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1. High Prevalence of SARS-CoV-2 Omicron Infection Despite High Seroprevalence, Sweden, 2022

Author

Ramona Groenheit, Philip Bacchus, Ilias Galanis, Klara Sondén, Ioana Bujila, Tatiana Efimova, Fredrik Garli, Oskar Karlsson Lindsjö, Mikael Mansjö, Elin Movert, Aleksandra Pettke, Marie Rapp, Maike Sperk, Sandra Söderholm, Karin Valentin Asin, Sarah Zanetti, Maria Lind Karlberg, Andreas Bråve, Kim Blom, and Jonas Klingström

Subjects
COVID-19, respiratory infections, SARS-CoV-2, SARS, coronavirus disease, zoonoses, Medicine, Infectious and parasitic diseases, RC109-216
Abstract

We performed 2 surveys during 2022 to estimate point prevalences of SARS-CoV-2 infection compared with overall seroprevalence in Sweden. Point prevalence was 1.4% in March and 1.5% in September. Estimated seroprevalence was >80%, including among unvaccinated children. Continued SARS-CoV-2 surveillance is necessary for detecting emerging, possibly more pathogenic variants.

Published
2023
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2. Point prevalence of SARS-CoV-2 infection in Sweden at six time points during 2020

Author

Ramona Groenheit, Jessica Beser, Sharon Kühlmann Berenzon, Ilias Galanis, Edward van Straten, Jan Duracz, Marie Rapp, Disa Hansson, Mikael Mansjö, Sandra Söderholm, Shaman Muradrasoli, Anna Risberg, Richard Ölund, Andreas Wiklund, Kristoffer Metzkes, Matilda Lundberg, Philip Bacchus, Karin Tegmark Wisell, and Andreas Bråve

Subjects
SARS-CoV-2, COVID-19, Point prevalence, Large-scale prevalence surveys, Symptoms, Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background In order to estimate the prevalence and understand the spread of SARS-CoV-2 in Sweden, the Public Health Agency of Sweden, with support from the Swedish Armed Forces, conducted a series of point prevalence surveys between March and December 2020. Methods Sampling material and instructions on how to perform self-sampling of the upper respiratory tract were delivered to the homes of the participants. Samples were analysed by real-time PCR, and the participants completed questionnaires regarding symptoms. Findings The first survey in the Stockholm region in March 2020 included 707 participants and showed a SARS-CoV-2 prevalence of 2.5%. The following five surveys, performed on a national level, with between 2461 and 2983 participants, showed SARS-CoV-2 prevalences of 0.9% (April), 0.3% (May), 0.0% (August), 0.0% (September), and 0.7% (December). All positive cases who responded to questionnaires reported experiencing symptoms that occurred from 2 weeks before the date of sampling up to and including the date of sampling. Interpretation None of the individuals shown to be PCR-positive were asymptomatic at the time of sampling or in the 14 days prior to sampling. This is in contrast to many other surveys in which a substantial proportion of positive cases have been reported to be asymptomatic. Our surveys demonstrate a decreasing ratio between notified cases and the observed prevalence throughout the year, in line with increasing testing capacity and the consecutive inclusion of all symptomatic individuals in the case definition for testing.

Published
2022
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3. Seroprevalence of SARS-CoV-2 in Sweden, April 26 to May 9, 2021

Author

Jessica Beser, Ilias Galanis, Theresa Enkirch, Sharon Kühlmann Berenzon, Edward van Straten, Jan Duracz, Marie Rapp, Katherina Zakikhany, Mikael Mansjö, Julia Wigren Byström, Mattias N. E. Forsell, Ramona Groenheit, Karin Tegmark Wisell, and Andreas Bråve

Subjects
Medicine, Science
Abstract

Abstract A national point seroprevalence study of SARS-CoV-2 was conducted in Sweden in April–May 2021. In total, 2860 individuals 3 to 90 years old from a probability-based web panel were included. Results showed that an estimated 32.6% of the population in Sweden had detectable levels of antibodies, and among non-vaccinated 20.1% had detectable levels of antibodies. We tested for differences in seroprevalence between age groups and by sex and estimated seroprevalence among previously infected participants by time since reporting.

