Improving the accuracy of Respiratory Syncytial Virus (RSV) incidence among hospitalised adults in Bristol, UK

Katie L Lihou; Robert J Challen; Anastasia Chatzilena; George Y Qian; Glenda Oben; Jade N King; Serena McGuinness; M B Morales-Aza; Kaltun Duale; Ainhoa Rodriguez Pereira; William Healy; Jennifer L Oliver; Nick A Maskell; Adam H R Finn; Leon Danon; Catherine Hyams; Avon CAP  Research Group

doi:10.1101/2025.01.24.25321075

Improving the accuracy of Respiratory Syncytial Virus (RSV) incidence among hospitalised adults in Bristol, UK

Katie L Lihou, Robert J Challen, Anastasia Chatzilena, George Y Qian, Glenda Oben, Jade N King, Serena McGuinness, M B Morales-Aza, Kaltun Duale, Ainhoa Rodriguez Pereira, William Healy, Jennifer L Oliver, Nick A Maskell, Adam H R Finn, Leon Danon, Catherine Hyams^*, Avon CAP Research Group

^*Corresponding author for this work

Research output: Working paper › Preprint

Abstract

Respiratory Syncytial Virus (RSV) burden in adults is of interest due to recently-licensed vaccines, however, estimates are affected by test characteristics.

We conducted a prospective cohort study of adults with acute lower respiratory tract disease (aLRTD) hospitalised in Bristol from April 2022–March 2023. RSV was detected by RT-PCR at standard-of-care and by additional nasopharyngeal, saliva, and sputum samples. Latent class analysis quantified and adjusted for test error and multiple testing.

6906/11445 aLRTD cases (60%) were tested and 251 were positive (3.6%). Test-positivity peaked in December (7.9-12.7%). Among cases, 43% had pneumonia and 55% had non-pneumonic infection. Due to low positivity-rates and imperfect specificity, test-positivity (3.6%) overestimated true prevalence (2.3%). Adjusted adult population incidence/1000-person-years was 0.33 (0.21-0.49), and 2.02 (1.10-3.06) in ≥75-year-olds.

RSV vaccines could reduce morbidity of hospitalised adult aLRTD, including non-pneumonic infection. Adult RSV burden accuracy is improved by adjustment for test characteristics, particularly estimates out-of-season.

Original language	English
Publisher	medRxiv
DOIs	https://doi.org/10.1101/2025.01.24.25321075
Publication status	Submitted - 25 Jan 2025

Publication series

Name	medRxiv
Publisher	Cold Spring Harbor Laboratory Press

Research Groups and Themes

Health Data Science

Keywords

RSV
Test error
Respiratory
Epidemiology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1101/2025.01.24.25321075

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Lihou, K. L., Challen, R. J., Chatzilena, A., Qian, G. Y., Oben, G., King, J. N., McGuinness, S., Morales-Aza, M. B., Duale, K., Rodriguez Pereira, A., Healy, W., Oliver, J. L., Maskell, N. A., Finn, A. H. R., Danon, L., Hyams, C., & Research Group, A. CAP. (2026). Improving the accuracy of Respiratory Syncytial Virus (RSV) incidence among hospitalised adults in Bristol, UK. (medRxiv). medRxiv. https://doi.org/10.1101/2025.01.24.25321075

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abstract = "Respiratory Syncytial Virus (RSV) burden in adults is of interest due to recently-licensed vaccines, however, estimates are affected by test characteristics.We conducted a prospective cohort study of adults with acute lower respiratory tract disease (aLRTD) hospitalised in Bristol from April 2022–March 2023. RSV was detected by RT-PCR at standard-of-care and by additional nasopharyngeal, saliva, and sputum samples. Latent class analysis quantified and adjusted for test error and multiple testing.6906/11445 aLRTD cases (60%) were tested and 251 were positive (3.6%). Test-positivity peaked in December (7.9-12.7%). Among cases, 43% had pneumonia and 55% had non-pneumonic infection. Due to low positivity-rates and imperfect specificity, test-positivity (3.6%) overestimated true prevalence (2.3%). Adjusted adult population incidence/1000-person-years was 0.33 (0.21-0.49), and 2.02 (1.10-3.06) in ≥75-year-olds.RSV vaccines could reduce morbidity of hospitalised adult aLRTD, including non-pneumonic infection. Adult RSV burden accuracy is improved by adjustment for test characteristics, particularly estimates out-of-season.",

keywords = "RSV, Test error, Respiratory, Epidemiology",

author = "Lihou, {Katie L} and Challen, {Robert J} and Anastasia Chatzilena and Qian, {George Y} and Glenda Oben and King, {Jade N} and Serena McGuinness and Morales-Aza, {M B} and Kaltun Duale and {Rodriguez Pereira}, Ainhoa and William Healy and Oliver, {Jennifer L} and Maskell, {Nick A} and Finn, {Adam H R} and Leon Danon and Catherine Hyams and {Research Group}, {Avon CAP}",

