Evidence for influenza and RSV interaction from 10 years of enhanced surveillance in Nha Trang, Vietnam, a modelling study

Naomi R. Waterlow; Michiko Toizumi; Edwin van Leeuwen; Hien Anh Thi Nguyen; Lay Myint-Yoshida; Rosalind M. Eggo; Stefan Flasche

doi:10.1371/journal.pcbi.1010234

Evidence for influenza and RSV interaction from 10 years of enhanced surveillance in Nha Trang, Vietnam, a modelling study

Naomi R. Waterlow^*, Michiko Toizumi, Edwin van Leeuwen, Hien Anh Thi Nguyen, Lay Myint-Yoshida, Rosalind M. Eggo, Stefan Flasche

^*Corresponding author for this work

UK Health Security Agency

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Abstract

Influenza and Respiratory Syncytial Virus (RSV) interact within their host posing the concern for impacts on heterologous viruses following vaccination. We aimed to estimate the population level impact of their interaction. We developed a dynamic age-stratified two-pathogen mathematical model that includes pathogen interaction through competition for infection and enhanced severity of dual infections. We used parallel tempering to fit its parameters to 11 years of enhanced hospital-based surveillance for acute respiratory illnesses (ARI) in children under 5 years old in Nha Trang, Vietnam. The data supported either a 41% (95% CrI: 36–54) reduction in susceptibility following infection and for 10.0 days (95%CrI 7.1–12.8) thereafter, or no change in susceptibility following infection. We estimate that co-infection increased the probability for an infection in <2y old children to be reported 7.2 fold (95% CrI 5.0–11.4); or 16.6 fold (95%CrI 14.5–18.4) in the moderate or low interaction scenarios. Absence of either pathogen was not to the detriment of the other. We find stronger evidence for severity enhancing than for acquisition limiting interaction. In this setting vaccination against either pathogen is unlikely to have a major detrimental effect on the burden of disease caused by the other.

Original language	English
Article number	e1010234
Journal	PLoS Computational Biology
Volume	18
Issue number	6
DOIs	https://doi.org/10.1371/journal.pcbi.1010234
Publication status	Published - 24 Jun 2022

Bibliographical note

Funding Information: NRW was supported by the Medical Research Council (grant number MR/N013638/1). EvL and RME declare funding from the National Institute for Health Research (NIHR) Health Protection Research Unit (HPRU) in Modelling and Health Economics, a partnership between PHE, Imperial College London, and LSHTM (grant number NIHR200908). EvL was supported by the European Union’s Horizon 2020 research and innovation programme - project EpiPose (101003688). SF is funded through a Sir Henry Dale Fellowship jointly funded by the Wellcome Trust and the Royal Society (grant number 208812/Z/17/Z). RME acknowledges an HDR UK Innovation Fellowship (grant: MR/S003975/1), MRC (grant: MC_PC 19065), and NIHR (grant: NIHR200908) for the Health Protection Research Unit in Modelling and Economics at LSHTM. The views expressed in this publication are those of the author(s) and not necessarily those of the funders.
This ARI surveillance study in Nha Trang was supported by Japan Program for Infectious Diseases Research and Infrastructure, Japan Agency for Medical Research and Development (AMED) under Grant Number JP21wm0125006. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript

Open Access: This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publisher Copyright: © 2022 Waterlow et al.

Citation: Waterlow NR, Toizumi M, van Leeuwen E, Thi Nguyen H-A, Myint-Yoshida L, Eggo RM, et al. (2022) Evidence for influenza and RSV interaction from 10 years of enhanced surveillance in Nha Trang, Vietnam, a modelling study. PLoS Comput Biol 18(6): e1010234.

DOI: https://doi.org/10.1371/journal.pcbi.1010234

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title = "Evidence for influenza and RSV interaction from 10 years of enhanced surveillance in Nha Trang, Vietnam, a modelling study",

abstract = "Influenza and Respiratory Syncytial Virus (RSV) interact within their host posing the concern for impacts on heterologous viruses following vaccination. We aimed to estimate the population level impact of their interaction. We developed a dynamic age-stratified two-pathogen mathematical model that includes pathogen interaction through competition for infection and enhanced severity of dual infections. We used parallel tempering to fit its parameters to 11 years of enhanced hospital-based surveillance for acute respiratory illnesses (ARI) in children under 5 years old in Nha Trang, Vietnam. The data supported either a 41% (95% CrI: 36–54) reduction in susceptibility following infection and for 10.0 days (95%CrI 7.1–12.8) thereafter, or no change in susceptibility following infection. We estimate that co-infection increased the probability for an infection in <2y old children to be reported 7.2 fold (95% CrI 5.0–11.4); or 16.6 fold (95%CrI 14.5–18.4) in the moderate or low interaction scenarios. Absence of either pathogen was not to the detriment of the other. We find stronger evidence for severity enhancing than for acquisition limiting interaction. In this setting vaccination against either pathogen is unlikely to have a major detrimental effect on the burden of disease caused by the other.",

