Previous Season Research Articles

Resurgence of common respiratory viruses in patients with community-acquired pneumonia (CAP)—A prospective multicenter study

BackgroundCommunity-acquired pneumonia (CAP) is a major global cause of death and hospitalization. Bacteria or community-acquired viruses (CARVs) cause CAP. COVID-19 associated restrictions effectively reduced the circulation of CARVs. ObjectivesThe aim of this study was to analyze the proportion of CARVs in adult patients with CAP from mid-2020 to mid-2023. Specifically, we aimed to compare the rate of influenza virus, SARS-CoV-2, and RSV detections in patients aged 18–59 years and ≥60 years. Study designWe analyze the proportion of 21 community-acquired respiratory viruses (CARVs) and three atypical bacteria (Bordetella pertussis, Legionella pneumophila, and Mycoplasma pneumoniae) in nasopharyngeal swab samples using molecular multiplex methods within the prospective, multicentre, multinational study of the German study Group CAPNETZ. We used stringent inclusion criteria throughout the study. ResultsWe identified CARVs in 364/1,388 (26.2 %) patients. In detail, we detected SARS-CoV-2 in 210/1,388 (15.1 %), rhino-/enterovirus in 64/1,388 (4.6 %), influenza virus in 23/1,388 (1.6 %) and RSV in 17/1,388 (1.2 %) of all patients. We detected RSV and influenza more frequently in patients ≥60 years, especially in 22/23 compared to the previous season. None of the atypical bacteria were detected. ConclusionsBeginning in 2023, we demonstrate a re-emergence of CARVs in CAP patients. Effective vaccines or specific antiviral therapies for more than two thirds of the detected viral infections are currently available. High detection rates of vaccine-preventable viruses in older age groups support targeted vaccination campaigns.

Repeated vaccination does not appear to significantly weaken the protective effect of influenza vaccine in the elderly: A test-negative case-control study in China

BackgroundThe impact of repeated influenza vaccination on vaccine effectiveness has been a topic of debate. Conducting more multinational, multicenter studies in different influenza seasons is crucial for a better understanding of this issue. There is a lack of comprehensive related research reports in China. MethodsUsing the Regional Health Information Platform, we conducted a test-negative case-control study to evaluate the impact of repeated vaccination on the prevention of laboratory-confirmed influenza in individuals aged 60 and above in Ningbo during four influenza seasons from 2018–19 to 2021–22. Influenza-positive cases and negative controls were matched in a 1:1 ratio based on the visiting hospital and the date of influenza testing. Propensity score adjustment and multivariable logistic regression were used to estimate risk and address confounding effects. ResultsDuring the study period, a total of 30,630 elderly patients underwent influenza virus nucleic acid or antigen testing. After exclusions, we included 1976 cases of influenza-positive and 1976 cases of influenza-negative controls. Multivariable logistic regression analysis revealed that individuals receiving the vaccine in two consecutive seasons did not exhibit a significantly increased risk of influenza illness compared to those receiving the vaccine only in the current season (adjusted odds ratio: 1.22, 95% confidence interval: 0.94–1.58). However, the risk of influenza illness was found to be elevated in individuals who received the vaccine only in the previous season (adjusted odds ratio: 1.56, 95% confidence interval: 1.15–2.10) and even further elevated in those who had not received the vaccine in either of the consecutive two seasons (adjusted odds ratio: 3.39, 95% confidence interval: 2.80–4.09). ConclusionsRegardless of the vaccination history in the previous season, receiving the current season influenza vaccine is the best choice for the elderly population. Our study supports the initiative to vaccinate elderly individuals against influenza annually.

Epidemiology of Injury and Illness in North American Professional Men's Soccer: Comparing COVID-19 Lockdown With Previous Seasons.

