Impact of public health measures on the post-COVID-19 respiratory syncytial virus epidemics in France

Abstract

Since the beginning of the COVID-19 pandemic, other respiratory illnesses decreased worldwide. This study described the consequences of public health measures on respiratory syncytial virus (RSV) severe infections in France, where an interseasonal resurgence of RSV occurred recently. All patients admitted to Necker Hospital (Paris) between August 2018 and April 2021 with a diagnosis of RSV-associated acute lung respiratory infection (ALRI) were enrolled. Characteristics of subjects with RSV-associated ALRI in 2020/2021 were compared to those infected during the two previous outbreaks. Overall, 664 inpatients were diagnosed with RSV-associated ALRI: 229, 183, and 252 during the 2018/2019, 2019/2020, and 2020/2021 outbreaks, respectively. During autumn 2020, a national lockdown began in France but schools remained open. A 3-month delayed RSV epidemic occurred at the end of this lockdown. Compared to previous outbreaks, the 2020/2021 epidemics involved more children aged 6 to 11 months (25.8% versus 13.1%, p < 0.0001), but less infants aged < 6 months (41.3% versus 56.6%, p < 0.0001) and less adults (0.0 versus 2.7%, p < 0.0001). Shorter length of stay at hospital, less frequent requirement of admission to intensive care unit, use of non-invasive ventilation, and/or high-flow nasal oxygen were observed in 2020/2021 than during previous epidemics ( p < 0.0001). Delayed RSV outbreak was associated with more hospitalizations for ALRI, higher age of pediatric inpatients, but milder median clinical phenotype. Reinforced public health measures (even while keeping nurseries and schools open with mandatory face masks since six years of age) could impact, at least transiently, the burden of RSV-related hospitalizations. Supplementary Information The online version contains supplementary material available at 10.1007/s10096-021-04323-1.

Association between the COVID-19 pandemic and pertussis derived from multiple nationwide data sources, France, 2013 to 2020

“…Previous studies have revealed a major impact of COVID-19 pandemic mitigation measures on transmissible diseases, such as, in the paediatric population, gastroenteritis, common cold, bronchiolitis and acute otitis media, but also measles [7,14]. However, a resurgence of some other common airborne infectious diseases has been observed in the setting of relaxed physical distancing recommendations, such as the delayed inter-seasonal respiratory syncytial virus (RSV) epidemic in France and in other parts of the world [15][16][17]. For now (December 2021), we have not observed a pertussis resurgence despite the end of the first lockdown and school fully reopening in France.…”

No durable impact of COVID-19 measures on the hospital burden of respiratory syncytial virus (France, 2018–2022)

“…recently reported that, at the beginning of the COVID-19 pandemic, the usual winter 2020/2021 Respiratory Syncytial Virus (RSV) peak did not occur in Oxfordshire, UK, with an inter-seasonal rise several months later, 1 as described worldwide. 2 , 3 , 4 , 5 , 6 We previously described, in our French tertiary hospital, that the delayed RSV 2020/2021 outbreak involved less adults and was associated with more hospitalization, higher age of pediatric inpatients and milder median clinical phenotype than observed before the COVID-19 pandemic. 2 In France, severe public restrictions (national lockdown, curfew) ended in May-June 2021, but some measures have been maintained (universal masking policy in adults and children ≥6 years in healthcare settings, schools, public transportations and most indoor spaces, educational interventions for prevention of community and healthcare-associated respiratory infections).…”

“… 2 , 3 , 4 , 5 , 6 We previously described, in our French tertiary hospital, that the delayed RSV 2020/2021 outbreak involved less adults and was associated with more hospitalization, higher age of pediatric inpatients and milder median clinical phenotype than observed before the COVID-19 pandemic. 2 In France, severe public restrictions (national lockdown, curfew) ended in May-June 2021, but some measures have been maintained (universal masking policy in adults and children ≥6 years in healthcare settings, schools, public transportations and most indoor spaces, educational interventions for prevention of community and healthcare-associated respiratory infections). Our study aims to evaluate (i) if these measures had an impact on the hospital burden of RSV in the 2021/2022 season when compared to the prepandemic outbreaks and (ii) if the epidemiological changes observed in 2020/2021 were also seen in 2021/2022.…”

Airway Administration of Bacterial Lysate OM-85 Protects Mice Against Respiratory Syncytial Virus Infection

“…The COVID-19 pandemic changed the landscape of almost all other viral respiratory infections leading transiently to a major decrease of viral cases including a delayed RSV outbreak ( 10 ). Public health and restrictive measures targeted at controlling transmission of SARS-CoV-2 have altered the epidemiology and seasonality of many respiratory viruses ( 11 – 13 ).…”