Published
2022
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4. Rapid emergence of omicron sublineages expressing spike protein R346T

Author

Ramona Groenheit, Ilias Galanis, Klara Sondén, Maike Sperk, Elin Movert, Philip Bacchus, Tatiana Efimova, Lina Petersson, Marie Rapp, Viktoria Sahlén, Sandra Söderholm, Karin Valentin Asin, Sarah Zanetti, Maria Lind Karlberg, Andreas Bråve, Jonas Klingström, and Kim Blom

Subjects
SARS-CoV-2, Point prevalence, National survey, Omicron, Spike protein, Receptor binding domain, Public aspects of medicine, RA1-1270
Published
2023
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5. New perspectives on respiratory syncytial virus surveillance at the national level: lessons from the COVID-19 pandemic

Author

Anne C. Teirlinck, Caroline K. Johannesen, Eeva K. Broberg, Pasi Penttinen, Harry Campbell, Harish Nair, Rachel M. Reeves, Håkon Bøås, Mia Brytting, Wei Cai, AnnaSara Carnahan, Jean-Sebastien Casalegno, Kostas Danis, Cillian De Gascun, Joanna Ellis, Hanne-Dorthe Emborg, Manuel Gijon, Raquel Guiomar, Siddhivinayak S. Hirve, Helena Jiřincová, Hanna Nohynek, Jesus Angel Oliva, Richard Osei-Yeboah, John Paget, Gatis Pakarna, Richard Pebody, Lance Presser, Marie Rapp, Janine Reiche, Ana Paula Rodrigues, Elina Seppälä, Maja Socan, Karol Szymanski, Ramona Trebbien, Jaromíra Večeřová, Sylvie van der Werf, Maria Zambon, Adam Meijer, and Thea K. Fischer

Subjects
Pulmonary and Respiratory Medicine
Abstract

Learning from the COVID-19 pandemic and considering the effects of this pandemic, we provide recommendations that can guide towards sustainable RSV surveillance with the potential to be integrated into the broader perspective of respiratory surveillance. https://bit.ly/40TsO0G

Published
2023

6. Nurses' Perceptions and Practices Toward Clinical Alarms in a Transplant Cardiac Intensive Care Unit: Exploring Key Issues Leading to Alarm Fatigue

Author

Charles Reed, Azizeh K. Sowan, Kami Marie Rapp, Tiffany Michelle Gomez, and Albert Tarriela

Subjects
Original Paper, Quality management, physiologic monitors, business.industry, Health technology, Health Informatics, Human Factors and Ergonomics, medicine.disease, critical care, ALARM, Patient safety, Nursing, nursing, Intensive care, Health care, Alarm management, Medical technology, Coronary care unit, Medicine, survey, Medical emergency, clinical alarms, R855-855.5, business, alarm fatigue
Abstract

BackgroundIntensive care units (ICUs) are complex work environments where false alarms occur more frequently than on non-critical care units. The Joint Commission National Patient Safety Goal .06.01.01 targeted improving the safety of clinical alarm systems and required health care facilities to establish alarm systems safety as a hospital priority by July 2014. An important initial step toward this requirement is identifying ICU nurses’ perceptions and common clinical practices toward clinical alarms, where little information is available. ObjectiveOur aim was to determine perceptions and practices of transplant/cardiac ICU (TCICU) nurses toward clinical alarms and benchmark the results against the 2011 Healthcare Technology Foundation’s (HTF) Clinical Alarms Committee Survey. MethodsA quality improvement project was conducted on a 20-bed TCICU with 39 full- and part-time nurses. Nurses were surveyed about their perceptions and attitudes toward and practices on clinical alarms using an adapted HTF clinical alarms survey. Results were compared to the 2011 HTF data. Correlations among variables were examined. ResultsAll TCICU nurses provided usable responses (N=39, 100%). Almost all nurses (95%-98%) believed that false alarms are frequent, disrupt care, and reduce trust in alarm systems, causing nurses to inappropriately disable them. Unlike the 2011 HTF clinical alarms survey results, a significantly higher percentage of our TCICU nurses believed that existing devices are complex, questioned the ability and adequacy of the new monitoring systems to solve alarm management issues, pointed to the lack of prompt response to alarms, and indicated the lack of clinical policy on alarm management (P

