Seasonality of Respiratory Syncytial Virus — United States, 2017–2023

Hamid, Sarah; Winn, Amber; Parikh, Rishika; Jones, Jefferson M.; McMorrow, Meredith; Prill, Mila M.; Silk, Benjamin J.; Scobie, Heather M.; Hall, Aron J.

doi:10.15585/mmwr.mm7214a1

Cited by 113 publications

(96 citation statements)

References 10 publications

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“…In line with this, our detection rate for IAV went from 0.8% during the first period, to 4.5% during the second period, which was higher than the influenza regional baseline of 2% symptomatic cases (CDC, 2022). The detection rate for RSV however, was well below the 3% threshold (Hamid et al, 2023) for both sampling periods, but case rates are typically higher in children (McLaughlin et al, 2022), who were not sampled in this study. As influenza and RSV return to their regular seasonal patterns, and SARS-CoV-2 outbreaks continue, the need for multiplexed testing of symptomatic individuals becomes increasingly crucial.…”

Section: Discussionmentioning

confidence: 54%

Exploring the potential of a saliva-based, RNA-extraction-free PCR test for the multiplexed detection of key respiratory pathogens

Allicock,

Lin,

Fajardo

et al. 2023

Preprint

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IntroductionEfforts to diagnose and monitor transmissible respiratory infections can be impaired by invasive or resource-intensive sample collection. Having extensively demonstrated the feasibility of saliva for SARS-CoV-2 detection, we sought to validate its potential for other common upper respiratory tract pathogens.MethodsWe modified our RNA-extraction-free SARS-CoV-2 PCR test for multiplexed detection of influenza A/B (IAV/IBV), respiratory syncytial virus (RSV) and human metapneumovirus (hMPV). Stability of virus detection in saliva from virus-positive patients was tested after storage at +4°C, room temperature (∼19°C), 30°C and 40°C for up to 7 days and through simulated shipping conditions. De-identified saliva samples were collected from individuals (≥18 years) with respiratory symptoms who were undergoing nasal-swab-based testing for SARS-CoV-2 (New Haven, CT). Saliva samples from SARS-CoV-2-negative individuals were tested with the multiplexed assay, with and without RNA extraction.ResultsThe limit of assay detection ranged from 3-6 copies/μl, virus target depending. Detection remained stable after prolonged sample storage at elevated temperatures and through shipping conditions. From the symptomatic testing sites, 1,095 clinical specimens tested SARS-CoV-2-negative. Upon multiplexed testing of their paired saliva, 41 (3.7%) tested positive (IAV, n=20; RSV, n=5; hMPV, n=7). Additionally, upon screening samples in singleplex for pneumococcus, 29 (3%) samples tested positive.ConclusionOur findings emphasize the adaptability of a low-cost, open-source saliva-based PCR test for common respiratory pathogens, beyond SARS-CoV-2. We demonstrated its utility in symptomatic individuals, identifying viral infection missed when testing focused solely on a singular target, such as SARS-CoV-2.

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Section: Discussionmentioning

confidence: 54%

Exploring the potential of a saliva-based, RNA-extraction-free PCR test for the multiplexed detection of key respiratory pathogens

Allicock,

Lin,

Fajardo

et al. 2023

Preprint

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“…During the COVID-19 pandemic, the circulation of respiratory viruses changed dramatically according to both clinical , and wastewater For example, in the US, there was limited influenza or respiratory syncytial virus (RSV) circulation in the northern hemisphere winter of 2021–2022. , During winter 2022–2023, the US experienced a “tripledemic” of respiratory viruses as clinics and hospitals recorded large numbers SARS-CoV-2, influenza, and RSV infections, at times overwhelming hospital capacity particularly in pediatric units . Nearly 40% of US households reported being infected by SARS-CoV-2, influenza, or RSV during the tripledemic period…”

Section: Introductionmentioning

confidence: 99%

More than a Tripledemic: Influenza A Virus, Respiratory Syncytial Virus, SARS-CoV-2, and Human Metapneumovirus in Wastewater during Winter 2022–2023

Boehm

Wolfe

White³

et al. 2023

Environ. Sci. Technol. Lett.

