Severity of influenza virus and respiratory syncytial virus coinfections in hospitalized adult patients

Zhang, Yulin; Zhao, Jun; Zou, Xiaohui; Xiong, Zhujia; Li, Binbin; Wang, Chunlei; Li, Haibo; Han, Jiajing; Liu, Xinmeng; Xia, Yudi; Lu, Binghuai; Cao, Bin

doi:10.1016/j.jcv.2020.104685

Cited by 19 publications

(18 citation statements)

References 28 publications

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“…Infection reporting rates vary by age-group and virus, and for RSV reporting rates are increased by a multiplier from 2012 onwards, due to the circulation of a new genotype that has increased the average severity of infection and thus the proportion of reported infections (ON-1) 37 . There is also a multiplier on the RSV reporting rates for dual infections, allowing them to be reported more frequently, for example because of increased propensity for respiratory disease that would require healthcare seeking (as observed in adults 4 ). Model equations are shown in supplement section 3.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Evidence for Influenza and RSV interaction from 10 years of enhanced surveillance in Nha Trang, Vietnam, a modelling study

Waterlow

Toizumi

Leeuwen

et al. 2021

Preprint

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Influenza and Respiratory Syncytial Virus (RSV) interact within their host posing the concern for heterologous ecological changes following vaccination. We aimed to estimate the population level impact of their interaction. We developed a dynamic age-stratified two-pathogen mathematical model that includes pathogen interaction through competition for infection and enhanced severity of dual infections. We used parallel tempering to fit it's parameters to 11 years of enhanced hospital-based surveillance for acute respiratory illnesses (ARI) in children under 5 years old in Nha Trang, Vietnam. The data supported either a 41% (95%CrI: 36 - 54) reduction in heterologous acquisition during infection and for 10.0 days (95%CrI 7.1 -12.8) thereafter, or no cross protection. We estimate that co-infection increased the probability for an infection in <2y old children to be reported 7.2 fold (95%CrI 5.0 - 11.4); or 16.6 fold (95%CrI 14.5 - 18.4) in the respective scenarios. Absence of either pathogen was not to the detriment of the other. We find stronger evidence for severity enhancing than for acquisition limiting interaction. In this setting vaccination against either pathogen is unlikely to have a major detrimental effect on the burden of disease caused by the other.

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Section: Methodsmentioning

confidence: 99%

“…The impact of vaccination may be enhanced if co-infections increase the propensity of severe disease beyond that of either pathogen 4 . However, the impact of vaccination may be lessened if vaccination reduces competitive pressure between influenza and RSV and thus leads to increased circulation of the other pathogen.…”

Section: Introductionmentioning

confidence: 99%

Evidence for Influenza and RSV interaction from 10 years of enhanced surveillance in Nha Trang, Vietnam, a modelling study

Waterlow

Toizumi

Leeuwen

et al. 2021

Preprint

View full text Add to dashboard Cite

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“…A second limitation is that we do not consider the potential impact of the interaction effect on disease severity, choosing to focus solely on the effect on susceptibility. Past research has yielded mixed results concerning the severity of coinfections with influenza and RSV: some studies have found coinfections to be more severe than infections with either virus alone 60, 61 , while others have found evidence of reduced severity 12, 15 . In the modeling study of influenza and RSV cocirculation in Vietnam discussed above, the fitted model was most consistent with a 2-20 times increase in reporting among coinfected individuals 23 .…”

Section: Discussionmentioning

confidence: 99%

Characterizing the interactions between influenza and respiratory syncytial viruses and their implications for epidemic control

Krämer

Casalegno

Cellès

2022

Preprint

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Pathogen-pathogen interactions represent a critical but little-understood feature of infectious disease dynamics. In particular, experimental evidence suggests that influenza viruses and respiratory syncytial viruses (RSV) compete with each other, such that infection with one confers temporary protection against the other. However, such interactions are challenging to study using common epidemiologic methods. Here, we use a mathematical modeling approach, in conjunction with detailed surveillance data from Hong Kong, to infer the strength and duration of the interaction between influenza and RSV. We further utilize our model to evaluate the potential of live attenuated influenza vaccines (LAIV) as a novel strategy to control RSV epidemics. We find evidence of strong, bidirectional interference, such that infection with either virus yields almost complete protection against infection with the other for two to four months. Furthermore, we demonstrate that the likely impact of widespread LAIV use depends on underlying viral circulation patterns. More broadly, we highlight the utility of mathematical models as a tool to characterize interactions and predict the indirect effects of vaccines.

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“…Infection reporting rates vary by age-group and virus, and for RSV reporting rates are increased by a multiplier from 2012 onwards, due to the circulation of a new genotype that has increased the average severity of infection and thus the proportion of reported infections (ON-1) [ 24 ]. There is also a multiplier on the RSV reporting rates for dual infections, allowing them to be reported more frequently, for example because of increased propensity for respiratory disease that would require healthcare seeking (as observed in adults [ 4 ]). Model equations are shown in section 3 in S1 Text .…”

Section: Methodsmentioning

confidence: 99%

“…The impact of vaccination may be enhanced if concurrent co-infections increase the propensity of severe disease beyond that of either pathogen [ 4 ]. However, the impact of vaccination may be lessened if vaccination reduces competitive pressure between influenza and RSV and thus leads to increased circulation of the other pathogen.…”

Section: Introductionmentioning

confidence: 99%

Evidence for influenza and RSV interaction from 10 years of enhanced surveillance in Nha Trang, Vietnam, a modelling study

et al. 2022

View full text Add to dashboard Cite

Influenza and Respiratory Syncytial Virus (RSV) interact within their host posing the concern for impacts on heterologous viruses following vaccination. We aimed to estimate the population level impact of their interaction. We developed a dynamic age-stratified two-pathogen mathematical model that includes pathogen interaction through competition for infection and enhanced severity of dual infections. We used parallel tempering to fit its parameters to 11 years of enhanced hospital-based surveillance for acute respiratory illnesses (ARI) in children under 5 years old in Nha Trang, Vietnam. The data supported either a 41% (95%CrI: 36–54) reduction in susceptibility following infection and for 10.0 days (95%CrI 7.1–12.8) thereafter, or no change in susceptibility following infection. We estimate that co-infection increased the probability for an infection in <2y old children to be reported 7.2 fold (95%CrI 5.0–11.4); or 16.6 fold (95%CrI 14.5–18.4) in the moderate or low interaction scenarios. Absence of either pathogen was not to the detriment of the other. We find stronger evidence for severity enhancing than for acquisition limiting interaction. In this setting vaccination against either pathogen is unlikely to have a major detrimental effect on the burden of disease caused by the other.

show abstract

Severity of influenza virus and respiratory syncytial virus coinfections in hospitalized adult patients

Cited by 19 publications

References 28 publications

Evidence for Influenza and RSV interaction from 10 years of enhanced surveillance in Nha Trang, Vietnam, a modelling study

Evidence for Influenza and RSV interaction from 10 years of enhanced surveillance in Nha Trang, Vietnam, a modelling study

Characterizing the interactions between influenza and respiratory syncytial viruses and their implications for epidemic control

Evidence for influenza and RSV interaction from 10 years of enhanced surveillance in Nha Trang, Vietnam, a modelling study

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