Determining the Relationship of Meteorological Factors and Severe Pediatric Respiratory Syncytial Virus (RSV) Infection in Central Peninsular Malaysia

Abstract

Respiratory syncytial virus (RSV) is the most common pathogen causing viral respiratory tract infections among younger children worldwide. The influence of meteorological factors on RSV seasonal activity is well-established for temperate countries; however, in subtropical countries such as Malaysia, relatively stable temperate climates do not clearly support this trend, and the available data are contradictory. Better understanding of meteorological factors and seasonality of RSV will allow effective strategic health management relating to RSV infection, particularly immunoprophylaxis of high-risk infants with palivizumab. Retrospectively, from 2017 to 2021, we examined the association between various meteorological factors (rainfall, rainy days, temperature, and relative humidity) and the incidence of RSV in children aged less than 12 years in Kuala Lumpur, Malaysia. RSV activity peaked in two periods (July to August and October to December), which was significantly correlated with the lowest rainfall (p < 0.007) and number of rainy days (p < 0.005). RSV prevalence was also positively associated with temperature (p < 0.006) and inversely associated with relative humidity (p < 0.006). Based on our findings, we recommend that immunoprophylaxis with palivizumab be administered in children aged less than 2 years where transmission of RSV is postulated to be the highest after the end of two monsoon seasons.

Associations between meteorological variation and hospitalisations for rotavirus infections in Kuala Lumpur, Malaysia

“…As suggested by Räsänen [ 29 ], the connection between seasonal epidemiology and human behavior, considering factors such as holiday seasons versus school and daycare periods, which involve increased indoor crowding and the use of public transportation. The complex interplay between rainfall patterns, local geography, sanitation infrastructure, and human behavior makes it challenging to draw definitive conclusions regarding the direct relationship between rainfall and diarrheal disease incidence [ 30 ].…”

Assessing the impact of COVID-19 on epidemiological changes of severe pediatric respiratory syncytial virus infections in Malaysia

“…In our latest epidemiological study, we identified two peaks of RSV seasonality occurring in distinct monsoon periods, specifically during July to August and October to December, coinciding with previous local and regional studies. ( 10 , 25–27 ). Surprisingly, in this study, we observed an unusual increase of RSV cases throughout the first half of 2021.…”

“…This is deemed as a global phenomenon as many countries reported a change in the seasonal variation of RSV during the COVID-19 pandemic ( 28 ). Typically, RSV infections peak during colder temperatures and reduced humidity, conditions favorable for the stability and transmission of the virus ( 10 ). However, in Shanghai, China, Ran Jia et al documented an unusual increase in the RSV detection rate during the summer of 2021 ( 28 ).…”

“…ARTI is defined as the presence of cough and cold with respiratory symptoms such as rapid breathing, tachypnoea above age limit, and/ or chest in-drawing, along with warning signs such as the inability to tolerate feeding, persistent vomiting, lethargy, or stridor ( 10 ). Symptomatic children with moderate to severe respiratory distress symptoms requiring NIV were admitted, and NPA was routinely obtained to detect various common respiratory viruses.…”

“…In our previous epidemiological study, we observed a sharp decline in RSV cases in 2020, possibly due to reduced exposure to RSV as a result of the nationwide lockdown. ( 10 ).…”