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

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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
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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
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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.

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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

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

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