Burden of respiratory syncytial virus infection in older adults hospitalised in England during 2023/24

Collaborators, Affiliations

Collaborators

HARISS network collaborators:
Elisabeth North⁵, Matthew Donati¹¹, Simon Tazzyman¹², Thushan de Silva¹³, Tristan W Clark¹⁴, Nicola White¹⁵, Tine Panduro¹⁶, Monique Andersson¹⁷, Suzy Gallier¹⁸, Sowsan Atabani¹⁹, Timothy Felton²⁰, Louise Berry²¹, Louise Lansbury²², Christopher Rawlinson²

Affiliations

¹ UK Health Security Agency, London, UK; School of Medicine, University of Nottingham, Nottingham, UK. Electronic address: rebecca.symes@ukhsa.gov.uk.
² UK Health Security Agency, London, UK.
³ School of Medicine, University of Nottingham, Nottingham, UK; NIHR Nottingham Biomedical Research Centre, Nottingham, UK.
⁴ Department of Virology, Manchester Medical Microbiology Partnership, Manchester University NHS Foundation Trust, Manchester, UK.
⁵ Academic Respiratory Unit, North Bristol NHS Trust, Bristol, UK.
⁶ Department of Virology, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK.
⁷ University Hospital Southampton NHS Foundation Trust, Southampton, UK.
⁸ Oxford Respiratory Trials Unit, University of Oxford, Oxford, UK; NIHR Oxford Biomedical Research Centre, Oxford, UK.
⁹ NIHR Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK; NIHR Midlands Patient Safety Research Collaboration, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK; PIONEER Hub in acute care, Health Data Research, UK.
¹⁰ School of Medicine, University of Nottingham, Nottingham, UK; Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK.
¹¹ UK Health Security Agency, South West Regional Laboratory and Severn Infection Sciences, Bristol, UK.
¹² South Yorkshire and Bassetlaw Pathology Network, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK.
¹³ Division of Clinical Medicine, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK.
¹⁴ School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
¹⁵ University Hospital Southampton, NHS Foundation Trust, Southampton, UK.
¹⁶ Oxford Respiratory Trials Unit, University of Oxford, Oxford, UK.
¹⁷ Nuffield Department of Clinical Laboratory Sciences, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
¹⁸ NIHR Birmingham Biomedical Research Centre, University of Birmingham, UK; NIHR Midlands Patient Safety Research Collaboration, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK; PIONEER Hub in acute care, Health Data Research, UK; Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.
¹⁹ UKHSA Birmingham Public Health Laboratory, Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
²⁰ Division of Infection, Immunity to Infection & Respiratory Medicine, The University of Manchester, Manchester, UK; Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
²¹ Department of Microbiology, Nottingham University Hospitals NHS Trust, Nottingham, UK.
²² Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK; NIHR Nottingham Biomedical Research Centre, Nottingham, UK.

PMID: 40780588
DOI: 10.1016/j.jinf.2025.106570

Free article

Burden of respiratory syncytial virus infection in older adults hospitalised in England during 2023/24

Rebecca Symes et al. J Infect. 2025 Sep.

Free article

. 2025 Sep;91(3):106570.

doi: 10.1016/j.jinf.2025.106570. Epub 2025 Aug 6.

Collaborators

HARISS network collaborators:
Elisabeth North⁵, Matthew Donati¹¹, Simon Tazzyman¹², Thushan de Silva¹³, Tristan W Clark¹⁴, Nicola White¹⁵, Tine Panduro¹⁶, Monique Andersson¹⁷, Suzy Gallier¹⁸, Sowsan Atabani¹⁹, Timothy Felton²⁰, Louise Berry²¹, Louise Lansbury²², Christopher Rawlinson²

Affiliations

¹ UK Health Security Agency, London, UK; School of Medicine, University of Nottingham, Nottingham, UK. Electronic address: rebecca.symes@ukhsa.gov.uk.
² UK Health Security Agency, London, UK.
³ School of Medicine, University of Nottingham, Nottingham, UK; NIHR Nottingham Biomedical Research Centre, Nottingham, UK.
⁴ Department of Virology, Manchester Medical Microbiology Partnership, Manchester University NHS Foundation Trust, Manchester, UK.
⁵ Academic Respiratory Unit, North Bristol NHS Trust, Bristol, UK.
⁶ Department of Virology, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK.
⁷ University Hospital Southampton NHS Foundation Trust, Southampton, UK.
⁸ Oxford Respiratory Trials Unit, University of Oxford, Oxford, UK; NIHR Oxford Biomedical Research Centre, Oxford, UK.
⁹ NIHR Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK; NIHR Midlands Patient Safety Research Collaboration, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK; PIONEER Hub in acute care, Health Data Research, UK.
¹⁰ School of Medicine, University of Nottingham, Nottingham, UK; Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK.
¹¹ UK Health Security Agency, South West Regional Laboratory and Severn Infection Sciences, Bristol, UK.
¹² South Yorkshire and Bassetlaw Pathology Network, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK.
¹³ Division of Clinical Medicine, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK.
¹⁴ School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
¹⁵ University Hospital Southampton, NHS Foundation Trust, Southampton, UK.
¹⁶ Oxford Respiratory Trials Unit, University of Oxford, Oxford, UK.
¹⁷ Nuffield Department of Clinical Laboratory Sciences, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
¹⁸ NIHR Birmingham Biomedical Research Centre, University of Birmingham, UK; NIHR Midlands Patient Safety Research Collaboration, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK; PIONEER Hub in acute care, Health Data Research, UK; Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.
¹⁹ UKHSA Birmingham Public Health Laboratory, Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
²⁰ Division of Infection, Immunity to Infection & Respiratory Medicine, The University of Manchester, Manchester, UK; Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
²¹ Department of Microbiology, Nottingham University Hospitals NHS Trust, Nottingham, UK.
²² Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK; NIHR Nottingham Biomedical Research Centre, Nottingham, UK.

