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Viral Infectious Diseases: Epidemiology and Prevention Through Vaccination

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A special issue of Infectious Disease Reports (ISSN 2036-7449). This special issue belongs to the section "Viral Infections".

Deadline for manuscript submissions: 31 July 2026 | Viewed by 26203

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Dr. George Rachiotis

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Department of Hygiene and Epidemiology, Medical Faculty, University of Thessaly, 41222 Larissa, Greece
Interests: epidemiology; occupational medicine; social determinants of health
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Dear Colleagues,

Viral diseases represent some of the complex interactions between the three components of the causal epidemiologic triad: agent, host, and environment. Viral agents have been characterized by a substantial degree of heterogeneity. In particular, certain viral agents (e.g., measles, rubella) seem to have evolved to a stable state with relatively little genetic variation over time at the population level, and diseases due to these biological agents have proved highly controllable through vaccination. On the contrary, several RNA viruses (e.g., influenza and coronaviruses, including SARS CoV-2) are more prone to mutations than many DNA viruses. Past and current experience indicate that certain viral agents of this group have been proved as considerable health hazards and socio-economic disruptors (Great Flu of 1918 and COVID-19 pandemics). Furthermore, for several viral-related diseases, there are effective and safe vaccines available, but there is a need for seroprevalence studies and also for the continuous monitoring of vaccination coverage. Moreover, vaccine hesitancy is an important obstacle to the vaccination against viral diseases.

Therefore, this Special Issue of Infectious Disease Reports entitled “Viral Infectious Diseases: Epidemiology and Prevention through Vaccination” is being launched, and we look forward to receiving your submissions (case reports, original papers, and systematic reviews/meta-analyses). You are welcome to send short proposals for submissions of feature papers to our Editorial Office for evaluation.

Dr. George Rachiotis
Guest Editor

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Keywords

viral infectious diseases
epidemiology
molecular epidemiology
seroprevalence
vaccination coverage
vaccine hesitancy

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Published Papers (11 papers)

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Research

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13 pages, 889 KB

Open AccessArticle

Epidemiological and Clinical Changes in RSV-Associated Pneumonia in Children in Mexico Before and During the COVID 19 Pandemic

by Ilen Adriana Diaz-Torres, Isamu Daniel Cabrera-Takane, Fanny Yasmin Ortega-Vargas, Aldo Agustin Herrera-González, Miguel Leonardo Garcia-León, Patricia Bautista-Carbajal, Daniel E. Noyola, Maria Susana Juárez-Tobías, Pedro Antonio Martínez-Arce, María del Carmen Espinosa-Sotero, Verónica Tabla-Orozco, Gerardo Martínez-Aguilar, Fabian Rojas-Larios and Rosa María Wong-Chew

Infect. Dis. Rep. 2025, 17(6), 139; https://doi.org/10.3390/idr17060139 - 8 Nov 2025

Viewed by 1693

Abstract

Background/Objectives: Respiratory syncytial virus (RSV) significantly affects young children. In 2020, at the beginning of the COVID-19 pandemic, widespread public health measures temporarily interrupted RSV transmission. However, by mid-2021, an atypical resurgence of RSV was observed. The objective of this study was to compare the clinical and epidemiological characteristics of RSV infections in children before and during the second half of the SARS-CoV-2 pandemic in Mexico. Methods: A comparative ambispective longitudinal epidemiological study was conducted using two distinct cohorts: one from 2010 to 2013 and another from 2021 to 2023. The study included children under five years of age diagnosed with RSV-related pneumonia. Statistical analyses included Student’s t-tests, chi-square tests, and logistic regression to identify risk factors associated with severe pneumonia. Incidence density was calculated as the number of RSV-positive pneumonia cases per 10 new pneumonia admissions per month. Results: The mean age of affected children increased from 10 to 15 months. RSV activity began earlier in 2021, emerging during the summer months, and showed a higher incidence than in previous seasons. RSV type B was significantly more common during the pandemic period (58.5% vs. 3.8%), and the proportion of co-infections also increased (60% vs. 39%), indicating a change in the viral landscape. Conclusions: These findings indicate a shift in RSV seasonality toward summer and autumn, increased case incidence, and infections in older children. These observations underscore the need for ongoing surveillance to better understand evolving RSV patterns, especially in the context of complex public health scenarios like the COVID-19 pandemic. Full article

