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. 2023 Jun;28(23):2200740.
doi: 10.2807/1560-7917.ES.2023.28.23.2200740.

Establishing severe acute respiratory infection (SARI) surveillance in a sentinel hospital, Ireland, 2021 to 2022

Melissa Brady  1   2 , Roisin Duffy  2   3 , Lisa Domegan  2 , Abigail Salmon  3 , Binita Maharjan  4 , Cathal O'Broin  5 , Charlene Bennett  6 , James Christle  4 , Jeff Connell  6 , Laura Feeney  4 , Nadra Nurdin  5 , Patrick Mallon  7   5 , Peter Doran  4   8 , Rosa McNamara  9 , Sarah O'Grady  4 , Sinead McDermott  3 , Naomi Petty-Saphon  2   10 , Joan O'Donnell  2
Affiliations

Establishing severe acute respiratory infection (SARI) surveillance in a sentinel hospital, Ireland, 2021 to 2022

Melissa Brady et al. Euro Surveill. 2023 Jun.

Abstract

BackgroundIn 2020, due to the COVID-19 pandemic, the European Centre for Disease Prevention and Control (ECDC) accelerated development of European-level severe acute respiratory infection (SARI) surveillance.AimWe aimed to establish SARI surveillance in one Irish hospital as part of a European network E-SARI-NET.MethodsWe used routine emergency department records to identify cases in one adult acute hospital. The SARI case definition was adapted from the ECDC clinical criteria for a possible COVID-19 case. Clinical data were collected using an online questionnaire. Cases were tested for SARS-CoV-2, influenza and respiratory syncytial virus (RSV), including whole genome sequencing (WGS) on SARS-CoV-2 RNA-positive samples and viral characterisation/sequencing on influenza RNA-positive samples. Descriptive analysis was conducted for SARI cases hospitalised between July 2021 and April 2022.ResultsOverall, we identified 437 SARI cases, the incidence ranged from two to 28 cases per week (0.7-9.2/100,000 hospital catchment population). Of 431 cases tested for SARS-CoV-2 RNA, 226 (52%) were positive. Of 349 (80%) cases tested for influenza and RSV RNA, 15 (4.3%) were positive for influenza and eight (2.3%) for RSV. Using WGS, we identified Delta- and Omicron-dominant periods. The resource-intensive nature of manual clinical data collection, specimen management and laboratory supply shortages for influenza and RSV testing were challenging.ConclusionWe successfully established SARI surveillance as part of E-SARI-NET. Expansion to additional sentinel sites is planned following formal evaluation of the existing system. SARI surveillance requires multidisciplinary collaboration, automated data collection where possible, and dedicated personnel resources, including for specimen management.

Keywords: COVID-19; Influenza; Ireland; Severe Acute Respiratory Infection; Syndromic surveillance; respiratory syncytial virus, RSV.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Teams involved in sentinel surveillance of SARI in one hospital, Ireland, 5 July 2021–3 April 2022
Figure 2
Figure 2
Timeline for implementing sentinel surveillance of SARI in one hospital, Ireland, 2021–2022
Figure 3
Figure 3
Surveillance workflow for SARI in one hospital, Ireland, 5 July 2021–3 April 2022
Figure 4
Figure 4
Number of SARI cases by week of admission, one hospital, Ireland, 5 July 2021–3 April 2022 (n = 437)
Figure 5
Figure 5
Number of SARI cases with SARS-CoV-2 (n = 226), RSV (n = 8) or influenza (n = 14) RNA detected, by week of admission, one hospital, Ireland, 5 July 2021–3 April 2022
Figure 6
Figure 6
Pango lineage of SARI cases with SARS-CoV-2 detected (n = 226) by week of admission, one hospital, Ireland, 5 July 2021–3 April 2022
See this image and copyright information in PMC

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