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RSV Epidemiological Surveillance: 2nd Edition

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A special issue of Viruses (ISSN 1999-4915). This special issue belongs to the section "Human Virology and Viral Diseases".

Deadline for manuscript submissions: closed (30 December 2025) | Viewed by 25536

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Dr. Emanuele Castagno

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Department of Pediatric Emergency, Regina Margherita Children’s Hospital–A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
Interests: pediatric emergency; pediatric procedural sedation and pain management; pediatric bioethics
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Dr. Irene Raffaldi

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Department of Pediatric Emergency, Regina Margherita Children’s Hospital–A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
Interests: pediatric emergency; infectious diseases; clinical toxicology; bedside ultrasound
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In the last two years, the spread of the respiratory syncytial virus (RSV) has completely changed due to a variety of factors. Firstly, the COVID-19 pandemic and associated restrictive measures induced a massive drop in RSV infections; then, however, an unusual resurgence with different epidemiological features was reported worldwide, both in young infants and older children.

On the other hand, new promising pharmacological options are expected to contribute to modifying RSV epidemiology in coming years, preventing RSV bronchiolitis in newborns and young infants, in particular. Lastly, climate change has a significant impact on respiratory virus circulation worldwide, including RSV. Considering this, epidemiological surveillance is vital to create future strategies for prevention and treatment.

The aim of this Special Issue is to provide a comprehensive picture of RSV epidemiology worldwide to contribute to the prevention and treatment of such infections in childhood. We invite researchers to contribute original articles, reviews, perspective articles, opinion papers, short communications, and case series on all the different aspects regarding RSV epidemiology, including (but not limited to) new epidemiological trends, prevention and treatment strategies, clinical features of RSV infection at different ages, and the impact of climate change.

Dr. Emanuele Castagno
Dr. Irene Raffaldi
Guest Editors

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Viruses is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

respiratory syncytial virus (RSV)
epidemiological surveillance
bronchiolitis
children
newborns
infants

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Related Special Issues

RSV Epidemiological Surveillance: 3rd Edition in Viruses (3 articles)
RSV Epidemiological Surveillance in Viruses (11 articles)

Published Papers (12 papers)

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Editorial

Jump to: Research, Review, Other

3 pages, 147 KB

Open AccessEditorial

Respiratory Syncytial Virus Epidemiology in Transition: Five Years of Profound Change

by Emanuele Castagno and Irene Raffaldi

Viruses 2026, 18(3), 360; https://doi.org/10.3390/v18030360 - 16 Mar 2026

Viewed by 556

Abstract

The landscape of respiratory syncytial virus (RSV) epidemiology has undergone unprecedented transformation over the past five years, fundamentally altering our understanding of viral transmission dynamics, disease burden across age groups, and preventive strategies [...] Full article

(This article belongs to the Special Issue RSV Epidemiological Surveillance: 2nd Edition)

Research

Jump to: Editorial, Review, Other

19 pages, 2373 KB

Open AccessArticle

Whole-Genome Phylodynamic Analysis of Respiratory Syncytial Virus—Maryland, USA, 2018–2024

by Ting-Xuan Zhuang, Amary Fall, Julie M. Norton, Omar Abdullah, Andrew Pekosz, Eili Klein and Heba H. Mostafa

Viruses 2026, 18(3), 331; https://doi.org/10.3390/v18030331 - 7 Mar 2026

Viewed by 1078

Abstract

Respiratory syncytial virus (RSV) is a leading cause of respiratory infections in infants and older adults, with epidemiological patterns shaped by viral evolution and diversity. To investigate the molecular epidemiology of RSV before and after the COVID-19 pandemic, we conducted genomic surveillance and phylodynamic analyses of RSV-A and RSV-B circulating in Maryland from 2018 to 2024. Whole-genome sequencing of RSV-positive samples (n = 451) was performed, and genomes were analyzed with phylogenetic and Bayesian methods to estimate evolutionary rates, population dynamics, selection pressures, and genetic diversity. RSV-A predominated in most seasons, while RSV-B showed episodic surges in 2018 and 2023. All RSV-A genomes belonged to the ON1 genotype, and RSV-B belonged to BA9, with sequential clade dominances including A.D.1, A.D.5.2, A.D.1.6, and B.D.E.1 across different epidemic seasons in Maryland. Bayesian analyses estimated evolutionary rates of 7.07 × 10⁻⁴ substitutions/site/year for RSV-A and 1.02 × 10⁻³ substitutions/site/year for RSV-B and temporal fluctuations in effective population size linked to pandemic-related disruptions. RSV-A displayed greater overall entropy, yet RSV-B evolved slightly faster. Genetic variability was concentrated in the G glycoprotein, with positively selected sites at codon 273 (RSV-A) and codon 217 (RSV-B). These findings demonstrate temporal fluctuations in RSV-A and RSV-B predominance, clade replacement, and ongoing viral adaptation throughout the COVID-19 era, underscoring the importance of integrated genomic and phylodynamic studies. Full article