(This article belongs to the Special Issue Viral Infectious Diseases: Epidemiology and Prevention Through Vaccination)

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9 pages, 235 KB

Open AccessArticle

Sex, Age, and COVID-19 Vaccine Characteristics Associated with Adverse Events After Vaccination and Severity: A Retrospective Analysis

by Edgar P. Rodríguez-Vidales, Jesús M. Santos-Flores, Mara I. Garza-Rodríguez, Ana M. Salinas-Martínez, Alejandra G. Martínez-Pérez, Roberto Montes de Oca-Luna and Alma R. Marroquín-Escamilla

Infect. Dis. Rep. 2025, 17(5), 108; https://doi.org/10.3390/idr17050108 - 3 Sep 2025

Cited by 2 | Viewed by 3409

Abstract

Background: Although the safety of COVID-19 vaccines has been demonstrated in clinical trials, real-world pharmacovigilance remains essential to detect rare or unexpected adverse events following immunization (AEFI). In Mexico, the national AEFI surveillance system is in place, yet there is limited analysis of state-level data. Objective: To characterize AEFI related to five COVID-19 vaccines and identify factors associated with AEFI type and seriousness in Nuevo León, Mexico. Methods: A retrospective analysis of the State of Nuevo León AEFI database was conducted, including all AEFI reports between December 2020 and June 2022 (n = 2213). Data included patient sex, age, vaccine type (Pfizer/BioNTech, AstraZeneca, Sinovac, Moderna, CanSino), number of doses (1 or ≥2), symptom categories, and AEFI seriousness. Symptoms were classified as local or systemic and grouped by organ systems. Descriptive analysis and binary multivariate logistic regression were used to examine associations between demographic and vaccine-related factors with AEFI type and severity. Odds ratios (OR) with 95% confidence intervals (CI) were estimated. Results: Most AEFI reports involved females aged 19–59 years and occurred after the first vaccine dose. The most frequently reported unexpected adverse events (UAEs) were mild to moderate, including injection-site reactions, headache, chills, fatigue, nausea, fever, dizziness, weakness, myalgia, and tachycardia. The Pfizer/BioNTech vaccine was associated with higher odds of arm pain and lower odds of hemorrhagic events. Receiving ≥2 doses increased the odds of arm pain and systemic symptoms. Less than 3% of AEFIs were classified as serious. Older adults (≥65 years) and second vaccine doses were associated with increased odds of a serious AEFI, while female sex and receiving the Pfizer/BioNTech vaccine were associated with reduced odds. Conclusions: In Nuevo León, most AEFIs related to COVID-19 vaccination were mild to moderate and resolved without complications. Serious AEFIs were uncommon, with older age and second doses associated with higher risk, and female sex and Pfizer/BioNTech vaccination associated with lower risk. These findings provide a local perspective on vaccine safety that complements national and international evidence. Full article

(This article belongs to the Special Issue Viral Infectious Diseases: Epidemiology and Prevention Through Vaccination)

18 pages, 293 KB

Open AccessArticle

Demographical and Clinical Characteristics, Risk Factors, and Prognosis of Adult Patients with Herpes Zoster in Türkiye: A Retrospective, Multi-Center Study (VARICOMP-Adult Study)

by Esin Senol, Alpay Azap, Selda Sayin Kutlu, Murat Kutlu, Ayse Erbay, Pelin Kocyigit, Emine Colgecen, Ozlem Ozbagcivan, Nilsel Ilter, Funda Yetkin, Serpil Sener, Birsen Mutlu, Rebiay Kiran, Nese Saltoglu, Burhan Engin and Ener Cagri Dinleyici

Infect. Dis. Rep. 2025, 17(3), 68; https://doi.org/10.3390/idr17030068 - 11 Jun 2025