After COVID-19 lockdown, studies across Europe and Asia examined its effect on professional soccer injury rates and severity; however, COVID-19 lockdown influence on injuries in United States men's professional soccer has not been evaluated. Injury and illness rates during the 2020 season were higher than the previous 2 seasons. Retrospective observational cohort study. Level 3. Medical staff from participating Major League Soccer (MLS) clubs entered injuries and athletic exposures during the study period into a league-wide electronic medical record system. Injury rate and severity were analyzed to examine differentials between the 2020 COVID season and historical controls. The injury incidence rate per 1000 hours in 2020 was 10.8, ie, higher than 2018 (5.4) and 2019 (5.0) (P < 0.05). Training injury incidence rate increased in 2020 (8.9) compared with 2018 (2.5) and 2019 (2.6) (P < 0.05), whereas match injury incidence decreased in 2020 (18.3) compared with 2018 (24.0) and 2019 (22.7) (P < 0.05). Incidence rates of lower extremity muscle injuries (6.04), anterior cruciate ligament (ACL) injuries (0.17), and concussions (0.49) were also higher in 2020 compared with 2018 (2.5, 0.07, 0.27) and 2019 (2.36, 0.05, 0.22) (P < 0.05). More injured players in 2020 missed >90 days (17.7%) than in 2018 (10.2%) and 2019 (10.1%) (P < 0.05). Incidence of all non-COVID-19 illness was higher in 2020 (3.93) than 2018 (1.53) and 2019 (1.32) (P < 0.05). During 2020, there were significant increases in incidence rates of overall injuries, training injuries, lower extremity muscular injuries, ACL injuries, concussions, and non-COVID illness, along with a higher percentage of players missing >90 days compared with the 2 previous seasons. These results may help clarify the effects of future MLS inseason work stoppages and periods of restricted training.

Individual foraging site fidelity persists within and across stopover seasons in a migratory shorebird, Numenius phaeopus (Whimbrel)

Abstract Site fidelity—returning repeatedly to the same site—can help many migratory species reduce uncertainty in their environment, especially when migratory stopover periods leave little time to explore and evaluate new habitat. Avian taxa, though, have shown wide variation in their levels of site fidelity during migration, and few studies have been able to examine individual-level fidelity at fine spatiotemporal scales. We used a high-resolution GPS tracking dataset of Numenius phaeopus (Whimbrel), a long-distance migratory shorebird, to assess levels of fidelity to specific foraging and roosting sites during migration, both within and between stopover seasons. We found that individuals are almost exclusively faithful to one shared roost site at night, but disperse to individual foraging territories during the day that overlap with each other by &amp;lt;20%. Individuals remain faithful to these distinct territories over time, on average shifting the center of their daily home ranges by &amp;lt;1.5 km within a single season, and overlapping with their previous season’s home range by 70% when they return during subsequent stopovers. Our findings reveal for the first time that a shorebird species exhibits fine-scale, individual foraging site fidelity during and between migratory stopovers—an important insight to inform effective conservation and management action.

Asian swamp eels (Synbranchidae, Monopterus) in Florida: distribution, spread, and range of hydrologic tolerance over twenty-seven years (1997–2023)

Asian swamp eels (Monopterus albus/javanensis) were first reported as introduced to Florida waterbodies in 1997 near Tampa and Miami; a third population was recorded by 1999 in Homestead. Initial assessments, published soon after swamp eels in southern Florida were first recorded in wetlands beyond canals and ponds (in 2007), concluded there was little threat to Florida’s aquatic ecosystems. Long-term data now suggest they precipitated population crashes of crayfishes and small fishes in the eastern Everglades. We used records from continuous long-term monitoring programs, sporadic monitoring studies, and online databases to reconstruct swamp eel presence across Florida. Monitoring studies provided wetland hydrologic variables to assess limits for swamp eels. From 1997–2007, populations in southern Florida remained restricted to canals; initial spread from 2007–2017 across southern Everglades National Park proceeded slowly and the two populations covered ~1500 km2 of southern Florida. From 2017–2022, the rate of spread increased as they spread west and north (~5800 km2 range). Through 2014, the Tampa population occurred only along southern/eastern Tampa Bay (~60 km2) but has since spread south along the Gulf Coast, east into central Florida, and south along the Lake Wales Ridge (~11,000 km2). We found evidence of two potentially new introductions, in Palm Beach County and Orlando. There was no clear evidence of limitation of wetland drying on swamp eel occurrence in the Everglades; they were captured in marshes that dried for 1–5 months during the previous dry season, but short-hydroperiod wetlands may have slowed spread. In the Everglades, evidence suggests swamp eels may have been inadvertently spread into marshes from canals used to deliver water for flood control and hydrologic restoration. Swamp eels are currently spreading unchecked across Florida, and there should be great concern about continued spread in this region and their establishment and spread elsewhere.

