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Observational Study
. 2023 Nov 11;228(10):1394-1399.
doi: 10.1093/infdis/jiad282.

Year-Round Respiratory Syncytial Virus Transmission in The Netherlands Following the COVID-19 Pandemic: A Prospective Nationwide Observational and Modeling Study

Yvette N Löwensteyn  1 , Zhe Zheng  2 , Neele Rave  1 , Michiel A G E Bannier  3 , Marie-Noëlle Billard  1 , Jean-Sebastien Casalegno  4 , Virginia E Pitzer  2 , Joanne G Wildenbeest  1 , Daniel M Weinberger  2 , Louis Bont  1 ; Surveillance of Pediatric REspiratory Admissions in Dutch hospitals (SPREAD) Study Group
Collaborators, Affiliations
Observational Study

Year-Round Respiratory Syncytial Virus Transmission in The Netherlands Following the COVID-19 Pandemic: A Prospective Nationwide Observational and Modeling Study

Yvette N Löwensteyn et al. J Infect Dis. .

Abstract

We initiated a nationwide prospective study to monitor respiratory syncytial virus (RSV)-related pediatric hospitalizations in 46 hospitals throughout the Netherlands between May 2021 and August 2022. We showed year-round RSV transmission in the Netherlands after an initial 2021 summer outbreak. The pattern was unprecedented and distinct from neighboring countries. We extended a dynamic simulation model to evaluate the impact of waning immunity on pediatric RSV hospitalizations in the Netherlands using 4 different scenarios. Our results suggest that the observed continuous RSV transmission pattern could be associated with waning immunity due to the period of very low RSV circulation during the COVID-19 pandemic.

Keywords: COVID-19; epidemic timing; respiratory syncytial virus; seasonality; waning immunity.

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Conflict of interest statement

Potential conflicts of interest. L. B. has regular interaction with pharmaceutical and other industrial partners but has not received personal fees or other personal benefits. University Medical Center Utrecht (UMCU) has received major funding (>€100 000 per industrial partner) for investigator-initiated studies from AbbVie, MedImmune, Janssen, the Bill & Melinda Gates Foundation, Nutricia (Danone), and MeMed Diagnostics; major cash or in-kind funding as part of the public–private partnership Innovative Medicines Initiative–funded RESCEU project from GSK, Novavax, Janssen, AstraZeneca, Pfizer, and Sanofi; major funding by Julius Clinical for participating in the INFORM study sponsored by MedImmune; minor funding for participation in trials by Regeneron and Janssen during 2015–2017 (total annual estimate less than €20 000); and minor funding for consultation and invited lectures by AbbVie, MedImmune, Ablynx, Bavaria Nordic, MabXience, Novavax, Pfizer, and Janssen (total annual estimate less than €20 000). L. B. is the founding chairman of the ReSViNET Foundation. V. E. P. has received reimbursement from Merck and Pfizer for travel expenses to scientific input engagements on respiratory syncytial virus. D. M. W. has received consulting fees from Pfizer, Merck, GSK, Affinivax, and Matrivax for work unrelated to this manuscript and is the principal investigator on research grants from Pfizer and Merck on work unrelated to this manuscript. Z. Z. is expected to receive consulting fees from Pfizer for work unrelated to this manuscript. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Weekly number of children aged <2 years admitted with respiratory syncytial virus (RSV) infection in the Netherlands between May 2021 and August 2022. Gray-shaded areas indicate period of school closures.
Figure 2.
Figure 2.
The simulated number of monthly respiratory syncytial virus (RSV) hospitalizations in children <2 years of age under 4 scenarios, 2018–2025. The projected RSV hospitalizations under 4 scenarios after the interruption of coronavirus disease 2019 (COVID-19)–related measures over time are plotted for July 2018 to June 2025. Scenario 2 corresponds to the simulated number of monthly RSV hospitalizations in children <2 years of age in the Netherlands. The green line corresponds to the total RSV hospitalizations in children <2 years of age; the orange line corresponds to RSV hospitalizations in infants <6 months of age; the purple line corresponds to RSV hospitalizations in children 1–<2 years of age. The shaded area corresponds to the period of the Surveillance of Pediatric Respiratory Admissions in Dutch Hospitals (SPREAD) study, May 2021–August 2022. A, Scenario 1: moderate level of nonpharmaceutical interventions (NPIs) and low level of virus importation, with no waning immunity. B, Scenario 2: moderate level of NPIs and low level of virus importation, with waning immunity. C, Scenario 3: moderate level of NPIs and high level of virus importation, with waning immunity. In previous scenarios, we assumed that COVID-19–related public health measures started in April 2020 and gradually relaxed since March 2021 over a 3-month period [7]. D, Scenario 4: strict NPIs but high level of virus importation, with waning immunity. Scenario 4 is similar to the observation in France and Germany with a few parameter adjustments. We assumed that COVID-19–related public health measures started at the end of March 2020 and gradually relaxed since the end of June 2021 over a 3-month period and that virus importation is 30 per 1 million travelers per month [7].
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References

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