of ARIs of which 81% occurred in children. Co‐detection was not associated with longer illness, more missed work/or school, or antibiotic use. Conclusion Non‐medically attended and medically attended ARIs associated with RV/EV resulted in clinical and socioeconomic burden, regardless of co‐detection of other respiratory pathogens.
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Affiliation(s)
| | - Melissa S Stockwell
- Columbia University Irving Medical Center, New York, New York, USA.,Mailman School of Public Health, Columbia University, New York, New York, USA.,New York-Presbyterian Hospital, New York, New York, USA
| | - Luis Alba
- Columbia University Irving Medical Center, New York, New York, USA
| | - Celibell Vargas
- Columbia University Irving Medical Center, New York, New York, USA
| | - Carrie Reed
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lisa Saiman
- Columbia University Irving Medical Center, New York, New York, USA.,New York-Presbyterian Hospital, New York, New York, USA
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