Agri-food supply chain optimization through a decentralized production process in the olive oil industry

A tactical/operational model is proposed to assist decision-making in harvest planning and olive oil production planning of the different producers in the rural sector, considering allocation and transportation decisions of the kilograms of olives to the production plant with temporary relocation decisions of the mobile olive oil mills through decentralized production activities in the agri-food supply chain. A Mixed Integer Linear Programming model is presented that maximizes the profit of small farmers in the production process of single-varietal extra virgin olive oil. The decisions are based on the geographical dispersion of the different olive growers and the oil concentration of the olive varieties in a certain period, which depends on the climatic conditions of each sector where the olives are cultivated. The mathematical programming model is applied in Coquimbo, Chile, using actual data collected from previous harvest seasons. The computational results of the optimization model indicate that transportation decisions impact olive harvesting and oil production decisions. It is concluded that cooperatives of small producers in the rural sector increase overall profits and reduce transportation costs and the number of kilometers traveled by at least 41% through a decentralized production process with mobile production plants.

Annual extent of prescribed burning on moorland in Great Britain and overlap with ecosystem services

AbstractIn the UK uplands, prescribed burning of unenclosed heath, grass and blanket bog (‘moorland’) is used to support game shooting and grazing. Burning on moorland is contentious due to its impact on peat soils, hydrology and habitat condition. There is little information on spatial and temporal patterns of burning, the overlap with soil carbon and sensitive habitats and, importantly, whether these patterns are changing. This information is required to assess the sustainability of burning and the effectiveness of new legislation. We developed a method for semi‐automated detection of burning using satellite imagery – our best performing model has a balanced accuracy of 84.9%. We identified annual burn areas in Great Britain in five burning seasons from 2017/18 to 2021/22 of 8333 to 20 974 ha (average 15 250 ha year−1). Annual extent in England in 2021/22 was 73% lower than the average of the four previous seasons. Burning was identified over carbon‐rich soils (mean 5150 ha or 34% by area of all burning annually) and on steep slopes – 915 ha across the five seasons (1.3%), contravening guidance. Burning (&gt;1 ha) was recorded in 14% of UK protected areas (PAs) and, within these, the percentage area of moorland burned varied from 2 to 31%. In England in some years, the percentage area of moorland burned inside PAs was higher than outside, while this was not the case in Scotland. Burning in sensitive alpine habitats totalled 158 ha across the five seasons. The reduction in burned area in England in 2021/22 could relate to England‐specific legislation, introduced in May 2021, to prohibit burning on deep peat in PAs. This suggests that regulation can be effective. However, the continued overlap with sensitive features suggests that burning falls short of sustainable practices. Our method will enable repeatable re‐assessment of burning extents and overlap with ecosystem services.

Legacy effects of early cotyledon removal on the growth, carbon and nitrogen storage, and drought response of Quercus variabilis seedlings

