Evidence map›Paper›PMID 41521151›Full record

ArticleInfluenza and other respiratory viruses2026

Changes in the Epidemiology of Influenza and Respiratory Syncytial Virus During 2020-2022 Relative to the Pre-COVID-19 Pandemic Period (2017-2020) From Systematic Sentinel Syndromic Surveillance in South Africa.

Sibongile Walaza, Jocelyn Moyes, Anne von Gottberg, Nicole Wolter, Amelia Buys, Fahima Moosa, Mignon du Plessis, Gary Reubenson, Jeremy Nel, Heather J Zar and 10 more

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In one paragraph

Article in Influenza and other respiratory viruses, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Sibongile WalazaCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
Jocelyn MoyesCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
Anne von GottbergCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
Nicole WolterCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
Amelia BuysCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
Fahima MoosaCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
Mignon du PlessisCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
Gary ReubensonDepartment of Paediatrics & Child Health, Rahima Moosa Mother & Child Hospital, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.
Jeremy NelDepartment of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Heather J ZarDepartment of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, and SA-MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa.
Halima DawoodDepartment of Medicine, Greys Hospital, Pietermaritzburg, South Africa.
Ebrahim VariavaDepartment of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Mvuyo MakhasiCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
Omphile MekgoeDepartment of Medicine, Klerksdorp-Tshepong Hospital Complex, Klerksdorp, South Africa.
Fathima NabbyDepartment of Health KwaZulu-Natal, Pietermaritzburg Metropolitan Hospitals, University of KwaZulu-Natal, Pietermaritzburg, South Africa.
Neydis BauteDepartment of Paediatrics, Mapulaneng Hospital, Hazyview, South Africa.
Jackie KleynhansCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
Susan MeiringDivison of Public Health Surveillance and Response, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
Vanessa QuanDivison of Public Health Surveillance and Response, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.ORCID https://orcid.org/0000-0003-1666-4752
Cheryl CohenCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.ORCID https://orcid.org/0000-0003-0376-2302

Funding

African Field Epidemiology Network (AFENET) AF-NICD-001/2021Centers for Disease Control and Prevention Foundation 5U01IP001048Centers for Disease Control and Prevention Foundation NU51IP000930Centers for Disease Control and Prevention Foundation U01IP001048Gates Foundation INV-018978NCIRD CDC HHS H23 IP000930NCIRD CDC HHS U01 IP001048
6 · The paper itself

Abstract

backgroundNonpharmaceutical interventions, implemented during the COVID-19 pandemic, affected the transmission of other respiratory pathogens.

methodsSystematically collected respiratory illness surveillance data and consistent case definitions were used to describe changes in influenza and respiratory syncytial virus (RSV)-associated outpatient visits and hospitalisations in South Africa during the first 3 years of the COVID-19 pandemic relative to a pre-COVID-19 pandemic period (2017-2019).

resultsIn 2020, influenza circulation almost ceased. In 2021 an out-of-season circulation was observed with a return to prepandemic timing, albeit with a higher peak in 2022. During the pandemic period, influenza-associated influenza-like illness (ILI) was more common in those aged ≥ 5 years compared to < 6 months. Patients with influenza-associated severe respiratory illness (SRI) were less likely to be ≥ 45 years versus < 6 months and less likely to be admitted to ICU (aOR 0.2, 95% CI 0.04-0.8). RSV circulation declined at the start of the pandemic, with an out-of-season spring resurgence in 2020 followed by a return to prepandemic timing in 2021 and a higher peak in 2022. During the pandemic, compared to the prepandemic period, patients with RSV-associated SRI were more likely to be aged 1-4 years (aOR 1.5, 95% CI 1.2-1.8) versus < 6 months and less likely to be admitted to ICU (aOR 0.5, 95% CI 0.3-0.8).

conclusionWe report low levels of influenza circulation and out-of-season RSV circulation in 2020 with changes in the age distribution of cases and risk of ICU admission. Return to prepandemic timing was earlier for RSV, with higher seasonal peaks for influenza-associated ILI and RSV-associated SRI in 2022.

Indexed as

COVID-19Influenza, HumanRespiratory Syncytial Virus InfectionsAdolescentAdultChildChild, PreschoolFemaleHospitalizationHumansInfantMaleMiddle AgedPandemicsSeasonsSentinel Surveillancenonpharmaceutical interventionsrespiratory infectionSARS‐CoV‐2seasonalitysurveillance

Identifiers

PMID41521151
PMCPMC12790951

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.