Qi Chia Hui, Lim Robyn, Pung Rachael
Ministry of Health, Singapore.
Centre for the Mathematical Modelling of infectious Diseases, Centre for Epidemic Prepardness and Response, and Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
Influenza Other Respir Viruses. 2025 Apr;19(4):e70098. doi: 10.1111/irv.70098.
The patterns of circulation and burden of influenza and respiratory syncytial virus (RSV) in Singapore are affected by the COVID-19 pandemic containment measures. These patterns in relation to SARS-CoV-2 in a post-pandemic era are unclear.
Using data from 2015 to 2023, we estimated excess influenza-, RSV- and SARS-CoV-2-associated hospitalisation in Singapore, adjusted for rhinovirus/enterovirus activity in generalised additive models. The data include pneumonia and influenza (P&I) hospitalisation from a national inpatient database and a community-wide acute respiratory infection (ARI) sentinel surveillance programme, stratified by age groups.
Across all age groups, the proportion of hospitalisation associated with influenza, SARS-CoV-2 and RSV was 13.2% (95% CI 5.0%-21.6%), 19.3% (95% CI 13.8%-25.0%) and 4.0% (95% CI 0.9%-12.1%) in 2023, respectively. From 2019 to 2023, all-age influenza-associated hospitalisation declined from 264.4 per 100,000 person-years (95% CI 214.2-313.2) to 203.7 per 100,000 person-years (95% CI 76.8-333.6). In contrast, all-age RSV-associated hospitalisation after the pandemic was 62.2 per 100,000 person-years (95% CI 13.8-186.9), similar to pre-pandemic observations. Peak seasonal influenza occurred 3-8 weeks later as compared with the time of pre-pandemic peak influenza activity.
The overall burden of influenza has declined after the COVID-19 pandemic and its burden is comparable with SARS-CoV-2. Furthermore, shifts in the timing of peak influenza activity suggest a potential need to review the timing of vaccine recommendations in Singapore.
新加坡流感和呼吸道合胞病毒（RSV）的流行模式及负担受到新冠疫情防控措施的影响。在后疫情时代，这些模式与严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的关系尚不清楚。
利用2015年至2023年的数据，我们在广义相加模型中对鼻病毒/肠道病毒活动进行校正后，估算了新加坡流感、RSV和SARS-CoV-2相关的超额住院情况。数据包括来自全国住院患者数据库的肺炎和流感（P&I）住院情况以及一项社区范围的急性呼吸道感染（ARI）哨点监测项目，按年龄组分层。
在所有年龄组中，2023年与流感、SARS-CoV-2和RSV相关的住院比例分别为13.2%（95%置信区间5.0%-21.6%）、19.3%（95%置信区间13.8%-25.0%）和4.0%（95%置信区间0.9%-12.1%）。从2019年到2023年，全年龄组流感相关住院率从每10万人年264.4例（95%置信区间214.2-313.2）降至每10万人年203.7例（95%置信区间76.8-333.6）。相比之下，疫情后全年龄组RSV相关住院率为每10万人年62.2例（95%置信区间13.8-186.9），与疫情前的观察结果相似。季节性流感高峰出现的时间比疫情前流感活动高峰时间晚3-8周。
新冠疫情后流感的总体负担有所下降，其负担与SARS-CoV-2相当。此外，流感活动高峰时间的变化表明新加坡可能需要重新审视疫苗接种建议的时间。
