Decline of influenza and respiratory syncytial virus detection in facility-based surveillance during the COVID-19 pandemic, South Africa, January to October 2020

Stefano Tempia; Sibongile Walaza; Jinal N Bhiman; Meredith L McMorrow; Jocelyn Moyes; Thulisa Mkhencele; Susan Meiring; Vanessa Quan; Kate Bishop; Johanna M McAnerney; Anne von Gottberg; Nicole Wolter; Mignon Du Plessis; Florette K Treurnicht; Orienka Hellferscee; Halima Dawood; Fathima Naby; Ebrahim Variava; Comfort Siwele; Neydis Baute; Jeremy Nel; Gary Reubenson; Heather J Zar; Cheryl Cohen

doi:10.2807/1560-7917.ES.2021.26.29.2001600

Surveillance Open Access

Like 0

Download

Decline of influenza and respiratory syncytial virus detection in facility-based surveillance during the COVID-19 pandemic, South Africa, January to October 2020
Stefano Tempia^1,2,3,4 , Sibongile Walaza^3,4 , Jinal N Bhiman⁴ , Meredith L McMorrow¹ , Jocelyn Moyes^3,4 , Thulisa Mkhencele⁴ , Susan Meiring⁵ , Vanessa Quan⁵ , Kate Bishop⁵ , Johanna M McAnerney⁴ , Anne von Gottberg^4,6 , Nicole Wolter^4,6 , Mignon Du Plessis⁴ , Florette K Treurnicht^4,7 , Orienka Hellferscee^4,6 , Halima Dawood^8,9 , Fathima Naby^10,11 , Ebrahim Variava^12,13,14 , Comfort Siwele¹⁵ , Neydis Baute¹⁶ , Jeremy Nel¹⁷ , Gary Reubenson¹⁸ , Heather J Zar^19,20 , Cheryl Cohen^3,4
View Affiliations Hide Affiliations

Affiliations: ¹ Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States ² MassGenics, Duluth, Georgia, United States ³ School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa ⁴ Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa ⁵ Division of Public Health Surveillance and Response, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa ⁶ School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa ⁷ Division of Virology, National Health Laboratory Service, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa ⁸ Department of Medicine, Greys Hospital, Pietermaritzburg, South Africa ⁹ Caprisa, University of KwaZulu-Natal, Pietermaritzburg, South Africa ¹⁰ Department of Paediatrics, Pietermaritzburg Metropolitan Hospital, Pietermaritzburg, South Africa ¹¹ Department of Paediatrics, University of KwaZulu Natal, Durban, South Africa ¹² Department of Medicine, Klerksdorp-Tshepong Hospital Complex, Klerksdorp, South Africa ¹³ Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa ¹⁴ Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa ¹⁵ Department of Paediatrics, Matikwana Hospital, Mkhuhlu, South Africa ¹⁶ Department of Paediatrics, Mapulaneng Hospital, Bushbuckridge, South Africa ¹⁷ Department of Medicine, Helen Joseph Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa ¹⁸ Department of Paediatrics and Child Health, Rahima Moosa Mother and Child Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg South Africa ¹⁹ Department of Paediatrics & Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa ²⁰ SA-MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa

Correspondence:
Stefano Tempia
stefanot nicd.ac.za
View Citation Hide Citation

Citation style for this article: Tempia Stefano, Walaza Sibongile, Bhiman Jinal N, McMorrow Meredith L, Moyes Jocelyn, Mkhencele Thulisa, Meiring Susan, Quan Vanessa, Bishop Kate, McAnerney Johanna M, von Gottberg Anne, Wolter Nicole, Du Plessis Mignon, Treurnicht Florette K, Hellferscee Orienka, Dawood Halima, Naby Fathima, Variava Ebrahim, Siwele Comfort, Baute Neydis, Nel Jeremy, Reubenson Gary, Zar Heather J, Cohen Cheryl. Decline of influenza and respiratory syncytial virus detection in facility-based surveillance during the COVID-19 pandemic, South Africa, January to October 2020. Euro Surveill. 2021;26(29):pii=2001600. https://doi.org/10.2807/1560-7917.ES.2021.26.29.2001600 Received: 26 Aug 2020; Accepted: 19 Nov 2020

Abstract

Background

In South Africa, COVID-19 control measures to prevent SARS-CoV-2 spread were initiated on 16 March 2020. Such measures may also impact the spread of other pathogens, including influenza virus and respiratory syncytial virus (RSV) with implications for future annual epidemics and expectations for the subsequent northern hemisphere winter.

