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Wang Q, Xiu S, Yang L, Li L, Yang M, Wang X, Shen Y, Wang W, Lin L. Perceptions about respiratory syncytial virus (RSV) and attitudes toward the RSV vaccine among the general public in China: A cross-sectional survey. Hum Vaccin Immunother 2024; 20:2310916. [PMID: 38369712 PMCID: PMC10877988 DOI: 10.1080/21645515.2024.2310916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/24/2024] [Indexed: 02/20/2024] Open
Abstract
Our study aims to assess the public's perceptions of respiratory syncytial virus (RSV) and attitudes toward the RSV vaccine and to identify associated factors in China. A nationwide cross-sectional survey conducted using an online platform between August 16 and September 14, 2023. Questions related to socio-demographics, awareness, knowledge, perceptions of susceptibility and severity of RSV, and attitudes toward the RSV vaccine were included in the questionnaire. We used the chi-square test and logistic regression model to explore the associated factors. Overall, 2133 individuals were included in this study. Nearly a quarter of participants (24.3%) indicated that they had never heard of RSV. The proportion of individuals aged over 50 years reporting never having heard of RSV (36.5%) and having a low knowledge level of RSV (55.3%) was significantly higher that of other younger age groups. More than half of individuals (55.7%) exhibited low level of perceptions of susceptibility concerning RSV infection. A total of 68.4% of the participants expressed willingness to receive the RSV vaccine. Younger age was positively associated with a higher willingness to be vaccinated. The most frequent reason for declining the vaccine was "Concern about vaccine's safety or side effects." About 60% of individuals considered a price of RSV vaccine below 200 CNY (28 USD) as acceptable. The awareness and perceived susceptibility to RSV infection were limited to the Chinese public. It is necessary to take measures to address the low awareness and knowledge of RSV and acceptability of the RSV vaccine among older adults.
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Affiliation(s)
- Qiang Wang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Shixin Xiu
- Department of Immunization, Wuxi Center for Disease Control and Prevention, Wuxi, China
| | - Liuqing Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
- Centre for Digital Public Health in Emergencies, Institute for Risk and Disaster Reduction, University College London, London, UK
| | - Lan Li
- Centre for Digital Public Health in Emergencies, Institute for Risk and Disaster Reduction, University College London, London, UK
| | - Min Yang
- Department of Immunization, Wuxi Center for Disease Control and Prevention, Wuxi, China
| | - Xuwen Wang
- Department of Immunization, Wuxi Center for Disease Control and Prevention, Wuxi, China
| | - Yuan Shen
- Department of Immunization, Wuxi Center for Disease Control and Prevention, Wuxi, China
| | - Weibing Wang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Leesa Lin
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- Laboratory of Data Discovery for Health (D4H), Hong Kong Science Park, Hong Kong Special Administrative Region, China
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong KongSpecial Administrative Region, China
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Michelin L, Bellei N, Ferreira da Costa Gomes M, Raboni SM, Kairalla M, Correa RA, Levi M, Chebabo A, Ballalai I, Cimerman S, Roteli-Martins CM, Aidé S, Dalcolmo MP, de Veras BMG, De Ávila Kfouri R, Cintra O. Respiratory syncytial virus: challenges in diagnosis and impact on the elderly: Recommendations from a multidisciplinary panel. Hum Vaccin Immunother 2024; 20:2388943. [PMID: 39161095 PMCID: PMC11340750 DOI: 10.1080/21645515.2024.2388943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/21/2024] Open
Abstract
Respiratory syncytial virus (RSV) is an important cause of respiratory illness. While most attention is paid to childhood infection, the RSV burden in adults ≥60 y should also be considered. In Brazil, this is generally underrecognized, where greater focus is toward other respiratory pathogens. This article presents insights from a multidisciplinary panel gathered to review epidemiologic data and current diagnostic approaches to RSV in Brazil (and their limitations) and develop communication strategies to improve knowledge and awareness. National surveillance data indicate a steady increase in cases of RSV-related severe acute respiratory illness (RSV-SARI) in those aged ≥60 y in recent years, with high fatality rates (>30%). Routine RSV testing in older individuals with respiratory symptoms is relatively low. Educational activities targeted toward health-care professionals and the general public are critical to raising awareness of the importance of RSV in older individuals, particularly as protective vaccines are now available.
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Affiliation(s)
| | - Nancy Bellei
- Laboratório de Virologia Clínica, Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), Disciplina de Infectologia, São Paulo, Brazil
| | | | - Sonia M Raboni
- Molecular Virology Research Laboratory, Universidade Federal do Paraná, Curitiba, Brazil
| | | | - Ricardo Amorim Correa
- Departamento de Clínica Médica, Serviço de Pneumologia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Monica Levi
- Sociedade Brasileira de Imunizações (SBim), São Paulo, Brazil
| | - Alberto Chebabo
- Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Isabela Ballalai
- Sociedade Brasileira de Imunizações (SBim), Rio de Janeiro, Brazil
| | - Sergio Cimerman
- Sociedade Brasileira de Imunizações (SBim), São Paulo, Brazil
- Instituto de Infectologia Emílio Ribas, São Paulo, Brazil
- Universidade Paulista (UNIP) - Campus Alphaville, São Paulo, Brazil
| | | | - Susana Aidé
- Maternal and Child Department, Faculty of Medicine, Universidade Federal Fluminense, Rio de Janeiro, Brazil
| | | | | | - Renato De Ávila Kfouri
- Universidade Federal de Sao Paulo, Sao Paulo, Brazil
- Sociedade Brasileira de Imunizações (SBim), São Paulo, Brazil
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3
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Zeng B, Liu X, Yang Q, Wang J, Ren Q, Sun F. Efficacy and safety of vaccines to prevent respiratory syncytial virus infection in infants and older adults: A systematic review and meta-analysis. Int J Infect Dis 2024; 146:107118. [PMID: 38878994 DOI: 10.1016/j.ijid.2024.107118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 07/08/2024] Open
Abstract
OBJECTIVES To determine the efficacy and safety of respiratory syncytial virus (RSV) vaccines in infants and older adults. METHODS We performed a systematic review and meta-analysis of randomized control trials that evaluated the efficacy of maternal RSV immunization against infections in infants, as well as the efficacy of RSV vaccines in older adults. The primary outcome was the vaccine efficacy against RSV-related lower respiratory tract disease (LRTD). Grading of Recommendations Assessment, Development and Evaluation criteria was used to evaluate the level of evidence. RESULTS Ten trials were included in the review. For maternal vaccination, the RSV vaccine showed favourable efficacy against RSV-related LRTD (vaccine efficacy 57.3%, 95% confidence interval [CI] 31.3-73.5; low certainty) and RSV-related severe LRTD (vaccine efficacy 81.9%, 95% CI 56.8-92.4; moderate certainty) in infants within 90 days after birth. For older adults, Meta-analysis showed that RSV vaccines could also reduce the risk of RSV-related LRTD (vaccine efficacy 78.3%, 95% CI 65.6-86.3; moderate certainty) and RSV-related severe LRTD (vaccine efficacy 86.5%, 95% CI 68.3-94.3; moderate certainty). There was no significant difference in serious adverse events between RSV vaccines and placebo. CONCLUSION RSV vaccines have the potential to offer protection against RSV disease in both infants and older adults, without apparent safety concerns.
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Affiliation(s)
- Baoqi Zeng
- Central Laboratory, Tianjin Fifth Central Hospital (Peking University Binhai Hospital), Tianjin, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Tianjin Key Laboratory of Epigenetic for Organ Development of Preterm Infants, Tianjin Fifth Central Hospital, Tianjin, China; Emergency Department of Tianjin Fifth Central Hospital, Tianjin, China.
| | - Xiaozhi Liu
- Central Laboratory, Tianjin Fifth Central Hospital (Peking University Binhai Hospital), Tianjin, China; Tianjin Key Laboratory of Epigenetic for Organ Development of Preterm Infants, Tianjin Fifth Central Hospital, Tianjin, China; High Altitude Characteristic Medical Research Institute, Huangnan Tibetan Autonomous Prefecture People's Hospital, Qinghai, China
| | - Qingqing Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Junjian Wang
- Emergency Department of Tianjin Fifth Central Hospital, Tianjin, China
| | - Qingcuo Ren
- High Altitude Characteristic Medical Research Institute, Huangnan Tibetan Autonomous Prefecture People's Hospital, Qinghai, China
| | - Feng Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
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Bonneux B, Jacoby E, Ceconi M, Stobbelaar K, Delputte P, Herschke F. Direct-acting antivirals for RSV treatment, a review. Antiviral Res 2024; 229:105948. [PMID: 38972604 DOI: 10.1016/j.antiviral.2024.105948] [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: 04/19/2024] [Revised: 06/20/2024] [Accepted: 06/24/2024] [Indexed: 07/09/2024]
Abstract
Respiratory syncytial virus (RSV) causes respiratory disease and complications in infants, the elderly and the immunocompromised. While three vaccines and two prophylactic monoclonal antibodies are now available, only one antiviral, ribavirin, is currently approved for treatment. This review aims to summarize the current state of treatments directly targeting RSV. Two major viral processes are attractive for RSV-specific antiviral drug discovery and development as they play essential roles in the viral cycle: the entry/fusion process carried out by the fusion protein and the replication/transcription process carried out by the polymerase complex constituted of the L, P, N and M2-1 proteins. For each viral target resistance mutations to small molecules of different chemotypes seem to delineate definite binding pockets in the fusion proteins and in the large proteins. Elucidating the mechanism of action of these inhibitors thus helps to understand how the fusion and polymerase complexes execute their functions. While many inhibitors have been studied, few are currently in clinical development for RSV treatment: one is in phase III, three in phase II and two in phase I. Progression was halted for many others because of strategic decisions, low enrollment, safety, but also lack of efficacy. Lessons can be learnt from the halted programs to increase the success rate of the treatments currently in development.
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Affiliation(s)
- Brecht Bonneux
- Laboratory for Microbiology, Parasitology and Hygiene, University of Antwerp, Universiteitsbaan 1, 2610, Wilrijk, Belgium; Janssen Pharmaceutica NV, Turnhoutseweg 30, 2340, Beerse, Belgium
| | - Edgar Jacoby
- Janssen Pharmaceutica NV, Turnhoutseweg 30, 2340, Beerse, Belgium
| | - Martina Ceconi
- Laboratory for Microbiology, Parasitology and Hygiene, University of Antwerp, Universiteitsbaan 1, 2610, Wilrijk, Belgium
| | - Kim Stobbelaar
- Janssen Pharmaceutica NV, Turnhoutseweg 30, 2340, Beerse, Belgium
| | - Peter Delputte
- Laboratory for Microbiology, Parasitology and Hygiene, University of Antwerp, Universiteitsbaan 1, 2610, Wilrijk, Belgium.
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Mitratza M, Elsobky M, Liang C, Bruyndonckx R, Polkowska-Kramek A, Ewnetu WB, Peerawaranun P, Tran TMP, Nuttens C, Grajales AG, Nzula S, Gessner BD, Begier E. Estimated Incidence of Hospitalizations Attributable to RSV Infection Among Adults in Ontario, Canada, Between 2013 and 2019. Infect Dis Ther 2024; 13:1949-1962. [PMID: 39004648 PMCID: PMC11343949 DOI: 10.1007/s40121-024-01018-w] [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: 04/01/2024] [Accepted: 07/02/2024] [Indexed: 07/16/2024] Open
Abstract
INTRODUCTION Adult respiratory syncytial virus (RSV) burden is underestimated due to non-specific symptoms, limited standard-of-care and delayed testing, reduced diagnostic test sensitivity-particularly when using single diagnostic specimen-when compared to children, and variable test sensitivity based on the upper airway specimen source. We estimated RSV-attributable hospitalization incidence among adults aged ≥ 18 years in Ontario, Canada, using a retrospective time-series model-based approach. METHODS The Institute for Clinical Evaluative Sciences data repository provided weekly numbers of hospitalizations (from 2013 to 2019) for respiratory, cardiovascular, and cardiorespiratory disorders. The number of hospitalizations attributable to RSV was estimated using a quasi-Poisson regression model that considered probable overdispersion and was based on periodic and aperiodic time trends and viral activity. As proxies for viral activity, weekly counts of RSV and influenza hospitalizations in children under 2 years and adults aged 60 years and over, respectively, were employed. Models were stratified by age and risk group. RESULTS In patients ≥ 60 years, RSV-attributable incidence rates were high for cardiorespiratory hospitalizations (range [mean] in 2013-2019: 186-246 [215] per 100,000 person-years, 3‒4% of all cardiorespiratory hospitalizations), and subgroups including respiratory hospitalizations (144-192 [167] per 100,000 person-years, 5‒7% of all respiratory hospitalizations) and cardiovascular hospitalizations (95-126 [110] per 100,000 person-years, 2‒3% of all cardiovascular hospitalizations). RSV-attributable cardiorespiratory hospitalization incidence increased with age, from 14-18 [17] hospitalizations per 100,000 person-years (18-49 years) to 317-411 [362] per 100,000 person-years (≥ 75 years). CONCLUSIONS Estimated RSV-attributable respiratory hospitalization incidence among people ≥ 60 years in Ontario, Canada, is comparable to other incidence estimates from high-income countries, including model-based and pooled prospective estimates. Recently introduced RSV vaccines could have a substantial public health impact.
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Affiliation(s)
| | | | - Caihua Liang
- Pfizer Inc, 66 Hudson Blvd E, New York, NY, 10001, USA.
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Falsey AR, Hosman T, Bastian AR, Vandenberghe S, Chan EKH, Douoguih M, Heijnen E, Comeaux CA, Callendret B. Long-term efficacy and immunogenicity of Ad26.RSV.preF-RSV preF protein vaccine (CYPRESS): a randomised, double-blind, placebo-controlled, phase 2b study. THE LANCET. INFECTIOUS DISEASES 2024; 24:1015-1024. [PMID: 38801826 DOI: 10.1016/s1473-3099(24)00226-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 03/20/2024] [Accepted: 03/28/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Ad26.RSV.preF-RSV preF protein showed 80·0% vaccine efficacy against respiratory syncytial virus (RSV) lower respiratory tract disease (LRTD) in older adults during one RSV season. No RSV vaccines have shown three-season efficacy. We aimed to evaluate efficacy of Ad26.RSV.preF-RSV preF protein over three RSV seasons. METHODS CYPRESS was a randomised, double-blind, placebo-controlled, phase 2b study done at 40 US clinical research centres wherein adults aged 65 years or older were centrally randomly assigned 1:1 by computer algorithm to receive Ad26.RSV.preF-RSV preF protein or placebo (one intramuscular injection) on day 1. Investigators, participants, site personnel, and the sponsor were masked to vaccine allocation, except for individuals involved in preparation of study vaccinations. The primary endpoint (first occurrence of RSV-mediated LRTD meeting one of three case definitions) was previously reported. Here, the predefined exploratory endpoint of vaccine efficacy against RSV-positive LRTD was assessed in the per-protocol efficacy set (all participants randomly assigned and vaccinated without protocol deviations affecting efficacy) through season 1 and from day 365 until the end of season 3. Humoral and cellular immunogenicity was assessed in a subset of randomly assigned and vaccinated participants. The secondary endpoint of safety through the first RSV season was previously reported; follow-up for selected safety outcomes (fatal adverse events, adverse events leading to study discontinuation, serious adverse events, and vaccine-related serious adverse events) until study completion is reported here in all randomly assigned and vaccinated participants. This trial is registered with ClinicalTrials.gov, NCT03982199 and is complete. FINDINGS Of 6672 adults screened, 5782 participants (2891 each receiving vaccine or placebo) were enrolled and vaccinated between Aug 5 and Nov 13, 2019. The season 2 per-protocol efficacy set included 2124 vaccine recipients and 2126 placebo recipients (season 3: 864 and 881; across three seasons: 2795 and 2803, respectively). Vaccine efficacy against RSV LRTD was 76·1% (95% CI 26·9-94·2) over seasons 2 and 3 and 78·7% (57·3-90·4) across three seasons. For those in the immunogenicity subset (vaccine n=97; placebo n=98), immune responses remained above baseline for at least 1 year. Serious adverse events occurred in 47 (2·1%) and 12 (1·3%) vaccine recipients and 45 (2·1%) and 10 (1·1%) placebo recipients during seasons 2 and 3, respectively. No treatment-related serious or fatal adverse events were reported. INTERPRETATION Ad26.RSV.preF-RSV preF protein maintained high efficacy against RSV LRTD in older adults across three RSV seasons. FUNDING Janssen Vaccines & Prevention.