Predation of cotyledons can reduce short-term survival and growth in emerging oak seedlings, potentially affecting species recruitment. However, the physiological basis of reduced seedling performance after early cotyledon predation and the mid-term consequences of cotyledon predation on seedling drought tolerance remain poorly understood. We performed an experiment where we simulated predation by systematically removing cotyledons from Quercus variabilis seedlings at seven growth stages during emergence in the first growing season. We assessed survival, growth, and nitrogen (N) and non-structural carbohydrate (NSC) storage. Subsequently, in the second growing season, we assessed drought tolerance in seedlings with cotyledons removed at four growth stages in the previous season, and subjected seedlings to two drought levels to assess overall performance. During the first growing season, seedling survival showed less sensitivity to cotyledon removal compared to growth, N and NSC storage, which were significantly reduced when cotyledons were removed within the first 4 days after emergence. Early cotyledon removal (4 days after emergence) in the first growing season enhanced drought tolerance in the second growing season by reducing leaf embolism vulnerability, but it did not affect leaf drought tolerance traits such as the osmotic potential or the modulus of elasticity. Early cotyledon removal had a lasting effect on seedling growth and N and NSC storage building in the second growing season. Additionally, it exacerbated the negative consequences of drought on seedlings growth and N storage building, but it did not influence survival or NSC storage. Our findings evidence that early cotyledon removal in emerging oak seedlings has significant short- and medium-term repercussions on growth and capacity to store N and NSC, and it hinders the capacity of seedlings to respond to drought despite early cotyledon removal increases leaf drought tolerance. These functional legacies can influence oak seedling recruitment.

Predicting Team Success in the Indian Premier League Cricket 2024 Season Using Random Forest Analysis

Background. Random Forest is a popular machine learning algorithm used for classification and regression tasks. The study purpose is to investigate the use of Random Forest machine learning to predict the winning chances of teams in the 2024 Indian Premier League (IPL) season. Objectives. By analyzing comprehensive player statistics, including matches played, batting and bowling averages, as well as fielding contributions, the study aims to understand the factors that influence team success in T20 cricket and provide actionable insights for team management, betting markets, and cricket enthusiasts. Material and methods. The study involved 10 cricket teams competing in the IPL 2024 season. Player statistics and match outcomes data from previous IPL seasons were collected and cleaned, with missing values addressed through imputation. The features were based on player statistics, including both aggregate measures and calculated metrics. A Random Forest is chosen as the machine learning model, trained using preprocessed data, with features derived from player statistics as input and match outcomes as the target variable. The dataset was split into training and validation sets, using methodologies such as cross-validation to ensure a robust model performance. Results. The Random Forest model demonstrates strong predictive performance, with a low Mean Squared Error (MSE) of 8.2174, Root Mean Squared Error (RMSE) of 2.8666, and a high R-Squared value of 0.9173, indicating approximately 91.73% variance explained in the data. Chennai Super Kings emerge as frontrunners with a predicted performance percentage of 83.4%, while teams like Punjab Kings and Lucknow Super Giants show lower predicted performance percentages, suggesting potential areas for its improvement. Conclusions. This study reveals the effectiveness of Random Forest machine learning in forecasting IPL match outcomes based on player statistics. It provides valuable insights into team dynamics and offers actionable recommendations for team management and cricket enthusiasts. The findings enrich our understanding of IPL match dynamics, contribute to the evolution of cricket analytics, and promote greater engagement with sport, ultimately enhancing the fan experience in the IPL.

COVID-19 Vaccination Coverage, and Rates of SARS-CoV-2 Infection and COVID-19-Associated Hospitalization Among Residents in Nursing Homes - National Healthcare Safety Network, United States, October 2023-February 2024.

Nursing home residents are at increased risk for developing severe COVID-19. Nursing homes report weekly facility-level data on SARS-CoV-2 infections, COVID-19-associated hospitalizations, and COVID-19 vaccination coverage among residents to CDC's National Healthcare Safety Network. This analysis describes rates of incident SARS-CoV-2 infection, rates of incident COVID-19-associated hospitalization, and COVID-19 vaccination coverage during October 16, 2023-February 11, 2024. Weekly rates of SARS-CoV-2 infection ranged from 61.4 to 133.8 per 10,000 nursing home residents. The weekly percentage of facilities reporting one or more incident SARS-CoV-2 infections ranged from 14.9% to 26.1%. Weekly rates of COVID-19-associated hospitalization ranged from 3.8 to 7.1 per 10,000 residents, and the weekly percentage of facilities reporting one or more COVID-19-associated hospitalizations ranged from 2.6% to 4.7%. By February 11, 2024, 40.5% of nursing home residents had received a dose of the updated 2023-2024 COVID-19 vaccine that was first recommended in September 2023. Although the peak rate of SARS-CoV-2 infection among nursing home residents was lower during the 2023-24 respiratory virus season than during the three previous respiratory virus seasons, nursing home residents continued to be disproportionately affected by SARS-CoV-2 infection and related severe outcomes. Vaccination coverage remains suboptimal in this population. Ongoing surveillance for SARS-CoV-2 infections and COVID-19-associated hospitalizations in this population is necessary to develop and evaluate evidence-based interventions for protecting nursing home residents.