Methods

We assessed the detection of influenza and RSV through facility-based syndromic surveillance of adults and children with mild or severe respiratory illness in South Africa from January to October 2020, and compared this with surveillance data from 2013 to 2019.

Results

Facility-based surveillance revealed a decline in influenza virus detection during the regular season compared with previous years. This was observed throughout the implementation of COVID-19 control measures. RSV detection decreased soon after the most stringent COVID-19 control measures commenced; however, an increase in RSV detection was observed after the typical season, following the re-opening of schools and the easing of measures.

Conclusion

COVID-19 non-pharmaceutical interventions led to reduced circulation of influenza and RSV in South Africa. This has limited the country’s ability to provide influenza virus strains for the selection of the annual influenza vaccine. Delayed increases in RSV case numbers may reflect the easing of COVID-19 control measures. An increase in influenza virus detection was not observed, suggesting that the measures may have impacted the two pathogens differently. The impact that lowered and/or delayed influenza and RSV circulation in 2020 will have on the intensity and severity of subsequent annual epidemics is unknown and warrants close monitoring.

This work is licensed under a Creative Commons Attribution 4.0 International License.

Article metrics loading...

/content/10.2807/1560-7917.ES.2021.26.29.2001600

2021-07-22

2024-12-31

Click here for cited by

/content/10.2807/1560-7917.ES.2021.26.29.2001600

Full text loading...

/deliver/fulltext/eurosurveillance/26/29/eurosurv-26-29_5.html?itemId=/content/10.2807/1560-7917.ES.2021.26.29.2001600&mimeType=html&fmt=ahah

