Infodemiology of RSV in Italy (2017–2022): An Alternative Option for the Surveillance of Incident Cases in Pediatric Age?

Abstract

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.

Respiratory Syncytial Virus Prevention through Monoclonal Antibodies: A Cross-Sectional Study on Knowledge, Attitudes, and Practices of Italian Pediatricians

“…As RSV rather circulates among siblings than from parents and older adults to children, the actual circulation of the pathogen can be more easily understood from professionals working in these areas than in regions characterized by one-child households [ 5 ]. Moreover, a regional molecular surveillance system for RSV has also been implemented well before the inception of national programs [ 12 , 59 , 99 , 100 , 101 ]. Collectively, these factors may have diffusely increased the shared awareness on RSV infections, their complications, and the available preventative options.…”

“…In order to ascertain the potential influence of media coverage on the shared beliefs and the eventual risk perception of respondents [ 4 , 51 , 99 , 115 ], a specific analysis was performed on the relative search volumes for RSV on Google Trends™. Google Trends TM provides a normalized value ranging from 0 to 100, that is proportional to the ratio between the keyword-related queries and the total of web queries, representing a proxy of the general interest of the media on this topic [ 100 , 116 , 117 ]. As no significant correlation with RPS estimates and GKS was found ( Table S4 ) [ 86 ], even though social desirability bias cannot be easily ruled out, media coverage had a reasonably limited impact on our estimates.…”

Invasive Meningococcal Disease and Meningococcal Serogroup B Vaccination in Adults and Their Offspring: Knowledge, Attitudes, and Practices in Italy (2019)

“…An extensive representation of certain topics in the media may reasonably lead to overstating the true significance of this pathogen from a public health point of view [ 102 ]. While the appropriate measurement of the qualitative and quantitative coverage of a specific topic by conventional media is particularly difficult to achieve, Google Trends™ may represent a reliable proxy for new media coverage [ 103 , 104 , 105 , 106 ]. Google Trends TM is an open online tool [ 107 , 108 , 109 ], where web searches on a certain topic are reported as relative search volumes (RSV), i.e., the normalized value ranging from 0 to 100 and proportional to the ratio between the keyword-related queries and the total number of web queries.…”

Prospective Attitudes towards Respiratory Syncytial Virus (RSV) Vaccination: Validation of a Survey Instrument among Young Females in Jordan Pending Vaccine Authorization

“…Based on the extensive literature on the subject of vaccination hesitancy, several domains are expected to govern the decision of pregnant women to receive RSV vaccination [29][30][31]. Several relevant domains are expected to play the major role in the decision to get vaccinated, including (1) knowledge, attitude and beliefs about RSV and its vaccination; (2) perceived risks and concerns related to the vaccine and the disease in infants; (3) convenient access to vaccination and its prompt availability; (4) social influence and support; (5) personal experience of vaccination; (6) the belief in vaccine conspiracy; and (7) the calculation of decision-making to get vaccinated, among others [30].…”

“…Respiratory syncytial virus (RSV) is a prominent causative agent for lower respiratory tract infections globally, particularly among infants and young children in low- and middle-income countries (LMICs) [ 1 , 2 , 3 , 4 ]. According to the Global Burden of Diseases, Injuries, and Risk Factors Study, RSV was implicated in 10.7 million cases of lower respiratory tract infections (LRTI) and over 41,000 deaths among children below the age of 5 years in the year 2016, despite the difficulty in obtaining accurate estimates [ 5 , 6 ]. The high burden of RSV infections is also manifested in its greater risk among infants compared to other respiratory viruses (e.g., influenza virus), highlighting the extensive burden of RSV on health care services and the need for effective preventive measures to reduce its burden [ 7 , 8 , 9 , 10 ].…”