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Sondlane H, Ogunbayo A, Donato C, Mogotsi M, Esona M, Hallbauer U, Bester P, Goedhals D, Nyaga M. Whole genome molecular analysis of respiratory syncytial virus pre and during the COVID-19 pandemic in Free State province, South Africa. Virus Res 2024; 347:199421. [PMID: 38942296 PMCID: PMC11283024 DOI: 10.1016/j.virusres.2024.199421] [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: 01/29/2024] [Revised: 05/14/2024] [Accepted: 06/16/2024] [Indexed: 06/30/2024]
Abstract
Respiratory syncytial virus (RSV) is the most predominant viral pathogen worldwide in children with lower respiratory tract infections. The Coronavirus disease 2019 (COVID-19) pandemic and resulting nonpharmaceutical interventions perturbed the transmission pattern of respiratory pathogens in South Africa. A seasonality shift and RSV resurgence was observed in 2020 and 2021, with several infected children observed. Conventional RSV-positive nasopharyngeal swabs were collected from various hospitals in the Free State province, Bloemfontein, South Africa, from children suffering from respiratory distress and severe acute respiratory infection between 2020 to 2021. Overlapping genome fragments were amplified and complete genomes were sequenced using the Illumina MiSeq platform. Maximum likelihood phylogenetic and evolutionary analysis were performed on both RSV-A/-B G-genes with published reference sequences from GISAID and GenBank. Our study strains belonged to the RSV-A GA2.3.2 and RSV-B GB5.0.5a clades. The upsurge of RSV was due to pre-existing strains that predominated in South Africa and circulating globally also driving these off-season RSV outbreaks during the COVID-19 pandemic. The variants responsible for the resurgence were phylogenetically related to pre-pandemic strains and could have contributed to the immune debt resulting from pandemic imposed restrictions. The deviation of the RSV season from the usual pattern affected by the COVID-19 pandemic highlights the need for ongoing genomic surveillance and the identification of genetic variants to prevent unforeseen outbreaks in the future.
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Affiliation(s)
- Hlengiwe Sondlane
- Next Generation Sequencing Unit and Division of Virology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Ayodeji Ogunbayo
- Next Generation Sequencing Unit and Division of Virology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Celeste Donato
- Enteric Diseases Group, Murdoch Children's Research Institute, Parkville, VIC, Australia; Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia; The Centre for Pathogen Genomics, The Doherty Institute, University of Melbourne, Australia
| | - Milton Mogotsi
- Next Generation Sequencing Unit and Division of Virology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Mathew Esona
- Diarrheal Pathogens Research Unit, Sefako Makgatho Health Sciences University, Medunsa 0204, Pretoria, South Africa
| | - Ute Hallbauer
- Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Phillip Bester
- Division of Virology, School of Pathology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Dominique Goedhals
- Division of Virology, School of Pathology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa; PathCare, Pretoria, South Africa
| | - Martin Nyaga
- Next Generation Sequencing Unit and Division of Virology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
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Chen Y, Zhao X, Ye C, Zhou J, Wang J, Ye X. Epidemiology and viral loads of respiratory syncytial virus in hospitalized children prior to and during COVID-19 pandemic in Hangzhou, China. J Med Virol 2024; 96:e29855. [PMID: 39119991 DOI: 10.1002/jmv.29855] [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: 03/13/2024] [Revised: 07/30/2024] [Accepted: 08/01/2024] [Indexed: 08/10/2024]
Abstract
Non-pharmaceutical interventions (NPIs) implemented to control SARS-CoV-2 have significantly influenced the activity of respiratory pathogens. This study investigated epidemiological changes among hospitalized patients with respiratory syncytial virus (RSV) before (2017-2019) and during (2020-2022) the COVID-19 pandemic in Hangzhou, China. We also examined viral load distribution across demographic and temporal variables. Nasopharyngeal swabs were collected and RSV loads were quantified using reverse transcriptase polymerase chain reaction (RT-qPCR). RSV epidemic characteristics, seasonal dynamics, and viral load distributions were compared between pre- and pandemic years. General linear models were employed to assess associations between viral loads and age. Among 19 742 cases, 1576 and 2092 tested positive during the pre- and pandemic years, respectively. From February to July 2020, the implementation of NPIs led to the cessation of RSV circulation. However, after these measures were relaxed, RSV cases resurged over two consecutive seasons during the pandemic, notably affecting older children compared to those in the pre-pandemic years (1.00 years, IQR: 0.50-2.00 vs. 0.58 years, IQR: 0.27-1.00, p < 0.001). Specifically, in 2021-2022, an off-season resurgence of RSV began earlier (mid-June), lasted longer (40 weeks), and involved more positive cases (1238 cases) than both 2020-2021 and pre-pandemic years. Viral load distribution demonstrated a clear age-related relationship in both pre- and pandemic years, with younger children consistently showing higher viral loads, independently of gender and season (all p-values for trends <0.001). These findings highlight the impact of NPIs on RSV epidemiology and underscore the need to prioritize RSV infection prevention in younger children from the perspective of viral load.
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Affiliation(s)
- Yunying Chen
- Department of Laboratory Medicine, Hangzhou Children's Hospital, Hangzhou, People's Republic of China
| | - Xinfeng Zhao
- Department of Laboratory Medicine, Hangzhou Children's Hospital, Hangzhou, People's Republic of China
| | - Cuiying Ye
- Department of Laboratory Medicine, Hangzhou Children's Hospital, Hangzhou, People's Republic of China
| | - Jun Zhou
- Department of Laboratory Medicine, Hangzhou Children's Hospital, Hangzhou, People's Republic of China
| | - Jie Wang
- Department of Laboratory Medicine, Hangzhou Children's Hospital, Hangzhou, People's Republic of China
| | - Xianfei Ye
- Department of Laboratory Medicine, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
- Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, Hangzhou, People's Republic of China
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Hou M, Liu G, Meng C, Dong L, Fang Y, Wang L, Wang N, Cai C, Wang H. Circulation patterns and molecular characteristics of respiratory syncytial virus among hospitalized children in Tianjin, China, before and during the COVID-19 pandemic (2017-2022). Virol Sin 2024:S1995-820X(24)00114-7. [PMID: 39067791 DOI: 10.1016/j.virs.2024.07.004] [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: 10/25/2023] [Accepted: 07/24/2024] [Indexed: 07/30/2024] Open
Abstract
Respiratory syncytial virus (RSV) is the main pathogen that causes hospitalization for acute lower respiratory tract infections (ALRIs) in children. With the reopening of communities and schools, the resurgence of RSV in the COVID-19 post-pandemic era has become a major concern. To understand the circulation patterns and genotype variability of RSV in Tianjin before and during the COVID-19 pandemic, a total of 19,531 nasopharyngeal aspirate samples from hospitalized children in Tianjin from July 2017 to June 2022 were evaluated. Direct immunofluorescence and polymerase chain reaction (PCR) were used for screening RSV-positive samples and subtyping, respectively. Further analysis of mutations in the second hypervariable region (HVR2) of the G gene was performed through Sanger sequencing. Our results showed that 16.46% (3,215/19,531) samples were RSV positive and a delayed increase in the RSV infection rates occurred in the winter season from December 2020 to February 2021, with the average RSV-positive rate of 35.77% (519/1,451). The ON1, with H258Q and H266L substitutions, and the BA9, with T290I and T312I substitutions, are dominant strains that alternately circulate every 1-2 years in Tianjin, China, from July 2017 to June 2022. In addition, novel substitutions, such as N296Y, K221T, N230K, V251A in the BA9 genotype, and L226I in the ON1 genotype, emerged during the COVID-19 pandemic. Analysis of clinical characteristics indicated no significant differences between RSV-A and RSV-B groups. This study provides a theoretical basis for clinical prevention and treatment. However, further studies are needed to explore the regulatory mechanism of host immune responses to different lineages of ON1 and BA9 in the future.
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Affiliation(s)
- Mengzhu Hou
- Tianjin Pediatric Research Institute, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin, 300134, China
| | - Guangping Liu
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Chao Meng
- Department of Medical Laboratory, Tianjin Second People's Hospital, Tianjin, 300192, China
| | - Lili Dong
- Department of Respiratory, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, 300134, China
| | - Yulian Fang
- Tianjin Pediatric Research Institute, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin, 300134, China
| | - Lu Wang
- Tianjin Pediatric Research Institute, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin, 300134, China
| | - Ning Wang
- Tianjin Pediatric Research Institute, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin, 300134, China
| | - Chunquan Cai
- Tianjin Pediatric Research Institute, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin, 300134, China.
| | - Hanjie Wang
- School of Life Sciences, Tianjin University and Tianjin Engineering Center of Micro-Nano Biomaterials and Detection-Treatment Technology, Tianjin Key Laboratory of Function and Application of Biological Macromolecular Structures, Tianjin, 300072, China.
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Williams TC, Marlow R, Hardelid P, Lyttle MD, Lewis KM, Mpamhanga CD, Cunningham S, Roland D. Clinical Impact of Serious Respiratory Disease in Children Under the Age of 2 Years During the 2021-2022 Bronchiolitis Season in England, Scotland, and Ireland. J Infect Dis 2024; 230:e111-e120. [PMID: 39052749 PMCID: PMC11272072 DOI: 10.1093/infdis/jiad551] [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: 06/26/2023] [Revised: 11/03/2023] [Accepted: 11/29/2023] [Indexed: 12/04/2023] Open
Abstract
BACKGROUND Interventions introduced to reduce the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led to a widespread reduction in childhood infections. However, from spring 2021 onwards the United Kingdom and Ireland experienced an unusual out-of-season epidemic of respiratory disease. METHODS We conducted a prospective observational study (BronchStart), enrolling children 0-23 months of age presenting with bronchiolitis, lower respiratory tract infection, or first episode of wheeze to 59 emergency departments across England, Scotland, and Ireland from May 2021 to April 2022. We combined testing data with national admissions datasets to infer the impact of respiratory syncytial virus (RSV) disease. RESULTS The BronchStart study collected data on 17 899 presentations for 17 164 children. Risk factors for admission and escalation of care included prematurity and congenital heart disease, but most admissions were for previously healthy term-born children. Of those aged 0-11 months who were admitted and tested for RSV, 1907 of 3912 (48.7%) tested positive. We estimate that every year in England and Scotland 28 561 (95% confidence interval, 27 637-29 486) infants are admitted with RSV infection. CONCLUSIONS RSV infection was the main cause of hospitalizations in this cohort, but 51.3% of admissions in infants were not associated with the virus. The majority of admissions were in previously healthy term-born infants.
