Abstract:Several respiratory pathogens are responsible for influenza-like illness (ILI) and severe respiratory infections (SARI), among which human respiratory syncytial virus (hRSV) represents one of the most common aetiologies. We analysed the hRSV prevalence among subjects with ILI or SARI during the five influenza seasons before the emergence of SARS-CoV-2 epidemic in Sicily (Italy). Respiratory specimens from ILI outpatients and SARI inpatients were collected in the framework of the Italian Network for the Influen… Show more
“…A time- and resource-consuming health threat, RSV-related infections are difficult to prevent through common public health measures. 1 , 55 , 171 , 172 Universal NPI are not sufficient to manage recurrent RSV epidemics as these would have to be stringent and permanent, which is clearly not sustainable, particularly at the household level. 50 , 110 , 111 , 173 Less-than-universal NPI may fail to reduce circulation and spreading of RSV among susceptible individuals.…”
Section: Discussionmentioning
confidence: 99%
“…Although this epidemiological observation could be interpreted to suggest that RSV is more frequently spread among children of this age group, it is possible that school-age children are bringing RSV home and infecting the 12- to-23-month-old infants who have the highest rate of infection. 55 In other words, RSV infections nearly double the number of primary care consultation compared with influenza, resulting in a time- and resource-consuming issue, not only for medical professionals, but also for parents caring for their children. 33 Figure 2.…”
Section: Epidemiology and Burden Of Diseasementioning
confidence: 99%
“… 3 , 4 As the half-life of maternal RSV-NA usually ranges from 36 to 42 days, 82 , 83 with even shorter estimates, 84 it is reasonable that all children become susceptible or even highly susceptible to RSV infection shortly after the first month of live. 1 , 55 , 85 …”
Respiratory syncytial virus (RSV) is a highly contagious seasonal virus and the leading cause of Lower Respiratory Tract Infections (LRTI), including pneumonia and bronchiolitis in children. RSV-related LRTI cause approximately 3 million hospitalizations and 120,000 deaths annually among children <5 years of age. The majority of the burden of RSV occurs in previously healthy infants. Only a monoclonal antibody (mAb) has been approved against RSV infections in a restricted group, leaving an urgent unmet need for a large number of children potentially benefiting from preventive measures. Approaches under development include maternal vaccines to protect newborns, extended half-life monoclonal antibodies to provide rapid long-lasting protection, and pediatric vaccines. RSV has been identified as a major global priority but a solution to tackle this unmet need for all children has yet to be implemented. New technologies represent the avenue for effectively addressing the leading-cause of hospitalization in children <1 years old.
“…A time- and resource-consuming health threat, RSV-related infections are difficult to prevent through common public health measures. 1 , 55 , 171 , 172 Universal NPI are not sufficient to manage recurrent RSV epidemics as these would have to be stringent and permanent, which is clearly not sustainable, particularly at the household level. 50 , 110 , 111 , 173 Less-than-universal NPI may fail to reduce circulation and spreading of RSV among susceptible individuals.…”
Section: Discussionmentioning
confidence: 99%
“…Although this epidemiological observation could be interpreted to suggest that RSV is more frequently spread among children of this age group, it is possible that school-age children are bringing RSV home and infecting the 12- to-23-month-old infants who have the highest rate of infection. 55 In other words, RSV infections nearly double the number of primary care consultation compared with influenza, resulting in a time- and resource-consuming issue, not only for medical professionals, but also for parents caring for their children. 33 Figure 2.…”
Section: Epidemiology and Burden Of Diseasementioning
confidence: 99%
“… 3 , 4 As the half-life of maternal RSV-NA usually ranges from 36 to 42 days, 82 , 83 with even shorter estimates, 84 it is reasonable that all children become susceptible or even highly susceptible to RSV infection shortly after the first month of live. 1 , 55 , 85 …”
Respiratory syncytial virus (RSV) is a highly contagious seasonal virus and the leading cause of Lower Respiratory Tract Infections (LRTI), including pneumonia and bronchiolitis in children. RSV-related LRTI cause approximately 3 million hospitalizations and 120,000 deaths annually among children <5 years of age. The majority of the burden of RSV occurs in previously healthy infants. Only a monoclonal antibody (mAb) has been approved against RSV infections in a restricted group, leaving an urgent unmet need for a large number of children potentially benefiting from preventive measures. Approaches under development include maternal vaccines to protect newborns, extended half-life monoclonal antibodies to provide rapid long-lasting protection, and pediatric vaccines. RSV has been identified as a major global priority but a solution to tackle this unmet need for all children has yet to be implemented. New technologies represent the avenue for effectively addressing the leading-cause of hospitalization in children <1 years old.
