Rhinovirus spread in children during the COVID‐19 pandemic despite social restrictions—A nationwide register study in Finland

Abstract

Social restrictions during the coronavirus disease 2019 pandemic strongly affected the epidemiology of influenza and respiratory syncytial virus (RSV). As rhinovirus seemed to spread despite the restrictions, we aimed to analyze rhinovirus epidemiology in children during the pandemic. This register‐based study used data from the Finnish Infectious Disease Register. Nationwide rhinovirus findings from July 2015 to March 2021 were included and stratified by age (0–4, 5–9, and 10–14). Cumulative 14‐day incidence per 100000 children was calculated. Four thousand five hundred and seventy six positive rhinovirus findings were included, of which 3788 (82.8%) were among children aged 0–4. The highest recorded incidence was 36.2 among children aged 0–4 in October 2017. The highest recorded incidence during the pandemic period was 13.6 in November 2020. The impact of the restrictions was mostly seen among children aged 0–4 years of age in weeks 14–22 in 2020. The incidence has since remained near reference levels in all age groups. Strict restrictions temporarily interrupted the circulation of rhinovirus in spring 2020. Rhinovirus incidence returned to normal levels soon after the harsh restrictions were lifted. These looser social restrictions prevented RSV and influenza seasons but failed to prevent the spread of rhinovirus.

Different Circulation Pattern of Multiple Respiratory Viruses in Southern China During the COVID-19 Pandemic

“…Meanwhile, the impact of NPIs on some other respiratory viruses was more limited in Guangzhou. Such phenomenon was also reported in Australia, Finland, Italy, Japan, the US and elsewhere (Sberna et al, 2020;Sullivan et al, 2020;Kuitunen et al, 2021;Takashita et al, 2021). In particular, RHV was also reported to circulate as usual among children in Finland (Kuitunen et al, 2021) or even higher than usual in Japan and Australia (Sullivan et al, 2020;Takashita et al, 2021), during the period with various control measures against COVID-19.…”

“…Such phenomenon was also reported in Australia, Finland, Italy, Japan, the US and elsewhere (Sberna et al, 2020;Sullivan et al, 2020;Kuitunen et al, 2021;Takashita et al, 2021). In particular, RHV was also reported to circulate as usual among children in Finland (Kuitunen et al, 2021) or even higher than usual in Japan and Australia (Sullivan et al, 2020;Takashita et al, 2021), during the period with various control measures against COVID-19. In Guangzhou, we observed weaker suppression of non-enveloped viruses (RHV, ADV in our study) compared to enveloped viruses (influenza, RSV and HMPV in our study), as have also been reported in South Korea (Park et al, 2021).…”

Respiratory virus detection during the COVID‐19 pandemic in Queensland, Australia

“… 7 , 37 Increased rhinovirus activity was reported previously in Australia 38 and North America 39 when children returned to school from vacation, and more recently in New South Wales, Western Australia, New Zealand, the United Kingdom and Europe following the easing of COVID‐19 restrictions. 5 , 7 , 12 , 35 , 40 , 41 In addition to being transmitted directly and indirectly by respiratory secretions, rhinoviruses can also be shed in stools. 42 Moreover, it is a non‐enveloped virus, which is less susceptible to alcohol‐gel based hand sanitisers recommended during the COVID‐19 pandemic and it survives on surfaces for prolonged periods.…”

Changes to the practice of pediatric otolaryngology as a consequence of the COVID-19 pandemic

“…In a study based in Finland, social restrictions were associated with a decline in influenza and respiratory syncytial virus [ 14 ]. However, non-pharmaceutical interventions, including face masks or improved hygiene measures, were not effective in preventing the spread of rhinovirus in children [ 16 ]. As viral upper respiratory tract infections have a casual role with eustachian tube obstruction and abnormal middle ear pressure, the global and regional prevalence of different viruses of varying virulence could play a role in the incidence of conditions in pediatric otolaryngology [ 17 ].…”