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

Waterlow, Naomi R.; Toizumi, Michiko; Leeuwen, Edwin van; Nguyen, Hien-Anh Thi; Myint-Yoshida, Lay; Eggo, Rosalind M

doi:10.1371/journal.pcbi.1010234

Cited by 6 publications

(10 citation statements)

References 46 publications

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Section: Discussionmentioning

confidence: 99%

“…Note that neither could, nor did we intend to show the absence of viral interference from RSV against influenza viruses. To study viral interference from RSV in shaping the transmission dynamics of influenza may require time-series data from multiple epidemic seasons, as shown in a modeling study (27). The method successfully identified the biennial pattern of RSV epidemics in certain regions of the US and atypical RSV seasons following the pandemic.…”

Section: Discussionmentioning

confidence: 99%

“…Mathematical models that explicitly depict the underlying mechanisms of viral transmission have advantages in being able to integrate heterogeneous mechanisms and test different hypotheses (23)(24)(25). Some mathematical models have been proposed to study the effect of viral interference between RSV and influenza viruses at the population level and to quantify the interactions by fitting the models to incidence data (26)(27)(28). However, these models did not capture the natural infection history of RSV, which are characterized by intermediate immunity lying between perfectly and imperfectly immunizing infections (29).…”

Section: Introductionmentioning

confidence: 99%

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The role of viral interference in shaping RSV epidemics following the 2009 H1N1 influenza pandemic

Li,

Thindwa,

Weinberger

et al. 2024

Preprint

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Respiratory syncytial virus (RSV) primarily affects infants, young children, and older adults, with seasonal outbreaks in the United States (US) peaking around December or January. Despite the limited implementation of non-pharmaceutical interventions, disrupted RSV activity was observed in different countries following the 2009 influenza pandemic, suggesting possible viral interference from influenza. Although interactions between the influenza A/H1N1 pandemic virus and RSV have been demonstrated at an individual level, it remains unclear whether the disruption of RSV activity at the population level can be attributed to viral interference. In this work, we first evaluated changes in the timing and intensity of RSV activity across 10 regions of the US in the years following the 2009 influenza pandemic using dynamic time warping. We observed a reduction in RSV activity following the pandemic, which was associated with intensity of influenza activity in the region. We then developed an age-stratified, two-pathogen model to examine various hypotheses regarding viral interference mechanisms. Based on our model estimates, we identified three mechanisms through which influenza infections could interfere with RSV: 1) reducing susceptibility to RSV coinfection; 2) shortening the RSV infectious period in coinfected individuals; and 3) reducing RSV infectivity in coinfection. Our study offers statistical support for the occurrence of atypical RSV seasons following the 2009 influenza pandemic. Our work also offers new insights into the mechanisms of viral interference that contribute to disruptions in RSV epidemics and provides a model-fitting framework that enables the analysis of new surveillance data for studying viral interference at the population level.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The role of viral interference in shaping RSV epidemics following the 2009 H1N1 influenza pandemic

Li,

Thindwa,

Weinberger

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…Previous evidence of the interaction of RSV and seasonal influenza on the population level implies that prevention of one could inadvertently lead to an increase in the burden of the other [23][26]. Recent modeling work suggests a competition between RSV and influenza with infection reducing heterologous acquisition by 41% for 10 days among children after infection in Nha Trang, Vietnam [40]. We provide additional evidence for the competition between RSV and influenza at the population level in a more diverse region in the U.S. and the level of competition could be differentiated by location.…”

Section: Discussionmentioning

confidence: 99%

Characterizing Potential Interaction Between Respiratory Syncytial Virus and Seasonal Influenza in the U.S.

Chen,

Gokhale,

Liu

et al. 2023

Preprint

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RSV and seasonal influenza are two of the most important causes of respiratory infection that consistently peak during winter months in the U.S. Here, we characterized the circulation of these viruses in the U.S. with weekly positive case reports and genetic surveillance and used a mathematical modeling approach to explore their potential interaction at an HHS regional level. Our analyses showed RSV and seasonal influenza co-circulate with various relatively epidemic sizes and seasonal overlaps across seasons and regions. We found RSV might have different evolutionary dynamics compared to seasonal influenza, with local persistence may play a role in underlying annual epidemics. Our analysis supports a competitive interaction between RSV and seasonal influenza in most HHS regions and we speculate that cross-immunity after infection might be the major driver of viral competition. Together, our work supports the competition between RSV and seasonal influenza across the U.S. at a population level. Our findings are important for the future development of protective strategies against these respiratory viruses.

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“…Globally, in 2019 there were an estimated 17.2 billion upper respiratory tract infections (1), which is a common presentation of the over 200 known respiratory virus strains that cause illness in humans (1). These viruses may interact, resulting in cross-protective or enhancing effects for transmission and/or disease severity (2)(3)(4)(5), and can result in unintended knock-on effects from public health interventions. However, other factors, including a change in behaviour relevant to transmission, may also underlie apparent pathogen interaction.…”

Section: Introductionmentioning

confidence: 99%

Transient increased risk of influenza infection following RSV infection in South Africa; findings from the PHIRST study, South Africa, 2016-2018

Waterlow

Kleynhans

Wolter

et al. 2023

Preprint

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Large-scale prevention of respiratory syncytial virus (RSV) infection may have ecological consequences for co-circulating pathogens, including influenza. We assessed if and for how long RSV infection alters the risk for subsequent influenza infection. We analysed a prospective longitudinal cohort study conducted in South Africa between 2016 and 2018. For participating households, nasopharyngeal samples were taken twice weekly, irrespective of symptoms, across three respiratory virus seasons, and real-time polymerase chain reaction (PCR) was used to identify infection with RSV and/or influenza. We fitted an individual-level hidden markov transmission model in order to estimate RSV and influenza infection rates and their interdependence. Of a total of 122113 samples collected, 1265 (1.0%) were positive for influenza and 1002 (0.8%) positive for RSV, with 15 (0.01%) samples from 12 individuals positive for both influenza and RSV. We observed 2.25-fold higher incidence of co-infection than expected if assuming infections were unrelated. We estimated that infection with influenza is 2.13 (95% CI 0.97 - 4.69) times more likely when already infected with, and for a week following, RSV infection, adjusted for age. This equates to 1.4% of influenza infections that may be attributable to RSV in this population. Due to the local seasonality (RSV season precedes the influenza season), we were unable to estimate changes in RSV infection risk following influenza infection. RSV infection was associated with an increased risk for influenza infection for a short period after infection. However, the impact on population-level transmission dynamics of this individual-level synergistic effect was not measurable in this setting.

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

Cited by 6 publications

References 46 publications

The role of viral interference in shaping RSV epidemics following the 2009 H1N1 influenza pandemic

The role of viral interference in shaping RSV epidemics following the 2009 H1N1 influenza pandemic

Characterizing Potential Interaction Between Respiratory Syncytial Virus and Seasonal Influenza in the U.S.

Transient increased risk of influenza infection following RSV infection in South Africa; findings from the PHIRST study, South Africa, 2016-2018

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