Global patterns in monthly activity of influenza virus, respiratory syncytial virus, parainfluenza virus, and metapneumovirus: a systematic analysis

RSV Global Epidemiology Network, RESCEU Investigators

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background Influenza virus, respiratory syncytial virus, parainfluenza virus, and metapneumovirus are the most common viruses associated with acute lower respiratory infections in young children (= 65 years). A global report of the monthly activity of these viruses is needed to inform public health strategies and programmes for their control.

Methods In this systematic analysis, we compiled data from a systematic literature review of studies published between Jan 1, 2000, and Dec 31, 2017; online datasets; and unpublished research data. Studies were eligible for inclusion if they reported laboratory-confirmed incidence data of human infection of influenza virus, respiratory syncytial virus, parainfluenza virus, or metapneumovirus, or a combination of these, for at least 12 consecutive months (or 52 weeks equivalent); stable testing practice throughout all years reported; virus results among residents in well-defined geographical locations; and aggregated virus results at least on a monthly basis. Data were extracted through a three-stage process, from which we calculated monthly annual average percentage (AAP) as the relative strength of virus activity. We defined duration of epidemics as the minimum number of months to account for 75% of annual positive samples, with each component month defined as an epidemic month. Furthermore, we modelled monthly AAP of influenza virus and respiratory syncytial virus using site-specific temperature and relative humidity for the prediction of local average epidemic months. We also predicted global epidemic months of influenza virus and respiratory syncytial virus on a 5 degrees by 5 degrees grid. The systematic review in this study is registered with PROSPERO, number CRD42018091628.

Findings We initally identified 37 335 eligible studies. Of 21 065 studies remaining after exclusion of duplicates, 1081 full-text articles were assessed for eligibility, of which 185 were identified as eligible. We included 246 sites for influenza virus, 183 sites for respiratory syncytial virus, 83 sites for parainfluenza virus, and 65 sites for metapneumovirus. Influenza virus had clear seasonal epidemics in winter months in most temperate sites but timing of epidemics was more variable and less seasonal with decreasing distance from the equator. Unlike influenza virus, respiratory syncytial virus had clear seasonal epidemics in both temperate and tropical regions, starting in late summer months in the tropics of each hemisphere, reaching most temperate sites in winter months. In most temperate sites, influenza virus epidemics occurred later than respiratory syncytial virus (by 0.3 months [95% CI -0.3 to 0.9]) while no clear temporal order was observed in the tropics. Parainfluenza virus epidemics were found mostly in spring and early summer months in each hemisphere. Metapneumovirus epidemics occurred in late winter and spring in most temperate sites but the timing of epidemics was more diverse in the tropics. Influenza virus epidemics had shorter duration (3.8 months [3.6 to 4.0]) in temperate sites and longer duration (5.2 months [4.9 to 5.5]) in the tropics. Duration of epidemics was similar across all sites for respiratory syncytial virus (4.6 months [4.3 to 4.8]), as it was for metapneumovirus (4.8 months [4.4 to 5.1]). By comparison, parainfluenza virus had longer duration of epidemics (6.3 months [6.0 to 6.7]). Our model had good predictability in the average epidemic months of influenza virus in temperate regions and respiratory syncytial virus in both temperate and tropical regions. Through leave-one-out cross validation, the overall prediction error in the onset of epidemics was within 1 month (influenza virus -0.2 months [-0.6 to 0.1]; respiratory syncytial virus 0.1 months [-0.2 to 0.4]).

Interpretation This study is the first to provide global representations of month-by-month activity of influenza virus, respiratory syncytial virus, parainfluenza virus, and metapneumovirus. Our model is helpful in predicting the local onset month of influenza virus and respiratory syncytial virus epidemics. The seasonality information has important implications for health services planning, the timing of respiratory syncytial virus passive prophylaxis, and the strategy of influenza virus and future respiratory syncytial virus vaccination. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd.