Published
2015

7. Recommendations for respiratory syncytial virus surveillance at the national level

Author

Janine Reiche, Harish Nair, Raquel Guiomar, Manuel Gijon, Kostas Danis, Håkon Bøås, Martina Havlíčková, Joanne O Gorman, Bruno Lina, Marie Rapp, Hanne-Dorthe Emborg, Rachel M Reeves, Eeva Broberg, Ramona Trebbien, AnnaSara Carnahan, Anne C. Teirlinck, Gatis Pakarna, Sylvie van der Werf, Siddhivinayak Hirve, Hanna Nohynek, Silke Buda, Are Stuwitz Berg, Maja Socan, Jesus Angel Oliva, Thea Kølsen Fischer, Harry Campbell, Adam Meijer, Karol Szymanski, John Paget, National Institute for Public Health and the Environment [Bilthoven] (RIVM), European Centre for Disease Prevention and Control [Stockholm, Sweden] (ECDC), Norwegian Institute of Public Health [Oslo] (NIPH), University of Edinburgh, Public Health Agency of Sweden, Hospices Civils de Lyon (HCL), Université de Lyon, Riga East University Hospital, National Institute for Health and Welfare [Helsinki], Statens Serum Institut [Copenhagen], Robert Koch Institute [Berlin] (RKI), Instituto de Salud Carlos III [Madrid] (ISC), Health Protection Surveillance Centre (HPSC), Netherlands Institute for Health Services Research [Utrecht] (NIVEL), National Institute of Public Health - National Institute of Hygiene [Poland], Santé publique France - French National Public Health Agency [Saint-Maurice, France], National Institute of Public Health, Ljubljana, Slovenia, Penta [Padova], National Institute of Public Health [Prague], Instituto Nacional de Saùde Dr Ricardo Jorge [Portugal] (INSA), World Health Organisation (WHO), Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Virologie (CNRS-UMR3569), Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Nordsjællands Hospital [Hillerød, Denmark], and University of Southern Denmark (SDU)

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, [SDV]Life Sciences [q-bio], MEDLINE, Respiratory Syncytial Virus Infections, Virus, Epidemiology, medicine, media_common.cataloged_instance, Humans, National level, European union, Intensive care medicine, Child, Respiratory Tract Infections, media_common, Aged, Respiratory tract infections, business.industry, Public health, Respiratory infection, Infant, Hospitalization, Child, Preschool, Respiratory Syncytial Virus, Human, Task Force Report, business, Sentinel Surveillance
Abstract

Respiratory syncytial virus (RSV) is a common cause of acute lower respiratory tract infections and hospitalisations among young children and is globally responsible for many deaths in young children, especially in infants aged, Recommendations for developing a feasible and sustainable national surveillance strategy for respiratory syncytial virus that will enable harmonisation and data comparison at the European level. https://bit.ly/3rWUOOI

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8. Seasonality and geographical spread of respiratory syncytial virus epidemics in 15 European countries, 2010 to 2016