(This article belongs to the Special Issue RSV Epidemiological Surveillance: 2nd Edition)

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20 pages, 3695 KB

Open AccessArticle

Changes in the Epidemiology of Pneumonia in Children Younger than 14 Years Old During and After the COVID-19 Pandemic in Mexico, a National Multicenter Study

by Rosa María Wong-Chew, Patricia Bautista Carbajal, Verónica Tabla-Orozco, María Del Carmen Espinosa-Sotero, Pedro Antonio Martínez-Arce, Daniel E. Noyola, María Susana Juárez-Tobías, Gerardo Martínez-Aguilar, Fabian Rojas-Larios, Izveydi Zuyino Mondragón-Salinas and Miguel Leonardo García-León

Viruses 2026, 18(2), 270; https://doi.org/10.3390/v18020270 - 22 Feb 2026

Viewed by 1338

Abstract

Background: In 2019, pneumonia caused 740,180 deaths in children under five years of age, representing 22% of global mortality in this age group. During the COVID-19 pandemic, public health interventions markedly reduced the circulation of most respiratory viruses other than SARS-CoV-2, leading to significant post-pandemic shifts in respiratory pathogen epidemiology. This study aimed to characterize the epidemiology, clinical features, and risk factors associated with respiratory viruses and bacteria causing pneumonia in Mexican children during the late pandemic and post pandemic periods. Methods: Children younger than 14 years with pneumonia were recruited from seven hospitals in Mexico. Demographic and clinical data were collected, and nasopharyngeal swabs were analyzed using a multiplex PCR panel detecting 19 viruses and 7 bacteria. Univariate, bivariate, and logistic regression analyses were performed (SPSS v25). Results: A total of 1715 children were included: 704 during the pandemic (2021–2023) and 1011 post-pandemic (2023–2025). Co-infections (72% vs. 65%, p < 0.001), virus–virus co-infections (25% vs. 11%, p < 0.001), and single viral infections (20% vs. 15%, p = 0.007) were more frequent during the pandemic. Pathogen detection was high in both periods, though negative samples increased post-pandemic (5.4% vs. 15%, p < 0.001). During the pandemic, the 5 most frequently detected pathogens were rhinovirus (66%), RSV A and B (38%), Streptococcus pneumoniae (30%), Haemophilus influenzae (28%), human metapneumovirus (13%). In the post-pandemic period, the 5 most frequently detected pathogens were rhinovirus (52%), Haemophilus influenzae (36%), Streptococcus pneumoniae (35%), RSV A and B (28%), metapneumovirus (11%). Rhinovirus and RSV predominated during the pandemic, whereas Haemophilus influenzae, Streptococcus pneumoniae, parainfluenza viruses, Bordetella pertussis, and Mycoplasma pneumoniae significantly increased post-pandemic. Conclusions: Pediatric pneumonia epidemiology shifted from a predominantly viral profile during the pandemic to increased bacterial detections and virus–bacteria co-infections post-pandemic, alongside re-emergence of typical RSV and influenza seasonality. Higher mean age and rhinovirus as the most frequent pathogen persist after the pandemic. Sustained molecular surveillance and reinforced vaccination programs remain essential in the post-pandemic era. Full article

(This article belongs to the Special Issue RSV Epidemiological Surveillance: 2nd Edition)