References

National Institute for Community Diseases (NICD). NICD daily report and commentary. Johannesburg: NICD; 2020. Available from: https://www.nicd.ac.za/diseases-a-z-index/covid-19/surveillance-reports
Olsen SJ, Azziz-Baumgartner E, Budd AP, Brammer L, Sullivan S, Pineda RF, et al. Decreased Influenza Activity During the COVID-19 Pandemic - United States, Australia, Chile, and South Africa, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(37):1305-9. https://doi.org/10.15585/mmwr.mm6937a6 PMID: 32941415
Sakamoto H, Ishikane M, Ueda P. Seasonal influenza activity during the SARS-CoV-2 outbreak in Japan. JAMA. 2020;323(19):1969-71. https://doi.org/10.1001/jama.2020.6173 PMID: 32275293
Cowling BJ, Ali ST, Ng TWY, Tsang TK, Li JCM, Fong MW, et al. Impact assessment of non-pharmaceutical interventions against coronavirus disease 2019 and influenza in Hong Kong: an observational study. Lancet Public Health. 2020;5(5):e279-88. https://doi.org/10.1016/S2468-2667(20)30090-6 PMID: 32311320
Wong NS, Leung CC, Lee SS. Abrupt Subsidence of Seasonal Influenza after COVID-19 Outbreak, Hong Kong, China. Emerg Infect Dis. 2020;26(11):2752-5. https://doi.org/10.3201/eid2611.200861 PMID: 32852264
Yeoh DK, Foley DA, Minney-Smith CA, Martin AC, Mace AO, Sikazwe CT, et al. The impact of COVID-19 public health measures on detections of influenza and respiratory syncytial virus in children during the 2020 Australian winter. Clin Infect Dis. 2021;72(12):2199-202. https://doi.org/10.1093/cid/ciaa1475 PMID: 32986804
Tempia S, Walaza S, Moyes J, McMorrow ML, Cohen AL, Edoka I, et al. Influenza disease burden among potential target risk groups for immunization in South Africa, 2013-2015. Vaccine. 2020;38(27):4288-97. https://doi.org/10.1016/j.vaccine.2020.04.045 PMID: 32389494
McMorrow ML, Tempia S, Walaza S, Treurnicht FK, Moyes J, Cohen AL, et al. The role of Human Immunodeficiency Virus in influenza- and respiratory syncytial virus-associated hospitalizations in South African children, 2011-2016. Clin Infect Dis. 2019;68(5):773-80. https://doi.org/10.1093/cid/ciy532 PMID: 29961814
Moyes J, Walaza S, Pretorius M, Groome M, von Gottberg A, Wolter N, et al. Respiratory syncytial virus in adults with severe acute respiratory illness in a high HIV prevalence setting. J Infect. 2017;75(4):346-55. https://doi.org/10.1016/j.jinf.2017.06.007 PMID: 28676408
Pretorius MA, Tempia S, Walaza S, Cohen AL, Moyes J, Variava E, et al. The role of influenza, RSV and other common respiratory viruses in severe acute respiratory infections and influenza-like illness in a population with a high HIV sero-prevalence, South Africa 2012-2015. J Clin Virol. 2016;75:21-6. https://doi.org/10.1016/j.jcv.2015.12.004 PMID: 26741826
Corman VM, Landt O, Kaiser M, Molenkamp R, Meijer A, Chu DK, et al. Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR. Euro Surveill. 2020;25(3):2000045. https://doi.org/10.2807/1560-7917.ES.2020.25.3.2000045 PMID: 31992387
Lancet Laboratories. Respiratory Virus Statistics. Johannesburg: Lancet Laboratories; 2020. Available from: http://www.lancet.co.za/respiratory-virus-stats-for-june-2020/
Department of Health. Australian Government. Australian Influenza Surveillance Report No.6, June 2020. Canberra: Department of Health; 2020. Available from: https://www1.health.gov.au/internet/main/publishing.nsf/Content/EE2273C903B9D74CCA25859A000ACFF2/$File/flu-06-2020.pdf
Institute of Environmental Science and Research, New Zealand Government. Current influenza surveillance intelligence. Porirua: Institute of Environmental Science and Research. [Accessed: 13 Jul 2020]. Available from: https://www.esr.cri.nz/our-services/consultancy/flu-surveillance-and-research
Epidemiology Department, Chile Ministry of Health. Situatión de Influenza y Virus Respiratorios, Informe 2020 (SE 1-23). [Situation of Influenza and Respiratory Viruses, Report 2020 (SE 1-23)]. Santiago: Chile Ministry of Health; 2020. Spanish. Available from: https://www.minsal.cl/wp-content/uploads/2020/06/Informe-SE-1-23-2020-Minsal-Influenza-web.pdf
National Directorate of Epidemiology and Strategic Information, Ministry of Health, Argentina Government. Boletín intergrado de vigilancia, SE 24-2020. [Integrated surveillance bulletin, SE 24-2020]. Santiago: Depto. de Epidemiologia DIPLAS/MINSAL; 2020. Spanish. Available from: https://www.argentina.gob.ar/sites/default/files/biv_500_se_24.pdf
Deyle ER, Maher MC, Hernandez RD, Basu S, Sugihara G. Global environmental drivers of influenza. Proc Natl Acad Sci USA. 2016;113(46):13081-6. https://doi.org/10.1073/pnas.1607747113 PMID: 27799563
Biggerstaff M, Cauchemez S, Reed C, Gambhir M, Finelli L. Estimates of the reproduction number for seasonal, pandemic, and zoonotic influenza: a systematic review of the literature. BMC Infect Dis. 2014;14(1):480. https://doi.org/10.1186/1471-2334-14-480 PMID: 25186370
Weber A, Weber M, Milligan P. Modeling epidemics caused by respiratory syncytial virus (RSV). Math Biosci. 2001;172(2):95-113. https://doi.org/10.1016/S0025-5564(01)00066-9 PMID: 11520501
Cohen C, Walaza S, Treurnicht FK, McMorrow M, Madhi SA, McAnerney JM, et al. In- and out-of-hospital mortality associated with seasonal and pandemic influenza and respiratory syncytial virus in South Africa, 2009-2013. Clin Infect Dis. 2018;66(1):95-103. https://doi.org/10.1093/cid/cix740 PMID: 29040527
South Africa Medical Research Council, Burden of Disease Research Unit. Report on weekly deaths in South Africa. 1 January – 13 October 2020 (week 41). Cape Town: Burden of Disease Research Unit, South Africa Medical Research Council 2020. Available from: https://www.samrc.ac.za/sites/default/files/files/2020-10-21/weekly13October2020.pdf
World Health Organization (WHO). Recommended composition of influenza virus vaccines for use in the 2021 southern hemisphere influenza season. Geneva: WHO; 2020. Available from: https://www.who.int/influenza/vaccines/virus/recommendations/202009_recommendation.pdf?ua=1

