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. 2023 Nov 20;17(11):e13219.
doi: 10.1111/irv.13219. eCollection 2023 Nov.

Seasonal and inter-seasonal RSV activity in the European Region during the COVID-19 pandemic from autumn 2020 to summer 2022

Margaux M I Meslé  1 , Mary Sinnathamby  1 , Piers Mook  1 ; WHO European Region Respiratory Network Group; Richard Pebody  1 , Anissa Lakhani  2 , Maria Zambon  2 , Odette Popovici  3 , Mihaela Lazăr  4 , Amela Dedeić Ljubović  5 , Nina Rodić Vukmir  6   7 , Ayşe Başak Altaş  8 , Emine Avci  8 , Katarzyna Łuniewska  9 , Karol Szymański  9 , Greta Gargasiene  10 , Svajune Muralyte  11 , Ausra Dziugyte  12 , Graziella Zahra  12 , Ana Rita Gonçalves  13 , Tania Spedaliero  13 , Guillaume Fournier  14 , Daniel Alvarez-Vaca  14 , Goranka Petrović  15 , Irena Tabain  15 , Katarina Prosenc  16 , Maja Socan  17 , Jelena Protic  18 , Dragana Dimitrijevic  19 , Alina Druc  20 , Mariana Apostol  20 , Kate Karolina Kalasnikova  21 , Sergejs Nikisins  22 , Janine Reiche  23 , Wei Cai  23 , Adam Meijer  24 , Anne Teirlinck  24 , Amparo Larrauri  25 , Inmaculada Casas  25 , Vincent Enouf  26 , Sophie Vaux  27 , Frederikke Kristensen Lomholt  28 , Ramona Trebbien  28 , Helena Jirincova  29 , Helena Sebestova  29 , Mónika Rózsa  30 , Zsuzsanna Molnár  30 , Gudrun Aspelund  31 , Gudrun Erna Baldvinsdottir  32 , Simon Cottrell  33 , Catherine Moore  33 , Athanasios Kossyvakis  34 , Kassiani Mellou  35 , Olga Sadikova  36 , Johanna Kristina Tamm  36 , Nathalie Bossuyt  37 , Isabelle Thomas  37 , Edita Staroňová  38 , Lyudmila Kudasheva  39 , Boris Pleshkov  39 , Niina Ikonen  40 , Otto Helve  40 , Emma Dickson  41 , Tanya Curran  42 , Kseniya Komissarova  43 , Kirill Stolyarov  43 , Veronika Vysotskaya  44 , Natallia Shmialiova  45 , Božidarka Rakočević  46 , Danijela Vujošević  46 , Romella Abovyan  47 , Shushan Sargsyan  47 , Khatuna Zakhashvili  48 , Ann Machablishvili  48 , Oksana Koshalko  49 , Iryna Demchyshyna  49 , Michal Mandelboim  50 , Aharona Glatman-Freedman  50 , Rory Gunson  51 , Shivani Karanwal  52 , Raquel Guiomar  53 , Ana Paula Rodrigues  54 , Charlene Bennett  54 , Lisa Domegan  55 , Arijana Kalaveshi  56 , Xhevat Jakupi  56 , Gurbangul Ovliyakulova  57 , Neli Korsun  58 , Nadezhda Vladimirova  58
Affiliations

Seasonal and inter-seasonal RSV activity in the European Region during the COVID-19 pandemic from autumn 2020 to summer 2022

Margaux M I Meslé et al. Influenza Other Respir Viruses. .

Abstract

Background: The emergence of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in early 2020 and subsequent implementation of public health and social measures (PHSM) disrupted the epidemiology of respiratory viruses. This work describes the epidemiology of respiratory syncytial virus (RSV) observed during two winter seasons (weeks 40-20) and inter-seasonal periods (weeks 21-39) during the pandemic between October 2020 and September 2022.

Methods: Using data submitted to The European Surveillance System (TESSy) by countries or territories in the World Health Organization (WHO) European Region between weeks 40/2020 and 39/2022, we aggregated country-specific weekly RSV counts of sentinel, non-sentinel and Severe Acute Respiratory Infection (SARI) surveillance specimens and calculated percentage positivity. Results for both 2020/21 and 2021/22 seasons and inter-seasons were compared with pre-pandemic 2016/17 to 2019/20 seasons and inter-seasons.

Results: Although more specimens were tested than in pre-COVID-19 pandemic seasons, very few RSV detections were reported during the 2020/21 season in all surveillance systems. During the 2021 inter-season, a gradual increase in detections was observed in all systems. In 2021/22, all systems saw early peaks of RSV infection, and during the 2022 inter-seasonal period, patterns of detections were closer to those seen before the COVID-19 pandemic.

Conclusion: RSV surveillance continued throughout the COVID-19 pandemic, with an initial reduction in transmission, followed by very high and out-of-season RSV circulation (summer 2021) and then an early start of the 2021/22 season. As of the 2022/23 season, RSV circulation had not yet normalised.

Keywords: COVID‐19 pandemic; Europe; epidemiology; respiratory syncytial virus; severity; surveillance.

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Conflict of interest statement

The following authors declare having received funding from the Innovative Medicines Initiative (IMI): Adam Meijer (The Netherlands) and Anne Teirlinck (The Netherlands). All other authors have no conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
Top row: Count of specimens tested (A) and percentage positivity (B) of RSV specimens per week from sentinel sources compared with the minimum (Min) and maximum (Max) from pre‐COVID‐19 pandemic seasons; middle row: count of non‐sentinel RSV detections compared to the minimum (Min) and maximum (Max) from pre‐COVID‐19 pandemic seasons (C); bottom row: count of specimens tested for RSV (D) and percentage positivity (E) from SARI sites across the selection of countries included, over several seasons. Note: percentage positivity was calculated when at least 10 specimens were tested; grey rectangles represent inter‐seasonal periods; seasons represent the time period ranging from week 40 to 39.
FIGURE 2
FIGURE 2
Summary of Moving Epidemic Method (MEM) calculations (calculated by authors) comparing percentage positivity in pre‐COVID‐19 pandemic seasons (2016/17 to 2019/20) and 2020/21 (weeks 40/2020 to 39/2021) and 2021/22 (weeks 40/2021 to 39/2022) seasons, where possible in the selection of countries included. Horizontal lines represent the epidemic threshold for each season where it could be calculated. Note: grey rectangles represent inter‐seasonal periods; the same epidemic threshold calculations were used for the 2021/22 and 2020/21 season. More detailed results can be found in Table S2.
FIGURE 3
FIGURE 3
Percentage positivity of positive specimens detected from SARI sites per age group, from the selection of countries included. Grey rectangles represent inter‐seasonal periods.
See this image and copyright information in PMC

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