Cited by 1 | Viewed by 2901

Abstract

Introduction: Over the past few decades, the rising incidence of herpes zoster (HZ) rates appears to have been a global phenomenon. In Türkiye, there is a lack of comprehensive studies addressing the HZ burden of disease, risk factors, and clinical characteristics. The aim of the VARICOMP-Adult study was to evaluate the clinical and demographic findings of adult patients with HZ. Patients and Methods: We enrolled the medical records of 1955 patients, 1010 females and 945 males, aged between 18 and 97 years between 2009 and 2014. Results: The presence of underlying conditions was present in 35.5% of patients and 345 patients (17.6%) had immunosuppression; 18.0% of patients required hospitalization. The mean age, the presence of underlying conditions, and immunosuppression in hospitalized cases with HZ were higher than those in outpatients. Logistic regression analysis revealed the following risk factors for hospitalization: age, immunosuppression, hypertension, hematological disorders, transplantation, COPD, and the presence of HZ opthalmicus or disseminated disease. We observed seven HZ cases with mortality aged between 58 and 80 years, and all cases had an underlying condition; 9.9% of the entire population reported postherpetic neuralgia (PHN), and age and no previous antiviral medications were the risk factors for PHN. Conclusions: This is the largest nationwide study of adult patients with HZ. Effective healthcare interventions such as antiviral therapy and immunization could prove beneficial in combating disease and treating HZ complications, especially in the high-risk population and individuals of older ages. Full article

(This article belongs to the Special Issue Viral Infectious Diseases: Epidemiology and Prevention Through Vaccination)

11 pages, 629 KB

Open AccessArticle

Comparative Epidemiological and Clinical Outcomes on COVID-19 and Seasonal Influenza Hospitalized Patients during 2023

by Constantin-Marinel Vlase, Mariana Stuparu Cretu, Mihaela-Camelia Vasile, George-Cosmin Popovici and Manuela Arbune

Infect. Dis. Rep. 2024, 16(5), 783-793; https://doi.org/10.3390/idr16050060 - 23 Aug 2024

Cited by 1 | Viewed by 2627

Abstract

COVID-19 and influenza are highly contagious respiratory viral diseases and priority global public health concerns. We conducted a retrospective observational study of COVID-19 and/or influenza hospitalized cases, during 2023. We identified 170 influenza cases, 150 COVID-19 cases and 3 co-infections. Overall, 29.10% of patients had at least one COVID-19 vaccine dose and 4.6% received the seasonal Flu vaccine. The demographic data found older patients in the COVID-19 group and a higher index of the comorbidities, mainly due to chronic heart diseases, hypertension, and diabetes. Fever, chills, and rhinorrhea were more frequently related to influenza, while cough was prevalent in COVID-19. Antibiotics were more used in influenza than COVID-19, either pre-hospital or in-hospital. The mortality rate within the first 30 days from the onset of the respiratory infection was higher in influenza compared to COVID-19. We concluded that the COVID-19 clinical picture in hospitalized patients is changing to influenza-like symptoms. The evolution is variable, related to chronic comorbidities, but influenza had more frequent severe forms. All through 2023, due to poor vaccination rates, COVID-19 and influenza have continued to cause numerous hospitalizations, and a new strategy for efficient vaccinations is required. Full article

(This article belongs to the Special Issue Viral Infectious Diseases: Epidemiology and Prevention Through Vaccination)

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12 pages, 875 KB

Open AccessArticle

Seroprevalence of Anti-SARS-CoV-2 IgG Antibodies in Healthcare Personnel in El Salvador Prior to Vaccination Campaigns

by José Elías Aguilar Ramírez, Adrianna Maliga, Allison Stewart, Allison Lino, José Eduardo Oliva, Xochitl Sandoval, Emily Zielinski-Gutierrez, Rafael Chacon-Fuentes, Parminder S. Suchdev, Susana Zelaya, Mario Sánchez, Delmy Lisseth Recinos, Beatriz López, Ella Hawes, Julie Liu, Shannon E. Ronca, Sarah M. Gunter, Kristy O. Murray and Rhina Domínguez