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Affiliation(s)
- Ann R Falsey
- University of Rochester School of Medicine, Infectious Diseases Unit, Rochester, NY, USA
| | - Tessa Hosman
- Janssen Vaccines & Prevention, Leiden, Netherlands
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Ohbayashi H, Sakurai T, Himeji D, Fukushima Y, Takahashi H, Kiyosue A, Sabater Cabrera E, Matsuki T, Molnar D, Preckler Moreno V, Damaso S, Pirçon JY, Moitinho de Almeida M. Burden of respiratory syncytial virus infections in older adults with acute respiratory infection in Japan: An epidemiological study among outpatients. Respir Investig 2024; 62:914-921. [PMID: 39126825 DOI: 10.1016/j.resinv.2024.06.003] [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: 04/12/2024] [Revised: 05/31/2024] [Accepted: 06/16/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is a leading cause of acute respiratory illness, with severe outcomes in older adults. Information on the prevalence, hospitalization rate, and impact on the health-related quality of life (HRQoL) of RSV in older adults with acute respiratory infections (ARI) in outpatient settings in Japan is limited. METHODS This multi-center epidemiological study included outpatients aged ≥60 years presenting with ARI between August 2021 and February 2023. Nasal and throat swabs were collected and tested by reverse transcription polymerase chain reaction (RT-PCR). The prevalence of RT-PCR-confirmed RSV (cRSV)-ARI, cRSV-lower respiratory tract disease (LRTD), and other respiratory viruses was calculated by season, region, age group, and RSV subtype. HRQoL was assessed via patient-reported outcomes. RESULTS The study included 923 ARI episodes (cRSV-ARI: N = 24; non-cRSV-ARI: N = 899). In years 1 and 2 (August 2021-July 2022 and August 2022-February 2023), the prevalence of cRSV-ARI was 2.5% and 2.8%, respectively. There was a predominance of RSV-B and RSV-A subtypes in years 1 and 2, respectively. In years 1 and 2 combined, 37.5% of cRSV-ARI cases had lower respiratory tract infection; all cRSV-LRTD cases occurred in those aged 60-74 years. RSV-ARI cases reported throat, chest, and respiratory symptoms, leading to impaired functioning and HRQoL. CONCLUSIONS During the observed study period, RSV was circulating among older adults in Japan. RSV was a leading cause of ARI and LRTD. More data are needed to fully clarify the burden of RSV among older adults in Japan.
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Affiliation(s)
- Hiroyuki Ohbayashi
- Medical Corporation, Syureikai, Tohno Chuo Clinic, 1 Chome-14-1 Matsugasecho, Mizunami City, Gifu 50-6134, Japan
| | - Takayuki Sakurai
- NTT Medical Center, 5 Chome-9-22 Higashigotanda, Shinagawa City, Tokyo 141-8625, Japan
| | - Daisuke Himeji
- Miyazaki Prefectural Hospital, 5-30 Kitatakamatsucho, Miyazaki, 880-0017, Japan
| | - Yasushi Fukushima
- Fukuwa Clinic, 1 Chome-1-6, Kyobachi, Cyuo-ku, Tokyo 103-0027, Japan
| | - Hiroshi Takahashi
- Saka General Hospital, 16-5 Nishikicho, Shiogama, Miyagi 985-0024, Japan
| | - Arihiro Kiyosue
- Tokyo-Eki Center-building Clinic, 3 Chome-2-2 Nihonbashi, Chuo City, Tokyo 103-0027, Japan
| | | | - Taizo Matsuki
- GSK, Akasaka Intercity Air, 1 Chome-8-1 Akasaka, Minato City, Tokyo 107-0052, Japan
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8
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Sande CJ. The long-term efficacy of a respiratory syncytial virus vaccine for older adults. THE LANCET. INFECTIOUS DISEASES 2024; 24:941-942. [PMID: 38801825 DOI: 10.1016/s1473-3099(24)00290-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 05/29/2024]
Affiliation(s)
- Charles J Sande
- KEMRI-Wellcome Trust Research Programme, Kilifi 80108, Kenya; Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK.
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Amodio E, Belluzzo M, Genovese D, Palermo M, Pisciotta V, Vitale F. What 'case definition' for respiratory syncytial virus infection? Results of a systematic literature review to improve surveillance among the adults. J Public Health (Oxf) 2024; 46:326-334. [PMID: 38705841 DOI: 10.1093/pubmed/fdae066] [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: 09/09/2023] [Revised: 02/27/2024] [Accepted: 04/23/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND Human respiratory syncytial virus (hRSV) is a leading cause of acute lower respiratory tract infection in frail individuals, including children, the elderly and immunocompromised people, with mild to severe symptoms. World Health Organization claims hRSV causes most elderly influenza-like illnesses (ILI) and severe acute respiratory infections (SARI). In this study, different case definitions for hRSV surveillance were examined for accuracy. METHODS The following search query ('Respiratory Syncytial Virus' OR 'RSV' OR 'hRSV' AND 'case definition') was used on PubMed/MEDLINE and Scopus with a 15-year-old baseline age restriction to conduct a systematic literature review. RESULTS Of 12 records, 58% employed the SARI definition, 50% the ILI definition and 42% the acute respiratory infection (ARI) definition, with some overlap. In young adults (18-64 years old), most studies show RSV prevalence between 6.25 and 72.54 cases per 1000 per year, and 19.23 to 98.5 in older adults. The outpatient ARI and hospitalized SARI criteria are particularly sensitive and specific. CONCLUSIONS Disease burden measurement requires a clear case definition; however, current literature is questionable. Currently, hRSV surveillance uses numerous case definitions with debatable accuracy. The epidemiology, clinical characteristics, and disease burden of hRSV are difficult to characterize without a standard surveillance case definition.
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Affiliation(s)
- Emanuele Amodio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties 'G. D'Alessandro', University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
| | - Miriam Belluzzo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties 'G. D'Alessandro', University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
| | - Dario Genovese
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties 'G. D'Alessandro', University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
| | - Martina Palermo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties 'G. D'Alessandro', University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
| | - Vincenzo Pisciotta
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties 'G. D'Alessandro', University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
| | - Francesco Vitale
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties 'G. D'Alessandro', University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
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10
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Widagdo W, Bastian AR, Jastorff AM, Scheys I, De Paepe E, Comeaux CA, Ligtenberg N, Callendret B, Heijnen E. Concomitant Administration of Ad26.RSV.preF/RSV preF Protein Vaccine and High-Dose Influenza Vaccine in Adults 65 Years and Older: A Noninferiority Trial. J Infect Dis 2024; 230:e374-e383. [PMID: 38134393 PMCID: PMC11326816 DOI: 10.1093/infdis/jiad594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 12/13/2023] [Accepted: 12/21/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Since influenza and respiratory syncytial virus (RSV) carry significant burden in older adults with overlapping seasonality, vaccines for both pathogens would ideally be coadministered in this population. Here we evaluate the immunogenicity and safety of concomitant administration of Ad26.RSV.preF/RSV preF protein and high-dose seasonal influenza vaccine (Fluzone-HD) in adults ≥65 years old. METHODS Participants were randomized 1:1 to the Coadministration or Control group. The Coadministration group received concomitant Ad26.RSV.preF/RSV preF protein and Fluzone-HD on day 1 and placebo on day 29, while the Control group received Fluzone-HD and placebo on day 1 and Ad26.RSV.preF/RSV preF protein on day 29. Influenza hemagglutination-inhibiting and RSV preF-binding antibody titers were measured postvaccination and tested for noninferiority between both groups. Safety data were collected throughout the study and analyzed descriptively. RESULTS Coadministered Ad26.RSV.preF/RSV preF protein and Fluzone-HD vaccines induced noninferior immune responses compared to each vaccine administered alone. Seroconversion and seroprotection rates against influenza were similar between groups. Both vaccines remained well tolerated upon concomitant administration. CONCLUSIONS Coadministration of Ad26.RSV.preF/RSV preF protein and Fluzone-HD showed an acceptable safety profile and did not hamper the immunogenicity of either vaccine, thus supporting that both vaccines can be concomitantly administered in adults ≥65 years old.
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Affiliation(s)
- Widagdo Widagdo
- Janssen Vaccines and Prevention B.V., Leiden, The Netherlands
| | | | | | | | | | | | | | | | - Esther Heijnen
- Janssen Vaccines and Prevention B.V., Leiden, The Netherlands
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11
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Carrico J, Hicks KA, Wilson E, Panozzo CA, Ghaswalla P. The Annual Economic Burden of Respiratory Syncytial Virus in Adults in the United States. J Infect Dis 2024; 230:e342-e352. [PMID: 38060972 PMCID: PMC11326840 DOI: 10.1093/infdis/jiad559] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 12/05/2023] [Indexed: 08/17/2024] Open
Abstract
BACKGROUND Current estimates of the economic burden of respiratory syncytial virus (RSV) are needed for policymakers to evaluate adult RSV vaccination strategies. METHODS A cost-of-illness model was developed to estimate the annual societal burden of RSV in US adults aged ≥60 years. Additional analyses were conducted to estimate the burden of hospitalized RSV in all adults aged 50-59 years and in adults aged 18-49 years with potential RSV risk factors. RESULTS Among US adults aged ≥60 years, the model estimated 4.0 million annual RSV cases (95% uncertainty interval [UI], 2.7-5.6 million) and an annual economic burden of $6.6 billion (95% UI, $3.1-$12.9 billion; direct medical costs, $2.9 billion; indirect costs, $3.7 billion). The 4% of RSV cases that were hospitalized contributed to 94% of direct medical costs. Additional analyses estimated $422 million in annual hospitalization costs among all adults aged 50-59 years. Among adults aged 18-49 years with RSV risk factors, annual per capita burden was highest among people with congestive heart failure at $51 100 per 1000 people. DISCUSSION The economic burden of RSV is substantial among adults aged ≥50 years and among adults aged 18-49 years with RSV risk factors, underscoring the need for preventive interventions for these populations.
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12
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Gómez JA, Cintra O, Berzanskis A, Pacheco S, Jaswantlal H, Hasnaoui AE, van Oorschot DAM, Guzman-Holst A. Burden of Disease Due to Respiratory Syncytial Virus in Adults in Five Middle-Income Countries. Infect Dis Rep 2024; 16:750-762. [PMID: 39195008 DOI: 10.3390/idr16040057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 07/26/2024] [Accepted: 08/08/2024] [Indexed: 08/29/2024] Open
Abstract
Respiratory syncytial virus (RSV) is an important cause of severe respiratory disease in older adults. Understanding the disease burden is crucial for guiding vaccination policy and raising disease awareness. We estimated the burden of RSV hospitalizations and deaths in adults in five middle-income countries: Argentina, Brazil, Chile, Mexico, and Malaysia. Hospital discharge and death statistics due to any respiratory disease (ICD-10 codes: J00-99) from 2010 to 2022 were obtained. The RSV attributable burden on hospitalizations and deaths by age group was determined for 2019 using previously published estimates. Latin American countries showed distinct annual peaks in respiratory-related hospitalizations and deaths during winter months that were absent in Malaysia. Among ≥20-year-olds in 2019, there were 14,604 RSV-attributable hospitalizations nationally in Argentina, 44,323 in Brazil, 4529 in Chile, 7416 in Malaysia, and 8651 in Mexico, and 60-74% in ≥65-year-olds. There were also 3518 RSV-attributable deaths in Argentina, 9115 in Brazil, 801 in Chile, 704 in Malaysia, and 3806 in Mexico 79-88% in ≥65-year-olds. Incidences of RSV-attributable hospitalizations in ≥75-year-olds ranged between 256.3 and 294.3 per 100,000 population, and deaths between 33.6 and 112.9 per 100,000 population. RSV is associated with a substantial disease burden beyond pediatric age groups, and preventive vaccines could have a major impact on this burden, especially in older adults.
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Affiliation(s)
- Jorge A Gómez
- Value Evidence & Outcomes, Vaccines, Emerging Markets, GSK, Buenos Aires 1429, Argentina
| | - Otavio Cintra
- Medical Affairs, Vaccines, Emerging Markets, GSK, Sao Paulo 04001-083, Brazil
| | - Arnas Berzanskis
- Medical Affairs, Vaccines, Emerging Markets, GSK, London WC1A 1DG, UK
| | - Salma Pacheco
- Medical Affairs, Vaccines, Emerging Markets, GSK, Mexico City 03330, Mexico
| | - Henny Jaswantlal
- Medical Affairs, Vaccines, Emerging Markets, GSK, Petaling Jaya 47800, Selangor, Malaysia
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13
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Wu Y, Lu Y, Bai Y, Zhu B, Chang F, Lu Y. Efficacy, Safety, and Immunogenicity of Subunit Respiratory Syncytial Virus Vaccines: Systematic Review and Meta-Analysis of Randomized Controlled Trials. Vaccines (Basel) 2024; 12:879. [PMID: 39204005 PMCID: PMC11360664 DOI: 10.3390/vaccines12080879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2024] [Revised: 07/23/2024] [Accepted: 07/24/2024] [Indexed: 09/03/2024] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is garnering increasing attention, with a growing number of subunit RSV vaccines under active clinical investigation. However, comprehensive evidence is limited. METHODS We conducted a comprehensive search across PubMed, Embase, the Cochrane Library, Web of Science, and ClinicalTrials.gov from database inception to 12 January 2024, focusing on published randomized controlled trials (RCTs). RESULTS A total of 17 studies were included, encompassing assessments of efficacy (5 studies), safety (17 studies), and immunogenicity (12 studies) of RSV subunit vaccines. The pooled risk ratio (RR) for RSV-associated acute respiratory infection (RSV-ARI) with subunit vaccines was 0.31 (95% CI: 0.23-0.43), for RSV-associated lower respiratory tract infection (RSV-LRTI), it was 0.32 (95% CI: 0.22-0.44), and for severe RSV-LRTI (RSV-SLRTI), it was 0.13 (95% CI: 0.06-0.29). There was no significant difference in serious adverse events (SAEs) between the vaccine and placebo groups, with a pooled RR of 1.05 (95% CI: 0.98-1.14). The pooled standardized mean difference (SMD) for the geometric mean titer (GMT) of neutralizing antibodies was 2.89 (95% CI: 2.43-3.35). CONCLUSION Subunit RSV vaccines exhibit strong efficacy, favorable safety profiles, and robust immunogenicity. Future research should focus on the cost-effectiveness of various vaccines to enhance regional and national immunization strategies.
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Affiliation(s)
| | | | | | | | | | - Yun Lu
- Correspondence: (F.C.); (Y.L.)