Original languageEnglish
Pages (from-to)E1031-E1045
Number of pages15
JournalThe Lancet Global Health
Volume7
Issue number8
DOIs
Publication statusPublished - Aug 2019

Cite this

@article{85a1c5d270fd445eb46f48e3569ea700,
title = "Global patterns in monthly activity of influenza virus, respiratory syncytial virus, parainfluenza virus, and metapneumovirus: a systematic analysis",
abstract = "Background Influenza virus, respiratory syncytial virus, parainfluenza virus, and metapneumovirus are the most common viruses associated with acute lower respiratory infections in young children (= 65 years). A global report of the monthly activity of these viruses is needed to inform public health strategies and programmes for their control.Methods In this systematic analysis, we compiled data from a systematic literature review of studies published between Jan 1, 2000, and Dec 31, 2017; online datasets; and unpublished research data. Studies were eligible for inclusion if they reported laboratory-confirmed incidence data of human infection of influenza virus, respiratory syncytial virus, parainfluenza virus, or metapneumovirus, or a combination of these, for at least 12 consecutive months (or 52 weeks equivalent); stable testing practice throughout all years reported; virus results among residents in well-defined geographical locations; and aggregated virus results at least on a monthly basis. Data were extracted through a three-stage process, from which we calculated monthly annual average percentage (AAP) as the relative strength of virus activity. We defined duration of epidemics as the minimum number of months to account for 75{\%} of annual positive samples, with each component month defined as an epidemic month. Furthermore, we modelled monthly AAP of influenza virus and respiratory syncytial virus using site-specific temperature and relative humidity for the prediction of local average epidemic months. We also predicted global epidemic months of influenza virus and respiratory syncytial virus on a 5 degrees by 5 degrees grid. The systematic review in this study is registered with PROSPERO, number CRD42018091628.Findings We initally identified 37 335 eligible studies. Of 21 065 studies remaining after exclusion of duplicates, 1081 full-text articles were assessed for eligibility, of which 185 were identified as eligible. We included 246 sites for influenza virus, 183 sites for respiratory syncytial virus, 83 sites for parainfluenza virus, and 65 sites for metapneumovirus. Influenza virus had clear seasonal epidemics in winter months in most temperate sites but timing of epidemics was more variable and less seasonal with decreasing distance from the equator. Unlike influenza virus, respiratory syncytial virus had clear seasonal epidemics in both temperate and tropical regions, starting in late summer months in the tropics of each hemisphere, reaching most temperate sites in winter months. In most temperate sites, influenza virus epidemics occurred later than respiratory syncytial virus (by 0.3 months [95{\%} CI -0.3 to 0.9]) while no clear temporal order was observed in the tropics. Parainfluenza virus epidemics were found mostly in spring and early summer months in each hemisphere. Metapneumovirus epidemics occurred in late winter and spring in most temperate sites but the timing of epidemics was more diverse in the tropics. Influenza virus epidemics had shorter duration (3.8 months [3.6 to 4.0]) in temperate sites and longer duration (5.2 months [4.9 to 5.5]) in the tropics. Duration of epidemics was similar across all sites for respiratory syncytial virus (4.6 months [4.3 to 4.8]), as it was for metapneumovirus (4.8 months [4.4 to 5.1]). By comparison, parainfluenza virus had longer duration of epidemics (6.3 months [6.0 to 6.7]). Our model had good predictability in the average epidemic months of influenza virus in temperate regions and respiratory syncytial virus in both temperate and tropical