Impact of COVID-19 on production decisions of marginal, small and medium farmers: empirical evidence from South India

PurposeThis study analyzes the impact of COVID-19 on agricultural production in South India by evaluating the influence of market channels and socioeconomic conditions on the production decisions of farmers during two key cropping seasons. We base our analysis on primary data from 200 marginal, small and medium farmers, primarily focusing on the key seasonal crops, namely paddy and black gram.Design/methodology/approachWe studied the downstream supply chains of paddy and black gram crops in the district of Villupuram, situated in the South Indian state of Tamil Nadu. Using a Bi-Probit model, we analyzed the production decisions of marginal, small and medium farmers engaged in paddy and black gram cultivation. Various factors are considered, including farmers’ socioeconomic characteristics, gender, market channels accessed and the coping strategies employed.FindingsAfter the easing of lockdown measures in June 2020, our research revealed substantial disruptions in agricultural production during the critical Kharif and Rabi seasons. Most farmers refrained from returning to their fields during the Kharif season; those who did produced millet as the main crop. Factors such as choice of market channels in previous seasons, economic status, access to all-weather roads, labor availability, gender and coping strategies played an important role in the return to production in the subsequent Kharif and Rabi seasons.Research limitations/implicationsOur data revealed several interesting threads related to price volatility, irrigation and access to markets and their impact on food security. The role of intermediaries and market channels in providing liquidity emerges as an important aspect of farmers' choice of markets. The pandemic impacted all these factors, but a detailed analysis was beyond the scope of this study.Social implicationsWe also find that resilience to economic shocks varies not only by economic status but also by gender and social groups. Farmers with female members are more likely to be resilient, and marginal and small farmers primarily belong to social groups that are economically less developed.Originality/valueThis study contributes to the literature on factors influencing farmer choice and decision-making and provides nuances to discussions by analyzing crop-specific supply chains, highlighting the critical role of socioeconomic factors. It also highlights the role of demographics and infrastructural factors like access to all-weather roads and access to markets that influence farmers’ production decisions.

Impact de la nouvelle réglementation du CACI sur les comportements de souscription des licences : étude au sein d’une fédération multisport

Purpose: The aims of this study are to assess the impacts of recent regulatory changes regarding the issuance of the Medical Certificate of No Contraindication (CACI) for sports practice on the registration for sports licenses. For disciplines with no particular constraints, the regulation now shifts medical responsibility towards sports federations and athletes. In light of these regulatory changes, two main hypotheses are posited: the first assumes a significant decrease in the number of CACI issued following the transfer of medical responsibility to federations and athletes; the second presumes that the streamlined procedures lead to an earlier registration for licenses.Methodology: The analysis relied on data collected within the French Federation of University Sports (FFSU) for the two seasons prior to the COVID-19 outbreak and the 2022-2023 season. For each season, the number of registered licenses, the number of CACI issued, and the dynamics of adherence were analyzed.Results: The results affirm the first hypothesis, displaying a 94% decrease in the CACI provided for disciplines with no constraints during the 2022-2023 season compared to previous seasons within the FFSU. Pertaining to the second hypothesis, a trend towards an earlier registration of licenses was identified due to the removal of the CACI requirement for disciplines with no constraints and its substitution with a health questionnaire.Conclusion: The findings of this study indicate that regulatory changes have influenced license registration behaviors, facilitating quicker adherence by athletes while significantly reducing the number of CACI issued.

Trends in emergency department visits during cold weather seasons among patients experiencing homelessness in Ontario, Canada: a retrospective population-based cohort study.

