Epidemiology of respiratory syncytial virus in Central Queensland, Australia
DOI:
https://doi.org/10.33321/cdi.2024.48.45Keywords:
epidemiology, Respiratory syncytial virus, seasonality, surveillance, AustraliaAbstract
Respiratory syncytial virus (RSV) is the leading cause of bronchiolitis and pneumonia in infants. Little is known about the epidemiology, burden, and seasonality of RSV in subtropical regions of Australia like Central Queensland. This information is important to plan prevention strategies, including therapeutics, future vaccines, and health system preparedness.
We collected data on laboratory-confirmed RSV cases and admissions in Central Queensland for the period 1 July 2021 to 31 December 2022. From July 2021, RSV was listed as a nationally notifiable condition on laboratory-confirmed diagnosis.
During the study period, 1,142 laboratory-confirmed cases of RSV (50.0% female sex) were reported, with 169 cases (14.8%) requiring hospital admission, 12 of which (7.1%) required intensive care unit/high dependency unit admissions; two deaths occurred. Of cases requiring hospital admission, RSV was listed as the primary diagnosis in 113/169 cases (66.9%); 63/169 admitted cases (37.3%) had a major comorbidity. Of all cases, 55.4% were in children < 5 years of age (20.9% hospitalised); 35.7% in children < 2 years of age (24.3% hospitalised), and 19.1% in children < 12 months of age (27.5% hospitalised). Children under five years of age made up 78.1% of admissions, a rate of 9.0 admissions per 1,000 children over the 18-month study period, with an average age of 15.8 months (standard deviation, SD: 13.1 months) in this cohort. Indigenous children aged < 5 years were over-represented in cases (rate ratio, RR: 1.6; 95% confidence interval [95% CI]: 1.3–1.9) and admissions (RR: 1.6; 95% CI: 1.0–2.4). Antibiotics were prescribed to 48.5% of admitted cases under two years of age, despite documented bacterial infection in only 26.3% of these cases; antibiotic prescription was significantly higher in those who received a chest X-ray (p < 0.001). Of all cases, 33.5% occurred in July 2022 alone, with greater than 75.0% of cases occurring during June–August 2022.
RSV showed year-round activity with a distinctive winter peak in 2022; however, this season was likely affected by coronavirus disease 2019 (COVID-19) restrictions and behaviours. Ongoing surveillance is required to better understand the epidemiology and seasonality of RSV in Central Queensland.
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References
Borchers AT, Chang C, Gershwin ME, Gershwin LJ. Respiratory syncytial virus--a comprehensive review. Clin Rev Allergy Immunol. 2013;45(3):331–79. doi: https://doi.org/10.1007/s12016-013-8368-9.
Li Y, Wang X, Blau DM, Caballero MT, Feikin DR, Gill CJ et al. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019: a systematic analysis. Lancet. 2022;399(10340):2047–64. doi: https://doi.org/10.1016/S0140-6736(22)00478-0.
Lin HC, Liu YC, Hsing TY, Chen LL, Liu YC, Yen TY et al. RSV pneumonia with or without bacterial co-infection among healthy children. J Formos Med Assoc. 2022;121(3):687–93. doi: https://doi.org/10.1016/j.jfma.2021.08.012.
Obando-Pacheco P, Justicia-Grande AJ, Rivero-Calle I, Rodríguez-Tenreiro C, Sly P, Ramilo O et al. Respiratory syncytial virus seasonality: a global overview. J Infect Dis. 2018;217(9):1356–64. doi: https://doi.org/10.1093/infdis/jiy056.
Saravanos GL, Sheel M, Homaira N, Dey A, Brown E, Wang H et al. Respiratory syncytial virus-associated hospitalisations in Australia, 2006–2015. Med J Aust. 2019;210(10):447–53. doi: https://doi.org/10.5694/mja2.50159.
Gebremedhin AT, Hogan AB, Blyth CC, Glass K, Moore HC. Developing a prediction model to estimate the true burden of respiratory syncytial virus (RSV) in hospitalised children in Western Australia. Sci Rep. 2022;12(1):332. doi: https://doi.org/10.1038/s41598-021-04080-3.
Brusco NK, Alafaci A, Tuckerman J, Frawley H, Pratt J, Daley AJ et al. The 2018 annual cost burden for children under five years of age hospitalised with respiratory syncytial virus in Australia. Commun Dis Intell (2018). 2022;46. doi: https://doi.org/10.33321/cdi.2022.46.5.
McLaughlin JM, Khan F, Begier E, Swerdlow DL, Jodar L, Falsey AR. Rates of medically attended RSV among US adults: a systematic review and meta-analysis. Open Forum Infect Dis. 2022;9(7):ofac300. doi: https://doi.org/10.1093/ofid/ofac300.