regions. Through leave-one-out cross validation, the overall prediction error in the onset of epidemics was within 1 month (influenza virus -0.2 months [-0.6 to 0.1]; respiratory syncytial virus 0.1 months [-0.2 to 0.4]).Interpretation This study is the first to provide global representations of month-by-month activity of influenza virus, respiratory syncytial virus, parainfluenza virus, and metapneumovirus. Our model is helpful in predicting the local onset month of influenza virus and respiratory syncytial virus epidemics. The seasonality information has important implications for health services planning, the timing of respiratory syncytial virus passive prophylaxis, and the strategy of influenza virus and future respiratory syncytial virus vaccination. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd.",
keywords = "SEASONALITY, INFECTIONS, EPIDEMICS, DRIVERS",
author = "{RSV Global Epidemiology Network} and {RESCEU Investigators} and You Li and Reeves, {Rachel M.} and Xin Wang and Quique Bassat and Brooks, {W. Abdullah} and Cheryl Cohen and Moore, {David P.} and Marta Nunes and Barbara Rath and Harry Campbell and Harish Nair and Sozinho Acacio and Alonso, {Wladimir J.} and Martin Antonio and {Ayora Talavera}, Guadalupe and Darmaa Badarch and Baillie, {Vicky L.} and Gisela Barrera-Badillo and Godfrey Bigogo and Shobha Broor and Dana Bruden and Philippe Buchy and Peter Byass and James Chipeta and Wilfrido Clara and Duc-Anh Dang and {de Freitas Lazaro Emediato}, {Carla Cecilia} and {de Jong}, Menno and Diaz-Quinonez, {Jose Alberto} and Do, {Lien Anh Ha} and Fasce, {Rodrigo A.} and Luzhao Feng and Ferson, {Mark J.} and Angela Gentile and Gessner, {Bradford D.} and Doli Goswami and Sophie Goyet and Grijalva, {Carlos G.} and Natasha Halasa and Orienka Hellferscee and Danielle Hessong and Nusrat Homaira and Jorge Jara and Kathleen Kahn and Najwa Khuri-Bulos and Kotloff, {Karen L.} and Lanata, {Claudio F.} and Olga Lopez and {Lopez Bolanos}, {Maria Renee} and Lucero, {Marilla G.} and Florencia Lucion and Lupisan, {Socorro P.} and Madhi, {Shabir A.} and McCracken, {John P.} and Omphile Mekgoe and Cinta Moraleda and Jocelyn Moyes and Kim Mulholland and Munywoki, {Patrick K.} and Fathima Naby and {Thanh Hung Nguyen} and Nicol, {Mark P.} and Nokes, {D. James} and Noyola, {Daniel E.} and Daisuke Onozuka and Nandhini Palani and Yong Poovorawan and Mustafizur Rahman and Kaat Ramaekers and Candice Romero and Schlaudecker, {Elizabeth P.} and Brunhilde Schweiger and Phil Seidenberg and Simoes, {Eric A. F.} and Rosalyn Singleton and Sujatha Sistla and Katharine Sturm-Ramirez and Nungruthai Suntronwong and Agustinus Sutanto and Tapia, {Milagritos D.} and Somsak Thamthitiwat and Ilada Thongpan and Gayani Tillekeratne and Tinoco, {Yeny O.} and Treurnicht, {Florette K.} and Claudia Turner and Paul Turner and {van Doorn}, Rogier and {Van Ranst}, Marc and Benoit Visseaux and Sunthareeya Waicharoen and Jianwei Wang and Lay-Myint Yoshida and Zar, {Heather J.} and Ting Shi and Shanshan Zhang and Peter Openshaw and Jadwicha Wedzicha and Ann Falsey and Mark Miller and Philippe Beutels and Louis Bont and Andrew Pollard and Eva Molero and Federico Martinon-Torres and Terho Heikkinen and Adam Meijer and Fischer, {Thea Kolsen} and {van den Berge}, Maarten and Carlo Giaquinto and Rafael Mikolajczyk and Judy Hackett and Laura Dillon and Eskinder Tafesse and Bing Cai and Charles Knirsch and Lopez, {Antonio Gonzalez} and Ilse Dieussaert and Nadia Dermateau and Amanda Leach and Stoszek, {Sonia K.} and Scott Gallichan and Alexia Kieffer and Clarisse Demont and Angeline Denouel and Arnaud Cheret and Sandra Gavart and Jeroen Aerssens and Veronique Wyffels and Matthias Cleenewerck and Robert Fuentes and Brian Rosen",
year = "2019",
month = "8",
doi = "10.1016/S2214-109X(19)30264-5",
language = "English",
volume = "7",
pages = "E1031--E1045",
journal = "The Lancet Global Health",
issn = "2214-109X",
publisher = "Elsevier",
number = "8",