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10 pages, 214 KB

Open AccessArticle

Evaluating the Clinical Impact of BioFire Spotfire R/ST on the Management of Pediatric Respiratory Presentations in the Emergency Department: A Pre–Post Cross-Sectional Study in Chile

by Dona Benadof, Mirta Acuña, Yennybeth Leiva and Daniel Conei

Viruses 2026, 18(1), 139; https://doi.org/10.3390/v18010139 - 22 Jan 2026

Cited by 1 | Viewed by 1019

Abstract

Respiratory infections represent one of the leading causes of pediatric consultations and hospitalizations in Chile, where rapid etiological identification is essential for clinical decision-making. We evaluated the impact of implementing the BIOFIRE^® SPOTFIRE^® Respiratory (R) Panel in the pediatric Emergency Department of a public referral hospital in Santiago, using a pre–post cross-sectional design comparing two winter periods (July 2023 vs. July 2024). Clinical records, laboratory data, and operational indicators were analyzed to assess changes in diagnostic yield, turnaround time, hospitalizations, discharges, supplementary test requests, and antimicrobial use. A total of 470 patients were included (224 in 2023; 246 in 2024). The etiological detection rate increased from 58.0% to 87.8% after the implementation of Spotfire^® (p < 0.0001), with marked increases in the identification of adenovirus, RSV, rhinovirus/enterovirus, and seasonal coronaviruses. Rapid molecular testing was associated with a significant rise in emergency department discharges (23.7% vs. 57.3%; p < 0.0001) and a reduction in hospitalizations (76.3% vs. 42.7%; p < 0.0001) and readmissions (9.2% vs. 0.5%; p < 0.0001). Requests for complete blood counts, chest X-rays, and antimicrobial prescriptions at discharge also decreased significantly. These effects persisted in key subgroups, including infants and children with comorbidities. In this high-demand winter setting, the BIOFIRE^® SPOTFIRE^® R Panel improved diagnostic performance and supported more efficient and targeted clinical management. Full article

(This article belongs to the Special Issue RSV Epidemiological Surveillance: 2nd Edition)

20 pages, 3794 KB

Open AccessArticle

Tracking Respiratory Viruses in Pakistan (2022–2025): Genomic and Epidemiologic Insights from Sentinel Surveillance of Influenza, SARS-CoV-2, and RSV

by Nazish Badar, Abdul Ahad, Hamza Ahmed Mirza, Fazal Hanan, Asghar Javaid, Aamir Amanat, Zunira Saghir and Muhammad Salman

Viruses 2026, 18(1), 26; https://doi.org/10.3390/v18010026 - 23 Dec 2025

Viewed by 2006

Abstract

Influenza and other respiratory viruses pose significant public health threats among SARI patients, yet comprehensive surveillance data remain limited in Pakistan. This prospective, multi-center study characterized the burden, distribution, and molecular evolution of respiratory viruses among hospitalized SARI patients across seven tertiary hospitals from November 2022 to June 2025. Specimens were tested using RT-PCR for influenza, SARS-CoV-2, and RSV, with 375 samples sequenced via Oxford Nanopore Technology. Among 11,451 specimens, 2818 (24.6%) tested positive: RSV (1648, 14.4%), influenza (855, 7.5%; 45% H1N1pdm09, 35% H3N2, 20% influenza B), and SARS-CoV-2 (315, 2.8%). RSV predominantly affected children under 2 years (63%), while influenza and SARS-CoV-2 primarily impacted adults aged 15–40 years. Male predominance (65–79%) reflected healthcare access barriers. Strong winter seasonality (December–February) was observed for influenza and RSV. ICU admission rates were 17% for influenza, 16% for RSV, and 4% for SARS-CoV-2. Shortness of breath was associated with influenza (OR = 1.62) and RSV (OR = 1.27), while malaise (OR = 2.24) and myalgia (OR = 3.87) was associated with SARS-CoV-2. Phylogenetic analysis revealed vaccine-matched influenza clades and rapid SARS-CoV-2 variant succession (3–4 months). RSV is the primary SARI pathogen in young children, necessitating maternal vaccines and nirsevimab implementation. Sustained genomic surveillance remains essential for pandemic preparedness. Full article

(This article belongs to the Special Issue RSV Epidemiological Surveillance: 2nd Edition)

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11 pages, 1589 KB

Open AccessArticle

Timely Association of RSV Hospitalisation Waves in Children with the Detection of SARS-CoV-2 in the General Population in Eastern Bavaria

by Alexander Kiefer, Andreas Ambrosch, Benedikt M. J. Lampl, Fritz Schneble, Kai Rubarth, Stefan Vlaho, Matthias Keller and Michael Kabesch

