Journal Article

Examining the interseasonal resurgence of respiratory syncytial virus in Western Australia

Yeoh, Daniel K, Farhat, Asifa, Mace, Ariel O, Peplinski, Joseph, Levy, Avram, Moore, Hannah C, Lim, Selina Mei, Le, Huong, Hoeppner, Tobias, Blyth, Christopher, Hazelton, Briony, Martin, Andrew C, Phuong, Linny Kimly, Sikazwe, Chisha T, Lee, Wei Hao, Foley, David Anthony, Borland, Meredith L, Minney-Smith, Cara A, Bowen, Asha C

2022

Overview

BackgroundFollowing a relative absence in winter 2020, a large resurgence of respiratory syncytial virus (RSV) detections occurred during the 2020/2021 summer in Western Australia. This seasonal shift was linked to SARS-CoV-2 public health measures. We examine the epidemiology and RSV testing of respiratory-coded admissions, and compare clinical phenotype of RSV-positive admissions between 2019 and 2020.MethodAt a single tertiary paediatric centre, International Classification of Diseases, 10th edition Australian Modification-coded respiratory admissions longer than 12 hours were combined with laboratory data from 1 January 2019 to 31 December 2020. Data were grouped into bronchiolitis, other acute lower respiratory infection (OALRI) and wheeze, to assess RSV testing practices. For RSV-positive admissions, demographics and clinical features were compared between 2019 and 2020.ResultsRSV-positive admissions peaked in early summer 2020, following an absent winter season. Testing was higher in 2020: bronchiolitis, 94.8% vs 89.2% (p=0.01); OALRI, 88.6% vs 82.6% (p=0.02); and wheeze, 62.8% vs 25.5% (p<0.001). The 2020 peak month, December, contributed almost 75% of RSV-positive admissions, 2.5 times the 2019 peak. The median age in 2020 was twice that observed in 2019 (16.4 vs 8.1 months, p<0.001). The proportion of RSV-positive OALRI admissions was greater in 2020 (32.6% vs 24.9%, p=0.01). There were no clinically meaningful differences in length of stay or disease severity.InterpretationThe 2020 RSV season was in summer, with a larger than expected peak. There was an increase in RSV-positive non-bronchiolitis admissions, consistent with infection in older RSV-naïve children. This resurgence raises concern for regions experiencing longer and more stringent SARS-CoV-2 public health measures.

• Publisher: BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health,BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Aging (Individuals) / Bacterial infections / Bronchiolitis - epidemiology / Bronchiolitis - virology / Bronchopneumonia / Cerebral Palsy / child health / Children / Childrens health / Clinical Diagnosis / Codes / Coding / COVID-19 / COVID-19 - epidemiology / Demography / Epidemics / Epidemiology / Female / Flow Charts / Genotype & phenotype / Hospitalization / Hospitals / Humans / Infant / Infections / Laboratories / Male / Original Research / Pandemics / Patient admissions / Pediatrics / Phenotypes / Public health / Respiratory diseases / respiratory medicine / Respiratory Sounds - etiology / Respiratory syncytial virus / Respiratory Syncytial Virus Infections - diagnosis / Respiratory Syncytial Virus Infections - epidemiology / Respiratory Syncytial Virus, Human / Respiratory Tract Infections - epidemiology / Respiratory Tract Infections - virology / SARS-CoV-2 / Seasonal variations / Seasons / Severe acute respiratory syndrome coronavirus 2 / Statistical Analysis / Summer / Ventilation / virology / Viruses / Western Australia - epidemiology / Winter