“…Even though World Health Organization has started a global effort for developing reliable and international standards for RSV surveillance, RSV surveillance in the EU is fragmentary, only involving 20 out of 27 member states, and quite heterogeneous in terms of the collected data [ 20 ]. Notably, neither official data on RSV infections nor LRTIs for Italy had been made available until the 2022 reporting season [ 19 , 21 ].…”
Section: Introductionmentioning
confidence: 99%
“…While some observational studies based on the regional database have provided some snapshots of the clinical data [ 4 , 19 , 21 , 25 , 26 , 27 , 28 , 29 ], alternative options for monitoring RSV infection trends are therefore required, at least until epidemiological and virological surveillance is able to deliver appropriate and reliable information. In recent years, infodemiology (i.e., the science of distribution and determinants of information in an electronic medium, specifically the Internet, or in a population, with the ultimate aim to inform public health and public policy) [ 30 ] and infoveillance (i.e., epidemic surveillance performed by means of infodemiology) [ 31 , 32 ] have emerged as effective tools in predicting outbreaks of several infectious diseases, ranging from influenza to COVID-19 [ 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 ].…”
The aim of this study was to evaluate whether or not online queries for Respiratory Syncytial Virus (RSV) retrieved by means of Google Trends™ and the Italian Wikipedia analysis program mirror the occurrence of influenza-like illnesses (ILI), as reported by the Italian Influenza Surveillance network (InfluNet). Estimated rates for ILI in the general population and in the age groups 0–4 years and 5–14 years were obtained for the influenza seasons 2017–2018 to 2020–2021. Similarly, a weekly fraction of online searches was retrieved for a series of terms associated with Respiratory Syncytial Virus. Next, trends for daily visualization of Italian Wikipedia Pages for Human Respiratory Syncytial Virus, Pneumonia, Bronchiolitis, Influenza, and Respiratory Failure were similarly retrieved. The correlation of all search terms with ILI was analyzed by means of Spearman’s rank correlation analysis. Among search terms associated with the clinical diagnosis of Respiratory Syncytial Virus infections, the occurrence of ILI was highly correlated only with Bronchiolitis in the age group 0–4 years (β 0.210, p = 0.028), while more generic search terms, such as Bronchitis, fever, influenza, and Pneumonia, were identified as effective predictors of ILI, in general and by age groups. In a regression analysis modeled with ILIs as the outcome variable, daily visualizations for the Wikipedia pages on Bronchiolitis were identified as negative predictors for ILI in general (β = −0.152, p = 0.032), ILI in age group 0–4 years (β = −0.264, p = 0.001) and 5–14 years (β = −0.202, p = 0.006), while Influenza was characterized as a positive effector for ILIs in the age group 5–14 years (β = 0.245, p = 0.001). Interestingly, not only were the search terms extensively correlated with one another, but all of them were also characterized by autocorrelation through a Durbin-Watson test (all estimates DW < 2.0) In summary, our study identified a complicated pattern of data visualization as no clear association between rates of ILI in pediatric age group 0–4 and 5 to 14 years was actually found. Finally, our data stress that the infodemiology option may be quite problematic for assessing the time trend of RSV infections in Italy until more appropriate reporting will be made available, by sharing estimates of Lower Respiratory Tract Infections, and through a more accurate characterization of younger age groups.
Introduction
Respiratory syncytial virus (RSV) is an important cause of severe respiratory illness in older adults and adults with respiratory or cardiovascular comorbidities. Published estimates of its incidence and prevalence in adult groups vary widely. This article reviews the potential limitations affecting RSV epidemiology studies and suggests points to consider when evaluating or designing them.
Methods
Studies reporting the incidence or prevalence of RSV infection in adults in high-income Western countries from 2000 onwards were identified via a rapid literature review. Author-reported limitations were recorded, together with presence of other potential limitations. Data were synthesized narratively, with a focus on factors affecting incidence estimates for symptomatic infection in older adults.
Results
A total of 71 studies met the inclusion criteria, most in populations with medically attended acute respiratory illness (ARI). Only a minority used case definitions and sampling periods tailored specifically to RSV; many used influenza-based or other criteria that are likely to result in RSV cases being missed. The great majority relied solely on polymerase chain reaction (PCR) testing of upper respiratory tract samples, which is likely to miss RSV cases compared with dual site sampling and/or addition of serology. Other common limitations were studying a single season, which has potential for bias due to seasonal variability; failure to stratify results by age, which underestimates the burden of severe disease in older adults; limited generalizability beyond a limited study setting; and absence of measures of uncertainty in the reporting of results.
Conclusions
A significant proportion of studies are likely to underestimate the incidence of RSV infection in older adults, although the effect size is unclear and there is also potential for overestimation. Well-designed studies, together with increased testing for RSV in patients with ARI in clinical practice, are required to accurately capture both the burden of RSV and the potential public health impact of vaccines.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