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Affiliation(s)
- Thomas C Williams
- Child Life and Health, University of Edinburgh, Edinburgh, United Kingdom
- Department of Paediatric Respiratory and Sleep Medicine, Royal Hospital for Children and Young People, Edinburgh, United Kingdom
| | - Robin Marlow
- Emergency Department, Bristol Royal Hospital for Children, Bristol, United Kingdom
| | - Pia Hardelid
- Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Mark D Lyttle
- Emergency Department, Bristol Royal Hospital for Children, Bristol, United Kingdom
- Research in Emergency Care Avon Collaborative Hub, University of the West of England, Bristol, United Kingdom
| | - Kate M Lewis
- Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | | | - Steve Cunningham
- Department of Paediatric Respiratory and Sleep Medicine, Royal Hospital for Children and Young People, Edinburgh, United Kingdom
- Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom
| | - Damian Roland
- Paediatric Emergency Medicine Leicester Academic Group, Leicester Royal Infirmary, Leicester, United Kingdom
- Sapphire Group, Health Sciences, University of Leicester, Leicester, United Kingdom
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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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Servadio M, Finocchietti M, Vassallo C, Cipelli R, Heiman F, Di Lucchio G, Oresta B, Addis A, Belleudi V. An epidemiological investigation of high-risk infants for Respiratory Syncytial Virus infections: a retrospective cohort study. Ital J Pediatr 2024; 50:56. [PMID: 38528568 DOI: 10.1186/s13052-024-01627-8] [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: 07/14/2023] [Accepted: 03/13/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Respiratory Syncytial Virus (RSV) infections may lead to severe consequences in infants born preterm with breathing problems (such as bronchopulmonary dysplasia (BPD) and respiratory distress syndrome (RDS)) or congenital heart diseases (CHD). Since studies investigating the influence of different gestational age (WGA) and concomitant specific comorbidities on the burden of RSV infections are scarce, the present study aimed to better characterize these high-risk populations in the Italian context. METHODS This retrospective, longitudinal and record-linkage cohort study involved infants born between 2017 and 2019 in Lazio Region (Italy) and is based on data extracted from administrative databases. Each infant was exclusively included in one of the following cohorts: (1) BPD-RDS (WGA ≤35 with or without CHD) or (2) CHD (without BPD and/or RDS) or (3) Preterm (WGA ≤35 without BPD (and/or RDS) or CHD). Each cohort was followed for 12 months from birth. Information related to sociodemographic at birth, and RSV and Undetermined Respiratory Agents (URA) hospitalizations and drug consumption at follow-up were retrieved and described. RESULTS A total of 8,196 infants were selected and classified as 1,084 BPD-RDS, 3,286 CHD and 3,826 Preterm. More than 30% of the BPD-RDS cohort was composed by early preterm infants (WGA ≤ 29) in contrast to the Preterm cohort predominantly constitute by moderate preterm infants (98.2%), while CHD infants were primarily born at term (83.9%). At follow-up, despite the cohorts showed similar proportions of RSV hospitalizations, in BPD-RDS cohort hospitalizations were more frequently severe compared to those occurred in the Preterm cohort (p<0.01), in the BPD-RDS cohort was also found the highest proportion of URA hospitalizations (p<0.0001). In addition, BPD-RDS infants, compared to those of the remaining cohorts, received more frequently prophylaxis with palivizumab (p<0.0001) and were more frequently treated with adrenergics inhalants, and glucocorticoids for systemic use. CONCLUSIONS The assessment of the study clinical outcomes highlighted that, the demographic and clinical characteristics at birth of the study cohorts influence their level of vulnerability to RSV and URA infections. As such, continuous monitoring of these populations is necessary in order to ensure a timely organization of health care system able to respond to their needs in the future.
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Affiliation(s)
- Michela Servadio
- Department of Epidemiology of the Regional Health Service Lazio, Dipartimento di Epidemiologia del Servizio Sanitario Regionale del Lazio, Rome, Italy
- IQVIA Solutions Italy S.r.l., Milan, Italy
| | - Marco Finocchietti
- Department of Epidemiology of the Regional Health Service Lazio, Dipartimento di Epidemiologia del Servizio Sanitario Regionale del Lazio, Rome, Italy
| | | | | | | | | | - Bianca Oresta
- AstraZeneca S.p.A. - Medical Department, Milan, Italy
| | - Antonio Addis
- Department of Epidemiology of the Regional Health Service Lazio, Dipartimento di Epidemiologia del Servizio Sanitario Regionale del Lazio, Rome, Italy.
| | - Valeria Belleudi
- Department of Epidemiology of the Regional Health Service Lazio, Dipartimento di Epidemiologia del Servizio Sanitario Regionale del Lazio, Rome, Italy
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Xie LY, Wang T, Yu T, Hu X, Yang L, Zhong LL, Zhang B, Zeng SZ. Seasonality of respiratory syncytial virus infection in children hospitalized with acute lower respiratory tract infections in Hunan, China, 2013-2022. Virol J 2024; 21:62. [PMID: 38454522 PMCID: PMC10921640 DOI: 10.1186/s12985-024-02336-8] [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: 01/07/2024] [Accepted: 03/04/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND In China, respiratory syncytial virus (RSV) infections traditionally occur during the spring and winter seasons. However, a shift in the seasonal trend was noted in 2020-2022, during the coronavirus disease 2019 (COVID-19) pandemic. METHODS This study investigated the seasonal characteristics of RSV infection in children hospitalized with acute lower respiratory tract infections (ALRTIs). The RSV epidemic season was defined as RSV positivity in > 10% of the hospitalized ALRTI cases each week. Nine RSV seasons were identified between 2013 and 2022, and nonlinear ordinary least squares regression models were used to assess the differences in year-to-year epidemic seasonality trends. RESULTS We enrolled 49,658 hospitalized children diagnosed with ALRTIs over a 9-year period, and the RSV antigen-positive rate was 15.2% (n = 7,566/49,658). Between 2013 and 2022, the average onset and end of the RSV season occurred in week 44 (late October) and week 17 of the following year, respectively, with a typical duration of 27 weeks. However, at the onset of the COVID-19 pandemic, the usual spring RSV peak did not occur. Instead, the 2020 epidemic started in week 32, and RSV seasonality persisted into 2021, lasting for an unprecedented 87 weeks before concluding in March 2022. CONCLUSIONS RSV seasonality was disrupted during the COVID-19 pandemic, and the season exhibited an unusually prolonged duration. These findings may provide valuable insights for clinical practice and public health considerations.
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Affiliation(s)
- Le-Yun Xie
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 410005, Changsha, China
| | - Tao Wang
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 410005, Changsha, China
| | - Tian Yu
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 410005, Changsha, China.
| | - Xian Hu
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 410005, Changsha, China
| | - Le Yang
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 410005, Changsha, China
| | - Li-Li Zhong
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 410005, Changsha, China
| | - Bing Zhang
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 410005, Changsha, China
| | - Sai-Zhen Zeng
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 410005, Changsha, China.
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Liu S, Pan J, Chen Y, Ye L, Chen E, Wen X, Wu W, Wu B, Qi X, Chan TC, Sun W, Yu Z, Zhang T, Yan J, Jiang J. Human respiratory syncytial virus subgroups A and B outbreak in a kindergarten in Zhejiang Province, China, 2023. Front Public Health 2024; 12:1368744. [PMID: 38435292 PMCID: PMC10904655 DOI: 10.3389/fpubh.2024.1368744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 02/05/2024] [Indexed: 03/05/2024] Open
Abstract
Background In May-June 2023, an unprecedented outbreak of human respiratory syncytial virus (HRSV) infections occurred in a kindergarten, Zhejiang Province, China. National, provincial, and local public health officials investigated the cause of the outbreak and instituted actions to control its spread. Methods We interviewed patients with the respiratory symptoms by questionnaire. Respiratory samples were screened for six respiratory pathogens by real-time quantitative polymerase chain reaction (RT-PCR). The confirmed cases were further sequenced of G gene to confirm the HRSV genotype. A phylogenetic tree was reconstructed by maximum likelihood method. Results Of the 103 children in the kindergarten, 45 were classified as suspected cases, and 25 cases were confirmed by RT-PCR. All confirmed cases were identified from half of classes. 36% (9/25) were admitted to hospital, none died. The attack rate was 53.19%. The median ages of suspected and confirmed cases were 32.7 months and 35.8 months, respectively. Nine of 27 confirmed cases lived in one community. Only two-family clusters among 88 household contacts were HRSV positive. A total of 18 of the G gene were obtained from the confirmed cases. Phylogenetic analyses revealed that 16 of the sequences belonged to the HRSV B/BA9 genotype, and the other 2 sequences belonged to the HRSV A/ON1 genotype. The school were closed on June 9 and the outbreak ended on June 15. Conclusion These findings suggest the need for an increased awareness of HRSV coinfections outbreak in the kindergarten, when HRSV resurges in the community after COVID-19 pandemic.
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Affiliation(s)
- Shelan Liu
- Department of Infectious Diseases, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China
| | - Jinren Pan
- Department of Infectious Diseases, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China
| | - Yin Chen
- Department of Microbiology, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Ling Ye
- Department of Infectious Diseases, Daishan Country Centre for Disease Control and Prevention, Zhoushan, China
| | - Enfu Chen
- Department of Infectious Diseases, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China
| | - Xiaosha Wen
- Chinese Field Epidemiology Training Program, China Centre for Disease Control and Prevention, Beijing, China
| | - Wenjie Wu
- Department of Infectious Diseases, Zhoushan Municipal Centre for Disease Control and Prevention, Zhoushan, China
| | - Bing Wu
- Department of Microbiology, Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, China
| | - Xiaoqi Qi
- Chinese Field Epidemiology Training Program, China Centre for Disease Control and Prevention, Beijing, China
| | - Ta-Chien Chan
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan
| | - Wanwan Sun
- Department of Infectious Diseases, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China
| | - Zhao Yu
- Department of Infectious Diseases, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China
| | - Tongjie Zhang
- Department of Infectious Diseases, Daishan Country Centre for Disease Control and Prevention, Zhoushan, China
| | - Jianbo Yan
- Department of Infectious Diseases, Zhoushan Municipal Centre for Disease Control and Prevention, Zhoushan, China
| | - Jianmin Jiang
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China
- Key Lab of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Hangzhou, China
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Guadalupe-Fernández V, Martínez-Solanas E, Sabrià-Sunyé A, Ferrer-Mikoly C, Martínez-Mateo A, Ciruela-Navas P, Mendioroz J, Basile L. Investigating epidemiological distribution (temporality and intensity) of respiratory pathogens following COVID-19 de-escalation process in Catalonia, September 2016-June 2021: Analysis of regional surveillance data. PLoS One 2024; 19:e0285892. [PMID: 38335176 PMCID: PMC10857536 DOI: 10.1371/journal.pone.0285892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 05/03/2023] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Following the low incidence rates of non-SARS-CoV-2 respiratory viruses registered during the strict lockdown enforced in the pandemic, a resurgence of several endemic viruses in Catalonia (Spain) was noted during the early summer of 2021. OBJECTIVES In this study, we investigated whether the circulation of non-SARS-CoV-2 respiratory viruses in Catalonia, assessed by Microbiological Reporting System of Catalonia (MRSC) and the Epidemiological Surveillance Network of Catalonia, was affected by the strict lockdown measures, as well as, the implication of the Coronavirus Disease 19 (COVID-19) de-escalation process in the late season outbreaks registered during the 2020-2021 season. STUDY DESIGN A retrospective comparison of epidemic patterns in the respiratory viruses' incidence, using regional public health surveillance data from MRSC, was performed between weeks 26/2016 to week 27/2021. Data were expressed as the weekly total number of test positivity for individual viruses. A segmented negative binomial regression model was conducted, with two parameters included (level and trend) for each segment of the time series (2020 pre-lockdown, 2020 post-lockdown and 2021). Results were reported as a unit changed in the strict lockdown. RESULTS A total of 51588 confirmed cases of the different respiratory viruses were included in the analysis, the majority were influenza cases (63.7%). An immediate reduction in the weekly number of cases was observed in 2020 after the COVID-19 outbreak for human adenovirus virus (HAdV) (β2 = -2.606; P <0.01), human parainfluenza virus (HPIV) (β2 = -3.023; P <0.01), influenza virus (IFV) (β2 = -1.259; P <0.01), but not for respiratory syncytial virus (RSV), where the number of cases remained unchanged. During 2020, a significant negative trend was found for RSV (β3 = -0.170, P <0.01), and a positive trend for HAdV (β3 = 0.075, P <0.01). During 2021, a significant reduction in the weekly number of cases was also observed for all respiratory viruses, and a borderline non-significant reduction for HPIV (β3 = -0.027; P = 0.086). Moreover, significant positive trends were found for each viral pathogen, except for influenza during 2020-2021 season, where cases remained close to zero. The respiratory viruses increased activity and their late season epidemic start particularly affected children under 6 years old. CONCLUSIONS Our data not only provides evidence that occurrence of different respiratory virus infections was affected by the strict lockdown taken against SARS-CoV-2 but it also shows a late resurgence of seasonal respiratory viruses' cases during the 2020-2021 season following the relaxation of COVID-19-targeted non-pharmaceutical interventions.
