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. 2024 Dec 8;16(12):1892.
doi: 10.3390/v16121892.

Seasonal Shifts in Influenza, Respiratory Syncytial Virus, and Other Respiratory Viruses After the COVID-19 Pandemic: An Eight-Year Retrospective Study in Jalisco, Mexico

Ernestina Quintero-Salgado  1 , Jaime Briseno-Ramírez  2   3 , Gabriel Vega-Cornejo  2   4 , Roberto Damian-Negrete  2   5 , Gustavo Rosales-Chavez  2   6 , Judith Carolina De Arcos-Jiménez  1   5
Affiliations

Seasonal Shifts in Influenza, Respiratory Syncytial Virus, and Other Respiratory Viruses After the COVID-19 Pandemic: An Eight-Year Retrospective Study in Jalisco, Mexico

Ernestina Quintero-Salgado et al. Viruses. .

Abstract

The coronavirus disease 2019 (COVID-19) pandemic profoundly disrupted the epidemiology of respiratory viruses, driven primarily by widespread non-pharmaceutical interventions (NPIs) such as social distancing and masking. This eight-year retrospective study examines the seasonal patterns and incidence of influenza virus, respiratory syncytial virus (RSV), and other respiratory viruses across pre-pandemic, pandemic, and post-pandemic phases in Jalisco, Mexico. Weekly case counts were analyzed using an interrupted time series (ITS) model, segmenting the timeline into these three distinct phases. Significant reductions in respiratory virus circulation were observed during the pandemic, followed by atypical resurgences as NPIs were relaxed. Influenza displayed alternating subtype dominance, with influenza A H3 prevailing in 2022, influenza B surging in 2023, and influenza A H1N1 increasing thereafter, reflecting potential immunity gaps. RSV activity was marked by earlier onset and higher intensity post-pandemic. Other viruses, including human rhinovirus/enterovirus (HRV/HEV) and parainfluenza virus (HPIV), showed altered dynamics, with some failing to return to pre-pandemic seasonality. These findings underscore the need for adaptive surveillance systems and vaccination strategies to address evolving viral patterns. Future research should investigate the long-term public health implications, focusing on vaccination, clinical outcomes, and healthcare preparedness.

Keywords: COVID-19 impact; influenza seasonality; interrupted time series analysis; respiratory infections; respiratory viruses’ trends; virus resurgence; virus seasonality.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of case selection.
Figure 2
Figure 2
Coinfections detected among different respiratory viruses: (a) coinfections detected during the entire study period (2017–2024); (b) coinfections detected using the multiplex RT-PCR respiratory panel (2020–2024).
Figure 3
Figure 3
Monthly distribution of positive influenza virus cases: (a) monthly distribution of positive influenza cases (bars) alongside COVID-19 indicators and acute respiratory illness metrics (lines); (b) monthly distribution of positive cases by influenza subtypes (bars) alongside influenza positivity rates (lines).
Figure 3
Figure 3
Monthly distribution of positive influenza virus cases: (a) monthly distribution of positive influenza cases (bars) alongside COVID-19 indicators and acute respiratory illness metrics (lines); (b) monthly distribution of positive cases by influenza subtypes (bars) alongside influenza positivity rates (lines).
Figure 4
Figure 4
Monthly distribution of respiratory syncytial virus (RSV) positive tests: (a) monthly distribution of positive RSV cases (bars) alongside COVID-19 indicators and acute respiratory illness metrics (lines); (b) monthly distribution of positive RSV tests (bars) alongside RSV positivity rates (lines).
Figure 5
Figure 5
Monthly distribution of positive tests for other respiratory viruses: (a) monthly distribution of positive cases by virus type (bars) alongside COVID-19 indicators and acute respiratory illness metrics (lines); (b) monthly distribution of positive tests for other respiratory viruses (bars) alongside their group positivity rates (lines).
Figure 5
Figure 5
Monthly distribution of positive tests for other respiratory viruses: (a) monthly distribution of positive cases by virus type (bars) alongside COVID-19 indicators and acute respiratory illness metrics (lines); (b) monthly distribution of positive tests for other respiratory viruses (bars) alongside their group positivity rates (lines).
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