Decline of influenza and respiratory syncytial virus detection in facility-based surveillance during the COVID-19 pandemic, South Africa, January to October 2020

Citation style for this article: <a href="/search?value1=Stefano+Tempia&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Tempia Stefano</a>, <a href="/search?value1=Sibongile+Walaza&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Walaza Sibongile</a>, <a href="/search?value1=Jinal+N+Bhiman&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bhiman Jinal N</a>, <a href="/search?value1=Meredith+L+McMorrow&option1=author&noRedirect=true" class="nonDisambigAuthorLink">McMorrow Meredith L</a>, <a href="/search?value1=Jocelyn+Moyes&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Moyes Jocelyn</a>, <a href="/search?value1=Thulisa+Mkhencele&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mkhencele Thulisa</a>, <a href="/search?value1=Susan+Meiring&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Meiring Susan</a>, <a href="/search?value1=Vanessa+Quan&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Quan Vanessa</a>, <a href="/search?value1=Kate+Bishop&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bishop Kate</a>, <a href="/search?value1=Johanna+M+McAnerney&option1=author&noRedirect=true" class="nonDisambigAuthorLink">McAnerney Johanna M</a>, <a href="/search?value1=Anne+von+Gottberg&option1=author&noRedirect=true" class="nonDisambigAuthorLink">von Gottberg Anne</a>, <a href="/search?value1=Nicole+Wolter&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Wolter Nicole</a>, <a href="/search?value1=Mignon+Du+Plessis&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Du Plessis Mignon</a>, <a href="/search?value1=Florette+K+Treurnicht&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Treurnicht Florette K</a>, <a href="/search?value1=Orienka+Hellferscee&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hellferscee Orienka</a>, <a href="/search?value1=Halima+Dawood&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Dawood Halima</a>, <a href="/search?value1=Fathima+Naby&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Naby Fathima</a>, <a href="/search?value1=Ebrahim+Variava&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Variava Ebrahim</a>, <a href="/search?value1=Comfort+Siwele&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Siwele Comfort</a>, <a href="/search?value1=Neydis+Baute&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Baute Neydis</a>, <a href="/search?value1=Jeremy+Nel&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Nel Jeremy</a>, <a href="/search?value1=Gary+Reubenson&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Reubenson Gary</a>, <a href="/search?value1=Heather+J+Zar&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Zar Heather J</a>, <a href="/search?value1=Cheryl+Cohen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Cohen Cheryl</a>. Decline of influenza and respiratory syncytial virus detection in facility-based surveillance during the COVID-19 pandemic, South Africa, January to October 2020. <a href="/content/ecdc">Euro Surveill.</a> 2021;26(29):pii=2001600. <a href="https://doi.org/10.2807/1560-7917.ES.2021.26.29.2001600" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2021.26.29.2001600</a> Received: 26 Aug 2020;   Accepted: 19 Nov 2020

/content/10.2807/1560-7917.ES.2021.26.29.2001600

Data & Media loading...

Supplementary data

Download
- Supplementary Material

Submit comment

Comment moderation successfully completed

Submit your article here

Submit an Article

Decline of influenza and respiratory syncytial virus detection in facility-based surveillance during the COVID-19 pandemic, South Africa, January to October 2020

Abstract

Click here for cited by

Supplementary data

Supplementary Material