Shi T, Denouel A, Tietjen AK, Campbell I, Moran E, Li X et al. Global disease burden estimates of respiratory syncytial virus-associated acute respiratory infection in older adults in 2015: a systematic review and meta-analysis. J Infect Dis. 2020;222(Suppl 7):S577–83. doi: https://doi.org/10.1093/infdis/jiz059.
Tin Tin Htar M, Yerramalla MS, Moïsi JC, Swerdlow DL. The burden of respiratory syncytial virus in adults: a systematic review and meta-analysis. Epidemiol Infect. 2020;148:e48. doi: https://doi.org/10.1017/S0950268820000400.
Mejias A, Rodríguez-Fernández R, Oliva S, Peeples ME, Ramilo O. The journey to a respiratory syncytial virus vaccine. Ann Allergy Asthma Immunol. 2020;125(1):36–46. doi: https://doi.org/10.1016/j.anai.2020.03.017.
Hashem M, Hall CB. Respiratory syncytial virus in healthy adults: the cost of a cold. J Clin Virol. 2003;27(1):14–21. doi: https://doi.org/10.1016/s1386-6532(03)00047-7.
Barr R, Green CA, Sande CJ, Drysdale SB. Respiratory syncytial virus: diagnosis, prevention and management. Ther Adv Infect Dis. 2019;6:2049936119865798. doi: https://doi.org/10.1177/2049936119865798.
Friedman JN, Davis T, Somaskanthan A, Ma A. Avoid doing chest x rays in infants with typical bronchiolitis. BMJ. 2021;375:e064132. doi: https://doi.org/10.1136/bmj-2021-064132.
Garegnani L, Styrmisdóttir L, Roson Rodriguez P, Escobar Liquitay CM, Esteban I, Franco JV. Palivizumab for preventing severe respiratory syncytial virus (RSV) infection in children. Cochrane Database Syst Rev. 2021;11(11):CD013757. doi: https://doi.org/10.1002/14651858.CD013757.pub2.
O’Brien S, Borland ML, Cotterell E, Armstrong D, Babl F, Bauert P et al. Australasian bronchiolitis guideline. J Paediatr Child Health. 2019;55(1):42–53. doi: https://doi.org/10.1111/jpc.14104.
Smith DK, Seales S, Budzik C. Respiratory syncytial virus bronchiolitis in children. Am Fam Physician. 2017;95(2):94–9.
Mazur NI, Terstappen J, Baral R, Bardají A, Beutels P, Buchholz UJ et al. Respiratory syncytial virus prevention within reach: the vaccine and monoclonal antibody landscape. Lancet Infect Dis. 2023;23(1):e2–21. doi: https://doi.org/10.1016/S1473-3099(22)00291-2.
Paynter S. Humidity and respiratory virus transmission in tropical and temperate settings. Epidemiol Infect. 2015;143(6):1110–8. doi: https://doi.org/10.1017/S0950268814002702.
Bloom-Feshbach K, Alonso WJ, Charu V, Tamerius J, Simonsen L, Miller MA et al. Latitudinal variations in seasonal activity of influenza and respiratory syncytial virus (RSV): a global comparative review. PLoS One. 2013;8(2):e54445. doi: https://doi.org/10.1371/journal.pone.0054445.
Janet S, Broad J, Snape MD. Respiratory syncytial virus seasonality and its implications on prevention strategies. Hum Vaccin Immunother. 2018;14(1):234–44. doi: https://doi.org/10.1080/21645515.2017.1403707.
Tang JW, Loh TP. Correlations between climate factors and incidence--a contributor to RSV seasonality. Rev Med Virol. 2014;24(1):15–34. doi: https://doi.org/10.1002/rmv.1771.
Weber MW, Mulholland EK, Greenwood BM. Respiratory syncytial virus infection in tropical and developing countries. Trop Med Int Health. 1998;3(4):268–80. doi: https://doi.org/10.1046/j.1365-3156.1998.00213.x.
Yusuf S, Piedimonte G, Auais A, Demmler G, Krishnan S, Van Caeseele P et al. The relationship of meteorological conditions to the epidemic activity of respiratory syncytial virus. Epidemiol Infect. 2007;135(7):1077–90. doi: https://doi.org/10.1017/S095026880600776X.
McNally JD, Sampson M, Matheson LA, Hutton B, Little J. Vitamin D receptor (VDR) polymorphisms and severe RSV bronchiolitis: a systematic review and meta-analysis. Pediatr Pulmonol. 2014;49(8):790–9. doi: https://doi.org/10.1002/ppul.22877.