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Affiliation(s)
- Víctor Guadalupe-Fernández
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
- Research Support Unit of Central Catalonia, University Institute for Research in Primary Health Care Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
| | - Erica Martínez-Solanas
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
| | - Aurora Sabrià-Sunyé
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
| | - Carol Ferrer-Mikoly
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
| | - Ana Martínez-Mateo
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto Salud Carlos III, Madrid, Spain
| | - Pilar Ciruela-Navas
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto Salud Carlos III, Madrid, Spain
| | - Jacobo Mendioroz
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
- Research Support Unit of Central Catalonia, University Institute for Research in Primary Health Care Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
| | - Luca Basile
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
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10
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Chan CM, Wahab AA, Ali A. Assessing the impact of COVID-19 on epidemiological changes of severe pediatric respiratory syncytial virus infections in Malaysia. Front Public Health 2024; 12:1246921. [PMID: 38356949 PMCID: PMC10866006 DOI: 10.3389/fpubh.2024.1246921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 01/19/2024] [Indexed: 02/16/2024] Open
Abstract
Introduction Respiratory syncytial virus (RSV) is one of the leading causes of hospitalization and mortality among children with respiratory tract infections. The non-pharmaceutical preventive measures against severe acute respiratory syndrome coronavirus (COVID-19) may have reduced the transmission of RSV, altering its tropical epidemiological seasonality. Thus, this study represents the first attempt to evaluate changes in RSV epidemiology in the context of COVID-19 pandemic in Malaysia. Methods Conducted at a tertiary hospital in Kuala Lumpur, Malaysia, this retrospective study analyzed collated data of children aged <12 years who were admitted for severe respiratory infections from 2017 to 2022. Time series models were used to predict the differences between actual and forecasted RSV cases, while logistic regression assessed the statistical association between RSV and COVID-19. Results Among the 4,084 children analyzed, we reported a significant inverse relationship between RSV and COVID-19 infections during the pandemic (2020-2021) (p < 0.05). In 2020, the RSV positivity rate sharply declined to 8.3 and 5.9%, respectively, in the two prominent seasons. Time series analysis showed a tremendous decrease in cases compared to the expected values, with reductions of 98.3% in the first season and 95.7% in the second season. However, following the lifting of the restriction order in 2022, RSV infections rose sharply with a positivity rate of 36.3%, higher than pre-COVID-19 pandemic levels. Conclusion This study provides evidence of increasing RSV cases post-COVID-19 pandemic, due to immunity debt. Hence, the healthcare system must be prepared to address future RSV outbreaks with the appropriate implementation of prophylaxis and public health measures.
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Affiliation(s)
- Chee Mun Chan
- Department of Pediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Research Center, Hospital Tunku Ampuan Besar Tuanku Aishah Rohani, UKM Specialist Children’s Hospital, Kuala Lumpur, Malaysia
| | - Asrul Abdul Wahab
- Department of Microbiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Adli Ali
- Department of Pediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Research Center, Hospital Tunku Ampuan Besar Tuanku Aishah Rohani, UKM Specialist Children’s Hospital, Kuala Lumpur, Malaysia
- Institute of IR4.0, Universiti Kebangsaan Malaysia, Bangi, Malaysia
- Infection and Immunology Health and Advanced Medicine Cluster, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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11
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Ramzali M, Salimi V, Cheraghali F, Hosseini SD, Yasaghi M, Samadizadeh S, Rastegar M, Nakstad B, Tahamtan A. Epidemiology and clinical features of respiratory syncytial virus (RSV) infection in hospitalized children during the COVID-19 pandemic in Gorgan, Iran. Health Sci Rep 2024; 7:e1787. [PMID: 38186938 PMCID: PMC10764657 DOI: 10.1002/hsr2.1787] [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: 09/21/2023] [Revised: 11/30/2023] [Accepted: 12/12/2023] [Indexed: 01/09/2024] Open
Abstract
Background and Aims Respiratory syncytial virus (RSV) is a leading cause of acute respiratory infection in infants and young children. Given the altered circulation patterns of respiratory viruses during the coronavirus disease pandemic-2019 (COVID-19), the study aimed to evaluate epidemiology and clinical features of RSV infections in hospitalized children during the COVID-19 pandemic in Gorgan, northeastern Iran. Molecular epidemiology studies on respiratory viral infections are necessary to monitor circulating viruses, disease severity, and clinical symptoms, in addition to early warning of new outbreaks. Methods Overall, 411 respiratory swab samples from hospitalized children from October 2021 to March 2022 were collected at Taleghani Children's Hospital, Gorgan, Iran. The incidence of RSV, as well as the circulating subgroups and genotypes, were investigated and confirmed using PCR methods. Additionally, all samples tested for severe acute respiratory syndrome-associated coronavirus 2 (SARS-CoV-2) and influenza, and demographic and clinical data were analyzed using SPSS software. Results The share of RSV, SARS-CoV-2, and influenza among hospitalized children with acute lower respiratory infections (ALRI) were 27%, 16.5%, and 4.1%, respectively. The RSV subgroup A (genotype ON1) was dominant over subgroup B (genotype BA9), with more severe clinical symptoms. Compared with the prepandemic era there were high numbers of hospitalized SARS-CoV-2 positive children and low numbers of other respiratory viruses. Despite this, the prevalence of ALRI-related RSV-disease among hospitalized children in our specialized pediatric center was higher than COVID-19 disease in the same cohort. Conclusions Studying the epidemiology of respiratory viruses and determining the circulating strains can contribute to effective infection control and treatment strategies.
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Affiliation(s)
- Mahnaz Ramzali
- Infectious Diseases Research CenterGolestan University of Medical SciencesGorganIran
- Department of Microbiology, School of MedicineGolestan University of Medical SciencesGorganIran
| | - Vahid Salimi
- Department of Virology, School of Public HealthTehran University of Medical SciencesTehranIran
| | - Fatemeh Cheraghali
- Department of Pediatrics, School of Medicine, Taleghani Children's HospitalGolestan University of Medical SciencesGorganIran
| | - Seyedeh Delafruz Hosseini
- Infectious Diseases Research CenterGolestan University of Medical SciencesGorganIran
- Department of Microbiology, School of MedicineGolestan University of Medical SciencesGorganIran
| | - Mohammad Yasaghi
- Infectious Diseases Research CenterGolestan University of Medical SciencesGorganIran
- Department of Microbiology, School of MedicineGolestan University of Medical SciencesGorganIran
| | - Saeed Samadizadeh
- Infectious Diseases Research CenterGolestan University of Medical SciencesGorganIran
- Department of Microbiology, School of MedicineGolestan University of Medical SciencesGorganIran
| | - Mostafa Rastegar
- Infectious Diseases Research CenterGolestan University of Medical SciencesGorganIran
- Department of Microbiology, School of MedicineGolestan University of Medical SciencesGorganIran
| | - Britt Nakstad
- Department of Pediatric and Adolescent HealthUniversity of BotswanaGaboroneBotswana
- Division of Paediatric and Adolescent Medicine, Institute of Clinical MedicineUniversity of OsloOsloNorway
| | - Alireza Tahamtan
- Infectious Diseases Research CenterGolestan University of Medical SciencesGorganIran
- Department of Microbiology, School of MedicineGolestan University of Medical SciencesGorganIran
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12
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Yoshioka S, Phyu WW, Wagatsuma K, Nagai T, Sano Y, Taniguchi K, Nagata N, Tomimoto K, Sato I, Kaji H, Sugata K, Sugiura K, Saito N, Aoki S, Suzuki E, Shimada Y, Hamabata H, Chon I, Otoguro T, Watanabe H, Saito R. Molecular Epidemiology of Respiratory Syncytial Virus during 2019-2022 and Surviving Genotypes after the COVID-19 Pandemic in Japan. Viruses 2023; 15:2382. [PMID: 38140623 PMCID: PMC10748361 DOI: 10.3390/v15122382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/01/2023] [Accepted: 12/02/2023] [Indexed: 12/24/2023] Open
Abstract
To evaluate the changes in respiratory syncytial virus (RSV) collected between 2019 and 2022, we analyzed RSV-A and RSV-B strains from various prefectures in Japan before and after the COVID-19 pandemic. RT-PCR-positive samples collected from children with rapid test positivity at outpatient clinics in 11 prefectures in Japan were sequenced for the ectodomain of the G gene to determine the genotype. Time-aware phylogeographic analyses were performed using the second hypervariable region (HVR) of the G gene from 2012 to 2022. Of 967 samples, 739 (76.4%) were found to be RSV-positive using RT-PCR. RSV peaked in September 2019 but was not detected in 2020, except in Okinawa. Nationwide epidemics occurred with peaks in July 2021 and 2022. The genotype remained the same, ON1 for RSV-A and BA9 for RSV-B during 2019-2022. Phylogeographic analysis of HVR revealed that at least seven clusters of RSV-A had circulated previously but decreased to two clusters after the pandemic, whereas RSV-B had a single monophyletic cluster over the 10 years. Both RSV-A and RSV-B were transferred from Okinawa into other prefectures after the pandemic. The RSV epidemic was suppressed due to pandemic restrictions; however, pre-pandemic genotypes spread nationwide after the pandemic.
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Grants
- not available Ministry of Education, Culture, Sports, Science and Technology
- 18K10043 Ministry of Education, Culture, Sports, Science and Technology
- 21K10414 Ministry of Education, Culture, Sports, Science and Technology
- 15fm0108009h0001-19fm0108009h005 Japan Agency for Medical Research and Development
- 20wm0125005h001-23wm0125005h004 Japan Agency for Medical Research and Development
- H24-Shinkou-Ippan-014 Ministry of Health, Labour and Welfare, and Sciences, Japan
- H27- Shinkougyousei-Shitei-001 Ministry of Health, Labour and Welfare, and Sciences, Japan
- H30-Shinkougyousei-Shitei-004 Ministry of Health, Labour and Welfare, and Sciences, Japan
- not available Niigata Prefectural Medical Association Grant
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Affiliation(s)
- Sayaka Yoshioka
- Division of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan; (S.Y.); (W.W.P.); (K.W.); (I.C.)
- Infectious Diseases Research Center of Niigata University (IDRC), Niigata University, Niigata 951-8510, Japan; (T.O.); (H.W.)
| | - Wint Wint Phyu
- Division of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan; (S.Y.); (W.W.P.); (K.W.); (I.C.)
- University of Medicine, Yangon, Myanmar
| | - Keita Wagatsuma
- Division of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan; (S.Y.); (W.W.P.); (K.W.); (I.C.)
| | - Takao Nagai
- Nagai Pediatric Clinic, Takamatsu 760-0002, Japan;
| | | | | | - Nobuo Nagata
- Hiraoka-Kouen Pediatric Clinic, Sapporo 004-0872, Japan;
| | | | - Isamu Sato
- Yoiko Pediatric Clinic Sato, Niigata 950-0983, Japan;
| | | | - Ken Sugata
- Mie National Hospital, Tsu 514-0125, Japan; (K.T.); (K.S.)
| | | | - Naruo Saito
- Saito Pediatric Clinic, Moriyama 524-0022, Japan;
| | | | | | | | | | - Irina Chon
- Division of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan; (S.Y.); (W.W.P.); (K.W.); (I.C.)
| | - Teruhime Otoguro
- Infectious Diseases Research Center of Niigata University (IDRC), Niigata University, Niigata 951-8510, Japan; (T.O.); (H.W.)
| | - Hisami Watanabe
- Infectious Diseases Research Center of Niigata University (IDRC), Niigata University, Niigata 951-8510, Japan; (T.O.); (H.W.)
| | - Reiko Saito
- Division of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan; (S.Y.); (W.W.P.); (K.W.); (I.C.)
- Infectious Diseases Research Center of Niigata University (IDRC), Niigata University, Niigata 951-8510, Japan; (T.O.); (H.W.)
