Respiratory syncytial virus infection in children of jinan: Epidemiological and clinical characteristics, 2022–2024

Objective: To retrospectively analyze the epidemiological characteristics and changing trends of respiratory syncytial virus (RSV) infection in children with acute respiratory infections (ARI) treated at the Children's Hospital Affiliated to Shandong University from 2022 to 2024. 

Methods: Children aged 0-18 years with ARI were enrolled, and targeted next-generation sequencing (T-NGS) was used to detect RSV positivity. The distribution of subtypes (A/B), seasonal prevalence, age-specific characteristics, and pathogen co-detection were analyzed.

Results: A total of 20,059 specimens were included, with an overall RSV positivity rate of 13.02%. The rates for 2022, 2023, and 2024 were 7.69%, 15.66%, and 6.81%, respectively (P < 0.001). The epidemic peaks of RSV occurred in January and November 2022, advanced to March-May 2023, and returned to January 2024. The RSV positivity rates showed a declining trend with increasing age (P trend < 0.001). Among the 2,612 RSV-positive specimens, subtype A accounted for 55.13%, subtype B for 43.57%, and mixed subtypes for 1.30%. Subtype A dominated in 2022 (88%), while subtypes A and B were nearly balanced in 2023–2024. Subtype A was more common in spring and summer, whereas subtype B predominated in autumn and winter (P < 0.001). The co-detection rate of bacteria showed an upward trend (P trend < 0.001), with Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus being the most common. Bacterial co-detection was higher with subtype A than subtype B (56.64% vs 42.02%, P < 0.001). In contrast, the viral co-detection rate exhibited a downward trend (P trend < 0.01), mainly involving human rhinovirus, adenovirus, and parainfluenza virus; the viral co-detection rate was also higher in subtype A than in subtype B (54.0% vs 44.48%, P < 0.001). Additionally, the co-detection with Mycoplasma pneumoniae and Bordetella pertussis showed an upward trend and was more common with subtype B (both P < 0.05).

Conclusion: The COVID-19 pandemic had a certain impact on the epidemic trend of RSV. In the post-pandemic period, RSV activity increased initially and then decreased, showing new characteristics such as a spring epidemic peak, subtype alternation, and predominant bacterial co-detection. Continuous monitoring of subtype changes and optimization of prevention and control strategies are needed.

To be updated shortly..