Viruses 2025, 17(12), 1584; https://doi.org/10.3390/v17121584 - 5 Dec 2025

Cited by 1 | Viewed by 1182

Abstract

Background: The Respiratory Syncytial Virus (RSV) season of 2023/2024 was conspicuously different from previous seasons, with an abrupt decrease in hospitalisation rates at the peak of the season, leading to two lower peaks instead of the expected one high peak of hospitalisations. Thus, we investigated whether there was an interference with other virus infection waves in the course of that RSV season. Methods: We analysed RSV seasons since 2016 in children who were hospitalised due to an RSV infection in Eastern Bavaria and investigated epidemiological features of RSV seasons after the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic at local, regional, and national levels. Results: Analysing patterns of four RSV seasons prior to and three seasons after the SARS-CoV-2 pandemic, we found that the paediatric RSV hospitalisation wave of the 2023/2024 season was weaker and less pronounced than expected. When we compared detailed local, regional, and national surveillance data of other viral infections, we found that paediatric RSV hospitalisation waves were anticyclical to SARS-CoV-2 infection waves, but not to rhinovirus or influenza waves in the general population. Discussion: Our data suggests that concomitant SARS-CoV-2 infection waves in the general population may disrupt infection chains of RSV in children and, thus, decrease RSV-associated hospitalisation. This factor should be taken into account when assessing the effects of the upcoming RSV prophylaxis in the future. Full article

(This article belongs to the Special Issue RSV Epidemiological Surveillance: 2nd Edition)

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15 pages, 1092 KB

Open AccessArticle

Burden and Characteristics of RSV-Associated Hospitalizations in Switzerland: A Nationwide Analysis from 2017 to 2023

by Elisa D. Bally-von Passavant, Neetha Joseph, Nike Julia Kräutler, Daphne McCarthy-Pontier, Giorgia Lüthi-Corridori, Fabienne Jaun, Jörg D. Leuppi and Maria Boesing

Viruses 2025, 17(11), 1407; https://doi.org/10.3390/v17111407 - 23 Oct 2025

Cited by 2 | Viewed by 2695

Abstract

Respiratory syncytial virus (RSV) is a major cause of respiratory illness, particularly in children, yet its burden in adults—especially in older adults—remains under-recognized. We analyzed RSV-related hospitalizations in Switzerland from 2017 to 2023 using national data from the Federal Statistical Office, including cases with RSV coded as either a primary or secondary diagnosis. Over 35,000 RSV-related hospitalizations were recorded. The highest incidence occurred in children under 10 years (390 per 100,000/year), with a second peak in adults ≥ 80 years (151 per 100,000/year). Older adults (≥60 years) accounted for more than 9700 hospitalizations overall, with an average of over 16,600 total hospital days per year. Average length of stay (LOS) was shortest in young children (4.6 days) and highest in adolescents (13.9 days), while in adults, it increased from 6.8 days (age 20–29) to 12.3 (age ≥ 80). Mechanical ventilation rates peaked at 12.6% in 60–69 year olds, and in-hospital mortality at 7.1% in those ≥80 years. In adults, RSV was more often recorded as a secondary diagnosis and commonly associated with chronic comorbidities, including chronic obstructive pulmonary disease, heart failure, kidney disease, and diabetes. Frailty-related diagnoses—such as cognitive or motor impairment, delirium, and need for nursing care—were also frequent. These findings highlight the importance of improved adult RSV surveillance and targeted prevention strategies in high-risk populations. Full article

(This article belongs to the Special Issue RSV Epidemiological Surveillance: 2nd Edition)

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15 pages, 1840 KB

Open AccessArticle

Association of Comorbidities with Adverse Outcomes in Adults Hospitalized with Respiratory Syncytial Virus (RSV) Infection: A Retrospective Cohort Study from Switzerland (2022–2024)

by Neetha Joseph, Elisa D. Bally-von Passavant, Giorgia Lüthi-Corridori, Fabienne Jaun, Sandra Mitrovic, Jörg Daniel Leuppi and Maria Boesing

