ArticleBMC infectious diseases2026
Asymmetric post-pandemic recovery of influenza A and B since 2020 in Hong Kong: an interrupted time-series (ITS) analysis of weekly surveillance data with subtype and lineage characterization.
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
backgroundInfluenza circulation declined markedly worldwide after the emergence of COVID-19 in 2020. Although early suppression was widely documented, less information is available on how influenza activity returned during later years, particularly for influenza A and influenza B and their subtype or lineage distributions.
methodsWeekly laboratory surveillance data from Hong Kong covering 2014-2024 were analyzed using interrupted time-series regression. Weekly numbers of tested specimens were included as an offset. Epidemiological week 1 of 2020 was used as the primary interruption point. Influenza A subtype activity, A(H1) and A(H3), and influenza B lineage activity, Victoria and Yamagata, were also examined descriptively. Other respiratory viruses (ORV) were included for general comparison.
resultsBoth influenza A and influenza B declined sharply during early 2020, although the decline was greater for influenza B. Influenza A activity increased again during later years, with recurrent seasonal peaks and variation in the relative activity of A(H1) and A(H3). Influenza B remained at comparatively low levels through much of the post-2020 period. Among characterized influenza B viruses, most detections belonged to the B/Victoria lineage, whereas B/Yamagata was not identified in later surveillance data. ORV circulation showed greater variability after 2020 and did not follow the same pattern observed for influenza.
conclusionRecovery patterns differed between influenza A and influenza B after 2020 in Hong Kong. Influenza A circulation resumed gradually, whereas influenza B activity remained lower and lineage diversity was reduced. Continued surveillance at the level of virus type, subtype, and lineage may help identify future changes in influenza circulation during the post-pandemic period.
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