Author

SONIA PEREZ CASTRO, Amparo Larrauri, Catherine Moore, Sylvie Van der WERF, Nuria Torner, Pedro Pechirra, FALCHI Alessandra, Bruno Lina, Lisa Domegan, Cathriona Kearns, Thea Kølsen Fischer, Maria Concepcion Delgado Sanz, Francisco Pozo, Simon De Lusignan, Lidia Brydak, Santiago Melón García, Ramona Trebbien, Inmaculada Casas, Richard Pebody, Silvia Jiménez-Jorge, European Centre for Disease Prevention and Control [Stockholm, Sweden] (ECDC), University of Turku, Turku University Hospital (TYKS), Génétique Moléculaire des Virus à ARN - Molecular Genetics of RNA Viruses (GMV-ARN (UMR_3569 / U-Pasteur_2)), Institut Pasteur [Paris] (IP)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Centre National de Référence des virus des infections respiratoires (dont la grippe) - National Reference Center Virus Influenzae [Paris] (CNR - laboratoire coordonnateur), Institut Pasteur [Paris] (IP)-Université Paris Cité (UPCité), Specific country acknowledgements Denmark: For Denmark the test results for respiratory syncytial virus in the season 2015/16 were obtained from the Danish Microbiology Database (MiBa, http://miba.ssi.dk), which contains all electronic reports from departments of clinical microbiology in Denmark since 2010, and we acknowledge the collaboration with the MiBa Board of Representatives. France: For primary care, sentinel networks: all GPs, paediatricians and their patients for providing the samples tested. For the hospital laboratory network, RENAL: Ile de France, - Ambroise Pare, Avicenne, Bichat, Bicêtre, Henri Mondor, Versailles, Necker, Paul Brousse, Pitie Salpetrière, Robert Debré, Saint-Louis, Cochin, Trousseau-Saint Antoine-Tenon, Pontoise, Poissy and Foch. Other regions: Strasbourg, Dijon, Reims, Nancy, Besançon, Lille, Amiens, Caen, Brest, Rennes, Orléans, Tours, Rouen, Angers, Nantes, Aix-en-Provence, Annecy, Bordeaux, Chambéry, Clermont-Ferrand, Grenoble, Limoges, Lyon, Marseille, Montpellier, Nice, Poitiers, Saint-Etienne and Toulouse. Hôpitaux Militaires: HIA Begin – Dr A. MERENS, HIA Legouest – Dr Y. ROBERT, HIA Clermont Tonnerre – Dr P. LE GUEN, Hôpitaux Militaires: Bordeaux – Lyon - Marseille – Toulon. Ireland: We would like to acknowledge the Irish sentinel GP network, hospital clinicians and clinical microbiologists for taking and providing specimens to the National Virus Reference Laboratory (NVRL) for RSV testing. Latvia: Laboratory specialists A.Aniščenko, T. Kolupajeva, for performing virological analyses. The Netherlands: GPs and their patients for taking and providing specimens, clinical microbiologists from diagnostic laboratories for providing weekly diagnostics virological reports, technicians in the laboratories for performing virological analyses. Poland: All members of NIC in Poland working in years 2010-2016, Voivodship Sanitary Epidemiological Stations in Poland. Portugal: We acknowledge the Colleagues from the National Institute of Health Dr Ricardo Jorge, I.P. that contributed to the supported of the National Influenza Surveillance Program. We acknowledge to the Portuguese GP Sentinel Network, to physicians from Emergency and Obstetric Units Network, to physicians of the EuroEva project and to the Portuguese Laboratory Network for Influenza Diagnosis. Spain: We would like to acknowledge all the professionals participating in the Spanish Influenza Surveillance System. Sweden: Contributing laboratories and paediatric clinics., We express our gratitude to the European Surveillance System data management team, especially Marius Valentin Valcu, Adrian Prodan and Cátia Cunha. We thank Silviu Lucian Ionescu for calculation of barycentres. We thank Cornelia Adlhoch for supporting the data collection for RSV within TESSy. We are grateful to Tommi Kärki for the support with preparation of Figure 2. We would also like to thank Julien Beauté, Phillip Zucs and Mike Catchpole for their valuable comments. We acknowledge all the members of the European Influenza Surveillance Network for their tireless work for influenza surveillance in European Union/European Economic Area countries and for testing for RSV and including the RSV detections in the weekly reporting., European Influenza Surveillance Network members from the contributing countries Denmark: Ramona Trebbien, Hanne-Dorthe Emborg, Tyra Grove Krause and Thea K Fischer (Statens Serum Institut, Copenhagen). Estonia: Natalja Kuznetsova, Liidia Dotsenko (Estonian Health Board, Laboratory of Communicable Diseases, Tallinn) and Olga Sadikova (Estonian Health Board, Department of CD surveillance and control, Influenza Centre, Tallinn). France: Sylvie Behillil (Unité de Génétique Moléculaire des Virus à ARN, UMR 3569 CNRS, Université Paris Diderot SPC, Institut Pasteur, Paris, CNR des Virus Influenzae, Institut Pasteur, Paris), Thierry Blanchon (Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP), F75012 Paris, France), Lisandru Capai (Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP), F75012 Paris, France), F75012, Paris, EA7310, Laboratoire de Virologie, Université de Corse-Inserm, Corte), Jean-Marie Cohen (Open Rome (Organize and Promote Epidemiological Network), Paris, France, Réseau des GROG, Paris), Vincent Enouf (Unité de Génétique Moléculaire des Virus à ARN, UMR 3569 CNRS, Université Paris Diderot SPC, Institut Pasteur, Paris, CNR des Virus Influenzae, Institut Pasteur, Paris), Alessandra Falchi (EA7310, Laboratoire de Virologie, Université de Corse-Inserm, Corte), Caroline Guerrisi (Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP), F75012 Paris, France), Bruno Lina (Laboratoire de Virologie, CNR des virus influenza, Institut des Agents Infectieux, Groupement Hospitalier Nord des HCL, Lyon, Laboratoire Virpath, CIRI Inserm U1111, CNRS 5308, ENS, UCBL, Faculté de Médecine LYON Est, Université de Lyon, Lyon), Thomas Hanslik (AP-HP, Hôpital Ambroise Paré, Service de Médecine interne, F-92100 Boulogne Billancourt, France), Shirley Masse (Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP), F75012 Paris, France, EA7310, Laboratoire de Virologie, Université de Corse-Inserm, Corte), Anne Mosnier (Open Rome (Organize and Promote Epidemiological Network), Paris, France, Réseau des GROG, Paris), Clément Turbelin (Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP), F75012 Paris, France), Martine Valette (Laboratoire de Virologie, CNR des virus influenza, Institut des Agents Infectieux, Groupement Hospitalier Nord des HCL, Lyon, Laboratoire Virpath, CIRI Inserm U1111, CNRS 5308, ENS, UCBL, Faculté de Médecine LYON Est, Université de Lyon, Lyon), Sylvie van der Werf (Unité de Génétique Moléculaire des Virus à ARN, UMR 3569 CNRS, Université Paris Diderot SPC, Institut Pasteur, Paris, CNR des Virus Influenzae, Institut Pasteur, Paris). Germany: Brunhilde Schweiger, Janine Reiche, Barbara Biere (National Influenza Centre, Robert Koch Institute, Berlin) and Silke Buda (Respiratory Infections Unit, Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin). Iceland: Gudrun Erna Baldvinsdottir (Department of Clinical Microbiology at Landspitali University Hospital, Reykjavik). Ireland: Lisa Domegan and Joan O Donnell (HSE-Health Protection Surveillance Centre, Dublin), Christina Byrne, Paul O’Reilly, Joanne Moran, Allison Waters and Cillian de Gascun (National Virus Reference Laboratory, University College Dublin, Dublin). Latvia: Natalija Zamjatina and Gatis Pakarna (Riga East University Hospital, Latvian Centre of Infectious Diseases, Riga) and Raina Nikiforova (Centre for Disease Prevention and Control, Riga). Malta: Jackie Maistre Melillo and Tanya Melillo (Infectious Disease Prevention and Control Unit, Msida). The Netherlands: Adam Meijer (Centre for Infectious Diseases Research, Diagnostics and Laboratory Surveillance, National Institute for Public Health and the Environment (RIVM), Bilthoven), Anne Teirlinck (Centre for Infectious Diseases, Epidemiology and Surveillance, RIVM) and Gé Donker (NIVEL, Netherlands Institute for Health Services Research, Utrecht). Poland: Lidia B. Brydak and Katarzyna Cieślak (National Influenza Centre, Department of Influenza Research, National Institute of Public Health - National Institute of Hygiene, Warsaw). Portugal: Raquel Guiomar, Paula Cristóvão and Pedro Pechirra (National Influenza Reference Laboratory, Infectious Diseases Department, National Institute of Health Dr Ricardo Jorge, I.P., Lisbon) and Ana Paula Rodrigues (Department of Epidemiology, National Institute of Health Dr Ricardo Jorge, I.P., Lisbon). Slovenia: Katarina Prosenc (National Laboratory for Health, Environment and Food, Slovenia) and Maja Socan (Public Health Institute, Slovenia). Spain: Amparo Larrauri, Concepcion Delgado-Sanz, Jesús Oliva, (National Centre of Epidemiology, CIBERESP, Instituto de Salud Carlos III, Madrid), Silvia Jiménez-Jorge (National Centre of Epidemiology, Instituto de Salud Carlos III, Madrid), Francisco Pozo, Inmaculada Casas (National Centre of Microbiology, Instituto de Salud Carlos III, Madrid), Jose María Navarro (Hospital Virgen de las Nieves de Granada), Virtudes Gallardo (Consejería de Salud, Andalucía), Manuel Omeñaca (HU Miguel Servet), Elisa Marco (Dirección General de Salud Pública, Aragón), Santiago Melón (HU Central de Asturias), Ismael Huerta (Dirección General de Salud Pública, Asturias), Jordi Reina (Hospital Son Espases de Palma de Mallorca), Carmen Pérez González (Hospital Dr Negrín de Las Palmas de Gran Canarias), Lucas González (Dirección General de Salud Pública, Canarias), Microbiologists of the Hospital Network of Castilla La Mancha, Maria Victoria García Rivera (Servicio de Epidemiología, Consejería de Sanidad), Raúl Ortiz de Lejarazu (National Influenza Center, Hospital Clínico Universitario Valladolid), Tomás Vega (Observatorio de Salud Pública, Castilla y León), Mª Ángeles Marcos (Hospital Clínico de Barcelona), Nuria Torner (Agència de Salut Pública, CIBERESP, Cataluña), Sonia Perez Castro (CH Meixoeiro, Vigo), Juan Garcia Costa (CH Santa María Nai, Ourense), María Jesús Purriños (Dirección Xeral Saúde Pública, Galicia), Antonio Moreno Docón (Hospital Virgen de la Arrixaca), Miriam Fernández (Clínica Universitaria de Navarra), Carmen Ezpeleta (Complejo Hospitalario de Navarra), Jesús Castilla (Instituto de Salud Pública, CIBERESP, Navarra), Miriam Blasco (Hospital de La Rioja de Logroño), Carmen Quiñones (Dirección General de Salud Pública y Consumo, La Rioja), José López Barba (Hospital de INGESA), Ana Rivas (Consejería de Sanidad y Bienestar Social, Ceuta). Sweden: AnnaSara Carnahan, Sarah Axelsson, Hélène Englund, Marie Rapp and Mia Brytting (Public Health Agency of Sweden, Stockholm). United Kingdom: Richard Pebody (PHE, Colindale), Joanna Ellis (PHE, Colindale), and Maria Zambon (PHE, Colindale), Simon de Lusignan (Royal College of General Practitioners, London), Naomh Gallagher, Chris Nugent and Cathriona Kearns (Public Health Agency, Northern Ireland), Simon Cottrell and Catherine Moore (Public Health Wales, Cardiff), Jim McMenamin (HPS, Glasgow).