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13
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Bents SJ, Viboud C, Grenfell BT, Hogan AB, Tempia S, von Gottberg A, Moyes J, Walaza S, Hansen C, Cohen C, Baker RE. Modeling the impact of COVID-19 nonpharmaceutical interventions on respiratory syncytial virus transmission in South Africa. Influenza Other Respir Viruses 2023; 17:e13229. [PMID: 38090227 PMCID: PMC10710953 DOI: 10.1111/irv.13229] [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: 06/12/2023] [Revised: 09/25/2023] [Accepted: 11/11/2023] [Indexed: 12/18/2023] Open
Abstract
Background The South African government employed various nonpharmaceutical interventions (NPIs) to reduce the spread of SARS-CoV-2. Surveillance data from South Africa indicates reduced circulation of respiratory syncytial virus (RSV) throughout the 2020-2021 seasons. Here, we use a mechanistic transmission model to project the rebound of RSV in the two subsequent seasons. Methods We fit an age-structured epidemiological model to hospitalization data from national RSV surveillance in South Africa, allowing for time-varying reduction in RSV transmission during periods of COVID-19 circulation. We apply the model to project the rebound of RSV in the 2022 and 2023 seasons. Results We projected an early and intense outbreak of RSV in April 2022, with an age shift to older infants (6-23 months old) experiencing a larger portion of severe disease burden than typical. In March 2022, government alerts were issued to prepare the hospital system for this potentially intense outbreak. We then assess the 2022 predictions and project the 2023 season. Model predictions for 2023 indicate that RSV activity has not fully returned to normal, with a projected early and moderately intense wave. We estimate that NPIs reduced RSV transmission between 15% and 50% during periods of COVID-19 circulation. Conclusions A wide range of NPIs impacted the dynamics of the RSV outbreaks throughout 2020-2023 in regard to timing, magnitude, and age structure, with important implications in a low- and middle-income countries (LMICs) setting where RSV interventions remain limited. More efforts should focus on adapting RSV models to LMIC data to project the impact of upcoming medical interventions for this disease.
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Affiliation(s)
- Samantha J. Bents
- Fogarty International Center, National Institutes of HealthBethesdaMarylandUSA
| | - Cécile Viboud
- Fogarty International Center, National Institutes of HealthBethesdaMarylandUSA
| | - Bryan T. Grenfell
- Department of Ecology and Evolutionary BiologyPrinceton UniversityPrincetonNew JerseyUSA
| | - Alexandra B. Hogan
- School of Population HealthUniversity of New South WalesSydneyNew South WalesAustralia
| | - Stefano Tempia
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- School of Public Health, Faculty of Health SciencesUniversity of WitwatersrandJohannesburgSouth Africa
| | - Anne von Gottberg
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- School of Pathology, Faculty of Health SciencesUniversity of WitwatersrandJohannesburgSouth Africa
- Department of Pathology, Faculty of Health SciencesUniversity of Cape TownCape TownSouth Africa
| | - Jocelyn Moyes
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- School of Public Health, Faculty of Health SciencesUniversity of WitwatersrandJohannesburgSouth Africa
| | - Sibongile Walaza
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- School of Public Health, Faculty of Health SciencesUniversity of WitwatersrandJohannesburgSouth Africa
| | - Chelsea Hansen
- Fogarty International Center, National Institutes of HealthBethesdaMarylandUSA
- Brotman Baty InstituteUniversity of WashingtonSeattleWashingtonUSA
- PandemiX Center, Department of Science & EnvironmentRoskilde UniversityRoskildeDenmark
| | - Cheryl Cohen
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- School of Public Health, Faculty of Health SciencesUniversity of WitwatersrandJohannesburgSouth Africa
| | - Rachel E. Baker
- School of Public HealthBrown UniversityProvidenceRhode IslandUSA
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14
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Rice E, Oakes DB, Holland C, Moore HC, Blyth CC. Respiratory syncytial virus in children: epidemiology and clinical impact post-COVID-19. Curr Opin Infect Dis 2023; 36:522-528. [PMID: 37830952 DOI: 10.1097/qco.0000000000000967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
PURPOSE OF REVIEW Respiratory syncytial virus (RSV) remains a leading cause of mortality and morbidity worldwide. RSV seasonality was disrupted by COVID-19-associated nonpharmaceutical interventions (NPIs). We review RSV seasonality, molecular epidemiology, clinical manifestations, and community awareness to inform future prevention strategies. RECENT FINDINGS An initial reduction of RSV disease observed with NPIs, and subsequent global resurgence was associated with a collapse in genetic diversity. A lack of immunity is suggested to have contributed to the resurgence of RSV cases experienced post COVID-19. The median age of children admitted with RSV increased during the resurgence, likely secondary to the expanded cohort of RSV-immune naive children. The pandemic also played a role in increased community awareness, which can be utilized as part of a coordinated public health effort to introduce prevention strategies. Further education on signs and symptoms of RSV is still required. SUMMARY mAbs and maternal vaccines targeting RSV have the potential to reduce paediatric morbidity, however this new era of RSV prevention will require ongoing research to facilitate community awareness and engagement, and better respiratory surveillance. Tackling the global burden of RSV will require a coordinated effort and measures to ensure access and affordability of new prevention strategies.
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Affiliation(s)
- Emily Rice
- Department of General Paediatrics, Perth Children's Hospital, Hospital Avenue
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia
| | - Daniel B Oakes
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia
| | - Charlie Holland
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia
- School of Population Health, Curtin University
| | - Hannah C Moore
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia
- School of Population Health, Curtin University
| | - Christopher C Blyth
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia
- Department of Infectious Diseases, Perth Children's Hospital, Hospital Avenue
- School of Medicine, University of Western Australia
- Department of Microbiology, PathWest Laboratory Medicine, QEII Medical Centre, Perth, Western Australia
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15
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Umar S, Yang R, Wang X, Liu Y, Ke P, Qin S. Molecular epidemiology and characteristics of respiratory syncytial virus among hospitalized children in Guangzhou, China. Virol J 2023; 20:272. [PMID: 37993935 PMCID: PMC10666375 DOI: 10.1186/s12985-023-02227-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/03/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Human respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory tract infection and hospitalization, especially in children. Highly mutagenic nature and antigenic diversity enable the RSV to successfully survive in human population. We conducted a molecular epidemiological study during 2017-2021 to investigate the prevalence and genetic characteristics of RSV. METHODS A total of 6499 nasopharyngeal (NP) swabs were collected from hospitalized children at Department of Pediatrics, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong, China. All NP swab specimens were preliminary screened for common respiratory viruses and then tested for RSV using specific PCR assays. Partial G genes of RSV were amplified for phylogenetic analysis and genetic characterization. RESULTS The overall detection rate for common respiratory viruses was 16.12% (1048/6499). Among those, 405 specimens (6.20%, 405/6499) were found positive for RSV. The monthly distribution of RSV and other respiratory viruses was variable, and the highest incidence was recorded in Autumn and Winter. Based on the sequencing of hypervariable region of G gene, 93 RSV sequences were sub-grouped into RSV-A (56, 60.2%) and RSV-B (37, 39.8%). There was no coinfection of RSV-A and RSV-B in the tested samples. Phylogenetic analysis revealed that RSV-A and RSV-B strains belonged to ON1 and BA9 genotypes respectively, indicating predominance of these genotypes in Guangzhou. Several substitutions were observed which may likely change the antigenicity and pathogenicity of RSV. Multiple glycosylation sites were noticed, demonstrating high selection pressure on these genotypes. CONCLUSION This study illustrated useful information about epidemiology, genetic characteristics, and circulating genotypes of RSV in Guangzhou China. Regular monitoring of the circulating strains of RSV in different parts of China could assist in the development of more effective vaccines and preventive measures.
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Affiliation(s)
- Sajid Umar
- Global Health Research Center, Duke Kunshan University, Kunshan, China
- Division of Natural and Applied Sciences (DNAS), Duke Kunshan University, Kunshan, China
| | - Rongyuan Yang
- Key Laboratory for Infectious Disease, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xinye Wang
- School of Biomedical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Yuntao Liu
- Emergency Department, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Peifeng Ke
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, No. 111 Dade Road, Yuexiu District, Guangzhou, China.
| | - Sheng Qin
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, No. 111 Dade Road, Yuexiu District, Guangzhou, China.
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16
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Lu L, Zhong H, Xu M, Jia R, Liu P, Su L, Cao L, Zhu X, Xu J. Diversity of classic and novel human astrovirus in outpatient children with acute gastroenteritis in Shanghai, China. Front Microbiol 2023; 14:1265843. [PMID: 38029144 PMCID: PMC10679754 DOI: 10.3389/fmicb.2023.1265843] [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: 07/24/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Human astrovirus (HAstV) is an important pathogen of acute gastroenteritis (AGE) in children. This study was aimed at investigating the diversity and epidemiology of classic and novel HAstV in outpatient children aged 0-16 years old with AGE in Shanghai. Methods From May 2020 to December 2022, a total of 1,482 stool samples were collected from children diagnosed as AGE from the Children's Hospital of Fudan University. HAstV was identified using pan-astrovirus consensus primers by Reverse transcription PCR. Results During the study period, 3.3% (49/1,482) of specimens were identified as HAstV, with a detection rate of 2.5% (37/1,482) for classic HAstV and 0.8% (12/1,482) for novel HAstV. Among the 12 novel HAstV strains, 11 (91.7%) belonged to the HAstV-MLB and 1 (8.3%) was HAstV-VA. Genotyping revealed six circulating genotypes. Strain HAstV-1 was predominant in the study population with a detection rate of 1.8% (26/1,482) followed by HAstV-MLB1 (0.7%, 10/1,482) and HAstV-4 (0.6%, 9/1,482). Of note, all the HAstV-4 strains detected in this study were close to one astrovirus strain isolated from Bactrian camels with 99.0-100.0% amino acid sequences identity. In this study, HAstV was detected in all age groups with the highest detection rate of HAstV-positive specimens observed in children older than 73 months (5.7%, 12/209). Discussion This study provided useful information and contributed to the molecular epidemiology of both classic and novel HAstV, which were simultaneously characterized and reported for the first time in Shanghai.
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Affiliation(s)
- Lijuan Lu
- Department of Clinical Laboratory, National Children’s Medical Center, Children’s Hospital of Fudan University, Shanghai, China
| | - Huaqing Zhong
- Department of Clinical Laboratory, National Children’s Medical Center, Children’s Hospital of Fudan University, Shanghai, China
| | - Menghua Xu
- Department of Clinical Laboratory, National Children’s Medical Center, Children’s Hospital of Fudan University, Shanghai, China
| | - Ran Jia
- Department of Clinical Laboratory, National Children’s Medical Center, Children’s Hospital of Fudan University, Shanghai, China
| | - Pengcheng Liu
- Department of Clinical Laboratory, National Children’s Medical Center, Children’s Hospital of Fudan University, Shanghai, China
| | - Liyun Su
- Department of Clinical Laboratory, National Children’s Medical Center, Children’s Hospital of Fudan University, Shanghai, China
| | - Lingfeng Cao
- Department of Clinical Laboratory, National Children’s Medical Center, Children’s Hospital of Fudan University, Shanghai, China
| | - Xunhua Zhu
- Department of Clinical Laboratory, National Children’s Medical Center, Children’s Hospital of Fudan University, Shanghai, China
| | - Jin Xu
- Department of Clinical Laboratory, National Children’s Medical Center, Children’s Hospital of Fudan University, Shanghai, China
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
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17
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Wu R, Zhang J, Mo L. Analysis of respiratory virus detection in hospitalized children with acute respiratory infection during the COVID-19 pandemic. Virol J 2023; 20:253. [PMID: 37919789 PMCID: PMC10623845 DOI: 10.1186/s12985-023-02218-5] [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: 05/09/2023] [Accepted: 10/27/2023] [Indexed: 11/04/2023] Open
Abstract
OBJECTIVE It is now understood that the Coronavirus disease 2019 (COVID-19) pandemic and its associated containment measures have influenced the epidemiology of other respiratory viruses. This study aimed to characterize respiratory virus infections in pediatric patients hospitalized for acute respiratory infections (ARIs) in East China both prior to and during the COVID-19 pandemic. METHODS We collected nasal secretions from 9782 pediatric ARI patients admitted to Shaoxing Maternal and Child Health Care Hospital between January 2018 and December 2022. We analyzed and compared changes in viral detection rates, epidemiological features, and clinical characteristics. RESULTS A total of 1633 strains from 7 common respiratory viruses were identified, with an overall positive rate of 16.35% (n = 821/5021) in 2018-2019 and 17.06% (n = 812/4761) in 2020-2022. Compared to 2018-2019, the positive rate for RSV significantly increased in 2020-2022, while detection rates for ADV, PIV-2, PIV-3, and flu-B showed reductions (P < 0.05). The RSV-positive rate experienced a more significant increase in winter compared to other seasons both before and during COVID-19 (P < 0.05), whereas PIV-3 predominantly circulated in spring and summer before COVID-19. CONCLUSION During the COVID-19 pandemic, marked variations in age distribution and seasonality of respiratory virus infections were observed among hospitalized children with ARIs in East China. Non-pharmaceutical interventions (NPIs) implemented during the pandemic yielded a limited impact on common respiratory viruses.