Wainwright C. Acute viral bronchiolitis in children- a very common condition with few therapeutic options. Paediatr Respir Rev. 2010;11(1):39–45. doi: https://doi.org/10.1016/j.prrv.2009.10.001.
Koehoorn M, Karr CJ, Demers PA, Lencar C, Tamburic L, Brauer M. Descriptive epidemiological features of bronchiolitis in a population-based cohort. Pediatrics. 2008;122(6):1196–203. doi: https://doi.org/10.1542/peds.2007-2231.
Simões EAF. RSV disease in the pediatric population: epidemiology, seasonal variability, and long-term outcomes. Manag Care. 2008;17(11 Suppl 12):3–6, discussion 18–9.
Queensland Government Department of Environment and Science. Climate change in the Central Queensland region. Version 1. Brisbane: Queensland Government Department of Environment and Science; 2019. Available from: https://www.qld.gov.au/__data/assets/pdf_file/0020/68141/central-qld-climate-change-impact-summary.pdf.
Queensland Government Statistician’s Office. Queensland Regional Profiles. [Webpage.] Brisbane: Queensland Government, Queensland Treasury; 2021. Available from: https://statistics.qgso.qld.gov.au/qld-regional-profiles.
Queensland Government Department of Health (Queensland Health). Central Queensland Hospital and Health Service: About us. [Webpage.] Brisbane: Queensland Health; April 2023. Available from: https://www.cq.health.qld.gov.au/about-us.
Queensland Health. List of notifiable conditions. [Internet.] Brisbane: Queensland Health; 26 August 2022. [Accessed on 27 October 2022.] Available from: https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/diseases-infection/notifiable-conditions/list.
Australian Bureau of Statistics. ERP by LGA (2021), Age and Sex, 2001 to 2022. [Online database.] Canberra: Australian Bureau of Statistics; 2022. [Accessed on 1 September 2022.] Available from: https://explore.data.abs.gov.au/vis?tm=%3DERP_LGA2022&hc[dataflowId]=ABS_ANNUAL_ERP_LGA2022&df[ds]=PEOPLE_TOPICS&df[id]=ABS_ANNUAL_ERP_LGA2022&df[ag]=ABS&df[vs]=&pd=2021%2C&dq=.3...LGA2022%2BSTE.A&ly[cl]=AGE&ly[rw]=LGA_2022.
Australian Government Bureau of Meteorology (BOM). Climate data online. [Webpage.] Canberra: BOM; 2023. Available from: http://www.bom.gov.au/climate/data/.
Stein RT, Bont LJ, Zar H, Polack FP, Park C, Claxton A et al. Respiratory syncytial virus hospitalization and mortality: systematic review and meta-analysis. Pediatr Pulmonol. 2017;52(4):556–69. doi: https://doi.org/10.1002/ppul.23570.
Homaira N, Briggs N, Pardy C, Hanly M, Oei JL, Hilder L et al. Association between respiratory syncytial viral disease and the subsequent risk of the first episode of severe asthma in different subgroups of high-risk Australian children: a whole-of-population-based cohort study. BMJ open. 2017;7(11):e017936. doi: https://doi.org/10.1136/bmjopen-2017-017936.
Homaira N, Oei JL, Mallitt KA, Abdel-Latif ME, Hilder L, Bajuk B et al. High burden of RSV hospitalization in very young children: a data linkage study. Epidemiol Infect. 2016;144(8):1612–21. doi: https://doi.org/10.1017/S0950268815003015.
Dede A, Isaacs D, Torzillo PJ, Wakerman J, Roseby R, Fahy R et al. Respiratory syncytial virus infections in Central Australia. J Paediatr Child Health. 2010;46(1–2):35–9. doi: https://doi.org/10.1111/j.1440-1754.2009.01614.x.
Basnayake TL, Morgan LC, Chang AB. The global burden of respiratory infections in indigenous children and adults: a review. Respirology. 2017;22(8):1518–28. doi: https://doi.org/10.1111/resp.13131.
Quinn EK, Massey PD, Speare R. Communicable diseases in rural and remote Australia: the need for improved understanding and action. Rural Remote Health. 2015;15(3):3371. doi: https://doi.org/10.22605/RRH3371.
Lim AYL, Khan S, Chapman G, Pazhamalil J, Platfuss T, Lam V et al. Acute bronchiolitis in regional Queensland: how well are we doing? Asia Pac J Paediatr Child Health. 2022;5:26–37. Available from: http://www.apjpch.com/pdfs/22123Mc9004905.pdf.
Oakley E, Brys T, Borland M, Neutze J, Phillips N, Krieser D et al. Medication use in infants admitted with bronchiolitis. Emerg Med Australas. 2018;30(3):389–97. doi: https://doi.org/10.1111/1742-6723.12968.
