Impact of nonpharmaceutical interventions on laboratory detections of influenza A and B in Canada

Lagacé-Wiens, Philippe; Sevenhuysen, Claire; Lee, Liza; Nwosu, Andrea; Smith, Tiffany

doi:10.14745/ccdr.v47i03a04

Cited by 19 publications

(28 citation statements)

References 18 publications

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“…In this study, we only observed one positive detection of influenza A in a wastewater sample from a major Canadian city and no detection of influenza B or respiratory syncytial virus. The lack of detection may be reflective of the low transmission rates of influenza and other respiratory viruses from 2020 to 2021 ( 41 – 43 ), or it may indicate that the GeneXpert is not suitable for surveillance of these pathogens, warranting further studies. Other clinical tests for the GeneXpert system have targets likely to be present in wastewater such as norovirus, Clostridium difficile , and various antimicrobial resistance genes.…”

Section: Discussionmentioning

confidence: 99%

A Sensitive and Rapid Wastewater Test for SARS-COV-2 and Its Use for the Early Detection of a Cluster of Cases in a Remote Community

Daigle

Racher

Hazenberg

et al. 2022

Appl Environ Microbiol

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Throughout the COVID-19 pandemic, wastewater surveillance has been used to monitor trends in SARS-CoV-2 prevalence in the community. A major challenge in establishing wastewater surveillance programs, especially in remote areas, is the need for a well-equipped laboratory for sample analysis. Currently, no options exist for rapid, sensitive, mobile, and easy-to-use wastewater tests for SARS-CoV-2. The performance of the GeneXpert System, which offers cartridge-based, rapid molecular clinical testing for SARS-CoV-2 in a portable platform, was evaluated using wastewater as the input. The GeneXpert demonstrated a SARS-CoV-2 limit of detection in wastewater below 32 copies/mL with a sample processing time of less than an hour. Using wastewater samples collected from multiple sites across Canada during February and March 2021, a high overall agreement (97.8%) was observed between the GeneXpert assay and laboratory-developed tests regarding the presence or absence of SARS-CoV-2. Additionally, with the use of centrifugal filters the detection threshold of the GeneXpert system was improved to <10 copies/mL in wastewater. Finally, to support on-site wastewater surveillance, GeneXpert testing was implemented in Yellowknife, a remote community in Northern Canada where its use successfully alerted public health authorities to undetected transmission of COVID-19. The identification of SARS-CoV-2 in wastewater triggered clinical testing of recent travelers and identification of new COVID-19 cases/clusters. Taken together, these results suggest the GeneXpert is a viable option for surveillance of SARS-CoV-2 in wastewater in locations that do not have access to established testing laboratories. Importance: Wastewater-based surveillance is a powerful tool that provides an unbiased measure of COVID-19 prevalence in a community. This work describes a sensitive wastewater rapid test for SARS-CoV-2 based on a widely distributed technology, the GeneXpert. The advantages of an easy-to-use wastewater test for SARS-CoV-2 are clear – it supports surveillance in remote communities, improves access to testing, and provides faster results allowing for an immediate public health response. The application of wastewater rapid testing in a remote community facilitated the detection of a COVID-19 cluster and triggered public health action, clearly demonstrating the utility of this technology. Wastewater surveillance will become increasingly important in the post-vaccination pandemic landscape as individuals with asymptomatic/mild infections continue transmitting SARS-CoV-2 but are unlikely to be tested.

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Section: Discussionmentioning

confidence: 99%

A Sensitive and Rapid Wastewater Test for SARS-COV-2 and Its Use for the Early Detection of a Cluster of Cases in a Remote Community

Daigle

Racher

Hazenberg

et al. 2022

Appl Environ Microbiol

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“…Our systematic review observed a lack of data from the Middle East, South East Asia, Western Pacific and Latin American regions regarding the number of acute respiratory cases sampled for influenza surveillance before the COVID-19 pandemic in 2019. Meanwhile, almost double the number of symptomatic cases were sampled as part of influenza surveillance during the current pandemic in Canada 11,17 . The WHO European region testing a large number of influenza samples reported a decline in surveillance samples during the COVID-19 pandemic and the lowest number of influenza types and subtypes were noted since the establishment of GISRS in 1952.…”

Section: Discussionmentioning

confidence: 99%

The impact of COVID-19 pandemic on influenza surveillance: a systematic review and meta-analysis

