PHHP 92 - Disrupted Epidemiology of Respiratory Viruses in Children During the COVID-19 Pandemic: A Single Site Experience

Tuesday, June 27, 2023

12:25 PM – 1:25 PM

Presenter(s)

TR

Toria Reisman, CHES (she/her/hers)

Infection Preventionist I
Cincinnati Children's Hospital Medical Center, United States

Co-Author(s)

AA

Andrea L. Ankrum, MS, MS, MT(ASCP), CIC, FAPIC

Infection Preventionist
Cincinnati Children's Hospital Medical Center
Cincinnati, OH, United States
FS

Felicia Scaggs-Huang, MD, MSc.

Associate Director of Infection Prevention & Control
Cincinnati Children's Hospital Medical Center, United States

Disclosure(s):

Felicia Scaggs-Huang, MD, MSc.: No financial relationships to disclose

Background: Respiratory viral infections are a significant cause of morbidity and mortality in the pediatric population. Pre-pandemic, respiratory viruses such as respiratory syncytial virus (RSV) and influenza followed a predictable seasonality with peak hospitalizations in the winter from bronchiolitis and pneumonia. We hypothesize that the emergence of coronavirus disease (COVID-19) and subsequent public health mandates in 2020 altered the epidemiology of other respiratory viruses in the pediatric population.

Methods: This retrospective descriptive study at a quaternary pediatric hospital system examined the incidence of influenza and RSV in pediatric patients who underwent antigen and molecular testing for any reason through our institution’s laboratory from 2017-2022. We defined the onset and conclusion of a respiratory season as a 2% test positivity rate. We compared the number of cases and duration of season by year and virus.

Results: Our 2017-2019/20 influenza seasons commenced at around week 45 with an average duration of 27 weeks. There were 1448 influenza cases in 2017 with higher case counts in 2018 (3042) and 2019 (4805). No true seasonality was detected for influenza in 2020/21 with 5 reported cases. The 2021/22 flu season began at week 45 with a 32-week duration and 3124 cases. The 2022/23 flu season began at week 37 with 4510 cases by week 48. For RSV, the 2017-2019/20 seasons started at week 44, averaged 283 cases and 25 weeks in length. There were only 4 cases in the 2020/21 season. The 2021/22 season began in week 4 and lasted for 39 weeks with 517 cases. In 2022, cases began in week 21 with 1309 cases thus far.

Conclusions: Pre-pandemic, our pediatric patient population experienced respiratory viruses with seasonality similar to national trends. The COVID-19 pandemic likely interrupted normal RSV and influenza epidemiology with longer and earlier seasons than historically reported.

Learning Objectives:

Demonstrate the change in the epidemiologic nature of RSV and influenza by utilizing data from 2017-2022.
Upon completion, participant will define pre-pandemic and post-pandemic trends for RSV and influenza among the pediatric population.
Upon completion, participant will understand the impact of the COVID-19 pandemic on the typical seasonality of RSV and influenza in the pediatric population.