Unprecedented Outbreak of Respiratory Syncytial Virus in Taiwan Associated with ON1 Variant Emergence between 2010 and 2020

Abstract

Background: A national outbreak of respiratory syncytial virus (RSV) has been observed in the community since August 2020 in Taiwan even under strict COVID-19 related public health measures.Methods: We reviewed a national laboratory-based surveillance network established by Taiwan Centers for Disease Control for respiratory viral pathogens between 2010 and 2020. A retrospective study of 257 children Findings: National data from 2020 showed an enormous increase in RSV case numbers. The RSV positivity rate in 2020 had an approximately 4-fold surge compared to 2010 in Taiwan (OR 3.79; 95% CI, 3.06–4.69; p Interpretation: The unprecedented 2020 RSV epidemic caused by novel ON1 variants suggests that the mutations may confer a fitness advantage over other genotypes. Further studies on viral replication, antigenic changes, and virulence are required.Funding: This work was supported by the Chang Gung Memorial Hospital in Taiwan [Grant CMRPG3K1011 and CMRPG3K1141 ]; Ministry of Science Technology in Taiwan [MOST 108-2314-B-182A-156-MY3]; China Medical University, Taiwan [Grant CMU 108-S-23, CMU109-MF-111]Declaration of Interests: No potential conflict of interest was reported by the authors.Ethics Approval Statement: This study was approved by the Research and Ethics Committee of Chang Gung Memorial Hospital (IRB:202100450B0, 202100569A3).