Sabeena¹,

Ravishankar

Robin

2022

Preprint

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Influenza activity was reported to be below the seasonal levels during the COVID-19 pandemic globally. However, during the SARS-CoV-2 outbreak, the routine real-time surveillance of influenza like illness (ILI) and acute respiratory infection (ARI) was adversely affected due to the changes in priorities, economic constraints, repurposing of hospitals for COVID care and closure of outpatient services. A systematic review and meta-analysis were carried out to assess the pooled proportion of symptomatic cases tested for influenza virus before the COVID-19 pandemic in 2019 and during the pandemic in 2020/2021. The study was designed based on PRISMA guidelines and the meta-analysis was performed to synthesise the pooled proportion of patients sampled for influenza surveillance before the COVID-19 pandemic in 2019 and during the pandemic in 2020/21 with 95% confidence interval (CI). The overall pooled proportion of symptomatic cases undergone influenza surveillance before and during the pandemic was 2.38% (95% CI 2.08%-2.67%) and 4.18% (95% CI 3.8%-4.52%) respectively. However, the pooled proportion of samples tested for influenza before the pandemic was 0.69% (95% CI 0.45-0.92%) and during the pandemic was 0.48% (95% CI 0.28-0.68%) when studies from Canada were excluded. The meta-analysis concludes that globally there was a decline in influenza surveillance during the COVID-19 pandemic except in Canada.

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“…Many nonpharmacological epidemiological measures implemented during the COVID‐19 pandemic, including quarantining, wearing masks, social distancing, and frequent hand washing, are known to decrease influenza infections. 3 , 4 , 5 , 6 Furthermore, a recent study found that decreases in influenza infections were associated with the implementation and timing of COVID‐19‐related nonpharmacological interventions in China and the United States. 7 These nonpharmacological interventions could account, at least in part, for the decrease in influenza infections in the 2019–2020 and 2020–2021 seasons.…”

Section: Discussionmentioning

confidence: 99%

“…Lagacé‐Wiens et al reported a decreased incidence of influenza during the COVID‐19 pandemic and reported that the weekly positivity rates declined from 20.16 to 0.11 during the COVID‐19 pandemic. 6 In our institution, an influenza test is ordered for influenza‐like illness seasonally. Consistent with the state and county trends, influenza testing and cases were higher in 2019–2020 seasons.…”

Section: Discussionmentioning

confidence: 99%

Change in patterns of hospitalization for influenza during COVID‐19 surges

Venkatram

Alapati

Dileep

et al. 2021

Influenza Resp Viruses

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Background Hospitalization due to influenza has been stable in recent years. In March 2020, New York was an epicenter for coronavirus disease 2019 (COVID‐19). Because influenza and COVID‐19 present similarly, there were serious concerns that coinfection of these viruses would burden the healthcare system. We compared incidence and outcomes of patients hospitalized with influenza before and during COVID‐19 (seasons 2017–2021). Methods We conducted a retrospective study evaluating hospitalized patients with influenza. Four influenza seasons were evaluated, 2017–2021, pre‐ and during COVID‐19 pandemic. We compared incidence of influenza and clinical outcomes across the seasons. Results We found 412 patients hospitalized due to influenza in the study period; 394 had influenza, and 18 had both influenza and COVID‐19 infections. Demographics across the four influenza seasons were comparable; the cohort was predominantly female (61%) and had an average age of 60 years old. Comorbid conditions were common. No outcome differences were found for patients with influenza when comparing influenza seasons prior to and during the COVID‐19 pandemic. The mortality for the entire cohort was 6.5%. During the COVID‐19 pandemic, there were 18 (4.4%) influenza patients coinfected with COVID‐19 and 32 (7.8%) patients with bacterial super infection. Predictors of mortality in patients with influenza included presence of shock, heart failure, bacterial pneumonia, and use of mechanical ventilation. Coinfection with COVID‐19 did not increase mortality. Conclusion We observed a significant decrease in the incidence of hospitalization due to influenza during the COVID‐19 pandemic. Clinical presentations and outcomes for patients with influenza remain stable. Being aware of possible increased mortality for patients with both influenza and bacterial pneumonia is important. Although coinfection with COVID‐19 did not increase mortality in influenza patients, identifying the specific virus responsible for infections has major therapeutic implications.

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Impact of nonpharmaceutical interventions on laboratory detections of influenza A and B in Canada

Cited by 19 publications

References 18 publications

A Sensitive and Rapid Wastewater Test for SARS-COV-2 and Its Use for the Early Detection of a Cluster of Cases in a Remote Community

A Sensitive and Rapid Wastewater Test for SARS-COV-2 and Its Use for the Early Detection of a Cluster of Cases in a Remote Community

The impact of COVID-19 pandemic on influenza surveillance: a systematic review and meta-analysis

Change in patterns of hospitalization for influenza during COVID‐19 surges

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