Subjects
0301 basic medicine, Infecções Respiratórias, Male, Pediatrics, medicine.medical_specialty, Epidemiology, [SDV]Life Sciences [q-bio], respiratory syncytial virus, 030106 microbiology, Respiratory Syncytial Virus Infections, Surveillance and Outbreak Report, Virus, 03 medical and health sciences, 0302 clinical medicine, Virology, medicine, media_common.cataloged_instance, Humans, In patient, geographic spread, 030212 general & internal medicine, ddc:610, European union, Respiratory system, Epidemics, Respiratory Tract Infections, media_common, Retrospective Studies, Respiratory tract infections, Geography, seasonality, Public Health, Environmental and Occupational Health, Respiratory infection, RSV, Retrospective cohort study, Seasonality, medicine.disease, Europe, Population Surveillance, Respiratory Syncytial Virus, Human, Female, Seasons, 610 Medizin und Gesundheit, Sentinel Surveillance
Abstract

Respiratory syncytial virus (RSV) is considered the major pathogen causing severe lower respiratory tract infections among infants and young children [1]. RSV is the most common cause of hospitalisation for acute lower respiratory tract infection in children younger than 5 years and is estimated to cause between 66,000 and 199,000 deaths worldwide every year [2]. Its significance in causing substantial morbidity and hospitalisation in the first year of life has been affirmed in a recent study and a meta-analysis [3,4]. In England, average annual hospital admission rates are 35.1 per 1,000 children younger than 1 year and 5.31 per 1,000 children aged 1–4 years [5]. In addition to children, RSV causes a substantial disease burden in elderly people and patients with chronic obstructive pulmonary disease [6,7]. RSV causes seasonal epidemics worldwide [8], with one to two epidemics each year [9] following latitudinal gradients in timing, duration, seasonal amplitude and between-year variability [8,9]. In some studies, the seasonal periodicity has been connected to climatic factors [9-11], but a common factor that explains all observed periodicity has not been established. Meteorological conditions such as temperature and high relative humidity have been reported as important predictors of RSV epidemics [9,12]. In the United States (US) and Japan, annual national and regional variation of RSV season onset and end has been reported [13-15]. In the Nordic countries, a major outbreak often alternates with a minor one, with the minor peak in the spring and a major one the following winter [16-19], a phenomenon reported also in Croatia [20], Denmark [21] and Germany [22]. RSV antigenic groups A and B alternate in two-year cycles in Finland, with dominance of the group A viruses in years 1981–82, 1985–86 and 1989–90 and the group B viruses 1983–84 and 1987–88 [17,19], and different genotypes dominate the circulation in consecutive epidemics in Korea [23]. In Spain, no biennial rhythm has been detected but rather a stable annual epidemic with a peak between week 52 and week 1 and circulation 2–8 weeks earlier than influenza viruses [24]. Similarly, in the United Kingdom (UK), one stable epidemic per year is observed [5]. Immunoprophylaxis to prevent RSV infection with a neutralising monoclonal antibody, palivizumab, has been developed for administration to target groups on a monthly basis during the RSV season [25]. However, this drug is limited to high-risk infants, the cost prohibits its use in low- and middle-income countries and the data on effectiveness of the drug in children at high risk other than infants born at gestational age

Published
2018

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