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14
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Scholz S, Dobrindt K, Tufts J, Adams S, Ghaswalla P, Ultsch B, Gottlieb J. The Burden of Respiratory Syncytial Virus (RSV) in Germany: A Comprehensive Data Analysis Suggests Underdetection of Hospitalisations and Deaths in Adults 60 Years and Older. Infect Dis Ther 2024; 13:1759-1770. [PMID: 38914915 PMCID: PMC11266327 DOI: 10.1007/s40121-024-01006-0] [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: 04/16/2024] [Accepted: 06/07/2024] [Indexed: 06/26/2024] Open
Abstract
INTRODUCTION In Germany, the estimation of the disease burden of respiratory syncytial virus (RSV) in older adults is limited. This makes it challenging for public health decision-makers to develop evidence-based recommendations for newly available vaccines against RSV for individuals aged 60 years and older (60+). This study investigates publicly available data sources in Germany to address the current gaps in evidence regarding the burden of RSV. METHODS Hospitalisation databases from the German Federal Statistical Office and national mortality statistic between 2000 and 2023, as well as regular surveillance reports from the national public health institute since 2014, were utilised to extract, combine and analyse data on RSV-related morbidity and mortality. These data were used to triangulate the age-specific burden of RSV. RESULTS The data indicate that the number of RSV-related outpatient consultations ranges between 1,313,100 and 3,911,800 cases per season from 2014/2015 to 2022/2023 for all age groups, with approximately 13.0% of outpatient consultations occurring in adults 60+. The significant increase in hospitalisations over time suggests that heightened testing due to the coronavirus disease 2019 (COVID-19) pandemic revealed the underdetection of inpatient RSV cases in pre-pandemic seasons. In the most recent season recorded, 2022/2023, the data show 12,800 RSV-related hospitalisations in adults 60+ (24% of all RSV-related hospitalisations) and 1340 in-hospital deaths in adults 60+ (93% of all RSV-related deaths). CONCLUSION The comparison of pre- to post-pandemic seasons strongly suggest up to a sevenfold underdetection of RSV in individuals 60+, and the analysis of in-hospital mortality reveals higher mortality rates compared with the general German mortality statistics. These findings highlight the urgent need to improve surveillance and implement targeted prevention strategies to mitigate the impact of RSV in older adults.
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Affiliation(s)
- Stefan Scholz
- Moderna Germany GmbH, c/o Design Offices, Brienner Straße 45a-d, 80333, Munich, Germany.
| | - Kristina Dobrindt
- Moderna Germany GmbH, c/o Design Offices, Brienner Straße 45a-d, 80333, Munich, Germany
| | - Jennifer Tufts
- Moderna Germany GmbH, c/o Design Offices, Brienner Straße 45a-d, 80333, Munich, Germany
| | - Sarah Adams
- Moderna Germany GmbH, c/o Design Offices, Brienner Straße 45a-d, 80333, Munich, Germany
| | | | - Bernhard Ultsch
- Moderna Germany GmbH, c/o Design Offices, Brienner Straße 45a-d, 80333, Munich, Germany.
| | - Jens Gottlieb
- Medizinische Hochschule Hannover (MHH), Klinik für Pneumologie und Infektiologie, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
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15
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Buynak R, Cannon K, DeAtkine D, Kirby J, Usdan L, Bhavsar A, Gérard C, Kuznetsova A, Jayadev A, Amare H, Valenciano S, Meyer N. Randomized, Open-Label Phase 3 Study Evaluating Immunogenicity, Safety, and Reactogenicity of RSVPreF3 OA Coadministered with FLU-QIV-HD in Adults Aged ≥ 65. Infect Dis Ther 2024; 13:1789-1805. [PMID: 38981954 PMCID: PMC11266338 DOI: 10.1007/s40121-024-00985-4] [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: 02/01/2024] [Accepted: 04/30/2024] [Indexed: 07/11/2024] Open
Abstract
INTRODUCTION Respiratory syncytial virus (RSV) and influenza pose major disease burdens in older adults due to an aging immune system and comorbidities; seasonal overlap exists between these infections. In 2023, the RSV prefusion protein F3 older adult (RSVPreF3 OA) vaccine was first approved in the USA as a single dose for prevention of lower respiratory tract disease due to RSV in adults aged ≥ 60 years. The vaccine has since been approved in the European Union and elsewhere. RSVPreF3 OA and FLU-QIV-HD could be coadministered if immunogenicity, safety, and reactogenicity are not affected. METHODS This open-label, randomized (1:1), controlled, phase 3 study in 1029 adults aged ≥ 65 years in the USA evaluated the immunogenicity (up to 1 month after last vaccine dose) and safety (up to 6 months after last vaccine dose) of RSVPreF3 OA coadministered with FLU-QIV-HD (co-ad group) versus FLU-QIV-HD alone followed by RSVPreF3 OA at a separate visit 1 month later (control group). Non-inferiority criterion was defined as an upper limit of the two-sided 95% confidence interval of the geometric mean titer (GMT) group ratio (control/co-ad) ≤ 1.5. Secondary endpoints included safety and reactogenicity. RESULTS Proportions of participants across age categories between groups and proportions of male (50.4%) and female (49.6%) participants were well balanced; most participants were white (68.7%). Group GMT ratios for RSV-A neutralizing titers, hemagglutination inhibition titers for four influenza vaccine strains, and RSV-B neutralizing titers were non-inferior in the co-ad group versus the control group. No clinically meaningful differences in local or systemic solicited and unsolicited adverse events (AEs), serious AEs, and potential immune-mediated diseases were identified. The most common solicited AEs in both groups were injection-site pain and myalgia. CONCLUSION In adults aged ≥ 65 years, coadministration of RSVPreF3 OA and FLU-QIV-HD was immunogenically non-inferior to the sequential administration of both vaccines 1 month apart, and had clinically acceptable safety and reactogenicity profile. TRIAL REGISTRATION ClinicalTrials.gov identifier, NCT05559476.
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Affiliation(s)
| | - Kevin Cannon
- Accellacare Clinical Research, Wilmington, NC, USA
| | | | - John Kirby
- Summit Medical Group, Jefferson City, TN, USA
| | - Lisa Usdan
- Clinical Neuroscience Solution Healthcare, Memphis, TN, USA
| | - Amit Bhavsar
- GSK Vaccines, Avenue Fleming 20, 1300, Wavre, Belgium
| | | | | | | | - Hiwot Amare
- GSK Vaccines, Avenue Fleming 20, 1300, Wavre, Belgium
| | | | - Nadia Meyer
- GSK Vaccines, Avenue Fleming 20, 1300, Wavre, Belgium
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16
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Lee YL, Hsieh SM, Lin YT, Shie SS, Yang CJ, Hsueh PR. Burden of respiratory syncytial virus in older adults in Taiwan: An expert perspective on knowledge gaps. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2024; 57:523-532. [PMID: 38839543 DOI: 10.1016/j.jmii.2024.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Accepted: 05/24/2024] [Indexed: 06/07/2024]
Abstract
The burden of respiratory syncytial virus (RSV) infection among older adults in Taiwan is not well understood due to a scarcity of published epidemiological data. Nonetheless, the increasing proportion of older adults is anticipated to translate to increased burden of RSV infection, presenting a challenge to the healthcare system. Thus, an expert meeting was convened among a panel of infectious disease specialists from Taiwan to evaluate the existing local evidence and data gaps related to RSV infection in older adults (aged ≥50 years), and propose steps to generating evidence on disease burden among this population. Overall, there are few studies on the clinical and economic burden of RSV infection in Taiwan, and existing data are limited by small sample sizes and highly selected populations. Inconsistent RSV testing practices among older adults contribute to under-diagnosis and under-reporting, driven by limitations to reimbursement policies that discourage proactive RSV testing in older adults, and the lack of appropriate, targeted RSV treatment. Crucially, the paucity of epidemiological data may perpetuate a lack of awareness of RSV among clinicians and the public, hinder investments into RSV testing at a policymaker level, and thereby impede implementation of consistent diagnostic practices, precluding a deeper understanding of RSV. To overcome these challenges, it is imperative to prioritize generation of epidemiological data to establish the burden of RSV infection among older adults in Taiwan. Such data would also support a multi-stakeholder group in assessing the impact of future RSV-related interventions, such as educational initiatives and preventative strategies including vaccines.
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Affiliation(s)
- Yu-Lin Lee
- Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung City, Taiwan; School of Medicine, Chung Shan Medical University, Taichung City, Taiwan
| | - Szu-Min Hsieh
- Department of Internal Medicine, Division of Infectious Diseases, National Taiwan University Hospital, Taipei City, Taiwan; College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yi-Tsung Lin
- Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei City, Taiwan; Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shian-Sen Shie
- Division of Infectious Diseases, Department of Internal Medicine, Chang-Gung Memorial Hospital, Taoyuan City, Taiwan
| | - Chia-Jui Yang
- Division of Infectious Diseases, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Po-Ren Hsueh
- Departments of Laboratory Medicine and Internal Medicine, China Medical University Hospital, China Medical University, Taichung City, Taiwan.
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17
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Schwarz TF, Hwang SJ, Ylisastigui P, Liu CS, Takazawa K, Yono M, Ervin JE, Andrews CP, Fogarty C, Eckermann T, Collete D, de Heusch M, De Schrevel N, Salaun B, Lambert A, Maréchal C, Olivier A, Nakanwagi P, Lievens M, Hulstrøm V. Immunogenicity and Safety Following 1 Dose of AS01E-Adjuvanted Respiratory Syncytial Virus Prefusion F Protein Vaccine in Older Adults: A Phase 3 Trial. J Infect Dis 2024; 230:e102-e110. [PMID: 39052726 PMCID: PMC11272088 DOI: 10.1093/infdis/jiad546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/10/2023] [Accepted: 12/12/2023] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND The recently approved AS01E-adjuvanted respiratory syncytial virus (RSV) prefusion F protein-based vaccine for older adults (RSVPreF3 OA) demonstrated high efficacy against RSV-related disease in ≥60-year-olds. METHODS This ongoing phase 3 study in ≥60-year-olds evaluates immune persistence until 3 years after RSVPreF3 OA vaccination. Here, we describe interim results on humoral and cell-mediated immunogenicity, reactogenicity, and safety until 1 year post-dose 1. RESULTS In total, 1653 participants were vaccinated. One month post-dose 1, neutralization titers increased 10.5-fold (RSV-A) and 7.8-fold (RSV-B) vs pre-dose 1. Titers then declined to levels 4.4-fold (RSV-A) and 3.5-fold (RSV-B) above pre-dose 1 at month 6 and remained 3.1-fold (RSV-A) and 2.3-fold (RSV-B) above pre-dose 1 levels after 1 year. RSVPreF3-binding immunoglobulin G levels and CD4+ T-cell frequencies showed similar kinetics. Solicited administration-site and systemic adverse events (mostly mild to moderate and transient) were reported by 62.2% and 49.5% of participants. Serious adverse events were reported by 3.9% of participants within 6 months post-dose 1; 1 case was considered vaccine related. CONCLUSIONS One RSVPreF3 OA dose elicited cell-mediated and RSV-A- and RSV-B-specific humoral immune responses that declined over time but remained above pre-dose 1 levels for at least 1 year. The vaccine was well tolerated with an acceptable safety profile. Clinical Trials Registration. NCT04732871 (ClinicalTrials.gov).
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Affiliation(s)
- Tino F Schwarz
- Institute of Laboratory Medicine and Vaccination Centre, Klinikum Würzburg Mitte, Germany
| | - Shinn-Jang Hwang
- En Chu Kong Hospital, New Taipei City, and Taipei Veterans General Hospital and School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | | | - Chiu-Shong Liu
- China Medical University and China Medical University Hospital, Taichung, Taiwan
| | - Kenji Takazawa
- Medical Corporation Shinanokai, Shinanozaka Clinic, Tokyo, Japan
| | | | - John E Ervin
- Alliance for Multispecialty Research, Kansas City, Missouri
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18
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Na B, Park YJ, Seo J, Park M, Baek JY, Lee JY, Kim M, Ahn JG, Lee ST, Kang JM. Genotype Analysis of Respiratory Syncytial Virus Before and After the COVID-19 Pandemic Using Whole-Genome Sequencing: A Prospective, Single-Center Study in Korea From 2019 to 2022. J Korean Med Sci 2024; 39:e206. [PMID: 39048301 PMCID: PMC11263766 DOI: 10.3346/jkms.2024.39.e206] [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: 02/06/2024] [Accepted: 06/09/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV), a highly transmissible virus, is the leading cause of lower respiratory tract infections. We examined molecular changes in the RSV genome before and after the coronavirus disease 2019 (COVID-19) pandemic in Korea, and investigated whether drug-resistant mutations were present. METHODS In this prospective, single-center study, RSV-positive respiratory samples were collected between September 2019 and December 2022. Long-read whole-genome sequencing (WGS) was performed, and the presence of known drug-resistant substitutions for palivizumab, nirsevimab, and suptavumab was investigated. RESULTS Overall, 288 respiratory samples were collected from 276 children. WGS data were available for 133 samples (71 and 62 samples from the pre- and post-pandemic periods, respectively). All RSV-A strains (n = 56) belonged to the GA2.3.5 (ON1) genotype, whereas all RSV-B strains (n = 77) belonged to the GB5.0.5a (BA) genotype. No significant differences in genotypes were observed between the pre- and post-pandemic periods. In addition, no notable mutations related to nirsevimab or palivizumab resistance were detected in the F gene. However, the L172Q and S173L substitutions, which are known to confer resistance to suptavumab, were present in all RSV-B samples. CONCLUSION Despite the unprecedented interruption of RSV seasonality, there were no significant molecular changes in circulating RSV strains in Korea related to nirsevimab or palivizumab resistance before and after the COVID-19 pandemic. However, RSV-specific drug-resistance substitutions for suptavumab were identified.
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Affiliation(s)
- Bonhyang Na
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
- Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Korea
| | - Yu Jin Park
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea.
| | - Jieun Seo
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Miri Park
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jee Yeon Baek
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Young Lee
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Minyoung Kim
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
- Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Gyun Ahn
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
- Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Korea
| | - Seung Tae Lee
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
- Dxome Co., Ltd., Seongnam, Korea
| | - Ji-Man Kang
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
- Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Korea.
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19
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Riccò M, Cascio A, Corrado S, Bottazzoli M, Marchesi F, Gili R, Giuri PG, Gori D, Manzoni P. Occurrence of Central Nervous System Complications of Respiratory Syncytial Virus Infections: A Systematic Review with Meta-Analysis. EPIDEMIOLOGIA 2024; 5:421-455. [PMID: 39051211 PMCID: PMC11270441 DOI: 10.3390/epidemiologia5030031] [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: 04/26/2024] [Revised: 07/16/2024] [Accepted: 07/16/2024] [Indexed: 07/27/2024] Open
Abstract
An increasing base of evidence suggests that respiratory syncytial virus (RSV) infections may be associated with neurological complications. In accord with the PRISMA statement, we performed a systematic review and meta-analysis on the occurrence of encephalitis and encephalopathy associated with documented RSV infections. PubMed, Embase, and Scopus databases were searched for eligible observational studies published up to 10 April 2024. Raw data included the occurrence of RSV infections among cases of encephalitis and/or encephalopathy and cases of encephalitis and/or encephalopathy among series of RSV infections. Data were pooled in a random effects model. Case reports were also collected, and their data pooled as a cumulative series. Heterogeneity was assessed using the I2 measure, while reporting bias was assessed by means of funnel plots and regression analysis. A total of 15 studies for a total of 7719 RSV infections and 1631 cases of encephalitis were analyzed. Moreover, 27 case reports and case series were retrieved, for a total of 84 individual cases of encephalitis/encephalopathy occurring during a documented RSV infection. A pooled prevalence of 2.20 cases of encephalitis/encephalopathy per 100 RSV cases (I2 = 99%) was calculated, while a prevalence of RSV infections among cases of encephalitis/encephalopathy was estimated to 3.53 per 100 cases for studies on respiratory specimens (I2 = 48%) and 0.37 per cases on central nervous system (CNS) specimens (I2 = 0%). Detection of RSV within the CNS was relatively rare (17.86% of pooled case reports), being associated with male gender (adjusted odds ratio [aOR] 5.021, 95% confidence interval [95%CI] 1.104 to 22.831) and recovery with long-term sequelae (aOR 5.699, 95%CI 1.152; 28.183). Case fatality ratio was estimated to be 0.43 per 100 cases on observational studies and 10.71% in case reports, a difference likely due to publication bias. In summary, RSV represented a not frequent but notable cause of encephalitis/encephalopathy in adults and children. The paucity of available studies not only recommends a cautious appraisal of our results but stresses the clinical significance of future studies on incident cases of encephalitis and/or encephalopathy.