Recent anecdotal reports suggest increasing numbers of people experiencing homelessness are visiting emergency departments (EDs) during cold weather seasons due to inadequate shelter availability. We examined monthly ED visits among patients experiencing homelessness to determine whether there has been a significant increase in such visits in 2022/2023 compared to prior years. We used linked health administrative data to identify cohorts experiencing homelessness in Ontario between October and March of the 2018/2019 to 2022/2023years. We analyzed the monthly rate of non-urgent ED visits as a proxy measure of visits plausibly attributable to avoidance of cold exposure, examining rates among patients experiencing homelessness compared to housed patients. We excluded visits for overdose or COVID-19. We assessed level and significance of change in the 2022/2023year as compared to previous cold weather seasons using Poisson regression. We identified a total of 21,588 non-urgent ED visits across the observation period among patients experiencing homelessness in Ontario. Non-urgent ED visits increased 27% (RR 1.24 [95% CI 1.14-1.34]) in 2022/2023 compared to previous cold weather seasons. In Toronto, such visits increased by 70% (RR 1.68 [95% CI 1.57-1.80]). Among housed patients, non-urgent ED visits did not change significantly during this time period. Rates of ED visits plausibly attributable to avoidance of cold exposure by individuals experiencing homelessness increased significantly in Ontario in 2022/2023, most notably in Toronto. This increase in ED visits may be related to inadequate access to emergency shelter beds and warming services in the community.

Does It Hurt Financially, Too? Effects of Injury Proneness on Contract Design in Major League Baseball

Abstract: This paper seeks to determine the financial costs of recent injuries and market expectations of players’ future attrition rates by investigating the impacts on free agent contract designs, as represented by the yearly salary and contract length. The empirical findings, derived from data about 698 free agent contracts in Major League Baseball between 2011 and 2018, indicate that injuries exert different impacts on salaries versus contract lengths. For example, free agents who recently injured an elbow or shoulder receive shorter contracts than those not injured in the previous season, but their salaries are not affected. Market expectations of player attrition in the upcoming season reduce both contract lengths and salaries. For players, these results reaffirm the importance of staying healthy and finding ways to signal the low likelihood of future injuries to ensure their remuneration. For managers, the results emphasize the need to track free agents’ health status carefully, especially to avoid a winner’s curse.

Factors Associated with Influenza-like Illness among Inmates in an All-male Prison, Songkhla Province, Thailand, 2023

On 9 Feb 2023, the Office of Disease Prevention and Control Region 12Songkhlawas informed of an influenza-like illness (ILI) cluster in an all-male prison in Songkhla Province. We investigated to identify the causative agent, possible sources and risk factors, and provide control measures. We conducted an active case finding by interviewing inmates and officers. Prison facilities and hygiene behaviors of inmates and officers were inspected. A retrospective cohort study was performed. Basic and effective reproductive numbers were estimated. The overall attack rate was 12.6% (474/3,648). Most cases were inmates from Wing C (80.4%). There were no severe cases or deaths. Of ten specimens tested, all were positive for influenza B/Victoria lineage, V1a.3a.2. Fifty-four percent of inmates had received influenza vaccine within the last 12 months. A mismatch between the viral strain in the vaccine and the one causing this outbreak likely contributed to the outbreak as the vaccine provided to the inmates was manufactured during the previous year's influenza season. Vaccine effectiveness was 36.2% against ILI. Having high-risk conditions (adjusted odds ratios (AOR) 2.83, 95% confidence interval (CI) 1.27–6.32) and sharing drinking glasses (AOR 2.02, 95% CI 1.21–3.36) were significant risk factors. The basic reproductive number for ILI in this outbreak was 1.36. The effective reproductive number ranged from 0.18–3.69. For effective management of ILI outbreaks in prisons, a continuous program of influenza vaccination following updated World Health Organization recommendations and a comprehensive surveillance system with rigorous respiratory illness management practices are suggested.

Establishment of Reference Reagents for Single-Radial-Immunodiffusion Assay on the 2022/23 Seasonal Influenza Vaccine in Japan and Their Quality Validation.

