Respiratory infectious diseases on the rise across WHO European Region – World Health Organization (WHO)
Nutrition
74th session of the WHO Regional Committee for Europe
Seasonal cold weather has set in across the WHO European Region, leading to circulation of respiratory pathogens and more people becoming sick. Many of these pathogens affect young children, especially those under 5 years, alongside other at-risk groups, such as people with comorbidities and people aged over 65 years. However, continuing successful prevention strategies can reduce the likelihood of most at-risk groups falling ill this winter.
According to the European Respiratory Virus Surveillance Summary, approximately half of the countries in the Region are experiencing higher levels of fever and cough, and some countries are reporting a sharp increase, including among young children.
A similar increase in hospitalizations was seen at this time last year, driven by an early seasonal increase in the circulation of respiratory syncytial virus (RSV), which is a leading cause of acute lower respiratory tract infections in infants and young children. RSV is a seasonal virus that recurs each year in Europe, with peaks mainly during the autumn, winter, and spring months (October to April). Common symptoms of RSV include a runny nose, decrease in appetite, coughing, sneezing, fever and wheezing. Most RSV infections resolve on their own in 1–2 weeks, but RSV can also cause more severe infections such as bronchiolitis, or inflammation of the small airways in the lung, and pneumonia – infection of the lungs.
WHO closely monitors select respiratory viruses and some of this recent increase is, again, due to a peak of RSV infections, against a backdrop of increasing cases of COVID-19 and a smaller but notable rise in seasonal influenza. Moreover, several countries in the Region are reporting an increase in infections and hospitalizations related to Mycoplasma pneumoniae, a common bacterial cause of community-acquired pneumonia among children.
The increase in RSV activity is also reflected in a sharp increase in RSV-related hospitalizations in young children in the last 5 weeks. RSV in children under 6 months of age accounts for 20% of acute lower respiratory tract infection episodes and almost half of all RSV deaths in children under 5 years of age. Although RSV infection is nearly unavoidable for most children, special care should be taken to protect preterm babies and infants under 6 months of age, particularly those with underlying lung and heart disease. In addition, toddlers who have not encountered RSV during the COVID-19 pandemic are at increased risk of infection.
Seasonal increases in respiratory infections are expected, and the data so far show nothing especially concerning or different about these pathogens or the severity of the disease they are causing in children. It is possible that many young children have not yet been fully exposed to some of these due to reduced circulation during the pandemic. In addition, Mycoplasma pneumoniae infection tends to circulate more intensely in some years than in others, every 2–4 years. The occurrence and spread of these pathogens can vary between countries, and even within countries, with national or local health departments best placed to assess activity in any one area.
COVID-19 is still around, causing severe illness and death in people with risk factors for severe disease, especially those who are over 65 years. While hospitalization rates remain low compared to this time last year, half of the countries in the Region reporting data on hospitalization due to COVID-19 are now seeing increasing trends, notably Czechia, Finland, Italy, Latvia, and Slovakia.
“To a large extent, a seasonal increase in respiratory pathogens is expected, but this year’s increase could also be attributed to infections among children who were protected during the pandemic, and because some of these pathogens vary in circulation each winter,” explained Dr Marc-Alain Widdowson, High-threat Pathogen Lead at the WHO Regional Office for Europe.
“COVID-19 and influenza vaccine recommendations remain targeted at the same high-risk groups: older adults, people with chronic diseases, those with immunocompromising conditions, people who are pregnant, and health workers. Receiving both vaccines is recommended where available.”
While it is important to note the increase, simple measures such as handwashing, staying home when ill, ensuring better ventilation in crowded spaces, and getting vaccinated when offered are often effective in curbing the spread of these viruses and protecting those most vulnerable.
For COVID-19 and seasonal influenza, an additional vaccine remains the best way to protect people at higher risk from severe disease. Influenza vaccines have been safely administered to millions of people for decades. COVID-19 vaccines helped to save an estimated 1.5 million lives and continue to do so. If offered, it is recommended that people receive both vaccines, especially those at higher risk of severe disease from COVID-19 and influenza. In some countries and areas in Europe, vaccines have recently become available for very young children at risk of RSV disease or for their mothers.
The winter respiratory illness season is far from over, and influenza transmission is only now increasing. As different pathogens can peak at different times, it is unclear at this stage what the rest of the season will look like. WHO is monitoring the situation closely with integrated surveillance for several diseases complemented by reports from national authorities and other sources.
“There are steps that we can take to protect ourselves, our loved ones and people at risk,” noted Dr Widdowson. “Health authorities also have an important role to play in ensuring that our health systems can manage multiple threats this winter. To support this, Member States should continue to engage with vulnerable groups to encourage the uptake of COVID-19 and influenza vaccines, to promote and carry out protective measures where and when needed, and to dispel false information that can jeopardize individual and public health and well-being
Events
