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Published on: November 10, 2023
Circulating pediatric respiratory pathogens in Taiwan during 2020: Dynamic change under low COVID-19 incidence
Jun Yi Sim1, Yu-Chin Chen2, Wei-Yun Hsu3
1Department of Pediatrics, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taiwan.
Insights
During COVID-19, nonpharmaceutical interventions altered pediatric respiratory virus patterns. Non-enveloped viruses circulated consistently, while enveloped viruses like RSV surged late in 2020 after restrictions eased.
Area of Science:
- Pediatric infectious diseases
- Epidemiology
- Virology
Background:
- The COVID-19 pandemic and associated nonpharmaceutical interventions (NPIs) significantly impacted the epidemiology of common respiratory pathogens.
- Taiwan reported a low incidence of COVID-19 cases in 2020, creating a unique environment to study pathogen dynamics.
Purpose of the Study:
- To investigate the dynamic changes in respiratory virus circulation among children in Taiwan during 2020.
- To analyze the impact of NPIs on the detection rates and types of respiratory pathogens.
Main Methods:
- A retrospective cohort study was conducted involving children aged 0-18 years presenting with fever or respiratory illness at a tertiary hospital.
- Nasopharyngeal swabs were analyzed using multiplex polymerase chain reaction (PCR).
- Respiratory syncytial virus (RSV) trends from 2017-2020 were compared using PCR and lateral flow assays.
Main Results:
- The overall detection rate of respiratory pathogens was 55% among 120 tested children.
- Detection rates decreased from 70% to 30% with strengthened NPIs, but non-enveloped viruses (rhinovirus/enterovirus, adenovirus) remained in circulation.
- Upon easing restrictions, detection rates exceeded 60%, with a notable outbreak of enveloped viruses (RSV, parainfluenza virus), and a delayed RSV epidemic surge in late 2020.
Conclusions:
- Strict NPIs led to sustained circulation of non-enveloped viruses, while eased restrictions facilitated a surge in enveloped viruses.
- Continuous surveillance of respiratory virus evolution is crucial.
- Easing public health restrictions requires careful consideration and balanced judgment to manage potential outbreaks.
Background:
In Taiwan, there were only 799 confirmed COVID-19 cases in 2020. The unique backdrop amidst a pandemic and promotion of nonpharmaceutical interventions generated some distinct changes in the epidemiology of common respiratory pathogens. In this study, we aimed to investigate the dynamic changes in respiratory pathogens in children during 2020.
Methods:
We performed a retrospective cohort study at a tertiary hospital in southern Taiwan during 2020. Patients aged 0-18 years who visited the pediatric emergency department were enrolled. Children who presented with clinical symptoms (fever or respiratory illness) and received nasopharyngeal swabs for multiplex polymerase chain reaction (PCR) were included in our analysis. We also compared respiratory syncytial virus (RSV) trends from previous years by PCR and lateral flow immunochromatographic assays from 2017 to 2020.
Results:
A total of 120 children were tested. The overall detection rate was 55%. With strengthened restrictions, the detection rate dropped from 70% to 30%. However, non-enveloped viruses (rhinovirus/enterovirus and adenovirus) were in constant circulation. Upon easing prevention measures, the detection rate remained above 60%, and an outbreak of an enveloped virus (RSV and parainfluenza virus) was noted. Compared with 2017-2019, the cyclical RSV epidemic was delayed, with a large surge in late 2020.
Conclusions:
We observed a constant circulation of non-enveloped viruses when strict nonpharmaceutical interventions were employed and a delayed surge of enveloped viruses during the easing of restrictions. Continuous surveillance and monitoring of the evolutionary dynamics of respiratory viruses is important, while easing restrictions requires balanced judgment.
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