Infect. Dis. Rep. 2024, 16(3), 531-542; https://doi.org/10.3390/idr16030040 - 7 Jun 2024

Viewed by 2545

Abstract

COVID-19, caused by the SARS-CoV-2 virus, is a highly pathogenic emerging infectious disease. Healthcare personnel (HCP) are presumably at higher risk of acquiring emerging infections because of occupational exposure. The prevalence of COVID-19 in HCP is unknown, particularly in low- to middle-income countries like El Salvador. The goal of this study was to determine the seroprevalence of anti-SARS-CoV-2 antibodies among HCP in El Salvador just prior to vaccine rollout in March 2021. We evaluated 2176 participants from a nationally representative sample of national healthcare institutions. We found 40.4% (n = 880) of the study participants were seropositive for anti-spike protein antibodies. Significant factors associated with infection included younger age; living within the central, more populated zone of the country; living in a larger household (≥7 members); household members with COVID-19 or compatible symptoms; and those who worked in auxiliary services (i.e., housekeeping and food services). These findings provide insight into opportunities to mitigate SARS-CoV-2 risk and other emerging respiratory pathogens in HCP in El Salvador. Full article

(This article belongs to the Special Issue Viral Infectious Diseases: Epidemiology and Prevention Through Vaccination)

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Review

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29 pages, 1191 KB

Open AccessReview

Trace Elements and Viral Infectious Diseases: Dual Roles in Pathogenesis and Immunity

by Carla Mariana da Silva Medeiros, Michely da Silva Sousa, Lucas Hestevan Malta Alfredo, Jemmyson Romário de Jesus and Cícero Alves Lopes Júnior

Infect. Dis. Rep. 2026, 18(2), 22; https://doi.org/10.3390/idr18020022 - 10 Mar 2026

Viewed by 513

Abstract

Introduction: Trace elements such as zinc, selenium, iron, copper, and manganese play a vital role in human health—especially in how the immune system responds and how the body handles viral infections. These trace elements have complex and sometimes context-dependent effects: while they can strengthen the body’s defenses, imbalances may promote viral replication and worsen tissue damage. Methods: Relevant articles discussed in this narrative review were identified through searches in major databases, including PubMed, Scopus, and Web of Science, primarily those published from 2020 onwards. Discussion: In this review, we examine key findings on how trace elements influence antioxidant defense, modulate viral replication, and regulate cytokine signaling, considering the context of innate immunity and the pathology of viral diseases. We discuss their impact on major infections such as HIV, viral hepatitis, and coronaviruses, highlighting how deficiencies or excesses of certain minerals can affect disease severity, immune responses, and clinical outcomes. The therapeutic use of trace element supplementation is also examined, emphasizing the importance of maintaining proper balance to avoid harmful effects. Conclusions: These findings contribute to a deeper understanding of the complex relationship between micronutrients and viral infections, which can inform the development of more effective prevention and treatment strategies. This review underscores the need for further clinical and experimental studies to define optimal levels of these elements in different health and disease scenarios. Full article

(This article belongs to the Special Issue Viral Infectious Diseases: Epidemiology and Prevention Through Vaccination)

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11 pages, 11719 KB

Open AccessCase Report

Spontaneous Pneumomediastinum, Subcutaneous Emphysema, and Pneumoperitoneum in RT-PCR-Confirmed Measles: A Pediatric Case Report

by Roberto Miguel Damián-Negrete, Alondra Denisse Hernández-Luna, Rocío Guadalupe Cano-Arias, Antonio Durán-Plaza, Judith Carolina De Arcos-Jiménez, Kathya Analí Rodríguez-González, Braulio Dazahel González-Flores, Pedro Iván Navarro-González and Jaime Briseno-Ramírez

Infect. Dis. Rep. 2026, 18(3), 39; https://doi.org/10.3390/idr18030039 - 24 Apr 2026

