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. 2024 Oct 11;11(10):ofae597.
doi: 10.1093/ofid/ofae597. eCollection 2024 Oct.

Incidence of Respiratory Syncytial Virus in Community-Dwelling Adults Aged 18-64 Years Over 2 Seasons, 2022-2024, in a North American Community

Wendelyn Bosch  1 , Lisa J Speiser  2 , Chung-Il Wi  3 , Katherine S King  4 , Traci L Natoli  3 , Kathy D Ihrke  3 , Matthew J Spiten  3 , Matthew J Binnicker  5 , Joseph D Yao  5 , Paul Y Takahashi  6 , Robert J Pignolo  7 , Brandon H Hidaka  8 , Randy M Foss  9 , Jean-Yves Pirçon  10 , Pouya Saeedi  10 , Mohamed Oujaa  10 , Young J Juhn  11
Affiliations

Incidence of Respiratory Syncytial Virus in Community-Dwelling Adults Aged 18-64 Years Over 2 Seasons, 2022-2024, in a North American Community

Wendelyn Bosch et al. Open Forum Infect Dis. .

Abstract

Background: The incidence of respiratory syncytial virus (RSV)-acute respiratory infection (ARI) in community-dwelling adults after the Omicron variant of the COVID-19 pandemic is unknown. Our aim was to assess the incidence of RSV-ARI in adults aged 18 to 64 years over 2 consecutive RSV seasons (October-April 2022-2024) in 4 US states.

Methods: This community-based prospective cohort study comprised 7501 participants in Minnesota, Wisconsin, Florida, and Arizona. We calculated RSV-ARI and RSV-lower respiratory tract disease (LRTD) incidence and attack rates. We reported unadjusted incidence by age group, gender, race and ethnicity, Charlson Comorbidity Index, socioeconomic status, residential state, and rural/urban setting.

Results: Seasons 1 and 2 had 2250 and 2377 ARI episodes, respectively, with an RSV-ARI positivity rate of 5.5% for season 1 and 5.8% for season 2 among those tested. In season 1, the overall incidence of RSV-ARI was 27.71 (95% CI, 22.82-33.34) per 1000 person-years (1.49% attack rate). Almost half (49.0%) had RSV-LRTD, with an incidence of 13.53 (95% CI, 10.19-17.61) per 1000 person-years (0.73% attack rate). In season 2, the RSV-ARI and RSV-LRTD incidence rates were 26.39 (95% CI, 21.73-31.75) per 1000 person-years (1.51% attack rate) and 12.43 (95% CI, 9.31-16.26) per 1000 person-years (0.72% attack rate). RSV-ARI incidence peaked in November 2022 and December 2023.

Conclusions: Our observations suggest that RSV-ARI incidence and seasonal pattern are shifting to prepandemic RSV epidemiology.

Keywords: acute respiratory infection; incidence; lower respiratory tract disease; respiratory syncytial virus.

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Conflict of interest statement

Potential conflicts of interest. M. J. B. is on the scientific advisory board for DiaSorin Molecular and has received honoraria for educational presentations sponsored by DiaSorin and Qiagen. J.-Y. P. and P. S. are employees of GSK and hold shares in the company as part of their employee remuneration. M. O. is a contractor by GSK. All other authors report no potential conflicts.

Figures

Figure 1.
Figure 1.
RSV-ARI for seasons 1 and 2 by month for the entire cohort. A few participants had ARI episodes with symptoms starting prior to surveillance each season (ie, in September) but were within the 7-day window when swabbed in early October and so were included. The numbers adjacent to the points refer to the number of positive RSV-ARI episodes. RSV positivity rate: the number of RSV-ARI–positive samples over the total number of ARI episodes with RSV results available. ARI, acute respiratory infection; RSV, respiratory syncytial virus.
Figure 2.
Figure 2.
RSV-ARI for seasons 1 and 2 by month for each state. A few participants had ARI episodes with symptoms starting prior to surveillance each season (ie, in September) but were within the 7-day window when swabbed in early October and so were included. The numbers adjacent to the points refer to the number of positive RSV-ARI episodes. RSV positivity rate: the number of RSV-ARI–positive samples over the total number of ARI episodes with RSV results available. ARI, acute respiratory infection; RSV, respiratory syncytial virus.
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