Viruses 2025, 17(8), 1030; https://doi.org/10.3390/v17081030 - 23 Jul 2025

Cited by 5 | Viewed by 2427

Abstract

Introduction: Respiratory Syncytial Virus (RSV) infection causes seasonal respiratory illness in both children and adults, with increasing recognition of its impact in older adults with chronic comorbidities. This study aimed to characterize adult patients hospitalized with RSV infection in Switzerland and identify comorbidities linked to poor outcomes. Methods: Adults hospitalized with RSV infection between May 2022 and April 2024 at a Swiss public teaching hospital were included in this retrospective observational study. To assess the association between comorbidities and patient outcomes, separate multivariable regression analyses for each comorbidity, adjusted for age and sex, were performed. The primary composite endpoint was ’severe course’ (in-hospital death or intensive care unit (ICU) admission), secondary endpoints included in-hospital death, ICU admission, and length of stay. Results: Among 136 included patients (mean age 78, 38% male), 98% had comorbidities, most commonly cardiovascular (75.7%), respiratory (51%), and chronic kidney disease (CKD) (36.7%). Further, 18.4% experienced a severe course. The ICU admission rate was 14.0%, in-hospital mortality 6.6%, and the median hospital stay of survivors was 6 days (IQR 4–10). CKD was significantly associated with severe course (OR 2.64, p = 0.045) and in-hospital mortality (OR 11.6, p = 0.025), while immunosuppression predicted ICU admission (OR 5.7, p = 0.018). Length of stay was not linked to any comorbidities. Conclusions: In this cohort of hospitalized adults, mainly elderly individuals with chronic comorbidities were tested positive for RSV. CKD and immunosuppression were associated with severe course. Prevention strategies, including RSV vaccination, should prioritize these high-risk populations. Full article

(This article belongs to the Special Issue RSV Epidemiological Surveillance: 2nd Edition)

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13 pages, 4658 KB

Open AccessArticle

Respiratory Syncytial Virus-Infected Human Mesenchymal Stem Cells Overexpress Toll-like Receptors and Change the Pattern of Distribution of Their Cytoskeleton

by César Alexis Rosales Velázquez, Laura Guadalupe Chavéz Gómez, Carlos Arturo Félix Espinosa, Mario Adan Moreno-Eutimio, Juan José Montesinos, Guadalupe R. Fajardo-Orduña and Rocio Tirado Mendoza

Viruses 2025, 17(6), 763; https://doi.org/10.3390/v17060763 - 28 May 2025

Cited by 1 | Viewed by 1538

Abstract

Acute respiratory tract infections (ARIs) are one of the major causes of morbimortality in children and adulthood. Furthermore, the respiratory syncytial virus (RSV) is the main pathogen in severe lower respiratory tract infections. In Mexico, RSV is the second cause of ARI, affecting mainly children and seniors. RSV infects the airway epithelium, including mesenchymal stem cells (MSCs). These cells express a variety of surface molecules which may function as viral receptors, i.e., Toll-like receptors (TLRs), but the consequences that viral infection has on their biological activities are poorly understood. The aim of this study is to determinate if RSV infection of MSC modifies the expression of stemness biomarkers, TLRs, and the organization of the cytoskeleton. To study the viral infection of MSCs, we determined the mRNA expression using qRT-PCR of SOX2, NANOG, and POU5F1; vimentin and actin; and TLRs 2, 4, and 6. In addition, we determined the cell surface expression of TLR 2 and 4 using flow cytometry. Our results showed that the infection did not change the mRNA expression of SOX2, NANOG, and POU5F1, but increased the mRNA expression of TLR4 and the cell surface expression. Meanwhile, the mRNA in the actin was unchanged, vimentin decreased, and the infection generated a redistribution of the cytoskeleton. Full article

(This article belongs to the Special Issue RSV Epidemiological Surveillance: 2nd Edition)

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13 pages, 277 KB

Open AccessArticle

Respiratory Syncytial Virus and Other Respiratory Viruses in Hospitalized Infants During the 2023–2024 Winter Season in Mexico

by José J. Leija-Martínez, Sandra Cadena-Mota, Ana María González-Ortiz, Juan Carlos Muñoz-Escalante, Gabriel Mata-Moreno, Pedro Gerardo Hernández-Sánchez, María Vega-Morúa and Daniel E. Noyola