}

Global patterns in monthly activity of influenza virus, respiratory syncytial virus, parainfluenza virus, and metapneumovirus : a systematic analysis. / RSV Global Epidemiology Network; RESCEU Investigators.

In: The Lancet Global Health, Vol. 7, No. 8, 08.2019, p. E1031-E1045.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Global patterns in monthly activity of influenza virus, respiratory syncytial virus, parainfluenza virus, and metapneumovirus

T2 - a systematic analysis

AU - RSV Global Epidemiology Network

AU - RESCEU Investigators

AU - Li, You

AU - Reeves, Rachel M.

AU - Wang, Xin

AU - Bassat, Quique

AU - Brooks, W. Abdullah

AU - Cohen, Cheryl

AU - Moore, David P.

AU - Nunes, Marta

AU - Rath, Barbara

AU - Campbell, Harry

AU - Nair, Harish

AU - Acacio, Sozinho

AU - Alonso, Wladimir J.

AU - Antonio, Martin

AU - Ayora Talavera, Guadalupe

AU - Badarch, Darmaa

AU - Baillie, Vicky L.

AU - Barrera-Badillo, Gisela

AU - Bigogo, Godfrey

AU - Broor, Shobha

AU - Bruden, Dana

AU - Buchy, Philippe

AU - Byass, Peter

AU - Chipeta, James

AU - Clara, Wilfrido

AU - Dang, Duc-Anh

AU - de Freitas Lazaro Emediato, Carla Cecilia

AU - de Jong, Menno

AU - Diaz-Quinonez, Jose Alberto

AU - Do, Lien Anh Ha

AU - Fasce, Rodrigo A.

AU - Feng, Luzhao

AU - Ferson, Mark J.

AU - Gentile, Angela

AU - Gessner, Bradford D.

AU - Goswami, Doli

AU - Goyet, Sophie

AU - Grijalva, Carlos G.

AU - Halasa, Natasha

AU - Hellferscee, Orienka

AU - Hessong, Danielle

AU - Homaira, Nusrat

AU - Jara, Jorge

AU - Kahn, Kathleen

AU - Khuri-Bulos, Najwa

AU - Kotloff, Karen L.

AU - Lanata, Claudio F.

AU - Lopez, Olga

AU - Lopez Bolanos, Maria Renee

AU - Lucero, Marilla G.

AU - Lucion, Florencia

AU - Lupisan, Socorro P.

AU - Madhi, Shabir A.

AU - McCracken, John P.

AU - Mekgoe, Omphile

AU - Moraleda, Cinta

AU - Moyes, Jocelyn

AU - Mulholland, Kim

AU - Munywoki, Patrick K.

AU - Naby, Fathima

AU - Thanh Hung Nguyen, null

AU - Nicol, Mark P.

AU - Nokes, D. James

AU - Noyola, Daniel E.

AU - Onozuka, Daisuke

AU - Palani, Nandhini

AU - Poovorawan, Yong

AU - Rahman, Mustafizur

AU - Ramaekers, Kaat

AU - Romero, Candice

AU - Schlaudecker, Elizabeth P.

AU - Schweiger, Brunhilde

AU - Seidenberg, Phil

AU - Simoes, Eric A. F.

AU - Singleton, Rosalyn

AU - Sistla, Sujatha

AU - Sturm-Ramirez, Katharine

AU - Suntronwong, Nungruthai

AU - Sutanto, Agustinus

AU - Tapia, Milagritos D.

AU - Thamthitiwat, Somsak

AU - Thongpan, Ilada

AU - Tillekeratne, Gayani

AU - Tinoco, Yeny O.

AU - Treurnicht, Florette K.

AU - Turner, Claudia

AU - Turner, Paul

AU - van Doorn, Rogier

AU - Van Ranst, Marc

AU - Visseaux, Benoit

AU - Waicharoen, Sunthareeya

AU - Wang, Jianwei

AU - Yoshida, Lay-Myint

AU - Zar, Heather J.

AU - Shi, Ting

AU - Zhang, Shanshan

AU - Openshaw, Peter

AU - Wedzicha, Jadwicha

AU - Falsey, Ann

AU - Miller, Mark

AU - Beutels, Philippe

AU - Bont, Louis

AU - Pollard, Andrew

AU - Molero, Eva

AU - Martinon-Torres, Federico

AU - Heikkinen, Terho

AU - Meijer, Adam

AU - Fischer, Thea Kolsen

AU - van den Berge, Maarten

AU - Giaquinto, Carlo

AU - Mikolajczyk, Rafael

AU - Hackett, Judy

AU - Dillon, Laura

AU - Tafesse, Eskinder

AU - Cai, Bing

AU - Knirsch, Charles

AU - Lopez, Antonio Gonzalez

AU - Dieussaert, Ilse

AU - Dermateau, Nadia

AU - Leach, Amanda

AU - Stoszek, Sonia K.

