Medicine and Health Sciences, Shree Guru Gobind Singh Tricentenary University, Gurugram, India.
Usher Institute of Population Health Research and Informatics, University of Edinburgh, Edinburgh, UK.
Influenza Other Respir Viruses. 2020 Nov;14(6):622-629. doi: 10.1111/irv.12672. Epub 2019 Aug 24.
Respiratory syncytial virus (RSV)-associated acute lower respiratory infection is a common cause for hospitalization and hospital deaths in young children globally. There is urgent need to generate evidence to inform immunization policies when RSV vaccines become available. The WHO piloted a RSV surveillance strategy that leverages the existing capacities of the Global Influenza Surveillance and Response System (GISRS) to better understand RSV seasonality, high-risk groups, validate case definitions, and develop laboratory and surveillance standards for RSV.
The RSV sentinel surveillance strategy was piloted in 14 countries. Patients across all age groups presenting to sentinel hospitals and clinics were screened all year-round using extended severe acute respiratory infection (SARI) and acute respiratory infection (ARI) case definitions for hospital and primary care settings, respectively. Respiratory specimens were tested for RSV at the National Influenza Centre (NIC) using standardized molecular diagnostics that had been validated by an External Quality Assurance program. The WHO FluMart data platform was adapted to receive case-based RSV data and visualize interactive visualization outputs.
Laboratory standards for detecting RSV by RT-PCR were developed. A review assessed the feasibility and the low incremental costs for RSV surveillance. Several challenges were addressed related to case definitions, sampling strategies, the need to focus surveillance on young children, and the data required for burden estimation.
There was no evidence of any significant adverse impact on the functioning of GISRS which is primarily intended for virologic and epidemiological surveillance of influenza.
呼吸道合胞病毒（RSV）相关的急性下呼吸道感染是导致全球幼儿住院和医院死亡的常见原因。当 RSV 疫苗问世时，急需生成证据来为免疫政策提供信息。世卫组织试点了一种 RSV 监测策略，利用全球流感监测和应对系统（GISRS）的现有能力，更好地了解 RSV 的季节性、高风险人群、验证病例定义，并为 RSV 制定实验室和监测标准。
RSV 哨点监测策略在 14 个国家进行了试点。所有年龄组的患者在哨点医院和诊所全年都按照扩展的严重急性呼吸道感染（SARI）和急性呼吸道感染（ARI）病例定义进行筛查，分别适用于医院和初级保健环境。使用经过外部质量保证计划验证的标准化分子诊断技术，在国家流感中心（NIC）对呼吸道标本进行 RSV 检测。适应了 WHO FluMart 数据平台，以接收基于病例的 RSV 数据并可视化交互式可视化输出。
制定了用于 RT-PCR 检测 RSV 的实验室标准。一项审查评估了 RSV 监测的可行性和低增量成本。解决了与病例定义、采样策略、需要将监测重点放在幼儿身上以及用于负担估计的数据相关的几个挑战。
没有证据表明 GISRS 的运作受到任何重大不利影响，GISRS 主要用于流感的病毒学和流行病学监测。
