ArticleFrontiers in cellular and infection microbiology2025
Six-year epidemiological dynamics of human respiratory syncytial virus infections in children in central China (2019-2024): pandemic suppression, 2023 resurgence, and immune debt effect.
Article in Frontiers in cellular and infection microbiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Pneumococcal Detection and Bacterial Co-Detection in Children After COVID-19: A Two-Year Multiplex PCR Study.Biomedicines · 2026Article
- Post-pandemic resurgence and collapse ofFrontiers in public health · 2026Article
- Epidemiology and lagged climatic drivers of pediatric viral lower respiratory tract infections in Tianjin, China (2023-2025).Frontiers in cellular and infection microbiology · 2026Article
- Epidemiology, temporal trends and co-infection of 13 respiratory pathogens in 32,125 children: a 3-year retrospective study.Frontiers in pediatrics · 2026Article
- Epidemiology of respiratory infectious diseases after the relaxation of COVID-19 policies: a retrospective study in Xiamen, China.Frontiers in public health · 2026Article
- Risk factors for ICU admission in hospitalized children with respiratory syncytial virus infection.Frontiers in cellular and infection microbiology · 2026Article
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Abstract
Background: Human respiratory syncytial virus (HRSV) is a leading cause of acute respiratory infections in children. COVID-19 NPIs significantly suppressed HRSV transmission. This study analyzed six-year epidemiological dynamics of pediatric HRSV infections in Henan Province, China, focusing on NPI suppression effects, the 2023 resurgence, and "Immune debt" impact. Methods: We retrospectively collected respiratory specimens from 80,920 children with acute respiratory diseases at Henan Children's Hospital (2019-2024). HRSV was detected using RT-qPCR. Positivity rates were analyzed by year, season, and age group. Results: During 2019-2024, HRSV positivity fluctuated markedly: 14.65% (2019), 16.34% (2021), 3.27% (2022 under strict NPIs), 21.47% (2023 post-NPIs), and 6.80% (2024). Interrupted time-series analysis indicated that NPI lifting in 2023 was associated with a significant surge in infection risk (OR = 668.77, 95% CI: 47.03-9509.28). Seasonal patterns shifted substantially, with the characteristic winter peak replaced by an off-season spring outbreak in April 2023 (57.41%). Multivariable logistic regression identified age as the strongest predictor, with infants <1 year having the highest risk (aOR = 9.02, 95% CI: 8.31-9.79) and a 4.91-fold higher positivity rate than school-aged children (22.98% vs. 4.68%; 95% CI: 4.59-5.25; P < 0.001). Conclusions: NPIs dramatically affected HRSV epidemiology. The intense post-suppression rebound strongly supports the "Immune debt" theory-accumulation of susceptible children driving resurgence. Establishing year-round, multi-pathogen surveillance systems is crucial for post-pandemic public health challenges.
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