AU - Gallichan, Scott

AU - Kieffer, Alexia

AU - Demont, Clarisse

AU - Denouel, Angeline

AU - Cheret, Arnaud

AU - Gavart, Sandra

AU - Aerssens, Jeroen

AU - Wyffels, Veronique

AU - Cleenewerck, Matthias

AU - Fuentes, Robert

AU - Rosen, Brian

PY - 2019/8

Y1 - 2019/8

N2 - Background Influenza virus, respiratory syncytial virus, parainfluenza virus, and metapneumovirus are the most common viruses associated with acute lower respiratory infections in young children (= 65 years). A global report of the monthly activity of these viruses is needed to inform public health strategies and programmes for their control.Methods In this systematic analysis, we compiled data from a systematic literature review of studies published between Jan 1, 2000, and Dec 31, 2017; online datasets; and unpublished research data. Studies were eligible for inclusion if they reported laboratory-confirmed incidence data of human infection of influenza virus, respiratory syncytial virus, parainfluenza virus, or metapneumovirus, or a combination of these, for at least 12 consecutive months (or 52 weeks equivalent); stable testing practice throughout all years reported; virus results among residents in well-defined geographical locations; and aggregated virus results at least on a monthly basis. Data were extracted through a three-stage process, from which we calculated monthly annual average percentage (AAP) as the relative strength of virus activity. We defined duration of epidemics as the minimum number of months to account for 75% of annual positive samples, with each component month defined as an epidemic month. Furthermore, we modelled monthly AAP of influenza virus and respiratory syncytial virus using site-specific temperature and relative humidity for the prediction of local average epidemic months. We also predicted global epidemic months of influenza virus and respiratory syncytial virus on a 5 degrees by 5 degrees grid. The systematic review in this study is registered with PROSPERO, number CRD42018091628.Findings We initally identified 37 335 eligible studies. Of 21 065 studies remaining after exclusion of duplicates, 1081 full-text articles were assessed for eligibility, of which 185 were identified as eligible. We included 246 sites for influenza virus, 183 sites for respiratory syncytial virus, 83 sites for parainfluenza virus, and 65 sites for metapneumovirus. Influenza virus had clear seasonal epidemics in winter months in most temperate sites but timing of epidemics was more variable and less seasonal with decreasing distance from the equator. Unlike influenza virus, respiratory syncytial virus had clear seasonal epidemics in both temperate and tropical regions, starting in late summer months in the tropics of each hemisphere, reaching most temperate sites in winter months. In most temperate sites, influenza virus epidemics occurred later than respiratory syncytial virus (by 0.3 months [95% CI -0.3 to 0.9]) while no clear temporal order was observed in the tropics. Parainfluenza virus epidemics were found mostly in spring and early summer months in each hemisphere. Metapneumovirus epidemics occurred in late winter and spring in most temperate sites but the timing of epidemics was more diverse in the tropics. Influenza virus epidemics had shorter duration (3.8 months [3.6 to 4.0]) in temperate sites and longer duration (5.2 months [4.9 to 5.5]) in the tropics. Duration of epidemics was similar across all sites for respiratory syncytial virus (4.6 months [4.3 to 4.8]), as it was for metapneumovirus (4.8 months [4.4 to 5.1]). By comparison, parainfluenza virus had longer duration of epidemics (6.3 months [6.0 to 6.7]). Our model had good predictability in the average epidemic months of influenza virus in temperate regions and respiratory syncytial virus in both temperate and tropical regions. Through leave-one-out cross validation, the overall prediction error in the onset of epidemics was within 1 month (influenza virus -0.2 months [-0.6 to 0.1]; respiratory syncytial virus 0.1 months [-0.2 to 0.4]).Interpretation This study is the first to provide global representations of month-by-month activity of influenza virus, respiratory syncytial virus, parainfluenza virus, and metapneumovirus. Our model is helpful in predicting the local onset month of influenza virus and respiratory syncytial virus epidemics. The seasonality information has important implications for health services planning, the timing of respiratory syncytial virus passive prophylaxis, and the strategy of influenza virus and future respiratory syncytial virus vaccination. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd.