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Affiliation(s)
- Ruoya Wu
- Nursing department, Shaoxing Maternity and Child Health Care Hospital, 305 East Street, Yuecheng District, Shaoxing, Zhejiang, P. R. China
| | - Jianwei Zhang
- Department of Pediatrics, Shaoxing Maternity and Child Health Care Hospital, 305 East Street, Yuecheng District, Shaoxing, Zhejiang, P. R. China
| | - Liyan Mo
- Nursing department, Shaoxing Maternity and Child Health Care Hospital, 305 East Street, Yuecheng District, Shaoxing, Zhejiang, P. R. China.
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18
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Ngiam JN, Koh MCY, Liong TS, Sim MY, Chhabra S, Goh W, Chew NWS, Sia CH, Goon PKC, Soong JTY, Tambyah PA, Cove ME. Inflammatory phenotypes may be more important than age and comorbidities in predicting clinical outcomes in hospitalised patients with COVID-19. IJID REGIONS 2023; 8:84-89. [PMID: 37529630 PMCID: PMC10307670 DOI: 10.1016/j.ijregi.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/13/2023] [Accepted: 06/23/2023] [Indexed: 08/03/2023]
Abstract
Objectives In critically ill patients with COVID-19, distinct hyperinflammatory and hypoinflammatory phenotypes have been described, with different outcomes and responses to therapy. We investigated if similar phenotypes exist in non-severe illness. Methods Consecutive patients with polymerase chain reaction (PCR) confirmed SARS-CoV-2 were examined. Baseline demographics and laboratory investigations were tabulated, including serum C-reactive protein. Patients were divided into those who were hyperinflammatory (defined as C-reactive protein >17 mg/l) or hypoinflammatory. Adverse outcomes, defined as requiring oxygenation, intensive care, or death, were recorded during the hospital stay. Clinical characteristics and outcomes were compared. Results Of the 1781 patients examined, 276 (15.5%) had a hyperinflammatory phenotype. They were older (51.8 ± 17.2 vs 40.3 ± 13.8 years, P <0.001), had a lower PCR cycle threshold (PCR cycle threshold value 19.3 ± 6.3 vs 22.7 ± 15.4, P = 0.025) at presentation, and more medical comorbidities. The hyperinflammatory phenotype was independently associated with adverse clinical outcomes, even after adjusting for age, medical history and viral load on multivariable analyses (adjusted odds ratio 5.78, 95% confidence interval 2.86-11.63). Conclusion Even in non-severe COVID-19, there are distinct hyper- and hypoinflammatory phenotypes, with the hyperinflammatory phenotype strongly associated with adverse clinical outcomes, that could be distinguished with a simple biomarker.
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Affiliation(s)
| | - Matthew CY Koh
- Department of Infectious Diseases, National University Health System, Singapore
| | - Tze Sian Liong
- Department of Medicine, National University Health System, Singapore
| | - Meng Ying Sim
- Department of Infectious Diseases, National University Health System, Singapore
| | - Srishti Chhabra
- Department of Infectious Diseases, National University Health System, Singapore
| | - Wilson Goh
- Department of Medicine, National University Health System, Singapore
| | - Nicholas WS Chew
- Department of Cardiology, National University Heart Centre Singapore, Singapore
| | - Ching-Hui Sia
- Department of Cardiology, National University Heart Centre Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Peter KC Goon
- Department of Medicine, National University Health System, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - John TY Soong
- Department of Medicine, National University Health System, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Paul Anantharajah Tambyah
- Department of Cardiology, National University Heart Centre Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Infectious Diseases Translational Research Programme, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore
| | - Matthew Edward Cove
- Department of Medicine, National University Health System, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Tramuto F, Maida CM, Mazzucco W, Costantino C, Amodio E, Sferlazza G, Previti A, Immordino P, Vitale F. Molecular Epidemiology and Genetic Diversity of Human Respiratory Syncytial Virus in Sicily during Pre- and Post-COVID-19 Surveillance Seasons. Pathogens 2023; 12:1099. [PMID: 37764907 PMCID: PMC10534943 DOI: 10.3390/pathogens12091099] [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: 07/21/2023] [Revised: 08/23/2023] [Accepted: 08/26/2023] [Indexed: 09/29/2023] Open
Abstract
Human respiratory syncytial virus (hRSV) is an important pathogen of acute respiratory tract infection of global significance. In this study, we investigated the molecular epidemiology and the genetic variability of hRSV over seven surveillance seasons between 2015 and 2023 in Sicily, Italy. hRSV subgroups co-circulated through every season, although hRSV-B mostly prevailed. After the considerable reduction in the circulation of hRSV due to the widespread implementation of non-pharmaceutical preventive measures during the COVID-19 pandemic, hRSV rapidly re-emerged at a high intensity in 2022-2023. The G gene was sequenced for genotyping and analysis of deduced amino acids. A total of 128 hRSV-A and 179 hRSV-B G gene sequences were obtained. The phylogenetic analysis revealed that the GA2.3.5a (ON1) and GB5.0.5a (BA9) genotypes were responsible for the hRSV epidemics in Sicily.; only one strain belonged to the genotype GB5.0.4a. No differences were observed in the circulating genotypes during pre- and post-pandemic years. Amino acid sequence alignment revealed the continuous evolution of the G gene, with a combination of amino acid changes specifically appearing in 2022-2023. The predicted N-glycosylation sites were relatively conserved in ON1 and BA9 genotype strains. Our findings augment the understanding and prediction of the seasonal evolution of hRSV at the local level and its implication in the monitoring of novel variants worth considering in better design of candidate vaccines.
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Affiliation(s)
- Fabio Tramuto
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”—Hygiene Section, University of Palermo, 90134 Palermo, Italy; (C.M.M.); (W.M.); (C.C.); (E.A.); (P.I.); (F.V.)
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90127 Palermo, Italy; (G.S.); (A.P.)
| | - Carmelo Massimo Maida
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”—Hygiene Section, University of Palermo, 90134 Palermo, Italy; (C.M.M.); (W.M.); (C.C.); (E.A.); (P.I.); (F.V.)
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90127 Palermo, Italy; (G.S.); (A.P.)
| | - Walter Mazzucco
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”—Hygiene Section, University of Palermo, 90134 Palermo, Italy; (C.M.M.); (W.M.); (C.C.); (E.A.); (P.I.); (F.V.)
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90127 Palermo, Italy; (G.S.); (A.P.)
| | - Claudio Costantino
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”—Hygiene Section, University of Palermo, 90134 Palermo, Italy; (C.M.M.); (W.M.); (C.C.); (E.A.); (P.I.); (F.V.)
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90127 Palermo, Italy; (G.S.); (A.P.)
| | - Emanuele Amodio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”—Hygiene Section, University of Palermo, 90134 Palermo, Italy; (C.M.M.); (W.M.); (C.C.); (E.A.); (P.I.); (F.V.)
| | - Giuseppe Sferlazza
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90127 Palermo, Italy; (G.S.); (A.P.)
| | - Adriana Previti
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90127 Palermo, Italy; (G.S.); (A.P.)
| | - Palmira Immordino
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”—Hygiene Section, University of Palermo, 90134 Palermo, Italy; (C.M.M.); (W.M.); (C.C.); (E.A.); (P.I.); (F.V.)
| | - Francesco Vitale
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”—Hygiene Section, University of Palermo, 90134 Palermo, Italy; (C.M.M.); (W.M.); (C.C.); (E.A.); (P.I.); (F.V.)
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90127 Palermo, Italy; (G.S.); (A.P.)
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20
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Ren L, Cui L, Wang Q, Gao L, Xu M, Wang M, Wu Q, Guo J, Lin L, Liang Y, Liu N, Cheng Y, Yang J, Yu H. Cost and health-related quality of life for children hospitalized with respiratory syncytial virus in Central China. Influenza Other Respir Viruses 2023; 17:e13180. [PMID: 37640557 PMCID: PMC10495873 DOI: 10.1111/irv.13180] [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: 01/29/2023] [Revised: 07/16/2023] [Accepted: 07/17/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND The economic burden of respiratory syncytial virus (RSV) infection and its impact on health-related quality of life (HRQoL) are not well-understood in China. This study assessed total cost and HRQoL for children hospitalized with RSV in Central China. METHODS Based on a prospective case series study in Henan Province in 2020-2021, inpatients aged 0-59 months with RSV-related acute respiratory infections (ARIs) were included into analysis. Total cost included direct medical cost (sum of medical cost before and during hospitalization), direct non-medical cost, and indirect cost. Direct medical cost during hospitalization data were extracted from the hospital information system. Other costs and HRQoL status were obtained from a telephone survey conducted in the caregivers of the enrolled patients. RESULTS Among 261 RSV-infected inpatients, caregivers of 170 non-severe cases (65.1%, 170/261) were successfully interviewed. Direct medical cost per episode was 1055.3 US dollars (US$) (95% CI: 998.2-1112.5 US$). Direct non-medical cost and indirect cost per episode were 83.6 US$ (95% CI: 77.5-89.7 US$) and 162.4 US$ (95% CI: 127.9-197.0 US$), respectively. Quality adjusted life years (QALY) loss for non-severe RSV hospitalization was 8.9 × 10-3 (95% CI: 7.9 × 10-3 -9.9 × 10-3 ). The majority of inpatients were <1 year of age comprising significantly higher cost and more QALY loss than older children. CONCLUSIONS RSV-associated hospitalization poses high economic and health burden in Central China particularly for children <1 year old. Our findings are crucial for determining the priority of interventions and allocation of health resources.