PMID: 40780588
DOI: 10.1016/j.jinf.2025.106570

Abstract

Objectives: We aimed to describe the incidence, presentation and clinical outcomes of RSV-associated acute respiratory infection (ARI) in older adults using a new national Hospital-based ARI Sentinel Surveillance (HARISS) system in England, prior to RSV vaccine introduction.

Methods: Adults aged ≥65 years from seven hospitals admitted for ≥24 hours with symptomatic ARI were included. We estimated the hospitalisation rate of RSV-associated ARI compared to influenza-associated ARI and assessed clinical outcomes using Poisson regression and mortality using Cox regression.

Results: This study included 2743 adults. During winter 2023/4 the hospitalisation rate for RSV-associated ARI was 58.3 per 100,000, compared to 114.6 per 100,000 for influenza-associated ARI. Hospitalisations increased with age. Exacerbation of chronic illness (lung disease, heart disease, frailty) was a common admission reason in RSV-associated ARI, with a combined incidence of 33.1 per 100,000. Most adults with RSV-associated ARI had at least one comorbidity (81%); a high proportion with immunosuppression (26%). Symptoms and clinical outcomes including mortality were similar between RSV- and influenza-associated ARI; 30-day mortality 10.6% vs 8.7% (adjusted hazard ratio 0.85, 95% confidence interval 0.6-1.2).

Conclusions: In England, RSV infection is a common cause of hospitalisation in older adults. Symptoms and clinical outcomes, including mortality, are comparable to influenza.

Keywords: Aged; Epidemiology; Hospitalisation; Respiratory syncytial virus; Respiratory syncytial virus vaccine; Respiratory tract infection; Sentinel surveillance.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: MZ: is Chair of the International Society for Respiratory Virus Diseases (ISRV). LS: UKHSA funding to LS’s institution for HARISS. Grants or contracts from NIHR Biomedical Research Centre, NIHR Patient Safety Research Collaborative, HDRUK Driver programme paid to LS’s institution. LS has a leadership role with the British Association for Lung Research. WSL: UKHSA funding to WSL’s institution as lead coordinating institution of HARISS. Unrestricted investigator-initiated research funding from Pfizer to WSL’s institution, for an unrelated multi-centre study in pneumonia in which WSL is the CI. WSL is Deputy Chair of Joint Committee on Vaccination and Immunisation (JCVI) (unpaid). SG: Grant funding from NIHR Birmingham Biomedical Research Centre, NIHR Patient Safety Research Collaborative, HDRUK, NIHR and MRC to affiliated institution (PIONEER Hub in acute care, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham). TC: Grants or contracts from Biomerieux, Inflammatix, SenseBiodetection, NIHR SPCR grant, NIHR HTA accelerator grant. Consulting fees from Biomerieux, Abbott, Cepheid, Synairgen, Lumos diagnostics. Payment or honoraria from Janssen (Speaker fees), Biomerieux (Speaker fees), Medscape (Webinar), Alira Health (Manuscript preparation), Sanofi (Manuscript preparation). Support to attend Biomerieux meeting 2024. Participation on data safety monitoring or advisory board for Roche, Shionogi, Roche Diagnostics, GSK, Seqirus, Sanofi. Synairgen research, owner of shares. MD: UKHSA funding to MD’s institution on a non-profit basis for sample handling for HARISS. The UKHSA Immunisation and Vaccine Preventable Diseases Division undertakes regulatory analyses and post-marketing surveillance for vaccine makers, for which cost recovery payments are charged.

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Burden of respiratory syncytial virus infection in older adults hospitalised in England during 2023/24

Collaborators

Affiliations

Burden of respiratory syncytial virus infection in older adults hospitalised in England during 2023/24

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

MeSH terms

LinkOut - more resources

Full Text Sources

Medical