Viruses 2024, 16(12), 1917; https://doi.org/10.3390/v16121917 - 14 Dec 2024

Cited by 13 | Viewed by 4347

Abstract

Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infections in young children. During the COVID-19 pandemic, a significant change in the epidemiology of RSV and other viruses occurred worldwide, leading to a reduction in the circulation of these infectious agents. After the pandemic, the resurgence of seasonal respiratory viruses occurred, but some features of these infections contrast to those registered prior to the pandemic. In the present work, we studied 390 children <5 years old admitted to the hospital to determine the contribution of RSV, SARS-CoV-2, human metapneumovirus (hMPV), and influenza viruses to acute respiratory infections during the 2023–2024 winter season in Mexico. RSV was the most frequently detected virus (n = 160, 41%), followed by SARS-CoV-2 (n = 69, 17.7%), hMPV (n = 68, 17.4%), and influenza A or B (n = 40, 10.26%). Fourteen patients required admission to the intensive care unit, including six (42.8%) with RSV infection. Four children died (1%). At least one of the four viruses was detected in all deceased patients: SARS-CoV-2 in one; SARS-CoV-2 and hMPV in two; and RSV, influenza A, and SARS-CoV-2 in one. The high impact of RSV and other respiratory viruses indicates the need to implement specific preventive programs to reduce the morbidity and mortality associated with them. Full article

(This article belongs to the Special Issue RSV Epidemiological Surveillance: 2nd Edition)

Review

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19 pages, 633 KB

Open AccessReview

Predictive Factors and Clinical Markers of Recurrent Wheezing and Asthma After RSV Infection

by Luca Buttarelli, Elisa Caselli, Sofia Gerevini, Pietro Leuratti, Antonella Gambadauro, Sara Manti and Susanna Esposito

Viruses 2025, 17(8), 1073; https://doi.org/10.3390/v17081073 - 31 Jul 2025

Cited by 7 | Viewed by 4277

Abstract

Respiratory syncytial virus (RSV) is a major cause of acute lower respiratory infections (ALRIs) in young children, especially bronchiolitis, with significant global health and economic impact. Increasing evidence links early-life RSV infection to long-term respiratory complications, notably recurrent wheezing and asthma. This narrative review examines these associations, emphasizing predictive factors and emerging biomarkers for risk stratification. Early RSV infection can trigger persistent airway inflammation and immune dysregulation, increasing the likelihood of chronic respiratory outcomes. Risk factors include severity of the initial infection, age at exposure, genetic susceptibility, prematurity, air pollution, and tobacco smoke. Biomarkers such as cytokines and chemokines are showing promise in identifying children at higher risk, potentially guiding early interventions. RSV-related bronchiolitis may also induce airway remodeling and promote Th2/Th17-skewed immune responses, mechanisms closely linked to asthma development. Advances in molecular profiling are shedding light on these pathways, suggesting novel targets for early therapeutic strategies. Furthermore, passive immunization and maternal vaccination offer promising approaches to reducing both acute and long-term RSV-related morbidity. A deeper understanding of RSV’s prolonged impact is essential to develop targeted prevention, enhance risk prediction, and improve long-term respiratory health in children. Future studies should aim to validate biomarkers and refine immunoprophylactic strategies. Full article

(This article belongs to the Special Issue RSV Epidemiological Surveillance: 2nd Edition)

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Other

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32 pages, 10393 KB

Open AccessSystematic Review

Respiratory Syncytial Virus Prevalence and Genotypic Distribution in the Countries of the Former Soviet Union: A Systematic Review and Meta-Analysis

by Denis E. Maslov, Ivan D. Osipov, Daria S. Zabelina, Anastasia A. Pak and Sergey V. Netesov

Viruses 2026, 18(1), 126; https://doi.org/10.3390/v18010126 - 19 Jan 2026

Viewed by 1249

Abstract

Respiratory syncytial virus (RSV) is among leading global causes of lower respiratory tract infections, yet data from Russia and other states of the Former Soviet Union (FSU) remain fragmented and structurally inconsistent. This systematic review aims to map and synthesize existing evidence on RSV epidemiology and genotypic distribution across the FSU. Published studies from eLIBRARY and PubMed databases queried for RSV prevalence data, together with public health surveillance datasets, were used to summarize RSV prevalence research across eight FSU countries. Random-effects meta-analysis across age strata showed high prevalence in children before 6 (21%) and a progressive decline with age, which is in agreement with global data. Prevalence estimates showed a high degree of variability partially explained by study scope and clinical presentation. We observed COVID-19-related seasonal disruptions of RSV seasonality, followed by gradual post-pandemic stabilization. Genotypic data reflects global trends with two cosmopolitan clades, A.D and B.D, and their descendants, dominating in the region. The review is limited by uneven geographical and temporal coverage, and scarce data on adults. The review provides the first integrated summary of RSV epidemiology across the FSU and underscores the need for expanded regional surveillance and genomic reporting. Full article

(This article belongs to the Special Issue RSV Epidemiological Surveillance: 2nd Edition)

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