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Affiliation(s)
- Lingshuang Ren
- School of Public HealthFudan University, Key Laboratory of Public Health Safety, Ministry of EducationShanghaiChina
| | - Lidan Cui
- Henan Engineering Research Center of Pediatric Infection and Critical CareChildren's Hospital Affiliated to Zhengzhou UniversityZhengzhouChina
| | - Qianli Wang
- Shanghai Institute of Infectious Disease and BiosecurityFudan UniversityShanghaiChina
| | - Liujiong Gao
- Henan Engineering Research Center of Pediatric Infection and Critical CareChildren's Hospital Affiliated to Zhengzhou UniversityZhengzhouChina
| | - Meng Xu
- School of Public HealthFudan University, Key Laboratory of Public Health Safety, Ministry of EducationShanghaiChina
| | - Meng Wang
- Henan Engineering Research Center of Pediatric Infection and Critical CareChildren's Hospital Affiliated to Zhengzhou UniversityZhengzhouChina
| | - Qianhui Wu
- School of Public HealthFudan University, Key Laboratory of Public Health Safety, Ministry of EducationShanghaiChina
| | - Jinxin Guo
- School of Public HealthFudan University, Key Laboratory of Public Health Safety, Ministry of EducationShanghaiChina
| | - Li Lin
- Henan Engineering Research Center of Pediatric Infection and Critical CareChildren's Hospital Affiliated to Zhengzhou UniversityZhengzhouChina
| | - Yuxia Liang
- School of Public HealthFudan University, Key Laboratory of Public Health Safety, Ministry of EducationShanghaiChina
| | - Nuolan Liu
- School of Public HealthFudan University, Key Laboratory of Public Health Safety, Ministry of EducationShanghaiChina
| | - Yibing Cheng
- Henan Engineering Research Center of Pediatric Infection and Critical CareChildren's Hospital Affiliated to Zhengzhou UniversityZhengzhouChina
| | - Juan Yang
- School of Public HealthFudan University, Key Laboratory of Public Health Safety, Ministry of EducationShanghaiChina
- Shanghai Institute of Infectious Disease and BiosecurityFudan UniversityShanghaiChina
| | - Hongjie Yu
- School of Public HealthFudan University, Key Laboratory of Public Health Safety, Ministry of EducationShanghaiChina
- Shanghai Institute of Infectious Disease and BiosecurityFudan UniversityShanghaiChina
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21
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Abu-Raya B, Viñeta Paramo M, Reicherz F, Lavoie PM. Why has the epidemiology of RSV changed during the COVID-19 pandemic? EClinicalMedicine 2023; 61:102089. [PMID: 37483545 PMCID: PMC10359735 DOI: 10.1016/j.eclinm.2023.102089] [Citation(s) in RCA: 37] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/22/2023] [Accepted: 06/23/2023] [Indexed: 07/25/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has drastically perturbed the epidemiology of Respiratory Syncytial Virus (RSV) respiratory tract infections in children. The reasons for this are not clear. In this article, we review the current literature and critically discuss the different theories to explain why the epidemiology of RSV has changed during the COVID-19 pandemic. Proposed mechanisms include decreased viral immunity in vulnerable age groups caused by the prolonged lack of RSV circulation early in the pandemic, potential Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2)-induced immune dysregulation, viral interactions between SARS-CoV-2 and RSV, and modifications in health-seeking behaviors as well as heath systems factors. Research in viral genomics and phylogeny, and more robust immunology research is needed to guide RSV prevention and health care resource planning.
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Affiliation(s)
- Bahaa Abu-Raya
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
- British Columbia Children's Hospital Research Institute, Vancouver, Canada
| | - Marina Viñeta Paramo
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
- British Columbia Children's Hospital Research Institute, Vancouver, Canada
| | - Frederic Reicherz
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
- British Columbia Children's Hospital Research Institute, Vancouver, Canada
| | - Pascal Michel Lavoie
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
- British Columbia Children's Hospital Research Institute, Vancouver, Canada
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22
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Divarathna MVM, Rafeek RAM, Morel AJ, Aththanayake C, Noordeen F. Epidemiology and risk factors of respiratory syncytial virus associated acute respiratory tract infection in hospitalized children younger than 5 years from Sri Lanka. Front Microbiol 2023; 14:1173842. [PMID: 37434712 PMCID: PMC10330818 DOI: 10.3389/fmicb.2023.1173842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 06/09/2023] [Indexed: 07/13/2023] Open
Abstract
Background Respiratory syncytial virus (RSV) is the leading cause of acute respiratory tract infections (ARTI) and a major cause of morbidity and mortality in children worldwide. Aim This study aimed to describe the prevalence and seasonal patterns of RSV and to determine the actual and predictive association of RSV-associated ARTI and clinical, socio-demographic, and climatic risk factors in children < 5 years. Methods Nasopharyngeal aspirates were collected from 500 children < 5 years admitted to the Kegalle General Hospital, Sri Lanka between May 2016 to July 2018. RSV and RSV subtypes were detected using immunofluorescence assay and real time RT-PCR, respectively. Descriptive and inferential statistics were done for the data analysis using Chi-square, Fisher's exact, Kruskal-Wallis test, and multiple binary logistic regression in the statistical package for social sciences (SPSS), version 16.0. Results Prevalence of RSV-associated ARTI was 28% in children < 5 years. Both RSV subtypes were detected throughout the study period. RSV-B was the dominant subtype detected with a prevalence of 72.14%. RSV infection in general caused severe respiratory disease leading to hypoxemia. Compared to RSV-B, RSV-A infection had more symptoms leading to hypoxemia. Factors increasing the risk of contracting RSV infection included number of people living (n > 6), having pets at home and inhaling toxic fumes. The inferential analysis predicts RSV infection in children < 5 years with ARTI, with a 75.4% probability with clinical and socio-demographic characteristics like age < 1 year, fever for > 4 days, cough, conjunctivitis, stuffiness, fatigue, six or more people at home, having pets at home and inhaling toxic fumes. Climatic factors like increases in temperature (°C), wind speed (Km/h), wind gust (Km/h), rainfall (mm) and atmospheric pressure (mb) showed a strong correlation with the RSV infection in children.
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Affiliation(s)
- Maduja V. M. Divarathna
- Department of Microbiology, Faculty of Medicine, Diagnostic and Research Virology Laboratory, University of Peradeniya, Peradeniya, Sri Lanka
| | - Rukshan A. M. Rafeek
- Department of Microbiology, Faculty of Medicine, Diagnostic and Research Virology Laboratory, University of Peradeniya, Peradeniya, Sri Lanka
| | | | | | - Faseeha Noordeen
- Department of Microbiology, Faculty of Medicine, Diagnostic and Research Virology Laboratory, University of Peradeniya, Peradeniya, Sri Lanka
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23
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Lu L, Jia R, Zhong H, Duan S, Xu M, Su L, Cao L, Xu J. Surveillance and epidemiological characterization of human adenovirus infections among outpatient children with acute gastroenteritis during the COVID-19 epidemic in Shanghai, China. Virol J 2023; 20:133. [PMID: 37344873 DOI: 10.1186/s12985-023-02105-z] [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: 02/25/2023] [Accepted: 06/17/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Human adenovirus (HAdV) has been recognized as one of the common enteric viruses associated with acute gastroenteritis (AGE) in children. The aim of this study was carried out to illustrate the epidemiological characterization of HAdV Infections among children younger than 15 years in Shanghai during COVID-19. METHODS During May 2020 and April 2022, 1048 fecal samples were collected from children ≤ 15 years diagnosed with AGE in the Children's Hospital of Fudan University. HAdV was identified by PCR and sequenced with specific primers. All the obtained sequences were analyzed by MEGA (version 6.0). Demographic information and clinical features data were also collected and analyzed. RESULTS In total, 97 (9.3%, 97/1048) samples were detected to be HAdV during May 2020 and April 2022. We found an atypical upsurge in HAdV infection in the year 2021 after a major suppression in the year 2020. Approximately 84.5% (82/97) of HAdV-infected children were aged 0-60 months. Among the 97 HAdV-positive samples, only two species and five genotypes were detected. HAdV-F (88.7%, 86/97) was the most prevalent species and HAdV-F41 (87.6%, 85/97) was the most common genotype. Diarrhea, vomiting, and fever were the main clinical manifestations in children infected with HAdV. The children aged from 0 to 12 months showed simpler patterns of clinical presentation than those of children older than 13 months. CONCLUSIONS Our findings described the epidemiological changes of HAdV infection in children with AGE during the COVID-19, which further underscored the importance of continuous surveillance of HAdV at both local and global scales.
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Affiliation(s)
- Lijuan Lu
- Department of Clinical Laboratory, Children's Hospital of Fudan University, National Children's Medical Center, 399 Wanyuan Road, Shanghai, 201102, China
| | - Ran Jia
- Department of Clinical Laboratory, Children's Hospital of Fudan University, National Children's Medical Center, 399 Wanyuan Road, Shanghai, 201102, China
| | - Huaqing Zhong
- Department of Clinical Laboratory, Children's Hospital of Fudan University, National Children's Medical Center, 399 Wanyuan Road, Shanghai, 201102, China
| | - Shuohua Duan
- School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
| | - Menghua Xu
- Department of Clinical Laboratory, Children's Hospital of Fudan University, National Children's Medical Center, 399 Wanyuan Road, Shanghai, 201102, China
| | - Liyun Su
- Department of Clinical Laboratory, Children's Hospital of Fudan University, National Children's Medical Center, 399 Wanyuan Road, Shanghai, 201102, China
| | - Lingfeng Cao
- Department of Clinical Laboratory, Children's Hospital of Fudan University, National Children's Medical Center, 399 Wanyuan Road, Shanghai, 201102, China
| | - Jin Xu
- Department of Clinical Laboratory, Children's Hospital of Fudan University, National Children's Medical Center, 399 Wanyuan Road, Shanghai, 201102, China.
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China.
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Chand K, Butt MI, Tahir HM. Parental Attitude, Knowledge, and Practices Regarding the Usage of Antibiotics for Upper Respiratory Tract Infections in Children During the COVID-19 Pandemic. Cureus 2023; 15:e39932. [PMID: 37415993 PMCID: PMC10319945 DOI: 10.7759/cureus.39932] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/03/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has raised knowledge of the proper antibiotic dosage for treating childhood upper respiratory tract infections (URTIs). In order to ensure proper antibiotic usage and prevent the establishment of illnesses that is antibiotic-resistant during the COVID-19 pandemic, parental attitudes, knowledge, and behaviour surrounding antibiotic use for URTIs in children are essential. The goal of this study was to find out the parental attitude, knowledge, and practices regarding the usage of antibiotics for URTIs in children during the COVID-19 epidemic. METHODOLOGY This cross-sectional was conducted in the Department of Paediatric Medicine, Central Hospital, Ganesh Nagar, New Delhi, India from September 2022 to February 2023. The study analysed a total of 500. All the children had URTIs. A structured questionnaire was randomly distributed among parents. Socio-demographic information like gender, age, occupation, monthly family income, and age of the children were noted at the time of enrollment. Outcomes were recorded in terms of responses to questions regarding attitude, knowledge, and practices regarding the use of antibiotics for URTIs in children during the COVID-19 epidemic. Results: Of a total of 500 parents, 380 (76.0%) were male. The mean age was 39.9±8.3 years while 280 (56.0%) participants were aged between 31 to 45 years. Relatively older age (p<0.0001) and occupational status as unemployed (p<0.0001) were found to have a significant association with response to "virus being the cause of COVID-19". Females (p=0.0004) and increasing age (p<0.0001) were found to have significant associations with incorrect responses to "antibiotics are essential for managing the symptoms in children with COVID-19". Incorrect responses to "without the use of antibiotics, children usually suffer from greater periods of sickness" were associated with females and increasing age (p<0.0001). Incorrect responses to "not using antibiotics will prove beneficial for the children suffering from COVID-19" were significantly associated with female gender (p=0.0016) and increasing age (p<0.0001). The incorrect responses to "how often are antibiotics being prescribed to the COVID-19 children" was significantly linked with females and relatively older age (p<0.0001). CONCLUSIONS Parental attitude, knowledge, and practices regarding the usage of antibiotics for URTIs in children during the COVID-19 epidemic showed variations. Parental attitude, knowledge, and practices were associated with gender, age, and socio-economic status.
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Affiliation(s)
- Kanwal Chand
- Department of Paediatric Medicine, Central Hospital, Delhi, IND
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25
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Ren L, Lin L, Zhang H, Wang Q, Cheng Y, Liu Q, Fang B, Xie L, Wang M, Yang J, Guo J, Zhang T, Lian H, Wang J, Yu H. Epidemiological and clinical characteristics of respiratory syncytial virus and influenza infections in hospitalized children before and during the COVID-19 pandemic in Central China. Influenza Other Respir Viruses 2023; 17:e13103. [PMID: 36824393 PMCID: PMC9895987 DOI: 10.1111/irv.13103] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 01/10/2023] [Indexed: 02/05/2023] Open
Abstract
Background Globally, the epidemiology of non-SARS-CoV-2 respiratory viruses like respiratory syncytial virus (RSV) and influenza virus was remarkably influenced by the implementation of non-pharmacological interventions (NPIs) during the COVID-19 pandemic. Our study explored the epidemiological and clinical characteristics of pediatric patients hospitalized with RSV or influenza infection before and during the pandemic after relaxation of NPIs in central China. Methods This hospital-based prospective case-series study screened pediatric inpatients (age ≤ 14 years) enrolled with acute respiratory infections (ARI) for RSV or influenza infection from 2018 to 2021. The changes in positivity rates of viral detection, epidemiological, and clinical characteristics were analyzed and compared. Results Median ages of all eligible ARI patients from 2018-2019 were younger than those from 2020-2021, so were ages of cases infected with RSV or influenza (RSV: 4.2 months vs. 7.2 months; influenza: 27.3 months vs. 37.0 months). Where the positivity rate for influenza was considerably decreased in 2020-2021 (1.4%, 27/1964) as compared with 2018-2019 (2.9%, 94/3275, P < 0.05), it was increased for RSV (11.4% [372/3275] vs. 13.3% [262/1964], P < 0.05) in the same period. The number of severe cases for both RSV and influenza infection were also decreased in 2020-2021 compared with 2018-2019. Conclusions The implemented NPIs have had varied impacts on common respiratory viruses. A more effective prevention strategy for RSV infections in childhood is needed.