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Wastewater monitoring can provide insights into respiratory disease occurrence in communities that contribute to the wastewater system. Using daily measurements of RNA of influenza A (IAV), respiratory syncytial virus (RSV), and human metapneumovirus (HMPV), as well as SARS-CoV-2 in wastewater solids from eight publicly owned treatment works in the Greater San Francisco Bay Area of California between July 2022 and early July 2023, we identify a “tripledemic” when concentrations of IAV, RSV, and SARS-CoV-2 peaked at approximately the same time. HMPV was also widely circulating. We designed novel hydrolysis probe RT-PCR assays for different IAV subtype markers to discern that the dominant circulating IAV subtype was H3N2. We show that wastewater data can be used to identify the onset and offset of wastewater disease occurrence events. This information can provide insight into disease epidemiology and timely, localized information to inform hospital staffing and clinical decision making to respond to circulating viruses. Whereas RSV and IAV wastewater events were mostly regionally coherent, HMPV events displayed localized occurrence patterns.

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“…The COVID-19 pandemic disrupted typical RSV circulation patterns, leading to atypical US epidemics during 2021 and 2022 . Specifically, a surge in RSV-related hospitalizations and ICU admissions among infants and young children occurred in the fall of 2022 .…”

Section: Introductionmentioning

confidence: 99%

Infants Admitted to US Intensive Care Units for RSV Infection During the 2022 Seasonal Peak

et al. 2023

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ImportanceRespiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infections (LRTIs) and infant hospitalization worldwide.ObjectiveTo evaluate the characteristics and outcomes of RSV-related critical illness in US infants during peak 2022 RSV transmission.Design, Setting, and ParticipantsThis cross-sectional study used a public health prospective surveillance registry in 39 pediatric hospitals across 27 US states. Participants were infants admitted for 24 or more hours between October 17 and December 16, 2022, to a unit providing intensive care due to laboratory-confirmed RSV infection.ExposureRespiratory syncytial virus.Main Outcomes and MeasuresData were captured on demographics, clinical characteristics, signs and symptoms, laboratory values, severity measures, and clinical outcomes, including receipt of noninvasive respiratory support, invasive mechanical ventilation, vasopressors or extracorporeal membrane oxygenation, and death. Mixed-effects multivariable log-binomial regression models were used to assess associations between intubation status and demographic factors, gestational age, and underlying conditions, including hospital as a random effect to account for between-site heterogeneity.ResultsThe first 15 to 20 consecutive eligible infants from each site were included for a target sample size of 600. Among the 600 infants, the median (IQR) age was 2.6 (1.4-6.0) months; 361 (60.2%) were male, 169 (28.9%) were born prematurely, and 487 (81.2%) had no underlying medical conditions. Primary reasons for admission included LRTI (594 infants [99.0%]) and apnea or bradycardia (77 infants [12.8%]). Overall, 143 infants (23.8%) received invasive mechanical ventilation (median [IQR], 6.0 [4.0-10.0] days). The highest level of respiratory support for nonintubated infants was high-flow nasal cannula (243 infants [40.5%]), followed by bilevel positive airway pressure (150 infants [25.0%]) and continuous positive airway pressure (52 infants [8.7%]). Infants younger than 3 months, those born prematurely (gestational age &lt;37 weeks), or those publicly insured were at higher risk for intubation. Four infants (0.7%) received extracorporeal membrane oxygenation, and 2 died. The median (IQR) length of hospitalization for survivors was 5 (4-10) days.Conclusions and RelevanceIn this cross-sectional study, most US infants who required intensive care for RSV LRTIs were young, healthy, and born at term. These findings highlight the need for RSV preventive interventions targeting all infants to reduce the burden of severe RSV illness.

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Seasonality of Respiratory Syncytial Virus — United States, 2017–2023

Cited by 113 publications

References 10 publications

Exploring the potential of a saliva-based, RNA-extraction-free PCR test for the multiplexed detection of key respiratory pathogens

Exploring the potential of a saliva-based, RNA-extraction-free PCR test for the multiplexed detection of key respiratory pathogens

More than a Tripledemic: Influenza A Virus, Respiratory Syncytial Virus, SARS-CoV-2, and Human Metapneumovirus in Wastewater during Winter 2022–2023

Infants Admitted to US Intensive Care Units for RSV Infection During the 2022 Seasonal Peak

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