Obolski U, Kassem E, Na’amnih W, Tannous S, Kagan V, Muhsen K. Unnecessary antibiotic treatment of children hospitalised with respiratory syncytial virus (RSV) bronchiolitis: risk factors and prescription patterns. J Glob Antimicrob Resist. 2021;27:303–8. doi: https://doi.org/10.1016/j.jgar.2021.10.015.
Machowska A, Stålsby Lundborg C. Drivers of irrational use of antibiotics in Europe. Int J Environ Res Public Health. 2018;16(1):27. doi: https://doi.org/10.3390/ijerph16010027.
Kalil J, Bowes J, Reddy D, Barrowman N, Le Saux N. Pediatric inpatient antimicrobial stewardship program safely reduces antibiotic use in patients with bronchiolitis caused by respiratory syncytial virus: a retrospective chart review. Pediatr Qual Saf. 2019;4(5):e211. doi: https://doi.org/10.1097/pq9.0000000000000211.
Basile K, Kok J, Dwyer DE. Point-of-care diagnostics for respiratory viral infections. Expert Rev Mol Diagn. 2018;18(1):75–83. doi: https://doi.org/10.1080/14737159.2018.1419065.
Schneider UV, Holm MKA, Bang D, Petersen RF, Mortensen S, Trebbien R et al. Point-of-care tests for influenza A and B viruses and RSV in emergency departments - indications, impact on patient management and possible gains by syndromic respiratory testing, Capital Region, Denmark, 2018. Euro Surveill. 2020;25(44):1900430. doi: https://doi.org/10.2807/1560-7917.ES.2020.25.44.1900430.
Pedersen CJ, Rogan DT, Yang S, Quinn JV. Using a novel rapid viral test to improve triage of emergency department patients with acute respiratory illness during flu season. J Clin Virol. 2018;108:72–6. doi: https://doi.org/10.1016/j.jcv.2018.09.008.
Rogan DT, Kochar MS, Yang S, Quinn JV. Impact of rapid molecular respiratory virus testing on real-time decision making in a pediatric emergency department. J Mol Diagn. 2017;19(3):460–7. doi: https://doi.org/10.1016/j.jmoldx.2017.01.009.
World Health Organization (WHO). WHO preferred product characteristics of monoclonal antibodies for passive immunization against respiratory syncytial virus (RSV) disease. Geneva: WHO; 8 June 2021. Available from: https://www.who.int/publications/i/item/9789240021853.
Morley C, Grimwood K, Maloney S, Ware RS. Meteorological factors and respiratory syncytial virus seasonality in subtropical Australia. Epidemiol Infect. 2018;146(6):757–62. doi: https://doi.org/10.1017/S0950268818000614.
Saravanos GL, Hu N, Homaira N, Muscatello DJ, Jaffe A, Bartlett AW et al. RSV epidemiology in Australia before and during COVID-19. Pediatrics. 2022;149(2):e2021053537. doi: https://doi.org/10.1542/peds.2021-053537.
Eden JS, Sikazwe C, Xie R, Deng YM, Sullivan SG, Michie A et al. Off-season RSV epidemics in Australia after easing of COVID-19 restrictions. Nat Commun. 2022;13(1):2884. doi: https://doi.org/10.1038/s41467-022-30485-3.
Foley DA, Phuong LK, Peplinski J, Lim SM, Lee WH, Farhat A et al. Examining the interseasonal resurgence of respiratory syncytial virus in Western Australia. Arch Dis Child. 2022;107(3):e7. doi: https://doi.org/10.1136/archdischild-2021-322507.
Agha R, Avner JR. Delayed seasonal RSV surge observed during the COVID-19 pandemic. Pediatrics. 2021;148(3):e2021052089. doi: https://doi.org/10.1542/peds.2021-052089.
Olsen SJ, Winn AK, Budd AP, Prill MM, Steel J, Midgley CM et al. Changes in influenza and other respiratory virus activity during the COVID-19 pandemic – United States, 2020-2021. MMWR Morb Mortal Wkly Rep. 2021;70(29):1013–9. doi: https://doi.org/10.15585/mmwr.mm7029a1.
Bardsley M, Morbey RA, Hughes HE, Beck CR, Watson CH, Zhao H et al. Epidemiology of respiratory syncytial virus in children younger than 5 years in England during the COVID-19 pandemic, measured by laboratory, clinical, and syndromic surveillance: a retrospective observational study. Lancet Infect Dis. 2023;23(1):56–66. doi: https://doi.org/10.1016/S1473-3099(22)00525-4.
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