Microbiology, PathWest Laboratory Medicine, Perth, Western Australia, Australia
Wesfarmers Centre for Vaccines and Infectious Diseases, University of Western Australia, Telethon Kids Institute, Nedlands, Western Australia, Australia.
Arch Dis Child. 2022 Mar;107(3):e7. doi: 10.1136/archdischild-2021-322507. Epub 2021 Aug 25.
Following a relative absence in winter 2020, a large resurgence of respiratory syncytial virus (RSV) detections occurred during the 2020/2021 summer in Western Australia. This seasonal shift was linked to SARS-CoV-2 public health measures. We examine the epidemiology and RSV testing of respiratory-coded admissions, and compare clinical phenotype of RSV-positive admissions between 2019 and 2020.
At a single tertiary paediatric centre, International Classification of Diseases, 10th edition Australian Modification-coded respiratory admissions longer than 12 hours were combined with laboratory data from 1 January 2019 to 31 December 2020. Data were grouped into bronchiolitis, other acute lower respiratory infection (OALRI) and wheeze, to assess RSV testing practices. For RSV-positive admissions, demographics and clinical features were compared between 2019 and 2020.
RSV-positive admissions peaked in early summer 2020, following an absent winter season. Testing was higher in 2020: bronchiolitis, 94.8% vs 89.2% (p=0.01); OALRI, 88.6% vs 82.6% (p=0.02); and wheeze, 62.8% vs 25.5% (p<0.001). The 2020 peak month, December, contributed almost 75% of RSV-positive admissions, 2.5 times the 2019 peak. The median age in 2020 was twice that observed in 2019 (16.4 vs 8.1 months, p<0.001). The proportion of RSV-positive OALRI admissions was greater in 2020 (32.6% vs 24.9%, p=0.01). There were no clinically meaningful differences in length of stay or disease severity.
The 2020 RSV season was in summer, with a larger than expected peak. There was an increase in RSV-positive non-bronchiolitis admissions, consistent with infection in older RSV-naïve children. This resurgence raises concern for regions experiencing longer and more stringent SARS-CoV-2 public health measures.
2020 年冬季，呼吸道合胞病毒（RSV）的检测相对较少，而在 2020/2021 年夏季，西澳大利亚州的 RSV 检测数量出现了大规模反弹。这种季节性变化与 SARS-CoV-2 的公共卫生措施有关。我们检查了呼吸编码入院的流行病学和 RSV 检测情况，并比较了 2019 年和 2020 年 RSV 阳性入院的临床表型。
在一家单一的三级儿科中心，我们将国际疾病分类，第 10 版澳大利亚修正版呼吸编码入院时间超过 12 小时的患者与 2019 年 1 月 1 日至 2020 年 12 月 31 日的实验室数据相结合。数据分为细支气管炎、其他急性下呼吸道感染（OALRI）和喘息，以评估 RSV 检测情况。对于 RSV 阳性入院患者，我们比较了 2019 年和 2020 年的人口统计学和临床特征。
RSV 阳性入院患者在 2020 年初夏达到高峰，而冬季则没有。2020 年的检测率更高：细支气管炎为 94.8%，高于 2019 年的 89.2%（p=0.01）；OALRI 为 88.6%，高于 2019 年的 82.6%（p=0.02）；喘息为 62.8%，高于 2019 年的 25.5%（p<0.001）。2020 年的峰值月（12 月）贡献了近 75%的 RSV 阳性入院患者，是 2019 年峰值的 2.5 倍。2020 年的中位年龄是 2019 年的两倍（16.4 个月对 8.1 个月，p<0.001）。2020 年 RSV 阳性 OALRI 入院患者比例更高（32.6%对 24.9%，p=0.01）。住院时间和疾病严重程度没有明显差异。
2020 年 RSV 季节在夏季，高峰比预期的更大。非细支气管炎 RSV 阳性入院人数增加，这与年长的 RSV 初治儿童感染有关。这种反弹引起了人们对经历更长时间和更严格 SARS-CoV-2 公共卫生措施的地区的关注。