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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
| | - Antonio Cascio
- Infectious and Tropical Diseases Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, “G D’Alessandro”, University of Palermo, AOUP P. Giaccone, 90127 Palermo, Italy;
| | - Silvia Corrado
- ASST Rhodense, Dipartimento della donna e Area Materno-Infantile, UOC Pediatria, 20024 Milan, 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, 10125 Torino, Italy
| | | | - Davide Gori
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| | - Paolo Manzoni
- Department of Public Health and Pediatric Sciences, University of Torino School of Medicine, 10125 Turin, Italy
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20
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Mejias A, Ramilo O. RSV Prevention Within Reach for Older Infants and Toddlers: The Role of Active Immunization. J Pediatric Infect Dis Soc 2024; 13:S125-S130. [PMID: 38995087 DOI: 10.1093/jpids/piae049] [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: 03/10/2024] [Accepted: 05/17/2024] [Indexed: 07/13/2024]
Abstract
This review article will summarize the vaccines and monoclonal antibodies currently under evaluation for the prevention of RSV disease in older infants, toddlers and young children. We will review the rationale for passive protection during the first months of life, and the role of active immunization afterwards, either with live attenuated, protein-based or mRNA vaccines.
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Affiliation(s)
- Asuncion Mejias
- Department of Infectious Diseases, St Jude Children's Research Hospital, Memphis, Tennessee, USA
- Department of Pediatrics, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Octavio Ramilo
- Department of Infectious Diseases, St Jude Children's Research Hospital, Memphis, Tennessee, USA
- Department of Pediatrics, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
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21
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Kesteleyn B, Herschke F, Darville N, Stoops B, Jacobs T, Jacoby E, Shaffer P, Lammens L, Van Rompaey D, Matcha K, Martinez Lamenca C, Coesemans E, Hache G, Pieters S, Lecomte M, Hu L, Demin S, Milligan C, Abeywickrema P, De Bruyn S, Van Den Berg J, Ysebaert N, De Zwart L, Nájera I, Rigaux P, Roymans D, Jonckers THM. Spiro-Azetidine Oxindoles as Long-Acting Injectables for Pre-Exposure Prophylaxis against Respiratory Syncytial Virus Infections. J Med Chem 2024; 67:10986-11002. [PMID: 38932487 DOI: 10.1021/acs.jmedchem.4c00514] [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: 06/28/2024]
Abstract
Respiratory syncytial virus (RSV) is a major cause of hospitalization in infants, the elderly, and immune-compromised patients. While a half-life extended monoclonal antibody and 2 vaccines have recently been approved for infants and the elderly, respectively, options to prevent disease in immune-compromised patients are still needed. Here, we describe spiro-azetidine oxindoles as small molecule RSV entry inhibitors displaying favorable potency, developability attributes, and long-acting PK when injected as an aqueous suspension, suggesting their potential to prevent complications following RSV infection over a period of 3 to 6 months with 1 or 2 long-acting intramuscular (IM) or subcutaneous (SC) injections in these immune-compromised patients.
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Affiliation(s)
- Bart Kesteleyn
- Janssen Research & Development, Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse 2340, Belgium
| | - Florence Herschke
- Janssen Research & Development, Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse 2340, Belgium
| | - Nicolas Darville
- Janssen Research & Development, Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse 2340, Belgium
| | - Bart Stoops
- Janssen Research & Development, Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse 2340, Belgium
| | - Tom Jacobs
- Janssen Research & Development, Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse 2340, Belgium
| | - Edgar Jacoby
- Janssen Research & Development, Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse 2340, Belgium
| | - Paul Shaffer
- Janssen Research & Development, 1400 McKean Rd, Spring House, Pennsylvania 19477, United States
| | - Lieve Lammens
- Janssen Research & Development, Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse 2340, Belgium
| | - Dries Van Rompaey
- Janssen Research & Development, Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse 2340, Belgium
| | - Kiran Matcha
- Janssen Research & Development, Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse 2340, Belgium
| | | | - Erwin Coesemans
- Janssen Research & Development, Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse 2340, Belgium
| | - Geerwin Hache
- Janssen Research & Development, Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse 2340, Belgium
| | - Serge Pieters
- Janssen Research & Development, Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse 2340, Belgium
| | - Morgan Lecomte
- Janssen Research & Development, Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse 2340, Belgium
| | - Lili Hu
- Janssen Research & Development, Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse 2340, Belgium
| | - Samuel Demin
- Janssen Research & Development, Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse 2340, Belgium
| | - Cynthia Milligan
- Janssen Research & Development, 1400 McKean Rd, Spring House, Pennsylvania 19477, United States
| | - Pravien Abeywickrema
- Janssen Research & Development, 1400 McKean Rd, Spring House, Pennsylvania 19477, United States
| | - Suzanne De Bruyn
- Janssen Research & Development, Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse 2340, Belgium
| | - Joke Van Den Berg
- Janssen Research & Development, Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse 2340, Belgium
| | - Nina Ysebaert
- Janssen Research & Development, Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse 2340, Belgium
| | - Loeckie De Zwart
- Janssen Research & Development, Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse 2340, Belgium
| | - Isabel Nájera
- Janssen Research & Development, Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse 2340, Belgium
| | - Peter Rigaux
- Janssen Research & Development, Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse 2340, Belgium
| | - Dirk Roymans
- Janssen Research & Development, Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse 2340, Belgium
| | - Tim H M Jonckers
- Janssen Research & Development, Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse 2340, Belgium
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Villar-Álvarez F, García-Ortega A, Entrenas-Castillo M. Impact of Respiratory Syncytial Virus in Patients With Chronic Respiratory Disease. OPEN RESPIRATORY ARCHIVES 2024; 6:100345. [PMID: 39026514 PMCID: PMC11255356 DOI: 10.1016/j.opresp.2024.100345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024] Open
Affiliation(s)
- Felipe Villar-Álvarez
- Pneumology Department, IIS Fundación Jiménez Díaz, CIBERES, Universidad Autónoma of Madrid, Madrid, Spain
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Ferguson M, Murray A, Pliamm L, Rombo L, Sanmartin Berglund J, David MP, De Schrevel N, Maschino F, Kotb S, Olivier A, Hulstrøm V. Lot-to-lot immunogenicity consistency of the respiratory syncytial virus prefusion F protein vaccine in older adults. Vaccine X 2024; 18:100494. [PMID: 38746060 PMCID: PMC11090873 DOI: 10.1016/j.jvacx.2024.100494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 04/23/2024] [Accepted: 04/26/2024] [Indexed: 05/16/2024] Open
Abstract
Background Previous phase 3 studies showed that the AS01E-adjuvanted respiratory syncytial virus (RSV) prefusion F protein-based vaccine for older adults (RSVPreF3 OA) is well tolerated and efficacious in preventing RSV-associated lower respiratory tract disease in adults ≥ 60 years of age. This study evaluated lot-to-lot immunogenicity consistency, reactogenicity, and safety of three RSVPreF3 OA lots. Methods This phase 3, multicenter, double-blind study randomized (1:1:1) participants ≥ 60 years of age to receive one of three RSVPreF3 OA lots. Serum RSVPreF3-binding immunoglobulin G (IgG) concentration was assessed at baseline and 30 days post-vaccination. Lot-to-lot consistency was demonstrated if the two-sided 95 % confidence intervals (CIs) of the RSVPreF3-binding IgG geometric mean concentration (GMC) ratios between each lot pair at 30 days post-vaccination were within 0.67 and 1.50. Solicited adverse events (AEs) within four days, unsolicited AEs within 30 days, and serious AEs (SAEs) and potential immune-mediated diseases within six months post-vaccination were recorded. Results A total of 757 participants received RSVPreF3 OA, of whom 708 were included in the per-protocol set (234, 237, and 237 participants for each lot). Lot-to-lot consistency was demonstrated: GMC ratios were 1.06 (95 % CI: 0.94-1.21), 0.92 (0.81-1.04), and 0.87 (0.77-0.99) between the lot pairs (lot 1/2; 1/3; 2/3). For the three lots, the RSVPreF3-binding IgG concentration increased 11.84-, 11.29-, and 12.46-fold post-vaccination compared to baseline. The reporting rates of solicited and unsolicited AEs, SAEs, and potential immune-mediated diseases were balanced between lots. Twenty-one participants reported SAEs; one of these-a case of atrial fibrillation-was considered by the investigator as vaccine-related. SAEs with a fatal outcome were reported for four participants, none of which were considered by the investigator as vaccine-related. Conclusion This study demonstrated lot-to-lot immunogenicity consistency of three RSVPreF3 OA vaccine lots and indicated that the vaccine had an acceptable safety profile.ClinicalTrials.gov: NCT05059301.
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Affiliation(s)
- Murdo Ferguson
- Colchester Research Group, 68 Robie, Truro, NS B2N 1L2, Canada
| | - Alexander Murray
- PharmQuest, 806 Green Valley Rd Ste 305, Greensboro, NC 27408, United States
| | - Lew Pliamm
- Canadian Phase Onward Inc., Polyclinic Family and Specialty Medicine Facility, Polyclinic Family Health Group, 2 Champagne Dr, Toronto, ON M3J 0K2, Canada
| | - Lars Rombo
- Clinical Research Centre Sörmland, Eskilstuna SE-631 88, Sweden
- Department of Medical Biochemistry and Microbiology, Zoonosis Science Center, Uppsala University, Uppsala SE-751 05, Sweden
| | - Johan Sanmartin Berglund
- Department of Health, Blekinge Institute of Technology, Valhallavägen 1, Karlskrona SE-371 79, Sweden
- Department of Clinical Sciences, Lund University, BMC I12, Lund SE-221 84, Sweden
| | | | | | | | - Shady Kotb
- GSK, Avenue Fleming 20, Wavre 1300, Belgium
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24
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Alfano F, Bigoni T, Caggiano FP, Papi A. Respiratory Syncytial Virus Infection in Older Adults: An Update. Drugs Aging 2024; 41:487-505. [PMID: 38713299 PMCID: PMC11193699 DOI: 10.1007/s40266-024-01118-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2024] [Indexed: 05/08/2024]
Abstract
Respiratory syncytial virus (RSV) infection represents one of the most common infections during childhood, with significant morbidity and mortality in newborns and in the early years of life. RSV is a common infection throughout all age groups, largely undetected and underestimated in adults, with a disproportionately high impact in older individuals. RSV infection has a wide range of clinical presentations, from asymptomatic conditions to acute pneumonia and severe life-threatening respiratory distress, including exacerbations of underlying chronic conditions. Overall, the incidence of RSV infections requiring medical attention increases with age, and it is highest among persons ≥ 70 years of age. As a consequence of a combination of an aging population, immunosenescence, and the related increased burden of comorbidities, high-income countries are at risk of developing RSV epidemics. The standard of care for RSV-infected patients remains supportive, including fluids, antipyretics, and oxygen support when needed. There is an urgent need for antivirals and preventive strategies in this population, particularly in individuals at higher risk of severe outcomes following RSV infection. In this review, we describe prevention and treatment strategies for RSV illnesses, with a deep focus on the novel data on vaccination that has become available (Arexvy, GSK, and Abrysvo, Pfizer) for older adults.
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Affiliation(s)
- Franco Alfano
- Respiratory Unit, Department of Translational Medicine, University of Ferrara Medical School, University of Ferrara, Sant'Anna University Hospital, Via Aldo Moro, 8, 44124, Ferrara, Italy
| | - Tommaso Bigoni
- Respiratory Unit, Department of Translational Medicine, University of Ferrara Medical School, University of Ferrara, Sant'Anna University Hospital, Via Aldo Moro, 8, 44124, Ferrara, Italy
| | - Francesco Paolo Caggiano
- Respiratory Unit, Department of Translational Medicine, University of Ferrara Medical School, University of Ferrara, Sant'Anna University Hospital, Via Aldo Moro, 8, 44124, Ferrara, Italy
| | - Alberto Papi
- Respiratory Unit, Department of Translational Medicine, University of Ferrara Medical School, University of Ferrara, Sant'Anna University Hospital, Via Aldo Moro, 8, 44124, Ferrara, Italy.
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25
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Wingo MT, Andersen CA, Bornstein SL, Huber JM, Szostek JH, Wieland ML. Update in Outpatient General Internal Medicine: Practice-Changing Evidence Published in 2023. Am J Med 2024; 137:494-499. [PMID: 38403180 DOI: 10.1016/j.amjmed.2024.02.017] [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: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 02/27/2024]
Abstract
The expansive scope of internal medicine can make it challenging for clinicians to stay informed about new literature that changes practice. Guideline updates and synthesis of relevant evidence can facilitate incorporation of advancements into clinical practice. The titles and abstracts from the seven general medicine journals with highest impact factors and relevance to outpatient internal medicine were reviewed by six internal medicine physicians. Coronavirus disease 19 research was excluded. The New England Journal of Medicine (NEJM), The Lancet, Journal of the American Medical Association (JAMA), The British Medical Journal (BMJ), Annals of Internal Medicine, JAMA Internal Medicine, and Mayo Clinic Proceedings were reviewed. Additionally, article synopsis collections and databases were evaluated: American College of Physicians Journal Club, NEJM Journal Watch, BMJ Evidence-Based Medicine, McMaster ACCESSSS/DynaMed Evidence Alerts, and Cochrane Reviews. A modified Delphi method was used to gain consensus based on clinical relevance to outpatient internal medicine, potential impact on practice, and strength of evidence. Article qualities and importance were debated until consensus was reached. Clusters of articles pertinent to the same topic were considered together. In total, seven practice-changing articles were included.
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Affiliation(s)
- Majken T Wingo
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Department of Medicine, Mayo Clinic, Rochester, MN.
| | - Carl A Andersen
- Division of General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Shari L Bornstein
- Division of General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Jill M Huber
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Jason H Szostek
- Division of General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Mark L Wieland
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Department of Medicine, Mayo Clinic, Rochester, MN
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26
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Centrone F, Loconsole D, Marziani A, Orlando VA, delle Fontane A, Minelli M, Chironna M. Respiratory Syncytial Virus (RSV) Hospitalizations in the Elderly in a Tertiary Care Hospital in Southern Italy as a Useful Proxy for Targeting Vaccine Preventive Strategies. Infect Dis Rep 2024; 16:491-498. [PMID: 38920893 PMCID: PMC11204164 DOI: 10.3390/idr16030037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/23/2024] [Accepted: 05/29/2024] [Indexed: 06/27/2024] Open
Abstract
RSV infection causes severe respiratory illness and mortality in the elderly, especially in the presence of comorbidities. Early identification of infection would result in appropriate clinical-therapeutic management, avoiding hospitalizations, the risk of healthcare-associated infections, and inappropriate antibiotic prescriptions, thus reducing healthcare costs and fighting antimicrobial resistance. The aim of this study was to assess RSV hospitalizations in subjects >64 years hospitalized in a large tertiary care hospital in Southern Italy, in order to assess their usefulness as a proxy for targeting a potential vaccination strategy. Fifty-two RSV-positive patients were identified from the 2014-2015 to the 2022-2023 seasons. RSV type B was found in 71.2% of cases. The median age was 78 years (IQR: 72-84) and 40.4% of the subjects had at least one comorbidity; 5.8% needed intensive care. The use of combined rapid tests for SARS-CoV-2/influenza/RSV identification in primary care settings may contribute to an improved definition of the burden of RSV in the elderly. The implementation of an anti-RSV vaccination strategy in the elderly population would reduce direct and indirect infection costs. More robust epidemiological data in Italy are needed for targeted preventive strategies.
