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The re-emergence of influenza following the COVID-19 pandemic in Victoria, Australia, 2021 to 2022
- Catherine GA Pendrey1,2,3 , Janet Strachan3 , Heidi Peck1 , Ammar Aziz1 , Jean Moselen1 , Rob Moss4 , Md Rezanur Rahaman2 , Ian G Barr1,5 , Kanta Subbarao1,5 , Sheena G Sullivan1,3,6
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View Affiliations Hide AffiliationsAffiliations: 1 WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia 2 National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia 3 Communicable Diseases, Health Protection Branch, Public Health Division, Department of Health, Victoria, Melbourne, Australia 4 School of Population and Global Health, University of Melbourne, Melbourne, Australia 5 Department of Immunology and Microbiology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia 6 Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, AustraliaCatherine Pendreycatherine.pendrey influenzacentre.org
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Citation style for this article: Pendrey Catherine GA, Strachan Janet, Peck Heidi, Aziz Ammar, Moselen Jean, Moss Rob, Rahaman Md Rezanur, Barr Ian G, Subbarao Kanta, Sullivan Sheena G. The re-emergence of influenza following the COVID-19 pandemic in Victoria, Australia, 2021 to 2022. Euro Surveill. 2023;28(37):pii=2300118. https://doi.org/10.2807/1560-7917.ES.2023.28.37.2300118 Received: 15 Feb 2023; Accepted: 28 Jun 2023
Abstract
COVID-19 pandemic mitigation measures, including travel restrictions, limited global circulation of influenza viruses. In Australia, travel bans for non-residents and quarantine requirements for returned travellers were eased in November 2021, providing pathways for influenza viruses to be re-introduced.
We aimed to describe the epidemiological and virological characteristics of the re-emergence of influenza in Victoria, Australia to inform public health interventions.
From 1 November 2021 to 30 April 2022, we conducted an epidemiological study analysing case notification data from the Victorian Department of Health to describe case demographics, interviewed the first 200 cases to establish probable routes of virus reintroduction and examined phylogenetic and antigenic data to understand virus diversity and susceptibility to current vaccines.
Overall, 1,598 notifications and 1,064 positive specimens were analysed. The majority of cases (61.4%) occurred in the 15–34 years age group. Interviews revealed a higher incidence of international travel exposure during the first month of case detections, and high levels of transmission in university residential colleges were associated with return to campus. Influenza A(H3N2) was the predominant subtype, with a single lineage predominating despite multiple importations.
Enhanced testing for respiratory viruses during the COVID-19 pandemic provided a more complete picture of influenza virus transmission compared with previous seasons. Returned international travellers were important drivers of influenza reemergence, as were young adults, a group whose role has previously been under-recognised in the establishment of seasonal influenza epidemics. Targeting interventions, including vaccination, to these groups could reduce future influenza transmission.
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