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Affiliation(s)
- Lingshuang Ren
- School of Public HealthFudan University, Key Laboratory of Public Health Safety, Ministry of EducationShanghaiChina
| | - Li Lin
- Children's Hospital Affiliated to Zhengzhou UniversityHenan Children's HospitalZhengzhouChina
| | - Hua Zhang
- Zhengzhou Central Hospital Affiliated to Zhengzhou UniversityZhengzhouChina
| | - Qianli Wang
- Shanghai Institute of Infectious Disease and BiosecurityFudan UniversityShanghaiChina
| | - Yibing Cheng
- Children's Hospital Affiliated to Zhengzhou UniversityHenan Children's HospitalZhengzhouChina
| | - Qin Liu
- Zhengzhou Central Hospital Affiliated to Zhengzhou UniversityZhengzhouChina
| | - Bing Fang
- Children's Hospital Affiliated to Zhengzhou UniversityHenan Children's HospitalZhengzhouChina
| | - Linsen Xie
- Zhengzhou Central Hospital Affiliated to Zhengzhou UniversityZhengzhouChina
| | - Meng Wang
- Children's Hospital Affiliated to Zhengzhou UniversityHenan Children's HospitalZhengzhouChina
| | - Juan Yang
- School of Public HealthFudan University, Key Laboratory of Public Health Safety, Ministry of EducationShanghaiChina
| | - Jinxin Guo
- School of Public HealthFudan University, Key Laboratory of Public Health Safety, Ministry of EducationShanghaiChina
| | - Tianchen Zhang
- Division of Infectious DiseaseJiangxi Province Center for Disease Control and PreventionNanchangChina
| | - Hongkai Lian
- Zhengzhou Central Hospital Affiliated to Zhengzhou UniversityZhengzhouChina
| | - Jiangtao Wang
- Children's Hospital Affiliated to Zhengzhou UniversityHenan Children's HospitalZhengzhouChina
| | - Hongjie Yu
- School of Public HealthFudan University, Key Laboratory of Public Health Safety, Ministry of EducationShanghaiChina,Shanghai Institute of Infectious Disease and BiosecurityFudan UniversityShanghaiChina
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Wang F, Zhu R, Qian Y, Sun Y, Chen D, Wang F, Zhou Y, Guo Q, Liu L, Xu Y, Cao L, Qu D, Zhao L. The changed endemic pattern of human adenovirus from species B to C among pediatric patients under the pressure of non-pharmaceutical interventions against COVID-19 in Beijing, China. Virol J 2023; 20:4. [PMID: 36624458 PMCID: PMC9828375 DOI: 10.1186/s12985-023-01962-y] [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: 11/10/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Under the pressure of non-pharmaceutical interventions (NPIs) targeting severe acute respiratory syndrome coronavirus 2, the prevalence of human adenovirus (HAdV) was monitored before and after NPIs launched on Jan 24, 2020 in pediatric patients in Beijing, China. METHODS Respiratory samples collected from children hospitalized with acute respiratory infections from Jan 2015 to Dec 2021 were screened by direct immunofluorescence test or capillary electrophoresis-based multiplex PCR assay. The hexon, penton base, and fiber genes were amplified from HAdV positive specimens, then sequenced. For HAdV typing, phylogenetic trees were built by MEGA X. Then clinical data of HAdV positive cases were collected. All data were evaluated using SPSS Statistics 22.0 software. RESULTS A total of 16,097 children were enrolled and 466 (2.89%, 466/16,097) were HAdV-positive. The positive rates of HAdV varied, ranging from 4.39% (151/3,438) in 2018 to1.25% (26/2,081) in 2021, dropped from 3.19% (428/13,408) to 1.41% (38/2,689) from before to after NPIs launched (P < 0.001). There were 350 cases typed into nine types of species B, C, or E and 34 recorded as undetermined. Among them, HAdV-B3 (51.56%, 198/384) was the most prevalent types from 2015 to 2017, and HAdV-B7 (29.17%, 112/384) co-circulated with HAdV-B3 from 2018 to 2019. After NPIs launched, HAdV-B3 and B7 decreased sharply with HAdV-B7 undetected in 2021, while HAdV-C1 became the dominant one and the undetermined were more. CONCLUSIONS The endemic pattern of HAdV changed in Beijing because of the NPIs launched for COVID-19. Especially, the dominant types changed from HAdV-B to HAdV-C.
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Affiliation(s)
- Fangming Wang
- grid.418633.b0000 0004 1771 7032Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Capital Institute of Pediatrics, Beijing, 100020 China ,grid.506261.60000 0001 0706 7839Graduate School of Peking Union Medical College, Beijing, 100730 China
| | - Runan Zhu
- grid.418633.b0000 0004 1771 7032Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Capital Institute of Pediatrics, Beijing, 100020 China
| | - Yuan Qian
- grid.418633.b0000 0004 1771 7032Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Capital Institute of Pediatrics, Beijing, 100020 China
| | - Yu Sun
- grid.418633.b0000 0004 1771 7032Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Capital Institute of Pediatrics, Beijing, 100020 China
| | - Dongmei Chen
- grid.418633.b0000 0004 1771 7032Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Capital Institute of Pediatrics, Beijing, 100020 China
| | - Fang Wang
- grid.418633.b0000 0004 1771 7032Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Capital Institute of Pediatrics, Beijing, 100020 China
| | - Yutong Zhou
- grid.418633.b0000 0004 1771 7032Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Capital Institute of Pediatrics, Beijing, 100020 China
| | - Qi Guo
- grid.418633.b0000 0004 1771 7032Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Capital Institute of Pediatrics, Beijing, 100020 China
| | - Liying Liu
- grid.418633.b0000 0004 1771 7032Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Capital Institute of Pediatrics, Beijing, 100020 China
| | - Yanpeng Xu
- grid.418633.b0000 0004 1771 7032Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Capital Institute of Pediatrics, Beijing, 100020 China
| | - Ling Cao
- grid.418633.b0000 0004 1771 7032Department of Respiratory Medicine, Affiliated Children’s Hospital, Capital Institute of Pediatrics, Beijing, 100020 China
| | - Dong Qu
- grid.418633.b0000 0004 1771 7032Department of Critical Care Medicine, Affiliated Children’s Hospital, Capital Institute of Pediatrics, Beijing, 100020 China
| | - Linqing Zhao
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Capital Institute of Pediatrics, Beijing, 100020, China. .,Graduate School of Peking Union Medical College, Beijing, 100730, China.
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Jiang M, Xu Y, Wu H, Zhu R, Sun Y, Chen D, Wang F, Zhou Y, Guo Q, Wu A, Qian Y, Zhou H, Zhao L. Changes in endemic patterns of respiratory syncytial virus infection in pediatric patients under the pressure of nonpharmaceutical interventions for COVID-19 in Beijing, China. J Med Virol 2023; 95:e28411. [PMID: 36524893 PMCID: PMC9878212 DOI: 10.1002/jmv.28411] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 11/16/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022]
Abstract
A series of nonpharmaceutical interventions (NPIs) was launched in Beijing, China, on January 24, 2020, to control coronavirus disease 2019. To reveal the roles of NPIs on the respiratory syncytial virus (RSV), respiratory specimens collected from children with acute respiratory tract infection between July 2017 and Dec 2021 in Beijing were screened by capillary electrophoresis-based multiplex PCR (CEMP) assay. Specimens positive for RSV were subjected to a polymerase chain reaction (PCR) and genotyped by G gene sequencing and phylogenetic analysis using iqtree v1.6.12. The parallel and fixed (paraFix) mutations were analyzed with the R package sitePath. Clinical data were compared using SPSS 22.0 software. Before NPIs launched, each RSV endemic season started from October/November to February/March of the next year in Beijing. After that, the RSV positive rate abruptly dropped from 31.93% in January to 4.39% in February 2020; then, a dormant state with RSV positive rates ≤1% from March to September, a nearly dormant state in October (2.85%) and November (2.98%) and a delayed endemic season in 2020, and abnormal RSV positive rates remaining at approximately 10% in summer until September 2021 were detected. Finally, an endemic RSV season returned in October 2021. There was a game between Subtypes A and B, and RSV-A replaced RSV-B in July 2021 to become the dominant subtype. Six RSV-A and eight RSV-B paraFix mutations were identified on G. The percentage of severe pneumonia patients decreased to 40.51% after NPIs launched. NPIs launched in Beijing seriously interfered with the endemic season of RSV.
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Affiliation(s)
- Ming‐Li Jiang
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina,Graduate School of Peking Union Medical CollegeBeijingChina
| | - Yan‐Peng Xu
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina
| | - Hui Wu
- Institute of Systems MedicineChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina,Suzhou Institute of Systems MedicineSuzhouChina
| | - Ru‐Nan Zhu
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina
| | - Yu Sun
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina
| | - Dong‐Mei Chen
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina
| | - Fang Wang
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina
| | - Yu‐Tong Zhou
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina
| | - Qi Guo
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina
| | - Aiping Wu
- Institute of Systems MedicineChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina,Suzhou Institute of Systems MedicineSuzhouChina
| | - Yuan Qian
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina
| | - Hang‐Yu Zhou
- Institute of Systems MedicineChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina,Suzhou Institute of Systems MedicineSuzhouChina
| | - Lin‐Qing Zhao
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina,Graduate School of Peking Union Medical CollegeBeijingChina
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Zhu L, Luo T, Yuan Y, Yang S, Niu C, Gong T, Wang X, Xie X, Luo J, Liu E, Fu Z, Tian D. Epidemiological characteristics of respiratory viruses in hospitalized children during the COVID-19 pandemic in southwestern China. Front Cell Infect Microbiol 2023; 13:1142199. [PMID: 37153160 PMCID: PMC10157792 DOI: 10.3389/fcimb.2023.1142199] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 03/16/2023] [Indexed: 05/09/2023] Open
Abstract
Background Multinational studies have reported that the implementation of nonpharmaceutical interventions (NPIs) to control severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission coincided with the decline of other respiratory viruses, such as influenza viruses and respiratory syncytial virus. Objective To investigate the prevalence of common respiratory viruses during the coronavirus disease 2019 (COVID-19) pandemic. Methods Respiratory specimens of children with lower respiratory tract infections (LRTIs) hospitalized at the Children's Hospital of Chongqing Medical University from January 1, 2018 to December 31, 2021 were collected. Seven common pathogens, including respiratory syncytial virus (RSV), adenovirus (ADV), influenza virus A and B (Flu A, Flu B), and parainfluenza virus types 1-3 (PIV1-3), were detected by a multiplex direct immunofluorescence assay (DFA). Demographic data and laboratory test results were analyzed. Results 1) A total of 31,113 children with LRTIs were enrolled, including 8141 in 2018, 8681 in 2019, 6252 in 2020, and 8059 in 2021.The overall detection rates decreased in 2020 and 2021 (P < 0.001). The detection rates of RSV, ADV, Flu A, PIV-1, and PIV-3 decreased when NPIs were active from February to August 2020, with Flu A decreasing most predominantly, from 2.7% to 0.3% (P < 0.05). The detection rates of RSV and PIV-1 resurged and even surpassed the historical level of 2018-2019, while Flu A continued decreasing when NPIs were lifted (P < 0.05). 2) Seasonal patterns of Flu A completely disappeared in 2020 and 2021. The Flu B epidemic was observed until October 2021 after a long period of low detection in 2020. RSV decreased sharply after January 2020 and stayed in a nearly dormant state during the next seven months. Nevertheless, the detection rates of RSV were abnormally higher than 10% in the summer of 2021. PIV-3 decreased significantly after the COVID-19 pandemic; however, it atypically surged from August to November 2020. Conclusion The NPIs implemented during the COVID-19 pandemic affected the prevalence and seasonal patterns of certain viruses such as RSV, PIV-3, and influenza viruses. We recommend continuous surveillance of the epidemiological and evolutionary dynamics of multiple respiratory pathogens, especially when NPIs are no longer necessary.