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Affiliation(s)
- Francesca Centrone
- Hygiene Unit, Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, 70124 Bari, Italy;
| | - Daniela Loconsole
- Hygiene Section, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy; (D.L.); (A.M.); (V.A.O.); (A.d.F.); (M.M.)
| | - Alfredo Marziani
- Hygiene Section, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy; (D.L.); (A.M.); (V.A.O.); (A.d.F.); (M.M.)
| | - Valentina Annachiara Orlando
- Hygiene Section, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy; (D.L.); (A.M.); (V.A.O.); (A.d.F.); (M.M.)
| | - Arianna delle Fontane
- Hygiene Section, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy; (D.L.); (A.M.); (V.A.O.); (A.d.F.); (M.M.)
| | - Martina Minelli
- Hygiene Section, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy; (D.L.); (A.M.); (V.A.O.); (A.d.F.); (M.M.)
| | - Maria Chironna
- Hygiene Section, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy; (D.L.); (A.M.); (V.A.O.); (A.d.F.); (M.M.)
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Tramuto F, Maida CM, Randazzo G, Guzzetta V, Santino A, Li Muli R, Costantino C, Graziano G, Amodio E, Mazzucco W, Vitale F. Whole-Genome Sequencing and Genetic Diversity of Human Respiratory Syncytial Virus in Patients with Influenza-like Illness in Sicily (Italy) from 2017 to 2023. Viruses 2024; 16:851. [PMID: 38932144 PMCID: PMC11209242 DOI: 10.3390/v16060851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 05/21/2024] [Accepted: 05/24/2024] [Indexed: 06/28/2024] Open
Abstract
Monitoring the genetic variability of human respiratory syncytial virus (hRSV) is of paramount importance, especially for the potential implication of key antigenic mutations on the emergence of immune escape variants. Thus, to describe the genetic diversity and evolutionary dynamics of hRSV circulating in Sicily (Italy), a total of 153 hRSV whole-genome sequences collected from 770 hRSV-positive subjects between 2017 and 2023, before the introduction of expanded immunization programs into the population, were investigated. The phylogenetic analyses indicated that the genotypes GA.2.3.5 (ON1) for hRSV-A and GB.5.0.5a (BA9) for hRSV-B co-circulated in our region. Amino acid (AA) substitutions in the surface and internal proteins were evaluated, including the F protein antigenic sites, as the major targets of immunoprophylactic monoclonal antibodies and vaccines. Overall, the proportion of AA changes ranged between 1.5% and 22.6% among hRSV-A, whereas hRSV-B varied in the range 0.8-16.9%; the latter was more polymorphic than hRSV-A within the key antigenic sites. No AA substitutions were found at site III of both subgroups. Although several non-synonymous mutations were found, none of the polymorphisms known to potentially affect the efficacy of current preventive measures were documented. These findings provide new insights into the global hRSV molecular epidemiology and highlight the importance of defining a baseline genomic picture to monitor for future changes that might be induced by the selective pressures of immunological preventive measures, which will soon become widely available.
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Affiliation(s)
- Fabio Tramuto
- Department of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialties “G. D’Alessandro”—Hygiene Section, University of Palermo, 90133 Palermo, Italy; (C.M.M.); (C.C.); (E.A.); (W.M.); (F.V.)
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90133 Palermo, Italy; (G.R.); (V.G.); (A.S.); (R.L.M.); (G.G.)
| | - Carmelo Massimo Maida
- Department of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialties “G. D’Alessandro”—Hygiene Section, University of Palermo, 90133 Palermo, Italy; (C.M.M.); (C.C.); (E.A.); (W.M.); (F.V.)
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90133 Palermo, Italy; (G.R.); (V.G.); (A.S.); (R.L.M.); (G.G.)
| | - Giulia Randazzo
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90133 Palermo, Italy; (G.R.); (V.G.); (A.S.); (R.L.M.); (G.G.)
| | - Valeria Guzzetta
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90133 Palermo, Italy; (G.R.); (V.G.); (A.S.); (R.L.M.); (G.G.)
| | - Arianna Santino
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90133 Palermo, Italy; (G.R.); (V.G.); (A.S.); (R.L.M.); (G.G.)
| | - Rita Li Muli
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90133 Palermo, Italy; (G.R.); (V.G.); (A.S.); (R.L.M.); (G.G.)
| | - Claudio Costantino
- Department of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialties “G. D’Alessandro”—Hygiene Section, University of Palermo, 90133 Palermo, Italy; (C.M.M.); (C.C.); (E.A.); (W.M.); (F.V.)
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90133 Palermo, Italy; (G.R.); (V.G.); (A.S.); (R.L.M.); (G.G.)
| | - Giorgio Graziano
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90133 Palermo, Italy; (G.R.); (V.G.); (A.S.); (R.L.M.); (G.G.)
| | - Emanuele Amodio
- Department of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialties “G. D’Alessandro”—Hygiene Section, University of Palermo, 90133 Palermo, Italy; (C.M.M.); (C.C.); (E.A.); (W.M.); (F.V.)
| | - Walter Mazzucco
- Department of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialties “G. D’Alessandro”—Hygiene Section, University of Palermo, 90133 Palermo, Italy; (C.M.M.); (C.C.); (E.A.); (W.M.); (F.V.)
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90133 Palermo, Italy; (G.R.); (V.G.); (A.S.); (R.L.M.); (G.G.)
| | - Francesco Vitale
- Department of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialties “G. D’Alessandro”—Hygiene Section, University of Palermo, 90133 Palermo, Italy; (C.M.M.); (C.C.); (E.A.); (W.M.); (F.V.)
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90133 Palermo, Italy; (G.R.); (V.G.); (A.S.); (R.L.M.); (G.G.)
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Athan E, Baber J, Quan K, Scott RJ, Jaques A, Jiang Q, Li W, Cooper D, Cutler MW, Kalinina EV, Anderson AS, Swanson KA, Gruber WC, Gurtman A, Schmoele-Thoma B. Safety and Immunogenicity of Bivalent RSVpreF Vaccine Coadministered With Seasonal Inactivated Influenza Vaccine in Older Adults. Clin Infect Dis 2024; 78:1360-1368. [PMID: 37992000 PMCID: PMC11093669 DOI: 10.1093/cid/ciad707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/02/2023] [Accepted: 11/15/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) and influenza are both typically seasonal diseases, with winter peaks in temperate climates. Coadministration of an RSV vaccine and influenza vaccine could be a benefit, requiring 1 rather than 2 visits to a healthcare provider for individuals receiving both vaccines. METHODS The primary immunogenicity objective of this phase 3, 1:1 randomized, double-blind, placebo-controlled study in healthy adults aged ≥65 years in Australia was to demonstrate noninferiority of immune responses with coadministration of the stabilized RSV prefusion F protein-based vaccine (RSVpreF) and seasonal inactivated influenza vaccine (SIIV) versus SIIV or RSVpreF administered alone, using a 1.5-fold noninferiority margin (lower bound 95% confidence interval >.667). Safety and tolerability were evaluated by collecting reactogenicity and adverse event data. RESULTS Of 1403 participants randomized, 1399 received vaccinations (median age, 70; range, 65‒91 years). Local reactions and systemic events were mostly mild or moderate when RSVpreF was coadministered with SIIV or administered alone. No vaccine-related serious adverse events were reported. Geometric mean ratios were 0.86 for RSV-A and 0.85 for RSV-B neutralizing titers at 1 month after RSVpreF administration and 0.77 to 0.90 for strain-specific hemagglutination inhibition assay titers at 1 month after SIIV. All comparisons achieved the prespecified 1.5-fold noninferiority margin. CONCLUSIONS The primary study objectives were met, demonstrating noninferiority of RSVpreF and SIIV immune responses when RSVpreF was coadministered with SIIV and that RSVpreF had an acceptable safety and tolerability profile when coadministered with SIIV. The results of this study support coadministration of RSVpreF and SIIV in an older-adult population. CLINICAL TRIALS REGISTRATION https://clinicaltrials.gov/study/NCT05301322.
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Affiliation(s)
- Eugene Athan
- Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - James Baber
- Vaccine Clinical Research, Pfizer Australia Pty Ltd, Sydney, New South Wales, Australia
| | - Karen Quan
- Vaccine Clinical Research, Pfizer Australia Pty Ltd, Sydney, New South Wales, Australia
| | | | - Anna Jaques
- Vaccine Clinical Research, Pfizer Australia Pty Ltd, Sydney, New South Wales, Australia
| | - Qin Jiang
- Pfizer Vaccine Research and Development, Collegeville, Pennsylvania, USA
| | - Wen Li
- Pfizer Vaccine Research and Development, Collegeville, Pennsylvania, USA
| | - David Cooper
- Pfizer Vaccine Research and Development, Pearl River, New York, USA
| | - Mark W Cutler
- Pfizer Vaccine Research and Development, Pearl River, New York, USA
| | - Elena V Kalinina
- Pfizer Vaccine Research and Development, Pearl River, New York, USA
| | | | - Kena A Swanson
- Pfizer Vaccine Research and Development, Pearl River, New York, USA
| | - William C Gruber
- Pfizer Vaccine Research and Development, Pearl River, New York, USA
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29
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Moghadas SM, Shoukat A, Bawden CE, Langley JM, Singer BH, Fitzpatrick MC, Galvani AP. Cost-effectiveness of Prefusion F Protein-based Vaccines Against Respiratory Syncytial Virus Disease for Older Adults in the United States. Clin Infect Dis 2024; 78:1328-1335. [PMID: 38035791 PMCID: PMC11093660 DOI: 10.1093/cid/ciad658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Two prefusion F protein-based vaccines, Arexvy and Abrysvo, have been authorized by the US Food and Drug Administration for protecting older adults against respiratory syncytial virus (RSV)-associated lower respiratory tract illness. We evaluated the health benefits and cost-effectiveness of these vaccines. METHODS We developed a discrete-event simulation model, parameterized with the burden of RSV disease including outpatient care, hospitalization, and death for adults aged 60 years or older in the United States. Taking into account the costs associated with these RSV-related outcomes, we calculated the net monetary benefit using quality-adjusted life-year (QALY) gained as a measure of effectiveness and determined the range of price-per-dose (PPD) for Arexvy and Abrysvo vaccination programs to be cost-effective from a societal perspective. RESULTS Using a willingness-to-pay of $95 000 per QALY gained, we found that vaccination programs could be cost-effective for a PPD up to $127 with Arexvy and $118 with Abrysvo over the first RSV season. Achieving an influenza-like vaccination coverage of 66% for the population of older adults in the United States, the budget impact of these programs at the maximum PPD ranged from $6.48 to $6.78 billion. If the benefits of vaccination extend to a second RSV season as reported in clinical trials, we estimated a maximum PPD of $235 for Arexvy and $245 for Abrysvo, with 2-year budget impacts of $11.78 and $12.25 billion, respectively. CONCLUSIONS Vaccination of older adults would provide substantial direct health benefits by reducing outcomes associated with RSV-related illness in this population.
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Affiliation(s)
- Seyed M Moghadas
- Agent-Based Modelling Laboratory, York University, Toronto, Ontario, Canada
| | - Affan Shoukat
- Agent-Based Modelling Laboratory, York University, Toronto, Ontario, Canada
| | - Carolyn E Bawden
- Department of Microbiology and Immunology, McGill University, Montreal, Quebec, Canada
| | - Joanne M Langley
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Burton H Singer
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA
| | - Meagan C Fitzpatrick
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, Connecticut, USA
| | - Alison P Galvani
- Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, Connecticut, USA
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Riccò M, Cascio A, Corrado S, Bottazzoli M, Marchesi F, Gili R, Giuri PG, Gori D, Manzoni P. Efficacy of Respiratory Syncytial Virus Vaccination to Prevent Lower Respiratory Tract Illness in Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Vaccines (Basel) 2024; 12:500. [PMID: 38793751 PMCID: PMC11126042 DOI: 10.3390/vaccines12050500] [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: 04/10/2024] [Revised: 05/01/2024] [Accepted: 05/03/2024] [Indexed: 05/26/2024] Open
Abstract
A systematic review and meta-analysis was designed in order to ascertain the effectiveness of respiratory syncytial virus (RSV) vaccination in preventing lower respiratory tract diseases (LRTD) in older adults (age ≥ 60 years). Studies reporting on randomized controlled trials (RCTs) were searched for in three databases (PubMed, Embase, and Scopus) and the preprint repository medRxiv until 31 March 2024. A total of nine studies were eventually included, two of which were conference proceedings. Our analysis included five RCTs on five RSV vaccines (RSVpreF, RSVPreF3, Ad26.RSV.preF, MEDI7510, and mRNA-1345). The meta-analysis documented a pooled vaccine efficacy of 81.38% (95% confidence interval (95% CI) 70.94 to 88.06) for prevention of LRTD with three or more signs/symptoms during the first RSV season after the delivery of the vaccine. Follow-up data were available for RSVPreF3 (2 RSV seasons), RSVpreF (mid-term estimates of second RSV season), and mRNA-1345 (12 months after the delivery of the primer), with a pooled VE of 61.15% (95% CI 45.29 to 72.40). After the first season, the overall risk for developing RSV-related LRTD was therefore substantially increased (risk ratio (RR) 4.326, 95% CI 2.415; 7.748). However, all estimates were affected by substantial heterogeneity, as suggested by the 95% CI of I2 statistics, which could be explained by inconsistencies in the design of the parent studies, particularly when dealing with case definition. In conclusion, adult RSV vaccination was quite effective in preventing LRTD in older adults, but the overall efficacy rapidly decreased in the second season after the delivery of the vaccine. Because of the heterogenous design of the parent studies, further analyses are required before tailoring specific public health interventions.
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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
| | - Antonio Cascio
- Infectious and Tropical Diseases Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, “G D’Alessandro”, University of Palermo, AOUP P. Giaccone, 90127 Palermo, Italy;
| | - Silvia Corrado
- ASST Rhodense, Dipartimento della donna e Area Materno-Infantile, UOC Pediatria, 20024 Milano, 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, 10125 Torino, Italy
| | | | - Davide Gori
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy;
| | - Paolo Manzoni
- Department of Public Health and Pediatric Sciences, University of Torino School of Medicine, 10125 Turin, Italy;
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Howa A, Zhu Y, Wyatt D, Markus T, Chappell J, Halasa N, Trabue C, Schaffner W, Grijalva C, Talbot H. Estimating the Undetected Burden of Respiratory Syncytial Virus Hospitalizations in Adults Through Capture-Recapture Methods. Influenza Other Respir Viruses 2024; 18:e13299. [PMID: 38700006 PMCID: PMC11066857 DOI: 10.1111/irv.13299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 05/05/2024] Open
Abstract
INTRODUCTION Traditional surveillance systems may underestimate the burden caused by respiratory syncytial virus (RSV). Capture-recapture methods provide alternatives for estimating the number of RSV-related hospitalizations in a population. METHODS Capture-recapture methods were used to estimate the number of RSV-related hospitalizations in adults in Middle Tennessee from two independent hospitalization surveillance systems during consecutive respiratory seasons from 2016-2017 to 2019-2020. Data from the Hospitalized Adult Influenza Vaccine Effectiveness Network (HAIVEN) and the Emerging Infections Program (EIP) were used. Annual RSV hospitalization rates were calculated using the capture-recapture estimates weighted by hospitals' market share divided by the corresponding census population. RESULTS Using capture-recapture methods, the estimated overall adult hospitalization rates varied from 8.3 (95% CI: 5.9-15.4) RSV-related hospitalizations per 10,000 persons during the 2016-2017 season to 28.4 (95% CI: 18.2-59.0) hospitalizations per 10,000 persons in the 2019-2020 season. The proportion of hospitalizations that HAIVEN determined ranged from 8.7% to 36.7% of the total capture-recapture estimated hospitalization, whereas EIP detected 23.5% to 52.7% of the total capture-recapture estimated hospitalizations. CONCLUSION Capture-recapture estimates showed that individual traditional surveillance systems underestimated the hospitalization burden in adults. Using capture-recapture allows for a more comprehensive estimate of RSV hospitalizations.