Potency tests for influenza vaccines are currently performed using a single-radial immunodiffusion (SRID) assay, which requires a reference antigen and anti-hemagglutinin (HA) serum as reference reagents. Reagents must be newly prepared each time a strain used for vaccine production is modified. Therefore, establishing reference reagents of consistent quality is crucial for conducting vaccine potency tests accurately and precisely. Here, we established reference reagents for the SRID assay to conduct lot release tests of quadrivalent influenza vaccines in Japan during the 2022/23 influenza season. The potency of reference antigens during storage was confirmed. Furthermore, we evaluated the cross-reactivity of each antiserum raised against the HA protein of the 2 lineages of influenza B virus toward different lineages of influenza B virus antigens to select a suitable procedure for the SRID assay for accurate measurement. Finally, the intralaboratory reproducibility of the SRID assay using the established reference reagents was validated, and the SRID reagents had sufficient consistent quality, comparable to that of the reagents used for testing vaccines during previous influenza seasons. Our study contributes to the quality control of influenza vaccines.

Atypical age distribution and high disease severity in children with RSV infections during two irregular epidemic seasons throughout the COVID-19 pandemic, Germany, 2021 to 2023.

BackgroundNon-pharmaceutical interventions (NPIs) during the COVID-19 pandemic affected respiratory syncytial virus (RSV) circulation worldwide.AimTo describe, for children aged < 5 years, the 2021 and 2022/23 RSV seasons in Germany.MethodsThrough data and 16,754 specimens from outpatient sentinel surveillance, we investigated RSV seasonality, circulating lineages, and affected children's age distributions in 2021 and 2022/23. Available information about disease severity from hospital surveillance was analysed for patients with RSV-specific diagnosis codes (n = 13,104). Differences between RSV seasons were assessed by chi-squared test and age distributions trends by Mann-Kendall test.ResultsRSV seasonality was irregular in 2021 (weeks 35-50) and 2022/23 (weeks 41-3) compared to pre-COVID-19 2011/12-2019/20 seasons (median weeks 51-12). RSV positivity rates (RSV-PR) were higher in 2021 (40% (522/1,291); p < 0.001) and 2022/23 (30% (299/990); p = 0.005) than in prior seasons (26% (1,430/5,511)). Known globally circulating RSV-A (lineages GA2.3.5 and GA2.3.6b) and RSV-B (lineage GB5.0.5a) strains, respectively, dominated in 2021 and 2022/23. In 2021, RSV-PRs were similar in 1 - < 2, 2 - < 3, 3 - < 4, and 4 - < 5-year-olds. RSV hospitalisation incidence in 2021 (1,114/100,000, p < 0.001) and in 2022/23 (1,034/100,000, p < 0.001) was approximately double that of previous seasons' average (2014/15-2019/20: 584/100,000). In 2022/23, proportions of RSV patients admitted to intensive care units rose (8.5% (206/2,413)) relative to pre-COVID-19 seasons (6.8% (551/8,114); p = 0.004), as did those needing ventilator support (6.1% (146/2,413) vs 3.8% (310/8,114); p < 0.001).ConclusionsHigh RSV-infection risk in 2-4-year-olds in 2021 and increased disease severity in 2022/23 possibly result from lower baseline population immunity, after NPIs diminished exposure to RSV.

Bronchiolitis 2022–2023: One of the most unexpected outbreaks over this past decade, Nouvelle-Aquitaine, France

BackgroundSince the Covid-19 pandemic, bronchiolitis outbreaks have been subject to disrupted seasonality, and a major impact on the healthcare system was observed in 2022–23. ObjectiveThe aim of this article is to describe the characteristics of the 2022–23 bronchiolitis epidemic in the Nouvelle-Aquitaine region, and its impact on the healthcare system. MethodWe described the indicators of dynamics, intensity, severity and impact provided by the bronchiolitis monitoring in place, and compared these with those from previous seasons. ResultsThe intensity of the 2022–23 epidemic (emergency department visits: 23 %; SOS Médecins acts: 15 %), and its impact in terms of bronchiolitis-related hospitalizations (45 %) were higher than in previous seasons (p < 0.05). ConclusionIn addition to earliness, the 2022–23 bronchiolitis epidemic was significant as regards its exceptional scale and major impact on the hospital system, requiring adaptation of the preexisting healthcare offer in response to the anticipated demand.

