Influenza-like illness surveillance may underestimate the incidence of respiratory syncytial virus in adult outpatients
Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved..
OBJECTIVES: Although respiratory syncytial virus (RSV) is a leading cause of acute respiratory infections (ARIs), it is unclear which of the case definitions that prompt swab collection predicts RSV best. We aimed to profile RSV-positive adults and to identify possible RSV case definitions.
METHODS: This individual-based pooled analysis was based on influenza-like illness (ILI) surveillance conducted among Italian outpatient adults. All samples were tested for influenza, RSV and other respiratory viruses.
RESULTS: RSV was detected in 5.2% of the 1240 ILI adults tested. The prevalence of fever/feverishness was significantly lower (83.3%) in individuals positive for RSV and those negative for both viruses (79.4%) than in influenza-positive subjects (96.2%). Conversely, 98.3% of RSV-positive adults reported cough. Compared with subjects who tested negative, the adjusted relative risk ratio of cough in RSV-positive subjects was much higher than in influenza-positive subjects (6.89 vs 2.79). Using ARI with cough as the RSV case definition increased specificity.
CONCLUSION: As fever/feverishness is more common among influenza than RSV cases, ILI-based surveillance may underestimate RSV incidence in adult outpatients. While broad ARI definitions are useful for routine RSV surveillance, their low specificity may hamper vaccine effectiveness studies. The use of further ARI qualifiers like cough increases specificity.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:141 |
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| Enthalten in: |
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases - 141(2024) vom: 12. März, Seite 106968 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Domnich, Alexander [VerfasserIn] |
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| Links: |
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| Themen: |
Acute respiratory infection |
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| Anmerkungen: |
Date Completed 15.03.2024 Date Revised 15.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ijid.2024.02.011 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368589862 |
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| 245 | 1 | 0 | |a Influenza-like illness surveillance may underestimate the incidence of respiratory syncytial virus in adult outpatients |
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| 500 | |a Date Completed 15.03.2024 | ||
| 500 | |a Date Revised 15.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved. | ||
| 520 | |a OBJECTIVES: Although respiratory syncytial virus (RSV) is a leading cause of acute respiratory infections (ARIs), it is unclear which of the case definitions that prompt swab collection predicts RSV best. We aimed to profile RSV-positive adults and to identify possible RSV case definitions | ||
| 520 | |a METHODS: This individual-based pooled analysis was based on influenza-like illness (ILI) surveillance conducted among Italian outpatient adults. All samples were tested for influenza, RSV and other respiratory viruses | ||
| 520 | |a RESULTS: RSV was detected in 5.2% of the 1240 ILI adults tested. The prevalence of fever/feverishness was significantly lower (83.3%) in individuals positive for RSV and those negative for both viruses (79.4%) than in influenza-positive subjects (96.2%). Conversely, 98.3% of RSV-positive adults reported cough. Compared with subjects who tested negative, the adjusted relative risk ratio of cough in RSV-positive subjects was much higher than in influenza-positive subjects (6.89 vs 2.79). Using ARI with cough as the RSV case definition increased specificity | ||
| 520 | |a CONCLUSION: As fever/feverishness is more common among influenza than RSV cases, ILI-based surveillance may underestimate RSV incidence in adult outpatients. While broad ARI definitions are useful for routine RSV surveillance, their low specificity may hamper vaccine effectiveness studies. The use of further ARI qualifiers like cough increases specificity | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Acute respiratory infection | |
| 650 | 4 | |a Adults | |
| 650 | 4 | |a Case definition | |
| 650 | 4 | |a Influenza-like illness | |
| 650 | 4 | |a Respiratory syncytial virus | |
| 650 | 4 | |a Rsv | |
| 650 | 7 | |a Influenza Vaccines |2 NLM | |
| 700 | 1 | |a Orsi, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Ogliastro, Matilde |e verfasserin |4 aut | |
| 700 | 1 | |a Ferrari, Allegra |e verfasserin |4 aut | |
| 700 | 1 | |a Bruzzone, Bianca |e verfasserin |4 aut | |
| 700 | 1 | |a Panatto, Donatella |e verfasserin |4 aut | |
| 700 | 1 | |a Icardi, Giancarlo |e verfasserin |4 aut | |
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