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Affiliation(s)
- Amanda C. Howa
- Department of Health PolicyVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Yuwei Zhu
- Department of BiostatisticsVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Dayna Wyatt
- Department of Health PolicyVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Tiffanie Markus
- Department of Health PolicyVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - James D. Chappell
- Department of PediatricsVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Natasha Halasa
- Department of PediatricsVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Christopher H. Trabue
- Department of MedicineUniversity of Tennessee College of MedicineNashvilleTennesseeUSA
| | - William Schaffner
- Department of Health PolicyVanderbilt University Medical CenterNashvilleTennesseeUSA
- Department of MedicineVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Carlos G. Grijalva
- Department of Health PolicyVanderbilt University Medical CenterNashvilleTennesseeUSA
- Department of Biomedical InformaticsVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - H. Keipp Talbot
- Department of Health PolicyVanderbilt University Medical CenterNashvilleTennesseeUSA
- Department of MedicineVanderbilt University Medical CenterNashvilleTennesseeUSA
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Shan S, Zhang W, Gao H, Huang PY, Du Z, Bai Y, Lau YC, Chen D, Lau EHY, Nealon J, Wu P. Global Seasonal Activities of Respiratory Syncytial Virus Before the Coronavirus Disease 2019 Pandemic: A Systematic Review. Open Forum Infect Dis 2024; 11:ofae238. [PMID: 38770210 PMCID: PMC11103620 DOI: 10.1093/ofid/ofae238] [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: 10/05/2023] [Accepted: 04/23/2024] [Indexed: 05/22/2024] Open
Abstract
Varied seasonal patterns of respiratory syncytial virus (RSV) have been reported worldwide. We conducted a systematic review on articles identified in PubMed reporting RSV seasonality based on data collected before 1 January 2020. RSV seasonal patterns were examined by geographic location, calendar month, analytic method, and meteorological factors including temperature and absolute humidity. Correlation and regression analyses were conducted to explore the relationship between RSV seasonality and study methods and characteristics of study locations. RSV seasons were reported in 209 articles published in 1973-2023 for 317 locations in 77 countries. Regular RSV seasons were similarly reported in countries in temperate regions, with highly variable seasons identified in subtropical and tropical countries. Longer durations of RSV seasons were associated with a higher daily average mean temperature and daily average mean absolute humidity. The global seasonal patterns of RSV provided important information for optimizing interventions against RSV infection.
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Affiliation(s)
- Songwei Shan
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China
| | - Weixin Zhang
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Huizhi Gao
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Pei-Yu Huang
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Zhanwei Du
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China
| | - Yuan Bai
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China
| | - Yiu-Chung Lau
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China
| | - Dongxuan Chen
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China
| | - Eric H Y Lau
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China
| | - Joshua Nealon
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Peng Wu
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China
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Foley DA, Minney-Smith CA, Tjea A, Nicol MP, Levy A, Moore HC, Blyth CC. The Changing Detection Rate of Respiratory Syncytial Virus in Adults in Western Australia between 2017 and 2023. Viruses 2024; 16:656. [PMID: 38793538 PMCID: PMC11125702 DOI: 10.3390/v16050656] [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: 03/28/2024] [Revised: 04/19/2024] [Accepted: 04/21/2024] [Indexed: 05/26/2024] Open
Abstract
The incidence of respiratory syncytial virus (RSV) in adults is inadequately defined and the impact of SARS-CoV-2-related non-pharmaceutical interventions (NPIs) is underexplored. Using laboratory data, we described the detection rate of RSV in adults ≥16 years in Western Australia (WA) between 2017 and 2023. With the exception of 2020, RSV detections rose annually between 2017 and 2023, reaching 50.7 per 100,000 in 2023 (95% confidence interval [CI], 47.9-53.8). RSV testing expanded considerably across the study period, with the testing in 2023 more than five times the 2017 total. The detection rate was highest in adults ≥60 years between 2017 and 2019, particularly those ≥75 years. Following 2020, the detections in all age groups increased, with the highest detection rate in 2023 in those ≥75-years (199.5 per 100,000; 95% CI, 180.5-220). NPIs significantly impacted RSV seasonality; the preceding winter pattern was disrupted, resulting in an absent 2020 winter season and two major summer seasons in 2020/21 and 2021/22. The RSV season began to realign in 2022, reverting to a winter seasonal pattern in 2023 and the largest season in the study period. Ongoing surveillance will be required to understand the stability of these increases and to delineate the impact of new immunisation strategies.
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Affiliation(s)
- David A. Foley
- Department of Microbiology, PathWest Laboratory Medicine WA, Nedlands, WA 6009, Australia (A.T.); (C.C.B.)
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia; (M.P.N.); (H.C.M.)
- School of Medicine, University of Western Australia, Perth, WA 6009, Australia
| | - Cara A. Minney-Smith
- Department of Microbiology, PathWest Laboratory Medicine WA, Nedlands, WA 6009, Australia (A.T.); (C.C.B.)
| | - Andrew Tjea
- Department of Microbiology, PathWest Laboratory Medicine WA, Nedlands, WA 6009, Australia (A.T.); (C.C.B.)
| | - Mark P. Nicol
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia; (M.P.N.); (H.C.M.)
- Marshall Centre, Biomedical Sciences, University of Western Australia, Perth, WA 6009, Australia
| | - Avram Levy
- Department of Microbiology, PathWest Laboratory Medicine WA, Nedlands, WA 6009, Australia (A.T.); (C.C.B.)
- Marshall Centre, Biomedical Sciences, University of Western Australia, Perth, WA 6009, Australia
| | - Hannah C. Moore
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia; (M.P.N.); (H.C.M.)
- School of Population Health, Curtin University, Perth, WA 6009, Australia
| | - Christopher C. Blyth
- Department of Microbiology, PathWest Laboratory Medicine WA, Nedlands, WA 6009, Australia (A.T.); (C.C.B.)
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia; (M.P.N.); (H.C.M.)
- School of Medicine, University of Western Australia, Perth, WA 6009, Australia
- Department of Infectious Diseases, Perth Children’s Hospital, Nedlands, WA 6009, Australia
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Morimoto T, Morikawa T, Imura H, Nezu M, Hamazaki K, Sakuma M, Chaumont A, Moitinho de Almeida M, Moreno VP, Ho Y, Harrington L, Matsuki T, Nakamura T. Rationale and protocol for a prospective cohort study of respiratory viral infections in patients admitted from emergency departments of community hospitals: Effect of respiratory Virus infection on EmeRgencY admission (EVERY) study. BMJ Open 2024; 14:e081037. [PMID: 38626982 PMCID: PMC11029217 DOI: 10.1136/bmjopen-2023-081037] [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: 10/18/2023] [Accepted: 03/27/2024] [Indexed: 04/19/2024] Open
Abstract
INTRODUCTION Respiratory syncytial virus (RSV) is a causative virus for the common cold worldwide and can result in hospitalisations and even death in patients with high-risk conditions and older adults. However, the relationship between RSV or other incidental respiratory infections and acute exacerbations of underlying conditions has not been well investigated. The primary objective of this study is to estimate RSV prevalence, risk factors for adverse outcomes or hospitalisation and their effect on the hospital course of patients with acute respiratory symptoms admitted from emergency departments. Furthermore, we evaluate the prevalence of other respiratory viruses associated with respiratory symptoms. METHODS AND ANALYSIS We are conducting a multicentre prospective cohort study in Japan. We plan to enrol 3000 consecutive patients admitted from emergency departments with acute respiratory symptoms or signs from 1 July 2023 to 30 June 2024. A nasopharyngeal swab is obtained within 24 hours of admission and the prevalence of RSV and other respiratory viruses is measured using the FilmArray Respiratory 2.1 panel. Paired serum samples are collected from patients with suspected lower respiratory infections to measure RSV antibodies at admission and 30 days later. Information on patients' hospital course is retrieved from the electronic medical records at discharge, death or 30 days after admission. Furthermore, information on readmission to the hospital and all-cause mortality is collected 180 days after admission. We assess the differences in clinical outcomes between patients with RSV or other respiratory viruses and those without, adjusting for baseline characteristics. Clinical outcomes include in-hospital mortality, length of hospital stay, disease progression, laboratory tests and management of respiratory symptoms or underlying conditions. ETHICS AND DISSEMINATION The study protocol was approved by the institutional review boards of participating hospitals. Our study reports will be published in academic journals as well as international meetings. TRIAL REGISTRATION NUMBER NCT05913700.
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Affiliation(s)
- Takeshi Morimoto
- Department of Clinical Epidemiology, Hyogo Medical University, Nishinomiya, Japan
| | - Toru Morikawa
- Department of Clinical Epidemiology, Hyogo Medical University, Nishinomiya, Japan
- Department of General Medicine, Nara City Hospital, Nara, Japan
| | - Haruki Imura
- Department of Infectious Disease, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Mari Nezu
- Department of Clinical Epidemiology, Hyogo Medical University, Nishinomiya, Japan
| | - Kenya Hamazaki
- Department of Clinical Epidemiology, Hyogo Medical University, Nishinomiya, Japan
- Department of General Internal Medicine, Kobe City Medical Center West Hospital, Kobe, Japan
| | - Mio Sakuma
- Department of Clinical Epidemiology, Hyogo Medical University, Nishinomiya, Japan
| | | | | | | | | | | | | | - Tsukasa Nakamura
- Department of Infectious Disease, Shimane Prefectural Central Hospital, Izumo, Shimane, Japan
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Quiros-Roldan E, Sottini A, Natali PG, Imberti L. The Impact of Immune System Aging on Infectious Diseases. Microorganisms 2024; 12:775. [PMID: 38674719 PMCID: PMC11051847 DOI: 10.3390/microorganisms12040775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 03/22/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
Immune system aging is becoming a field of increasing public health interest because of prolonged life expectancy, which is not paralleled by an increase in health expectancy. As age progresses, innate and adaptive immune systems undergo changes, which are defined, respectively, as inflammaging and immune senescence. A wealth of available data demonstrates that these two conditions are closely linked, leading to a greater vulnerability of elderly subjects to viral, bacterial, and opportunistic infections as well as lower post-vaccination protection. To face this novel scenario, an in-depth assessment of the immune players involved in this changing epidemiology is demanded regarding the individual and concerted involvement of immune cells and mediators within endogenous and exogenous factors and co-morbidities. This review provides an overall updated description of the changes affecting the aging immune system, which may be of help in understanding the underlying mechanisms associated with the main age-associated infectious diseases.
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Affiliation(s)
- Eugenia Quiros-Roldan
- Department of Infectious and Tropical Diseases, ASST- Spedali Civili and DSCS- University of Brescia, 25123 Brescia, Italy;
| | - Alessandra Sottini
- Clinical Chemistry Laboratory, Services Department, ASST Spedali Civili of Brescia, 25123 Brescia, Italy;
| | - Pier Giorgio Natali
- Mediterranean Task Force for Cancer Control (MTCC), Via Pizzo Bernina, 14, 00141 Rome, Italy;
| | - Luisa Imberti
- Section of Microbiology, University of Brescia, P. le Spedali Civili, 1, 25123 Brescia, Italy
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Eberlein V, Rosencrantz S, Finkensieper J, Besecke JK, Mansuroglu Y, Kamp JC, Lange F, Dressman J, Schopf S, Hesse C, Thoma M, Fertey J, Ulbert S, Grunwald T. Mucosal immunization with a low-energy electron inactivated respiratory syncytial virus vaccine protects mice without Th2 immune bias. Front Immunol 2024; 15:1382318. [PMID: 38646538 PMCID: PMC11026718 DOI: 10.3389/fimmu.2024.1382318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/18/2024] [Indexed: 04/23/2024] Open
Abstract
The respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory tract infections associated with numerous hospitalizations. Recently, intramuscular (i.m.) vaccines against RSV have been approved for elderly and pregnant women. Noninvasive mucosal vaccination, e.g., by inhalation, offers an alternative against respiratory pathogens like RSV. Effective mucosal vaccines induce local immune responses, potentially resulting in the efficient and fast elimination of respiratory viruses after natural infection. To investigate this immune response to an RSV challenge, low-energy electron inactivated RSV (LEEI-RSV) was formulated with phosphatidylcholine-liposomes (PC-LEEI-RSV) or 1,2-dioleoyl-3-trimethylammonium-propane and 1,2-dioleoyl-sn-glycero-3-phosphoethanolamine (DD-LEEI-RSV) for vaccination of mice intranasally. As controls, LEEI-RSV and formalin-inactivated-RSV (FI-RSV) were used via i.m. vaccination. The RSV-specific immunogenicity of the different vaccines and their protective efficacy were analyzed. RSV-specific IgA antibodies and a statistically significant reduction in viral load upon challenge were detected in mucosal DD-LEEI-RSV-vaccinated animals. Alhydrogel-adjuvanted LEEI-RSV i.m. showed a Th2-bias with enhanced IgE, eosinophils, and lung histopathology comparable to FI-RSV. These effects were absent when applying the mucosal vaccines highlighting the potential of DD-LEEI-RSV as an RSV vaccine candidate and the improved performance of this mucosal vaccine candidate.
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Affiliation(s)
- Valentina Eberlein
- Fraunhofer Institute for Cell Therapy and Immunology IZI, Leipzig, Germany
- Fraunhofer Cluster of Excellence Immune-Mediated Diseases (CIMD), Frankfurt am Main, Germany
| | - Sophia Rosencrantz
- Fraunhofer Cluster of Excellence Immune-Mediated Diseases (CIMD), Frankfurt am Main, Germany
- Fraunhofer Institute for Applied Polymer Research (IAP), Potsdam, Germany
| | - Julia Finkensieper
- Fraunhofer Institute for Cell Therapy and Immunology IZI, Leipzig, Germany
- Fraunhofer Cluster of Excellence Immune-Mediated Diseases (CIMD), Frankfurt am Main, Germany
| | - Joana Kira Besecke
- Fraunhofer Cluster of Excellence Immune-Mediated Diseases (CIMD), Frankfurt am Main, Germany
- Fraunhofer Institute for Organic Electronics, Electron Beam and Plasma Technology (FEP), Dresden, Germany
| | - Yaser Mansuroglu
- Fraunhofer Cluster of Excellence Immune-Mediated Diseases (CIMD), Frankfurt am Main, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), Frankfurt, Germany
| | - Jan-Christopher Kamp
- Department of Respiratory Medicine and Infectious Diseases, Hannover Medical School, Hannover, Germany
- Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
| | - Franziska Lange
- Fraunhofer Institute for Cell Therapy and Immunology IZI, Leipzig, Germany
- Fraunhofer Cluster of Excellence Immune-Mediated Diseases (CIMD), Frankfurt am Main, Germany
| | - Jennifer Dressman
- Fraunhofer Cluster of Excellence Immune-Mediated Diseases (CIMD), Frankfurt am Main, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), Frankfurt, Germany
| | - Simone Schopf
- Fraunhofer Cluster of Excellence Immune-Mediated Diseases (CIMD), Frankfurt am Main, Germany
- Fraunhofer Institute for Organic Electronics, Electron Beam and Plasma Technology (FEP), Dresden, Germany
| | - Christina Hesse
- Fraunhofer Cluster of Excellence Immune-Mediated Diseases (CIMD), Frankfurt am Main, Germany
- Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
- Fraunhofer Institute for Toxicology and Experimental Medicine (ITEM), Hannover, Germany
| | - Martin Thoma
- Fraunhofer Cluster of Excellence Immune-Mediated Diseases (CIMD), Frankfurt am Main, Germany
- Fraunhofer Institute for Manufacturing Engineering and Automation (IPA), Stuttgart, Germany
| | - Jasmin Fertey
- Fraunhofer Institute for Cell Therapy and Immunology IZI, Leipzig, Germany
- Fraunhofer Cluster of Excellence Immune-Mediated Diseases (CIMD), Frankfurt am Main, Germany
| | - Sebastian Ulbert
- Fraunhofer Institute for Cell Therapy and Immunology IZI, Leipzig, Germany
- Fraunhofer Cluster of Excellence Immune-Mediated Diseases (CIMD), Frankfurt am Main, Germany
| | - Thomas Grunwald
- Fraunhofer Institute for Cell Therapy and Immunology IZI, Leipzig, Germany
- Fraunhofer Cluster of Excellence Immune-Mediated Diseases (CIMD), Frankfurt am Main, Germany
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Korsun N, Trifonova I, Madzharova I, Alexiev I, Uzunova I, Ivanov I, Velikov P, Tcherveniakova T, Christova I. Resurgence of respiratory syncytial virus with dominance of RSV-B during the 2022-2023 season. Front Microbiol 2024; 15:1376389. [PMID: 38628867 PMCID: PMC11019023 DOI: 10.3389/fmicb.2024.1376389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/15/2024] [Indexed: 04/19/2024] Open
Abstract
Background Respiratory syncytial virus (RSV) is a common cause of upper and lower respiratory tract infections. This study aimed to explore the prevalence of respiratory syncytial virus (RSV) and other respiratory viruses in Bulgaria, characterize the genetic diversity of RSV strains, and perform amino acid sequence analyses of RSV surface and internal proteins. Methods Clinical and epidemiological data and nasopharyngeal swabs were prospectively collected from patients with acute respiratory infections between October 2020 and May 2023. Real-time PCR for 13 respiratory viruses, whole-genome sequencing, phylogenetic, and amino acid analyses were performed. Results This study included three epidemic seasons (2020-2021, 2021-2022, and 2022-2023) from week 40 of the previous year to week 20 of the following year. Of the 3,047 patients examined, 1,813 (59.5%) tested positive for at least one viral respiratory pathogen. RSV was the second most detected virus (10.9%) after SARS-CoV-2 (22%). Coinfections between RSV and other respiratory viruses were detected in 68 cases, including 14 with SARS-CoV-2. After two seasons of low circulation, RSV activity increased significantly during the 2022-2023 season. The detection rates of RSV were 3.2, 6.6, and 13.7% in the first, second, and third seasons, respectively. RSV was the most common virus found in children under 5 years old with bronchiolitis (40%) and pneumonia (24.5%). RSV-B drove the 2022-2023 epidemic. Phylogenetic analysis indicated that the sequenced RSV-B strains belonged to the GB5.0.5a and GB5.0.6a genotypes. Amino acid substitutions in the surface and internal proteins, including the F protein antigenic sites were identified compared to the BA prototype strain. Conclusion This study revealed a strong resurgence of RSV in the autumn of 2022 after the lifting of anti-COVID-19 measures, the leading role of RSV as a causative agent of serious respiratory illnesses in early childhood, and relatively low genetic diversity in circulating RSV strains.