SARS-CoV-2, influenza A/B and respiratory syncytial virus positivity and association with influenza-like illness and self-reported symptoms, over the 2022/23 winter season in the UK: a longitudinal surveillance cohort

BackgroundSyndromic surveillance often relies on patients presenting to healthcare. Community cohorts, although more challenging to recruit, could provide additional population-wide insights, particularly with SARS-CoV-2 co-circulating with other respiratory viruses.MethodsWe estimated the positivity and incidence of SARS-CoV-2, influenza A/B, and RSV, and trends in self-reported symptoms including influenza-like illness (ILI), over the 2022/23 winter season in a broadly representative UK community cohort (COVID-19 Infection Survey), using negative-binomial generalised additive models. We estimated associations between test positivity and each of the symptoms and influenza vaccination, using adjusted logistic and multinomial models.ResultsSwabs taken at 32,937/1,352,979 (2.4%) assessments tested positive for SARS-CoV-2, 181/14,939 (1.2%) for RSV and 130/14,939 (0.9%) for influenza A/B, varying by age over time. Positivity and incidence peaks were earliest for RSV, then influenza A/B, then SARS-CoV-2, and were highest for RSV in the youngest and for SARS-CoV-2 in the oldest age groups. Many test positives did not report key symptoms: middle-aged participants were generally more symptomatic than older or younger participants, but still, only ~ 25% reported ILI-WHO and ~ 60% ILI-ECDC. Most symptomatic participants did not test positive for any of the three viruses. Influenza A/B-positivity was lower in participants reporting influenza vaccination in the current and previous seasons (odds ratio = 0.55 (95% CI 0.32, 0.95)) versus neither season.ConclusionsSymptom profiles varied little by aetiology, making distinguishing SARS-CoV-2, influenza and RSV using symptoms challenging. Most symptoms were not explained by these viruses, indicating the importance of other pathogens in syndromic surveillance. Influenza vaccination was associated with lower rates of community influenza test positivity.

Impact of atmospheric forcing on SST biases in the LETKF-based ocean research analysis (LORA)

In the previous study, the authors have produced an eddy-resolving ocean ensemble analysis product called the local ensemble transform Kalman filter (LETKF)-based ocean research analysis (LORA) over the western North Pacific and Maritime Continent regions using an ocean data assimilation system driven by the Japanese operational atmospheric reanalysis dataset known as the JRA-55. However, the LORA includes warm biases in sea surface temperatures (SSTs) in coastal regions during the boreal winter. In this study, we perform sensitivity experiments with atmospheric forcing using an ocean forcing dataset known as the JRA55-do, which adjusts the JRA-55 to high-quality reference datasets to reduce biases and uncertainties. The results show that the nearshore warm SST biases are significantly improved by the JRA55-do. During the boreal autumn, the improvement comes from mainly two factors: (i) enhancement of surface cooling by latent heat releases caused by removing contamination of weak winds at the land grid cells, and (ii) weakening surface heating by downward shortwave radiation through the adjustment in the JRA55-do.During the boreal winter, enhanced cooling by the analysis increments suppresses the growth of the warm SST biases when the JRA55-do is used. However, if the JRA-55 dataset is used, the adaptive observation error inflation (AOEI) scheme acts negatively to keep the nearshore SST biases in winter. Based on the innovation statistics, the AOEI inflates the observation errors when the differences between the squared observation-minus-forecast innovations and the squared forecast ensemble spreads are larger than the prescribed observation error variance, and improves the accuracy in the open ocean, especially around the frontal regions. However, when substantial warm SST biases are formed in the previous season, AOEI's observation error inflation makes the analysis increments smaller and cannot suppress the warm biases.We also validate the analysis accuracy using various data such as sea surface height and horizontal velocities and find that the JRA55-do has significant advantages. Therefore, continuous maintenance and development of ocean forcing datasets are essential for ocean modeling and data assimilation.