ArticleBMC infectious diseases2026
Epidemic dynamics and age-specific distribution of respiratory pathogens: a direct-to-consumer surveillance study in four regions of China, October 2023-February 2025.
Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThis study characterizes the epidemiological features of key respiratory pathogens across four regions of China following the COVID-19 pandemic, aiming to enhance understanding of post-pandemic circulation patterns and supporting the development of targeted prevention strategies.
methodsSurveillance data on seven respiratory pathogens were collected (October 2023-February 2025) using a direct-to-consumer (DTC) testing approach. Demographic distributions, temporal trends, pairwise correlation analyses and symptom profiles were assessed.
resultsRespiratory syncytial virus (RSV) and human rhinovirus (HRV) exhibited a child pattern. Influenza B virus (IFV-B), human adenovirus (HAdV), and Mycoplasma pneumoniae (M. pneumoniae) demonstrated a school-age child pattern. In contrast, influenza A virus (IFV-A) and SARS-CoV-2 showed an elderly pattern. The epidemic patterns of pathogens were categorized into seasonal and year-round circulation. Correlation analyses revealed positive pairwise correlations between IFV-A and RSV, and between HRV and M. pneumoniae, while a negative correlation was observed between IFV-A and SARS-CoV-2. Clustering analysis based on symptom profiles identified three distinct categories: an upper respiratory tract symptom cluster (RSV, HRV), a systemic and respiratory symptom cluster (influenza viruses, SARS-CoV-2), and a systemic symptom cluster (HAdV, M. pneumoniae). Analysis of typical symptom (fever, cough, throat pain) co-occurrence for the seven pathogens showed that only IFV-A (50.14%) met the current Chinese respiratory pathogen surveillance case definition (fever with cough or throat pain); for the other six pathogens, the proportion was below 50%.
conclusionsPathogen distribution exhibited significant age-specific variation. The seasonality of different pathogens exhibited regional variations, providing valuable references for future preventive interventions. Notably, half of the individuals with single-pathogen detection reported symptoms that did not meet the current influenza-like illness (ILI) surveillance criteria. Therefore, case definitions should be optimized according to pathogen type in future surveillance efforts.
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