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Affiliation(s)
- Neli Korsun
- National Laboratory “Influenza and ARI”, Department of Virology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Ivelina Trifonova
- National Laboratory “Influenza and ARI”, Department of Virology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Iveta Madzharova
- National Laboratory “Influenza and ARI”, Department of Virology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Ivaylo Alexiev
- National Laboratory “Influenza and ARI”, Department of Virology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | | | - Ivan Ivanov
- Department of Infectious Diseases, Medical University, Sofia, Bulgaria
| | - Petar Velikov
- Department of Infectious Diseases, Medical University, Sofia, Bulgaria
| | | | - Iva Christova
- National Laboratory “Influenza and ARI”, Department of Virology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
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38
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Kenmoe S, Nair H. The disease burden of respiratory syncytial virus in older adults. Curr Opin Infect Dis 2024; 37:129-136. [PMID: 38197402 PMCID: PMC10911257 DOI: 10.1097/qco.0000000000001000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
PURPOSE OF REVIEW To highlight the respiratory syncytial virus (RSV) disease burden and the current developments and challenges in RSV prevention for older adults ≥60 years through analysis of RSV epidemiology and the effectiveness of emerging vaccines. RECENT FINDINGS In industrialized countries, RSV incidence rates and hospitalization rates among older adults are estimated to be 600.7 cases per 100 000 person-years and 157 hospitalizations per 100 000 person-years, respectively. Yet, accurately determining RSV morbidity and mortality in older adults is challenging, thus resulting in substantially under-estimating the disease burden. The in-hospital fatality rates vary substantially with age and geographies, and can be as high as 9.1% in developing countries. Two promising RSV vaccines for the elderly have been approved, demonstrating efficacies of up to 94.1%, signifying considerable advancement in RSV prevention. However, concerns over potential side effects remain. SUMMARY RSV is associated with a significant burden in older adults. While the landscape of RSV prevention in older adults is promising with the licensure of vaccines from two companies, current trial data underscore the need for additional studies. Addressing the real-world effectiveness of these vaccines, understanding potential rare side effects, and ensuring broad inclusivity in future trials are crucial steps to maximize their potential benefits.
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Affiliation(s)
- Sebastien Kenmoe
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Harish Nair
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
- School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
- School of Public Health, University of the Witwatersrand, South Africa
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39
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Sanz-Muñoz I, Castrodeza-Sanz J, Eiros JM. Potential Effects on Elderly People From Nirsevimab Use in Infants. OPEN RESPIRATORY ARCHIVES 2024; 6:100320. [PMID: 38617129 PMCID: PMC11015503 DOI: 10.1016/j.opresp.2024.100320] [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: 01/30/2024] [Accepted: 03/10/2024] [Indexed: 04/16/2024] Open
Abstract
Nirsevimab therapy has the potential to revolutionize infant respiratory syncytial virus (RSV) prophylaxis. But other populations suffering RSV, such the elderly or those over 60, may also be protected by using this novel antibody in the infant group. It is true that some studies link the use of nirsevimab to a reduction in the virus's ability to spread by lowering the viral load in infants as a result of the drug's long half-life. However, this protective effect may not be very significant because RSV transmission in the elderly typically comes from other elderly people or from school-aged children. Furthermore, RSV may be transmitted at any time of the year and not just during the period of nirsevimab protection due to its existence in human reservoirs. The reasons made here show that, even though nirsevimab treatment in infants may protect the elderly, this benefit would be limited and testimonial. Therefore, immunizing the elderly with currently licensed and developing vaccines should be a priority.
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Affiliation(s)
- Iván Sanz-Muñoz
- National Influenza Centre, Valladolid, Spain
- Instituto de Estudios de Ciencias de la Salud de Castilla y León, ICSCYL, Soria, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFECC), Spain
| | - Javier Castrodeza-Sanz
- National Influenza Centre, Valladolid, Spain
- Preventive Medicine and Public Health Unit, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
- Preventive Medicine and Public Department, Faculty of Medicine, Universidad de Valladolid, Valladolid, Spain
| | - José M. Eiros
- National Influenza Centre, Valladolid, Spain
- Microbiology Unit, Hospital Universitario Río Hortega, Valladolid, Spain
- Microbiology Unit, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
- Microbiology Department, Faculty of Medicine, Universidad de Valladolid, Valladolid, Spain
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40
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Ruiz-Galiana J, Cantón R, De Lucas Ramos P, García-Botella A, García-Lledó A, Hernández-Sampelayo T, Gómez-Pavón J, González Del Castillo J, Martín-Delgado MC, Martín Sánchez FJ, Martínez-Sellés M, Molero García JM, Moreno Guillén S, Rodríguez-Artalejo FJ, Rodríguez Fernandez R, Kestler M, Bouza E. Respiratory syncytial virus: A new era. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2024; 37:134-148. [PMID: 38205560 PMCID: PMC10945101 DOI: 10.37201/req/147.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 01/04/2024] [Indexed: 01/12/2024]
Abstract
Respiratory syncytial virus (RSV) is a major public health problem that has undergone significant changes in recent years. First of all, it has become easier to diagnose with highly reliable and rapidly available confirmatory tests. This has led to a better understanding of its epidemiology and RSV has gone from being a disease of the pediatric age group, severe only in infants and immunosuppressed children, to being a common disease in people of all ages, particularly important in patients of advanced age or with immunosuppressive diseases. Recent therapeutic and prophylactic advances, both with long-lasting monoclonal antibodies and vaccines, are another reason for satisfaction. For these reasons, the COVID and Emerging Pathogens Committee of the Illustrious Official College of Physicians of Madrid (ICOMEM) has considered it pertinent to review this subject in the light of new knowledge and new resources for dealing with this infection. We have formulated a series of questions that we believe will be of interest not only to members of the College but also to any non-expert in this subject, with a particular focus on the situation of RSV infection in Spain.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - E Bouza
- Servicio de Microbiología Clínica y Enfermedades Infecciosas del Hospital General Universitario Gregorio Marañón, Universidad Complutense. CIBERES. Ciber de Enfermedades Respiratorias. Madrid, Spain.
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41
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Perry D, Allan GM. Preventing respiratory syncytial virus in older adults. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2024; 70:258. [PMID: 38627002 PMCID: PMC11280667 DOI: 10.46747/cfp.7004258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Affiliation(s)
- Danielle Perry
- Clinical Evidence Expert for the College of Family Physicians of Canada and Assistant Adjunct Professor in the Department of Family Medicine at the University of Alberta in Edmonton
| | - G Michael Allan
- Director of Programs and Practice Support at the College of Family Physicians of Canada
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Polkowska-Kramek A, Begier E, Bruyndonckx R, Liang C, Beese C, Brestrich G, Tran TMP, Nuttens C, Casas M, Bayer LJ, Huebbe B, Ewnetu WB, Agudelo JLR, Gessner BD, von Eiff C, Rohde G. Estimated Incidence of Hospitalizations and Deaths Attributable to Respiratory Syncytial Virus Infections Among Adults in Germany Between 2015 and 2019. Infect Dis Ther 2024; 13:845-860. [PMID: 38520629 PMCID: PMC11058748 DOI: 10.1007/s40121-024-00951-0] [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: 11/26/2023] [Accepted: 02/22/2024] [Indexed: 03/25/2024] Open
Abstract
INTRODUCTION Respiratory syncytial virus (RSV) burden in adults is underestimated mainly due to unspecific symptoms and limited standard-of-care testing. We estimated the population-based incidence of hospitalization and mortality attributable to RSV among adults with and without risk factors in Germany. METHODS Weekly counts of hospitalizations and deaths for respiratory, cardiovascular, and cardiorespiratory diseases were obtained (Statutory Health Insurance database, 2015-2019). A quasi-Poisson regression model was fitted to estimate the number of hospitalizations and deaths attributable to RSV as a function of periodic and aperiodic time trends, and viral activity while allowing for potential overdispersion. Weekly counts of RSV and influenza hospitalizations in children < 2 years and adults ≥ 60 years, respectively, were used as viral activity indicators. Models were stratified by age group and risk status (defined as presence of selected comorbidities). RESULTS Population-based RSV-attributable hospitalization incidence rates were high among adults ≥ 60 years: respiratory hospitalizations (236-363 per 100,000 person-years) and cardiorespiratory hospitalizations (584-912 per 100,000 person-years). RSV accounted for 2-3% of all cardiorespiratory hospitalizations in this age group. The increase in cardiorespiratory hospitalization risk associated with underlying risk factors was greater in 18-44 year old persons (five to sixfold higher) than in ≥ 75 year old persons (two to threefold higher). CONCLUSIONS This is a first model-based study to comprehensively assess adult RSV burden in Germany. Estimated cardiorespiratory RSV hospitalization rates increased with age and were substantially higher in people with risk factors compared to those without risk factors. Our study indicates that RSV, like other respiratory viruses, contributes to both respiratory and cardiovascular hospitalizations. Effective prevention strategies are needed, especially among older adults ≥ 60 years and among adults with underlying risk factors.
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Affiliation(s)
| | | | | | - Caihua Liang
- Pfizer Inc, 66 Hudson Blvd E, New York, NY, 10001, USA.
| | | | | | | | | | - Maribel Casas
- P95 Pharmacovigilance and Epidemiology Services, Leuven, Belgium
| | | | | | | | | | | | | | - Gernot Rohde
- Medical Clinic I, Department of Respiratory Medicine, Goethe University Frankfurt, University Hospital, Frankfurt/Main, Germany
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Boattini M, Almeida A, Comini S, Bianco G, Cavallo R, Costa C. From Forgotten Pathogen to Target for New Vaccines: What Clinicians Need to Know about Respiratory Syncytial Virus Infection in Older Adults. Viruses 2024; 16:531. [PMID: 38675874 PMCID: PMC11053843 DOI: 10.3390/v16040531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 03/24/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
Respiratory syncytial virus (RSV) is increasingly recognized as being implicated in acute illness in older adults, with a significant weight in hospitalizations for respiratory illness and death. By means of a best-evidence review, this paper aims to investigate whether RSV can be considered a forgotten pathogen in older patients, looking at trends in the literature volume and exploring possible epidemiological and clinical features underlying the focus given to it. We then present an assessment of its disease burden and present and future strategies for its reduction, particularly in light of the recent availability of new vaccines.
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Affiliation(s)
- Matteo Boattini
- Microbiology and Virology Unit, University Hospital Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (G.B.)
- Department of Public Health and Paediatrics, University of Torino, 10126 Turin, Italy
- Lisbon Academic Medical Centre, 1649-028 Lisbon, Portugal
| | - André Almeida
- Department of Internal Medicine 4, Centro Hospitalar Universitário de Lisboa Central, Centro Clínico Académico de Lisboa, 1169-024 Lisbon, Portugal;
- NOVA Medical School, Universidade Nova de Lisboa, Centro Clínico Académico de Lisboa, 1169-056 Lisbon, Portugal
| | - Sara Comini
- Operative Unit of Clinical Pathology, Carlo Urbani Hospital, 60035 Jesi, Italy
| | - Gabriele Bianco
- Microbiology and Virology Unit, University Hospital Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (G.B.)
- Department of Public Health and Paediatrics, University of Torino, 10126 Turin, Italy
- Department of Experimental Medicine, University of Salento, Via Provinciale Monteroni n. 165, 73100 Lecce, Italy
| | - Rossana Cavallo
- Microbiology and Virology Unit, University Hospital Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (G.B.)
- Department of Public Health and Paediatrics, University of Torino, 10126 Turin, Italy
| | - Cristina Costa
- Microbiology and Virology Unit, University Hospital Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (G.B.)
- Department of Public Health and Paediatrics, University of Torino, 10126 Turin, Italy
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Riccò M, Parisi S, Corrado S, Marchesi F, Bottazzoli M, Gori D. Respiratory Syncytial Virus Infections in Recipients of Bone Marrow Transplants: A Systematic Review and Meta-Analysis. Infect Dis Rep 2024; 16:317-355. [PMID: 38667752 PMCID: PMC11050314 DOI: 10.3390/idr16020026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 03/18/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
Human Respiratory Syncytial Virus (RSV) is a common cause of respiratory tract infections. Usually associated with infants and children, an increasing amount of evidence suggests that RSV can cause substantial morbidity and mortality in immunocompromised individuals, including recipients of bone marrow transplantation (BMT). The present systematic review was therefore designed in accordance with the PRISMA guidelines to collect available evidence about RSV infections in BMT recipients. Three medical databases (PubMed, Embase, and MedRxiv) were therefore searched for eligible observational studies published up to 30 September 2023 and collected cases were pooled in a random-effects model. Heterogeneity was assessed using I2 statistics. Reporting bias was assessed by means of funnel plots and regression analysis. Overall, 30 studies were retrieved, including 20,067 BMT cases and 821 RSV infection episodes. Of them, 351 were lower respiratory tract infections, and a total of 78 RSV-related deaths were collected. A pooled attack rate of 5.40% (95% confidence interval [95%CI] 3.81 to 7.60) was identified, with a corresponding incidence rate of 14.77 cases per 1000 person-years (95%CI 9.43 to 20.11), and a case fatality ratio (CFR) of 7.28% (95%CI 4.94 to 10.60). Attack rates were higher in adults (8.49%, 95%CI 5.16 to 13.67) than in children (4.79%, 95%CI 3.05 to 7.45), with similar CFR (5.99%, 95%CI 2.31 to 14.63 vs. 5.85%, 95%CI 3.35 to 10.02). By assuming RSV attack rates as a reference group, influenza (RR 0.518; 95%CI 0.446 to 0.601), adenovirus (RR 0.679, 95%CI 0.553 to 0.830), and human metapneumovirus (RR 0.536, 95%CI 0.438 to 0.655) were associated with a substantially reduced risk for developing corresponding respiratory infection. Despite the heterogeneous settings and the uneven proportion of adult and pediatric cases, our study has identified high attack rates and a substantial CFR of RSV in recipients of BMT, stressing the importance of specifically tailored preventive strategies and the need for effective treatment options.