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Lihou, KL , Challen, RJ , Chatzilena, A , Qian, GY , Oben, G, King, JN, McGuinness, S , Morales-Aza, MB, Duale, K, Rodriguez Pereira, A, Healy, W, Oliver, JL, Maskell, NA , Finn, AHR , Danon, L , Hyams, C & Research Group, ACAP 2026 'Improving the accuracy of Respiratory Syncytial Virus (RSV) incidence among hospitalised adults in Bristol, UK' medRxiv, medRxiv. https://doi.org/10.1101/2025.01.24.25321075

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AU - Lihou, Katie L

AU - Challen, Robert J

AU - Chatzilena, Anastasia

AU - Qian, George Y

AU - Oben, Glenda

AU - King, Jade N

AU - McGuinness, Serena

AU - Morales-Aza, M B

AU - Duale, Kaltun

AU - Rodriguez Pereira, Ainhoa

AU - Healy, William

AU - Oliver, Jennifer L

AU - Maskell, Nick A

AU - Finn, Adam H R

AU - Danon, Leon

AU - Hyams, Catherine

AU - Research Group, Avon CAP

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N2 - Respiratory Syncytial Virus (RSV) burden in adults is of interest due to recently-licensed vaccines, however, estimates are affected by test characteristics.We conducted a prospective cohort study of adults with acute lower respiratory tract disease (aLRTD) hospitalised in Bristol from April 2022–March 2023. RSV was detected by RT-PCR at standard-of-care and by additional nasopharyngeal, saliva, and sputum samples. Latent class analysis quantified and adjusted for test error and multiple testing.6906/11445 aLRTD cases (60%) were tested and 251 were positive (3.6%). Test-positivity peaked in December (7.9-12.7%). Among cases, 43% had pneumonia and 55% had non-pneumonic infection. Due to low positivity-rates and imperfect specificity, test-positivity (3.6%) overestimated true prevalence (2.3%). Adjusted adult population incidence/1000-person-years was 0.33 (0.21-0.49), and 2.02 (1.10-3.06) in ≥75-year-olds.RSV vaccines could reduce morbidity of hospitalised adult aLRTD, including non-pneumonic infection. Adult RSV burden accuracy is improved by adjustment for test characteristics, particularly estimates out-of-season.

AB - Respiratory Syncytial Virus (RSV) burden in adults is of interest due to recently-licensed vaccines, however, estimates are affected by test characteristics.We conducted a prospective cohort study of adults with acute lower respiratory tract disease (aLRTD) hospitalised in Bristol from April 2022–March 2023. RSV was detected by RT-PCR at standard-of-care and by additional nasopharyngeal, saliva, and sputum samples. Latent class analysis quantified and adjusted for test error and multiple testing.6906/11445 aLRTD cases (60%) were tested and 251 were positive (3.6%). Test-positivity peaked in December (7.9-12.7%). Among cases, 43% had pneumonia and 55% had non-pneumonic infection. Due to low positivity-rates and imperfect specificity, test-positivity (3.6%) overestimated true prevalence (2.3%). Adjusted adult population incidence/1000-person-years was 0.33 (0.21-0.49), and 2.02 (1.10-3.06) in ≥75-year-olds.RSV vaccines could reduce morbidity of hospitalised adult aLRTD, including non-pneumonic infection. Adult RSV burden accuracy is improved by adjustment for test characteristics, particularly estimates out-of-season.

KW - RSV

KW - Test error

KW - Respiratory

KW - Epidemiology

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DO - 10.1101/2025.01.24.25321075

M3 - Preprint

T3 - medRxiv

BT - Improving the accuracy of Respiratory Syncytial Virus (RSV) incidence among hospitalised adults in Bristol, UK

PB - medRxiv

ER -

Improving the accuracy of Respiratory Syncytial Virus (RSV) incidence among hospitalised adults in Bristol, UK

Abstract

Publication series

Research Groups and Themes

Keywords

UN SDGs

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Cite this