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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
Authors: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
Abstract:BackgroundIn 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.MethodsWe 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.ResultsFacility-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.ConclusionCOVID-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.
Keywords:COVID-19   influenza   respiratory syncytial virus   influenza-like illness   severe respiratory illness
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