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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 Milan, Italy;
| | - Federico Marchesi
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Marco Bottazzoli
- Department of Otorhinolaryngology, APSS Trento, 38122 Trento, Italy
| | - Davide Gori
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
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45
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Lomholt FK, Emborg HD, Nørgaard SK, Nielsen J, Munkstrup C, Møller KL, Krog JS, Trebbien R, Vestergaard LS. Resurgence of Respiratory Syncytial Virus in the Summer of 2021 in Denmark-a Large out-of-season Epidemic Affecting Older Children. Open Forum Infect Dis 2024; 11:ofae069. [PMID: 38495773 PMCID: PMC10941316 DOI: 10.1093/ofid/ofae069] [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: 10/26/2023] [Accepted: 02/02/2024] [Indexed: 03/19/2024] Open
Abstract
Background When coronavirus disease 2019 (COVID-19) restrictions were lifted in Denmark in the spring of 2021, a surge in respiratory syncytial virus (RSV) cases followed, causing a large out-of-season epidemic. This study aims to investigate the summer epidemic compared with 3 typical pre-COVID-19 RSV winter seasons using Danish registers to identify RSV cases, RSV-related admissions, and use of intensive care treatment. Methods Incidence rates (IR) per 1000 person-years for RSV cases, RSV-related admissions, and intensive care treatment were calculated with 95% confidence interval (CI) for each season, stratified by age groups and incidence rate ratios (IRR) with 95% CI were calculated to compare the summer epidemic with the winter season for 2019-2020. Results In the summer epidemic, the IR of RSV cases and admissions exceeded previous winter seasons for all age groups. The highest increases in IRs were seen among children aged 2 to 3 years and 4 to 5 years. The IRR of cases were 4.6 (95% CI, 4.1-5.2) and 3.3 (2.6-4.2) and the IRR of admissions were 3.3 (2.7-4.2) and 3.8 (2.3-6.5) in the 2 age groups, respectively, when compared with the winter season 2019-2020. Conclusions Likely because of immunity debt following COVID-19 restrictions, the summer epidemic was significantly larger than previous winter seasons, most markedly among children aged 2 to 3 and 4 to 5 years but had a similar disease severity spectrum.
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Affiliation(s)
| | - Hanne-Dorthe Emborg
- Department of Infections Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Sarah Kristine Nørgaard
- Department of Infections Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Jens Nielsen
- Department of Infections Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Charlotte Munkstrup
- Department of Infections Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | | | - Jesper Schak Krog
- Department of Virus and Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
| | - Ramona Trebbien
- Department of Virus and Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
| | - Lasse Skafte Vestergaard
- Department of Infections Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
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Correa RA, Arancibia F, De Ávila Kfouri R, Chebabo A, García G, Gutiérrez Robledo LM, Lopardo G, Nemerovsky J, Pérez CM, Rendon A, Ruiz-Palacios GM, Aggarwal B, Berzanskis A, Cintra O. Understanding the Burden of Respiratory Syncytial Virus in Older Adults in Latin America: An Expert Perspective on Knowledge Gaps. Pulm Ther 2024; 10:1-20. [PMID: 38358618 PMCID: PMC10881952 DOI: 10.1007/s41030-024-00253-3] [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: 12/19/2023] [Accepted: 01/12/2024] [Indexed: 02/16/2024] Open
Abstract
Respiratory syncytial virus (RSV) is a significant global health concern and major cause of hospitalization, particularly among infants and older adults. The clinical impact of RSV is well characterized in infants; however, in many countries, the burden and risk of RSV in older populations are overlooked. In Latin America, there are limited data on RSV epidemiology and disease management in older adults. Therefore, the impact of RSV in this region needs to be addressed. Here, current insights on RSV infections in older populations in Latin America, including those with underlying health conditions, are discussed. We also outline the key challenges limiting our understanding of the burden of RSV in Latin America in a worldwide context and propose an expert consensus to improve our understanding of the burden of RSV in the region. By so doing, we aim to ultimately improve disease management and outcomes of those at risk and to alleviate the impact on healthcare systems.A graphical plain language summary is available with this article.
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Affiliation(s)
- Ricardo Amorim Correa
- Medical School, Pulmonology and Thoracic Surgery Department, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Francisco Arancibia
- Pulmonary Department, Instituto Nacional del Tórax and Clínica Santa María, Santiago de Chile, Chile
| | - Renato De Ávila Kfouri
- Pediatric Infectious Disease Specialist, Brazilian Pediatric Society and Brazilian Immunization, São Paulo, Brazil
| | - Alberto Chebabo
- University Hospital Clementino Fraga Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Luis Miguel Gutiérrez Robledo
- National Institute of Medical Sciences and Nutrition "S Zubiran" and National Institute of Geriatric Medicine, Mexico City, Mexico
| | - Gustavo Lopardo
- Infectious Diseases Department, Hospital Bernardo Houssay, Buenos Aires, Argentina
| | - Julio Nemerovsky
- Geriatrician Physician, Argentine Society of Gerontology and Geriatrics, Buenos Aires, Argentina
| | - Carlos M Pérez
- Faculty of Medicine and Science, Universidad San Sebastian, Santiago, Chile
| | - Adrian Rendon
- Universidad Autonoma de Nuevo León, Hospital Universitario "Dr. Jose Eleuterio Gonzalez", Centro de Investigación, Prevención y Tratamiento de Infecciones Respiratorias (CIPTIR), Monterrey, Mexico
| | - Guillermo M Ruiz-Palacios
- Department of Infectious Diseases, National Institute of Medical Sciences and Nutrition, Mexico City, Mexico
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Kim T, Choi SH. Epidemiology and Disease Burden of Respiratory Syncytial Virus Infection in Adults. Infect Chemother 2024; 56:1-12. [PMID: 38527779 PMCID: PMC10990889 DOI: 10.3947/ic.2024.0011] [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: 01/15/2024] [Accepted: 03/01/2024] [Indexed: 03/27/2024] Open
Abstract
Respiratory syncytial virus (RSV) constitutes a significant cause of respiratory illness and mortality among older adults, a demographic that is expanding with considerable impact on healthcare systems worldwide. The actual burden of RSV in this population may still be underestimated, owing to factors such as low awareness and suboptimal diagnostic sensitivity in adults, the lack of robust RSV surveillance systems, and the infrequent use of diagnostic testing. Recent advancements in respiratory virus detection have spurred further exploration into appropriate preventive and therapeutic strategies. The recent approval of two vaccines highlights the critical need for the precise estimation of the RSV disease burden to optimize the effectiveness and cost-efficiency of immunization programs. This narrative review aimed to summarize the existing knowledge of the RSV burden in adults with a particular focus on older adults, incorporating data from Korea. Overall, current estimates indicate that the annual RSV attack rate in the general adult population ranges from 1 - 7%, increasing to approximately 4 - 10% among elderly and high-risk groups. The in-hospital mortality rate can be estimated to be around 7 - 10%, rising up to 40% among intensive care unit-admitted patients. To elucidate RSV's disease burden, further continuing research, including population-based studies, is necessary.
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Affiliation(s)
- Taeeun Kim
- Division of Infectious Diseases, Department of Medicine, Nowon Eulji University Hospital, Seoul, Korea
| | - Sang-Ho Choi
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Redondo E, Rivero-Calle I, Mascarós E, Ocaña D, Jimeno I, Gil Á, Linares M, Onieva-García MÁ, González-Romo F, Yuste J, Martinón-Torres F. Respiratory Syncytial Virus Vaccination Recommendations for Adults Aged 60 Years and Older: The NeumoExperts Prevention Group Position Paper. Arch Bronconeumol 2024; 60:161-170. [PMID: 38311509 DOI: 10.1016/j.arbres.2024.01.004] [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: 12/18/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 02/06/2024]
Abstract
Respiratory syncytial virus (RSV) is a major cause of respiratory tract infections in adults, particularly older adults and those with underlying medical conditions. Vaccination has emerged as a potential key strategy to prevent RSV-related morbidity and mortality. This Neumoexperts Prevention (NEP) Group scientific paper aims to provide an evidence-based positioning and RSV vaccination recommendations for adult patients. We review the current literature on RSV burden and vaccine development and availability, emphasising the importance of vaccination in the adult population. According to our interpretation of the data, RSV vaccines should be part of the adult immunisation programme, and an age-based strategy should be preferred over targeting high-risk groups. The effectiveness and efficiency of this practice will depend on the duration of protection and the need for annual or more spaced doses. Our recommendations should help healthcare professionals formulate guidelines and implement effective vaccination programmes for adult patients at risk of RSV infection now that specific vaccines are available.
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Affiliation(s)
- Esther Redondo
- Infectious, Migrant, Vaccines and Preventive Activities Group of SEMERGEN, International Healthcare Centre of the City Council of Madrid, Madrid, Spain
| | - Irene Rivero-Calle
- Translational Paediatrics and Infectious Diseases Section, Paediatrics Department, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Genetics, Vaccines, and Infections Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, University of Santiago de Compostela, Santiago de Compostela, Spain; CIBER of Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Enrique Mascarós
- Health Department, Hospital la Fe, Primary Care Centre Arquitecto Tolsá, Valencia, Spain
| | - Daniel Ocaña
- Primary Care, Health Care Centre Algeciras, Algeciras, Spain
| | - Isabel Jimeno
- Primary Care Health Centre Isla de Oza, Vaccine Responsible of SEMG, Madrid, Spain
| | - Ángel Gil
- CIBER of Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Preventive and Public Health, Rey Juan Carlos University, Madrid, Spain
| | - Manuel Linares
- Specialist in Primary Care and Clinical Microbiology, Infectious Diseases Group SEMERGEN, Fundación io, Madrid, Spain
| | - María Ángeles Onieva-García
- Preventive Medicine and Public Health Unit, Hospital Universitario Reina Sofía, Cordoba, Spain; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Spain
| | - Fernando González-Romo
- Clinical Microbiology Department, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - José Yuste
- CIBER of Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Federico Martinón-Torres
- Translational Paediatrics and Infectious Diseases Section, Paediatrics Department, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Genetics, Vaccines, and Infections Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, University of Santiago de Compostela, Santiago de Compostela, Spain; CIBER of Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
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49
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Rojo-Alba S, Martínez ZP, González-Alba JM, Boga JA, Varela CO, Álvarez MAA, Fonseca CP, Clemente MMG, Rodriguez JG, García EG, Pérez MR, García SM, Álvarez-Argüelles ME. Respiratory syncytial virus incidence and typing in the last six seasons in the north of Spain (Asturias). Genetic characterization during the SARS-CoV-2 pandemic. J Med Virol 2024; 96:e29499. [PMID: 38469919 DOI: 10.1002/jmv.29499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 01/04/2024] [Accepted: 02/20/2024] [Indexed: 03/13/2024]
Abstract
Respiratory syncytial virus is associated with lower respiratory tract infections. As several types and genotypes can circulate at the same time, genomic characterization is important for timely epidemiological control and treatment measures. In the last 6 seasons (2017-2023), 191 236 nasopharyngeal swabs were processed for respiratory viruses to determine the etiology of acute respiratory infections, describe the incidence and distribution of RSV types and enrich the data of epidemiological molecular studies on RSV in Spain. The incidence of RSV reached 7% in the pre-pandemic season. RSV was most frequent in children under 5 years of age (12.6%), but was also significant in those over 70 years of age (5.63%). The measures taken to control SARS-CoV-2 infection were useful for RSV control and the incidence decreased to 1.8%, but caused a change in the types. Pre-pandemic, the majority circulating types were RSV-B/RSV-B/RSV-A and in the pandemic it was RSV-B/RSV-B. In the last season, RSV-B and RSV-A were detected in the same proportion. Genetic characterization showed three new clades. This has been taken into account to understand the epidemiology as well as the development of therapeutic and preventive strategies.
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Affiliation(s)
- Susana Rojo-Alba
- Department of Microbiology, Hospital Universitario Central de Asturias, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
| | - Zulema Pérez Martínez
- Department of Microbiology, Hospital Universitario Central de Asturias, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
| | - José María González-Alba
- Department of Microbiology, Hospital Universitario Central de Asturias, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
| | - José Antonio Boga
- Department of Microbiology, Hospital Universitario Central de Asturias, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
| | - Cristina Ochoa Varela
- Department of Microbiology, Hospital Universitario Central de Asturias, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
| | | | - Carmen Pérez Fonseca
- Department of Emergency, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - José Gutierrez Rodriguez
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
- Department of Geriatrics, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - Mercedes Rodríguez Pérez
- Department of Microbiology, Hospital Universitario Central de Asturias, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
| | - Santiago Melón García
- Department of Microbiology, Hospital Universitario Central de Asturias, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
| | - Marta Elena Álvarez-Argüelles
- Department of Microbiology, Hospital Universitario Central de Asturias, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
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50
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Kenmoe S, Chu HY, Dawood FS, Milucky J, Kittikraisak W, Matthewson H, Kulkarni D, Suntarattiwong P, Frivold C, Mohanty S, Havers F, Li Y, Nair H. Burden of Respiratory Syncytial Virus-Associated Acute Respiratory Infections During Pregnancy. J Infect Dis 2024; 229:S51-S60. [PMID: 37824420 DOI: 10.1093/infdis/jiad449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/04/2023] [Accepted: 10/10/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND With the licensure of maternal respiratory syncytial virus (RSV) vaccines in Europe and the United States, data are needed to better characterize the burden of RSV-associated acute respiratory infections (ARI) in pregnancy. The current study aimed to determine among pregnant individuals the proportion of ARI testing positive for RSV and the RSV incidence rate, RSV-associated hospitalizations, deaths, and perinatal outcomes. METHODS We conducted a systematic review, following PRISMA 2020 guidelines, using 5 databases (Medline, Embase, Global Health, Web of Science, and Global Index Medicus), and including additional unpublished data. Pregnant individuals with ARI who had respiratory samples tested for RSV were included. We used a random-effects meta-analysis to generate overall proportions and rate estimates across studies. RESULTS Eleven studies with pregnant individuals recruited between 2010 and 2022 were identified, most of which recruited pregnant individuals in community, inpatient and outpatient settings. Among 8126 pregnant individuals, the proportion with ARI that tested positive for RSV ranged from 0.9% to 10.7%, with a meta-estimate of 3.4% (95% confidence interval [CI], 1.9%-54%). The pooled incidence rate of RSV among pregnant individuals was 26.0 (95% CI, 15.8-36.2) per 1000 person-years. RSV hospitalization rates reported in 2 studies were 2.4 and 3.0 per 1000 person-years. In 5 studies that ascertained RSV-associated deaths among 4708 pregnant individuals, no deaths were reported. Three studies comparing RSV-positive and RSV-negative pregnant individuals found no difference in the odds of miscarriage, stillbirth, low birth weight, and small size for gestational age. RSV-positive pregnant individuals had higher odds of preterm delivery (odds ratio, 3.6 [95% CI, 1.3-10.3]). CONCLUSIONS Data on RSV-associated hospitalization rates are limited, but available estimates are lower than those reported in older adults and young children. As countries debate whether to include RSV vaccines in maternal vaccination programs, which are primarily intended to protect infants, this information could be useful in shaping vaccine policy decisions.
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Affiliation(s)
- Sebastien Kenmoe
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Helen Y Chu
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
| | - Fatimah S Dawood
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jennifer Milucky
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Wanitchaya Kittikraisak
- Influenza Program, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Hamish Matthewson
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Durga Kulkarni
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Piyarat Suntarattiwong
- Pediatric Infectious Diseases Unit, Queen Sirikit National Institute of Child Health, Bangkok, Thailand
| | - Collrane Frivold
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Sarita Mohanty
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Fiona Havers
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - You Li
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
- School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Harish Nair
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
- School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
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