AB - Background Influenza virus, respiratory syncytial virus, parainfluenza virus, and metapneumovirus are the most common viruses associated with acute lower respiratory infections in young children (= 65 years). A global report of the monthly activity of these viruses is needed to inform public health strategies and programmes for their control.Methods In this systematic analysis, we compiled data from a systematic literature review of studies published between Jan 1, 2000, and Dec 31, 2017; online datasets; and unpublished research data. Studies were eligible for inclusion if they reported laboratory-confirmed incidence data of human infection of influenza virus, respiratory syncytial virus, parainfluenza virus, or metapneumovirus, or a combination of these, for at least 12 consecutive months (or 52 weeks equivalent); stable testing practice throughout all years reported; virus results among residents in well-defined geographical locations; and aggregated virus results at least on a monthly basis. Data were extracted through a three-stage process, from which we calculated monthly annual average percentage (AAP) as the relative strength of virus activity. We defined duration of epidemics as the minimum number of months to account for 75% of annual positive samples, with each component month defined as an epidemic month. Furthermore, we modelled monthly AAP of influenza virus and respiratory syncytial virus using site-specific temperature and relative humidity for the prediction of local average epidemic months. We also predicted global epidemic months of influenza virus and respiratory syncytial virus on a 5 degrees by 5 degrees grid. The systematic review in this study is registered with PROSPERO, number CRD42018091628.Findings We initally identified 37 335 eligible studies. Of 21 065 studies remaining after exclusion of duplicates, 1081 full-text articles were assessed for eligibility, of which 185 were identified as eligible. We included 246 sites for influenza virus, 183 sites for respiratory syncytial virus, 83 sites for parainfluenza virus, and 65 sites for metapneumovirus. Influenza virus had clear seasonal epidemics in winter months in most temperate sites but timing of epidemics was more variable and less seasonal with decreasing distance from the equator. Unlike influenza virus, respiratory syncytial virus had clear seasonal epidemics in both temperate and tropical regions, starting in late summer months in the tropics of each hemisphere, reaching most temperate sites in winter months. In most temperate sites, influenza virus epidemics occurred later than respiratory syncytial virus (by 0.3 months [95% CI -0.3 to 0.9]) while no clear temporal order was observed in the tropics. Parainfluenza virus epidemics were found mostly in spring and early summer months in each hemisphere. Metapneumovirus epidemics occurred in late winter and spring in most temperate sites but the timing of epidemics was more diverse in the tropics. Influenza virus epidemics had shorter duration (3.8 months [3.6 to 4.0]) in temperate sites and longer duration (5.2 months [4.9 to 5.5]) in the tropics. Duration of epidemics was similar across all sites for respiratory syncytial virus (4.6 months [4.3 to 4.8]), as it was for metapneumovirus (4.8 months [4.4 to 5.1]). By comparison, parainfluenza virus had longer duration of epidemics (6.3 months [6.0 to 6.7]). Our model had good predictability in the average epidemic months of influenza virus in temperate regions and respiratory syncytial virus in both temperate and tropical regions. Through leave-one-out cross validation, the overall prediction error in the onset of epidemics was within 1 month (influenza virus -0.2 months [-0.6 to 0.1]; respiratory syncytial virus 0.1 months [-0.2 to 0.4]).Interpretation This study is the first to provide global representations of month-by-month activity of influenza virus, respiratory syncytial virus, parainfluenza virus, and metapneumovirus. Our model is helpful in predicting the local onset month of influenza virus and respiratory syncytial virus epidemics. The seasonality information has important implications for health services planning, the timing of respiratory syncytial virus passive prophylaxis, and the strategy of influenza virus and future respiratory syncytial virus vaccination. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd.

KW - SEASONALITY

KW - INFECTIONS

KW - EPIDEMICS

KW - DRIVERS

U2 - 10.1016/S2214-109X(19)30264-5

DO - 10.1016/S2214-109X(19)30264-5

M3 - Article

VL - 7

SP - E1031-E1045

JO - The Lancet Global Health

JF - The Lancet Global Health

SN - 2214-109X

IS - 8

ER -