Recommendations for respiratory syncytial virus surveillance at the national level

Abstract

Respiratory syncytial virus (RSV) is a common cause of acute lower respiratory tract infections (ALRI) and hospitalisations among young children and is globally responsible for many deaths in young children, especially in infants below 6 months of age. Furthermore, RSV is a common cause of severe respiratory disease and hospitalisation among the elderly. The development of new candidate vaccines and monoclonal antibodies highlights the need for reliable surveillance of RSV. In the European Union (EU), no up-to-date general recommendations on RSV surveillance are currently available. Based on outcomes of a workshop with 29 European experts in the field of RSV virology, epidemiology and public health, we provide recommendations to develop a feasible and sustainable national surveillance strategy for RSV that will enable harmonisation and data comparison at the European level. We discuss three surveillance components: active sentinel community surveillance, active sentinel hospital surveillance, and passive laboratory surveillance, using the EU acute respiratory infection (ARI) and WHO extended severe acute respiratory infection (SARI) case definitions. Furthermore, we recommend the use of quantitative reverse transcription polymerase chain reaction (qRT-PCR) based assays as the standard detection method for RSV and virus genetic characterisation, if possible, to monitor genetic evolution. These guidelines provide a basis for a good quality, feasible and affordable surveillance of RSV. Harmonisation of surveillance standards at European and global level will contribute to the wider availability of national level RSV surveillance data for regional and global analysis, and estimation of the RSV burden and impact of the future immunisation programmes.

Determination of respiratory syncytial virus epidemic seasons by using 95% confidence interval of positivity rates, 2011–2021, Germany

“…In Europe, an average RSV season starts in the beginning of December, peaks in early February, and continues until early April 6 . So far, there is no accepted method for defining start and end of RSV epidemic seasons, although few methods have been recently recommended 7 …”

“…6 So far, there is no accepted method for defining start and end of RSV epidemic seasons, although few methods have been recently recommended. 7 In Germany, RSV activities were commonly investigated within our national outpatient sentinel surveillance, and RSV epidemic seasons have been determined retrospectively. 8,9 This study aimed to establish a prospective, sensitive, and sustainable method to determine the start and end of RSV epidemic seasons on population level.…”

The impact of COVID-19 pandemic on bronchiolitis (lower respiratory tract infection) due to respiratory syncytial virus: A systematic review and meta-analysis

“…Sentinel surveillance of RSV is better in many European countries than in other parts of the world [32,33]. There is no data regarding the RSV activity from the majority of the Asian and African countries having higher RSV associated disease burden [34].…”

“…However, countries perceiving a very low number of RSV cases are at an increased risk of resurgence of RSV infection, mainly among older RSV-naïve children [31]. Sentinel surveillance of RSV is better in many European countries than in other parts of the world [32,33]. There is no data regarding the RSV activity from the majority of the Asian and African countries having higher RSV associated disease burden [34].…”

Expert opinion on strategies to improve vaccination coverage against seasonal influenza

“…los métodos de laboratorio deberían estandarizarse para poder ser consolidados [52]. En general, el sistema de vigilancia de VRS de preferencia será la vigilancia centinela activa, con pacientes de atención primaria y hospitalarios a los que se les toma muestras y se analizan de manera sistemática [54].…”