Viewed by 121

Abstract

Measles remains a major global public health challenge as declining vaccination coverage fuels outbreaks worldwide. Although pneumonia is the most recognized respiratory complication, spontaneous air leak syndrome—including pneumomediastinum, subcutaneous emphysema, and pneumoperitoneum—is rarely documented. We report the case of a 9-year-old previously healthy girl with no documented measles–rubella vaccination who presented with fever, maculopapular exanthem, Koplik spots, and persistent cough. Measles was confirmed by both immunoglobulin M enzyme-linked immunosorbent assay and real-time reverse transcription polymerase chain reaction. She developed sudden cervicothoracic swelling and chest pain. Chest radiography revealed pneumomediastinum and subcutaneous emphysema; computed tomography confirmed extensive air leak including pneumoperitoneum. Flexible bronchoscopy and upper gastrointestinal endoscopy excluded structural airway and esophageal injury. Laboratory evaluation revealed elevated hepatic transaminases, gamma-glutamyl transferase, lactate dehydrogenase, and D-dimer. Conservative management with high-flow supplemental oxygen and clinical surveillance led to progressive resolution. The patient was discharged on hospital day three, asymptomatic and breathing room air. This case highlights the spectrum of air leak complications in measles and supports conservative management in hemodynamically stable pediatric patients when structural injury has been excluded. Full article

(This article belongs to the Special Issue Viral Infectious Diseases: Epidemiology and Prevention Through Vaccination)

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8 pages, 757 KB

Open AccessCase Report

Hyponatremia Due to VZV-Induced SIADH in an Older Patient: Case Report and Literature Review

by Zuzanna Żak-Skryśkiewicz, Patrycja Krupińska, Carlo Bieńkowski and Przemysław Witek

Infect. Dis. Rep. 2025, 17(5), 106; https://doi.org/10.3390/idr17050106 - 30 Aug 2025

Viewed by 1537

Abstract

Introduction: Hyponatremia is a common finding in hospitalized patients, especially the elderly. Symptoms of hyponatremia can vary depending on the concentration of sodium in serum as well as the dynamics of its escalation. Hyponatremia can have many etiologies, including medication, vomiting, or diarrhea, and central nervous system disorders, including tumors, trauma, and infections. Case report: In this case, we present a 74-year-old patient who was admitted to the Department of Internal Medicine with symptomatic, acute, and severe hyponatremia in the course of the syndrome of inappropriate antidiuretic hormone secretion due to varicella zoster virus meningoencephalitis. Clinical improvement and normalization of natremia occurred after the initiation of causal treatment. Conclusion: Given the complexity of the potential causes of hyponatremia and the variety of treatments available, it is essential to thoroughly consider the possible reasons for electrolyte abnormalities, including uncommon ones such as central nervous system infections. Full article

(This article belongs to the Special Issue Viral Infectious Diseases: Epidemiology and Prevention Through Vaccination)

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10 pages, 2546 KB

Open AccessBrief Report

Humoral and Cell-Mediated Immunity Against SARS-CoV-2 in Healthcare Personnel Who Received Multiple mRNA Vaccines: A 4-Year Observational Study

by Hideaki Kato, Kaori Sano, Kei Miyakawa, Takayuki Kurosawa, Kazuo Horikawa, Yayoi Kimura, Atsushi Goto and Akihide Ryo

Infect. Dis. Rep. 2025, 17(3), 42; https://doi.org/10.3390/idr17030042 - 29 Apr 2025