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Affiliation(s)
- Lin Zhu
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Department of Respiratory Medicine, National Clinical Research Center for Child Health and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Tingting Luo
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Department of Respiratory Medicine, National Clinical Research Center for Child Health and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Yining Yuan
- School of Public Health, Chengdu Medical College, Chengdu, China
| | - Shu Yang
- College of Intelligent Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chao Niu
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Department of Respiratory Medicine, National Clinical Research Center for Child Health and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Ting Gong
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Department of Respiratory Medicine, National Clinical Research Center for Child Health and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Xueer Wang
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Department of Respiratory Medicine, National Clinical Research Center for Child Health and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaohong Xie
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Department of Respiratory Medicine, National Clinical Research Center for Child Health and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Jian Luo
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Department of Respiratory Medicine, National Clinical Research Center for Child Health and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Enmei Liu
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Department of Respiratory Medicine, National Clinical Research Center for Child Health and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Zhou Fu
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Department of Respiratory Medicine, National Clinical Research Center for Child Health and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Daiyin Tian
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Department of Respiratory Medicine, National Clinical Research Center for Child Health and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Daiyin Tian,
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29
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Guo YJ, Wang BH, Li L, Li YL, Chu XL, Li W. Epidemiological and genetic characteristics of respiratory syncytial virus infection in children from Hangzhou after the peak of COVID-19. J Clin Virol 2023; 158:105354. [PMID: 36525852 PMCID: PMC9747354 DOI: 10.1016/j.jcv.2022.105354] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/04/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is one of the main pathogens that causes acute lower respiratory tract infection (ARTI) in infants. During the Coronavirus Disease 2019 (COVID-19) pandemic, although strict interventions have been implemented, RSV infection has not decreased. OBJECTIVES To study the epidemiological and genetic characteristics of RSV circulating in Hangzhou after the peak of COVID-19. METHODS A total of 1225 nasopharyngeal swabs were collected from outpatients with ARTIs from July 2021 to January 2022 in The Children's Hospital, Zhejiang University School of Medicine. RESULTS A total of 267 (21.79%) of the 1225 samples were RSV positive. There was no gender bias. However, an obvious age preference for infection was observed, and children aged 3-6 years were more susceptible, which was very different from previous RSV pandemic seasons. Phylogenetic analysis of 115 sequenced RSV isolates showed that all the RSV-A viruses belong to the ON1 subtype, which could be clustered into three clusters. While all the RSV-B viruses belong to BA9. Further analysis of the mutations highlights the fixation of ten mutations, which should be given extra attention regarding their biological properties. CONCLUSION The incidence of RSV infection in preschool children reported in this study is high. Phylogenetic analysis showed that the subtype A ON1 genotype was the dominant strain in Hangzhou from July 2021 to January 2022.
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Affiliation(s)
- Ya-jun Guo
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health. Hangzhou 310052, PR China
| | - Bing-han Wang
- School of Public Health, Zhejiang University School of Medicine, Hangzhou 310052, PR China
| | - Lin Li
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health. Hangzhou 310052, PR China
| | | | - Xiao-li Chu
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health. Hangzhou 310052, PR China
| | - Wei Li
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health. Hangzhou 310052, PR China.
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30
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Mrcela D, Markic J, Zhao C, Viskovic DV, Milic P, Copac R, Li Y. Changes following the Onset of the COVID-19 Pandemic in the Burden of Hospitalization for Respiratory Syncytial Virus Acute Lower Respiratory Infection in Children under Two Years: A Retrospective Study from Croatia. Viruses 2022; 14:v14122746. [PMID: 36560751 PMCID: PMC9785187 DOI: 10.3390/v14122746] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/02/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
To understand the changes in RSV hospitalization burden in children younger than two years following the onset of the COVID-19 pandemic, we reviewed hospital records of children with acute lower respiratory infection (ALRI) between January 2018 and June 2022 in Split-Dalmatia County, Croatia. We compared RSV activity, age-specific annualized hospitalization rate, and disease severity between pre-COVID-19 and COVID-19 periods. A total of 942 ALRI hospital admissions were included. RSV activity remained low for the typical RSV epidemic during 2020-2021 winter. An out-of-season RSV resurgence was observed in late spring and summer of 2021. Before the COVID-19 pandemic, the annualized hospitalization rate for RSV-associated ALRI was 13.84/1000 (95% CI: 12.11-15.76) and highest among infants under six months. After the resurgence of RSV in the second half of 2021, the annualized hospitalization rate for RSV-associated ALRI in children younger than two years returned to the pre-pandemic levels with similar age distribution but a statistically higher proportion of severe cases. RSV immunization programs targeting protection of infants under six months of age are expected to remain impactful, although the optimal timing of administration would depend on RSV seasonality that has not yet been established in the study setting since the onset of the COVID-19 pandemic.
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Affiliation(s)
- Dina Mrcela
- School of Medicine, University of Split, Soltanska 2, 21000 Split, Croatia
| | - Josko Markic
- School of Medicine, University of Split, Soltanska 2, 21000 Split, Croatia
- Department of Pediatrics, University Hospital of Split, Spinciceva 1, 21000 Split, Croatia
| | - Chenkai Zhao
- Department of Epidemiology, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing 211166, China
| | | | - Petra Milic
- Department of Pediatrics, University Hospital of Split, Spinciceva 1, 21000 Split, Croatia
| | - Roko Copac
- Department of Physics, Faculty of Science, University of Split, Rudera Boskovića 33, 21000 Split, Croatia
| | - You Li
- Department of Epidemiology, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing 211166, China
- Correspondence:
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31
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Binns E, Tuckerman J, Licciardi PV, Wurzel D. Respiratory syncytial virus, recurrent wheeze and asthma: A narrative review of pathophysiology, prevention and future directions. J Paediatr Child Health 2022; 58:1741-1746. [PMID: 36073299 PMCID: PMC9826513 DOI: 10.1111/jpc.16197] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 08/19/2022] [Accepted: 08/21/2022] [Indexed: 01/11/2023]
Abstract
Globally, respiratory syncytial virus (RSV) is the leading cause of bronchiolitis and pneumonia in young children, and the association between severe RSV disease and later recurrent wheeze and asthma is well established. Whilst a causal link between RSV and wheeze/asthma is not yet proven, immunological evidence suggests skewing towards a Th2-type response, and dampening of IFN-γ antiviral immunity during RSV infection underpins airway hyper-reactivity in a subset of susceptible children after RSV infection. Age at primary RSV infection, viral co-infection and genetic influences may act as effect-modifiers. Despite the significant morbidity and mortality burden of RSV disease in children, there is currently no licensed vaccine. Recent advancements in RSV preventatives, including long-acting monoclonal antibodies and maternal vaccinations, show significant promise and we are on the cusp of a new era in RSV prevention. However, the potential impact of RSV preventatives on subsequent wheeze and asthma remains unclear. The ongoing COVID-19 pandemic and associated public health measures have disrupted the usual seasonality of RSV. Whilst this has posed challenges for health-care services it has also enhanced our understanding of RSV transmission. The near absence of RSV cases during the first year of the pandemic in the context of strict public health measures has provided a rare opportunity to study the impact of delayed age of primary RSV infection on asthma prevalence. In this review, we summarise current understanding of the association between RSV, recurrent wheeze and asthma with a focus on pathophysiology, preventative strategies and future research priorities.
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Affiliation(s)
- Elly Binns
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia,The Royal Melbourne HospitalMelbourneVictoriaAustralia
| | - Jane Tuckerman
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia,Infection and ImmunityMurdoch Children's Research InstituteMelbourneVictoriaAustralia
| | - Paul V Licciardi
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia,Infection and ImmunityMurdoch Children's Research InstituteMelbourneVictoriaAustralia
| | - Danielle Wurzel
- Infection and ImmunityMurdoch Children's Research InstituteMelbourneVictoriaAustralia,School of Population and Global HealthUniversity of MelbourneMelbourneVictoriaAustralia,Department of Respiratory MedicineRoyal Children's HospitalMelbourneVictoriaAustralia
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32
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Shen DP, Vermeulen F, Debeer A, Lagrou K, Smits A. Impact of COVID-19 on viral respiratory infection epidemiology in young children: A single-center analysis. Front Public Health 2022; 10:931242. [PMID: 36203684 PMCID: PMC9530989 DOI: 10.3389/fpubh.2022.931242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 08/22/2022] [Indexed: 01/24/2023] Open
Abstract
Background The COVID-19 pandemic impacts different health aspects. Concomitant with the adoption of non-pharmaceutical interventions (NPIs) to reduce the spread of SARS-CoV-2, global surveillance studies reported a reduction in occurrence of respiratory pathogens like influenza A and B virus (IAV & IBV) and respiratory syncytial virus (RSV). We hypothesized to observe this collateral benefit on viral respiratory infection epidemiology in young children. Methods Respiratory samples of children aged below 6 years, presenting at the outpatient clinic, emergency department, or pediatric infectious diseases department of the University Hospitals Leuven, between April 2017 and April 2021 were retrospectively analyzed. The occurrence (positivity rate), and seasonal patterns of viral respiratory infections were described. Chi-squared or Fisher's exact test (and Bonferroni correction) were used to explore differences in occurrence between 2020-2021 and previous 12-month (April to April) periods. Results We included 3020 samples (453 respiratory panels, 2567 single SARS-CoV-2 PCR tests). IAV and IBV were not detected from March and January 2020, respectively. For IAV, positivity rate in 2020-2021 (0%, n = 0) was significantly different from 2018-2019 (12.4%, n = 17) (p < 0.001) and 2019-2020 (15.4%, n = 19) (p < 0.001). IBV positivity rate in 2020-2021 (0%, n = 0) was not significantly different from previous periods. RSV occurrence was significantly lower in 2020-2021 (3.2%, n = 3), compared to 2017-2018 (15.0%, n = 15) (p = 0.006), 2018-2019 (16.1%, n = 22) (p = 0.002) and 2019-2020 (22.8%, n = 28) (p < 0.001). The RSV (winter) peak was absent and presented later (March-April 2021). Positivity rate of parainfluenza virus 3 (PIV-3) was significantly higher in 2020-2021 (11.8%, n = 11) than 2017-2018 (1%, n = 1) (p = 0.002). PIV-3 was absent from April 2020 to January 2021, whereas no clear seasonal pattern was distinguished the other years. For the other viruses tested, no significant differences in occurrence were observed between 2020-2021 and previous periods. From March 2020 onwards, 20 cases (0.7%) of SARS-CoV-2 were identified. Conclusion These findings reinforce the hypothesis of NPIs impacting the epidemiology of influenza viruses and RSV in young children. Compared to previous periods, no IAV and IBV cases were observed in the 2020-2021 study period, and the RSV peak occurred later. Since the pandemic is still ongoing, continuation of epidemiological surveillance, even on a larger scale, is indicated.
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Affiliation(s)
| | - François Vermeulen
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium,Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Anne Debeer
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium,Neonatal Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
| | - Katrien Lagrou
- Department of Laboratory Medicine and National Reference Centre for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium,Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Anne Smits
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium,Neonatal Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium,L-C&Y, KU Leuven Child & Youth Institute, Leuven, Belgium,*Correspondence: Anne Smits
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