[Note the original post date of the below advisory was December 10th. This was preceded by a state level advisory issued to Texas on December 9th, which triggered a ground truth feedback loop that provided supportive information to expand the advisory. This advisory remains current as of today and is relevant for the northern hemisphere.]
In the past week, Veratect has documented increasing trends of Respiratory Syncytial Virus (RSV) among pediatric cases in Texas, United States. On 8 December, Veratect issued a report documenting RSV cases above the epidemic threshold in Texas. Subsequent reports on 10 December within the localities of Houston, San Antonio and Temple corroborated such increases. Levels of the virus had also been surpassing the epidemic threshold in Kentucky for two weeks, as reported by Veratect on 7 December. While hospital admissions have been reported in Texas, no public health or health care services strain associated with RSV incidence has yet been noted.
The increase in RSV incidence in Texas is not unprecedented, as incidence historically begins to increase in October and peaks between mid December and mid January before declining in February. Surveillance data from the 2008-2009 season demonstrated a significant increase in positive test results between the end of November and first weeks of December.
Despite the expected timing of RSV upward trends, what has not been previously observed is the compound effect from co-circulating pandemic (H1N1) 2009 influenza virus, which has already demonstrated a disproportionate outcome of more severe disease in children. Texas has been reporting regional influenza activity to the Centers for Disease Control and Prevention (CDC) since the week ending 7 November; however, Veratect sources have cited concern among health care providers that the RSV situation this season could potentially escalate because of the focus on pandemic (H1N1) 2009.
Previous United States Situation Reports issued by Veratect have suggested the potential for additional strain on the emergency department-intensive care unit axis as expected by RSV transmission increase if elevated levels of pandemic (H1N1) 2009 are still present, particularly during the January-February time frame. Veratect continues to remain vigilant in tracking outcomes of pandemic (H1N1) 2009 co-circulation with RSV and potential effects on the public health sector.
[It is likely many areas of the northern hemisphere now have appreciable herd immunity levels for pH1N1, and levels of pH1N1 activity continue to decline in many areas of the US. It will be interesting to see what level of medical infrastructure strain will be observed this winter.]
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