Viewed by 1807

Abstract

Background/Objectives: The long-term effects of multiple updated vaccinations against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) have not been clarified. Humoral or cellular immunity dynamics in healthcare workers for four years were analyzed. Methods: Blood samples were collected at five time points from April 2021 to January 2024. Humoral immunity was analyzed using the 50% neutralizing titer (NT₅₀) against the original Omicron XBB and Omicron BA.2.86 strains and cellular immunity were analyzed using the ELISpot interferon-gamma releasing assay. NT₅₀s and the spot-forming count (SFC) of the ELISpot assay were compared in the SARS-CoV-2 Omicron XBB-, Omicron-infected, and uninfected subjects. Results: 32 healthcare workers (median age, 47 years) who received 3–7 vaccine doses were enrolled. The NT₅₀s against the original strain decreased after the second vaccination but were maintained after the third vaccine dose. NT₅₀s against the Omicron XBB and BA.2.86 strains were detected before the Omicron vaccine was introduced and increased following the updated vaccination. The NT₅₀s against the Omicron XBB and BA.2.86 strains were elevated after natural infection by the Omicron strain, albeit without differences compared with the findings in uninfected subjects. Multivariate regression analysis revealed no confounder that affected the antibody titer against the BA.2.86 strain at the fifth blood sampling. The median number of SFCs ranged from 78 to 208 after the first two doses. Conclusions: Multiple vaccinations induced the production of antibodies with divergent activity against emerging mutant strains and enhanced protective effects against the original strain. This finding supported the importance of updated vaccination. Full article

(This article belongs to the Special Issue Viral Infectious Diseases: Epidemiology and Prevention Through Vaccination)

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10 pages, 857 KB

Open AccessCase Report

Primary Varicella Infection in a Young Adult from the Democratic Republic of the Congo: A Case Report and Mini-Review

by Andrew McNaughton, Nessika Karsenti, Jason Kwan, Asal Adawi, Saniya Mansuri and Andrea K. Boggild

Infect. Dis. Rep. 2024, 16(4), 628-637; https://doi.org/10.3390/idr16040048 - 19 Jul 2024

Cited by 5 | Viewed by 4291

Abstract

We describe a case of an immunocompetent adult male patient originally from the Democratic Republic of Congo (DRC), who was referred to our unit for a several-day history of fever and a pruritic, vesicular rash. There was initial concern in the Emergency Department for Mpox (formerly known as “monkeypox”) given the current epidemiology versus other viral etiologies. Primary varicella zoster virus (pVZV) infection was ultimately diagnosed by PCR from a swabbed, unroofed lesion, and he recovered completely with supportive management and without antiviral therapy. We herein describe how common viral exanthems may best be differentiated in an emergency or outpatient setting. Full article

(This article belongs to the Special Issue Viral Infectious Diseases: Epidemiology and Prevention Through Vaccination)

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8 pages, 583 KB

Open AccessBrief Report

Respiratory Syncytial Virus (RSV) Hospitalizations in the Elderly in a Tertiary Care Hospital in Southern Italy as a Useful Proxy for Targeting Vaccine Preventive Strategies

by Francesca Centrone, Daniela Loconsole, Alfredo Marziani, Valentina Annachiara Orlando, Arianna delle Fontane, Martina Minelli and Maria Chironna

Infect. Dis. Rep. 2024, 16(3), 491-498; https://doi.org/10.3390/idr16030037 - 31 May 2024

Cited by 2 | Viewed by 3100

Abstract

RSV infection causes severe respiratory illness and mortality in the elderly, especially in the presence of comorbidities. Early identification of infection would result in appropriate clinical-therapeutic management, avoiding hospitalizations, the risk of healthcare-associated infections, and inappropriate antibiotic prescriptions, thus reducing healthcare costs and fighting antimicrobial resistance. The aim of this study was to assess RSV hospitalizations in subjects >64 years hospitalized in a large tertiary care hospital in Southern Italy, in order to assess their usefulness as a proxy for targeting a potential vaccination strategy. Fifty-two RSV-positive patients were identified from the 2014–2015 to the 2022–2023 seasons. RSV type B was found in 71.2% of cases. The median age was 78 years (IQR: 72–84) and 40.4% of the subjects had at least one comorbidity; 5.8% needed intensive care. The use of combined rapid tests for SARS-CoV-2/influenza/RSV identification in primary care settings may contribute to an improved definition of the burden of RSV in the elderly. The implementation of an anti-RSV vaccination strategy in the elderly population would reduce direct and indirect infection costs. More robust epidemiological data in Italy are needed for targeted preventive strategies. Full article

(This article belongs to the Special Issue Viral Infectious Diseases: Epidemiology and Prevention Through Vaccination)

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