Off-season RSV epidemics in Australia after easing of COVID-19 restrictions

John-Sebastian Eden, Chisha Sikazwe, Ruopeng Xie, Yi-Mo Deng, Sheena G. Sullivan, Alice Michie, Avram Levy, Elena Cutmore, Christopher C. Blyth, Philip N. Britton, Nigel Crawford, Xiaomin Dong, Dominic E. Dwyer, Kimberly M. Edwards, Bethany A. Horsburgh, David Foley, Karina Kennedy, Cara Minney-Smith, David Speers, Rachel L. Tulloch, Edward C. Holmes, Vijaykrishna Dhanasekaran (), David W. Smith (), Jen Kok () and Ian G. Barr ()
Additional contact information
John-Sebastian Eden: Westmead Institute for Medical Research
Chisha Sikazwe: PathWest Laboratory Medicine WA, Department of Microbiology
Ruopeng Xie: The University of Hong Kong
Yi-Mo Deng: Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity
Sheena G. Sullivan: Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity
Alice Michie: The University of Western Australia
Avram Levy: PathWest Laboratory Medicine WA, Department of Microbiology
Elena Cutmore: Westmead Institute for Medical Research
Christopher C. Blyth: PathWest Laboratory Medicine WA, Department of Microbiology
Philip N. Britton: The University of Sydney
Nigel Crawford: Murdoch Children’s Research Institute
Xiaomin Dong: Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity
Dominic E. Dwyer: The University of Sydney
Kimberly M. Edwards: The University of Hong Kong
Bethany A. Horsburgh: Westmead Institute for Medical Research
David Foley: PathWest Laboratory Medicine WA, Department of Microbiology
Karina Kennedy: Canberra Hospital
Cara Minney-Smith: PathWest Laboratory Medicine WA, Department of Microbiology
David Speers: PathWest Laboratory Medicine WA, Department of Microbiology
Rachel L. Tulloch: Westmead Institute for Medical Research
Edward C. Holmes: The University of Sydney
Vijaykrishna Dhanasekaran: The University of Hong Kong
David W. Smith: PathWest Laboratory Medicine WA, Department of Microbiology
Jen Kok: Westmead Hospital
Ian G. Barr: Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity

Nature Communications, 2022, vol. 13, issue 1, 1-9

Abstract: Abstract Human respiratory syncytial virus (RSV) is an important cause of acute respiratory infection with the most severe disease in the young and elderly. Non-pharmaceutical interventions and travel restrictions for controlling COVID-19 have impacted the circulation of most respiratory viruses including RSV globally, particularly in Australia, where during 2020 the normal winter epidemics were notably absent. However, in late 2020, unprecedented widespread RSV outbreaks occurred, beginning in spring, and extending into summer across two widely separated regions of the Australian continent, New South Wales (NSW) and Australian Capital Territory (ACT) in the east, and Western Australia. Through genomic sequencing we reveal a major reduction in RSV genetic diversity following COVID-19 emergence with two genetically distinct RSV-A clades circulating cryptically, likely localised for several months prior to an epidemic surge in cases upon relaxation of COVID-19 control measures. The NSW/ACT clade subsequently spread to the neighbouring state of Victoria and to cause extensive outbreaks and hospitalisations in early 2021. These findings highlight the need for continued surveillance and sequencing of RSV and other respiratory viruses during and after the COVID-19 pandemic, as mitigation measures may disrupt seasonal patterns, causing larger or more severe outbreaks.

Date: 2022
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DOI: 10.1038/s41467-022-30485-3

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