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Published on: December 10, 2013
Respiratory Syncytial Virus Infection Notification Trends and Interpretation of the Reported Case Data, 2018-2021,
Miyako Otsuka1, Ayu Kasamatsu1, Yuzo Arima1
1Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Japan.
Insights
The COVID-19 pandemic impacted respiratory syncytial virus (RSV) infection trends in Japan. While 2020 saw fewer RSV cases, 2021 experienced an early, high peak with more older children affected and milder presentations.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- The COVID-19 pandemic has influenced the epidemiology of various infectious diseases globally.
- Respiratory Syncytial Virus (RSV) is a common cause of respiratory infections in children, with significant public health implications.
Purpose of the Study:
- To describe the epidemiological trends of RSV infection among children in Japan from 2018 to 2021.
- To analyze the impact of the COVID-19 pandemic on RSV notification patterns, age distribution, and clinical presentation.
Main Methods:
- Utilized national surveillance data for RSV cases in children across Japan (2018-2021).
- Analyzed notification trends per sentinel site, age-specific case counts, and outpatient vs. hospital diagnoses.
- Examined RSV-attributed deaths from vital statistics.
Main Results:
- RSV notifications significantly decreased in 2020 compared to 2018-2019, likely due to COVID-19 countermeasures.
- 2021 showed an unseasonably early and high RSV peak, with increased cases in older children (2-4+ years) and a higher proportion of milder outpatient cases.
- RSV-attributed deaths decreased in 2020 and rebounded in 2021, but remained lower than pre-pandemic levels.
Conclusions:
- The COVID-19 pandemic caused significant, albeit temporary, disruptions to RSV epidemiology in Japan.
- The 2021 resurgence suggests a complex interplay of waning immunity and potential shifts in healthcare-seeking behavior.
- Continuous surveillance and multifaceted assessments are crucial for understanding and managing RSV due to its unpredictable nature.
Abstract:
In Japan, as elsewhere, the coronavirus disease 2019 (COVID-19) pandemic has affected notification trends of respiratory syncytial virus (RSV) infection. Here, we describe the epidemiological trends of cases of RSV infection among children reported during 2018-2021 in Japan based on the national surveillance system. Compared with 2018 and 2019, 2020 saw an unprecedented decrease in notifications of RSV infection per sentinel site. However, 2021 experienced an unseasonably early and high peak at week 28 (peak week in 2018 and 2019 was week 37), with a large resurgence in notifications nationwide and across regions. Regarding age, compared with 2018 and 2019, the number and proportion of case-patients aged 2, 3, and ≥4-years increased substantially in 2021, but the number of case-patients aged <1 year decreased slightly. Furthermore, in 2021, the ratio of notifications per site from outpatient clinics to notifications per site from hospitals increased, suggesting a proportionate increase in diagnoses of clinically milder cases. Notably, RSV-attributed deaths from vital statistics also dropped substantially in 2020 and rebounded in 2021 but were fewer than in 2018 or 2019. While the incidence of RSV infections likely declined in 2020 (possibly owing to COVID-19 countermeasures) and increased in 2021, notifications in 2021 appeared to be associated with milder presentations. Given the unpredictable epidemiology of RSV, continuous monitoring and pluralistic assessments are imperative.
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