author = "Waterlow, {Naomi R.} and Michiko Toizumi and {van Leeuwen}, Edwin and Nguyen, {Hien Anh Thi} and Lay Myint-Yoshida and Eggo, {Rosalind M.} and Stefan Flasche",

note = "Funding Information: NRW was supported by the Medical Research Council (grant number MR/N013638/1). EvL and RME declare funding from the National Institute for Health Research (NIHR) Health Protection Research Unit (HPRU) in Modelling and Health Economics, a partnership between PHE, Imperial College London, and LSHTM (grant number NIHR200908). EvL was supported by the European Union{\textquoteright}s Horizon 2020 research and innovation programme - project EpiPose (101003688). SF is funded through a Sir Henry Dale Fellowship jointly funded by the Wellcome Trust and the Royal Society (grant number 208812/Z/17/Z). RME acknowledges an HDR UK Innovation Fellowship (grant: MR/S003975/1), MRC (grant: MC_PC 19065), and NIHR (grant: NIHR200908) for the Health Protection Research Unit in Modelling and Economics at LSHTM. The views expressed in this publication are those of the author(s) and not necessarily those of the funders. This ARI surveillance study in Nha Trang was supported by Japan Program for Infectious Diseases Research and Infrastructure, Japan Agency for Medical Research and Development (AMED) under Grant Number JP21wm0125006. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript Open Access: This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Publisher Copyright: {\textcopyright} 2022 Waterlow et al. Citation: Waterlow NR, Toizumi M, van Leeuwen E, Thi Nguyen H-A, Myint-Yoshida L, Eggo RM, et al. (2022) Evidence for influenza and RSV interaction from 10 years of enhanced surveillance in Nha Trang, Vietnam, a modelling study. PLoS Comput Biol 18(6): e1010234. DOI: https://doi.org/10.1371/journal.pcbi.1010234",

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AU - Myint-Yoshida, Lay

AU - Eggo, Rosalind M.

AU - Flasche, Stefan

N1 - Funding Information: NRW was supported by the Medical Research Council (grant number MR/N013638/1). EvL and RME declare funding from the National Institute for Health Research (NIHR) Health Protection Research Unit (HPRU) in Modelling and Health Economics, a partnership between PHE, Imperial College London, and LSHTM (grant number NIHR200908). EvL was supported by the European Union’s Horizon 2020 research and innovation programme - project EpiPose (101003688). SF is funded through a Sir Henry Dale Fellowship jointly funded by the Wellcome Trust and the Royal Society (grant number 208812/Z/17/Z). RME acknowledges an HDR UK Innovation Fellowship (grant: MR/S003975/1), MRC (grant: MC_PC 19065), and NIHR (grant: NIHR200908) for the Health Protection Research Unit in Modelling and Economics at LSHTM. The views expressed in this publication are those of the author(s) and not necessarily those of the funders. This ARI surveillance study in Nha Trang was supported by Japan Program for Infectious Diseases Research and Infrastructure, Japan Agency for Medical Research and Development (AMED) under Grant Number JP21wm0125006. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript Open Access: This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Publisher Copyright: © 2022 Waterlow et al. Citation: Waterlow NR, Toizumi M, van Leeuwen E, Thi Nguyen H-A, Myint-Yoshida L, Eggo RM, et al. (2022) Evidence for influenza and RSV interaction from 10 years of enhanced surveillance in Nha Trang, Vietnam, a modelling study. PLoS Comput Biol 18(6): e1010234. DOI: https://doi.org/10.1371/journal.pcbi.1010234

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N2 - Influenza and Respiratory Syncytial Virus (RSV) interact within their host posing the concern for impacts on heterologous viruses following vaccination. We aimed to estimate the population level impact of their interaction. We developed a dynamic age-stratified two-pathogen mathematical model that includes pathogen interaction through competition for infection and enhanced severity of dual infections. We used parallel tempering to fit its parameters to 11 years of enhanced hospital-based surveillance for acute respiratory illnesses (ARI) in children under 5 years old in Nha Trang, Vietnam. The data supported either a 41% (95% CrI: 36–54) reduction in susceptibility following infection and for 10.0 days (95%CrI 7.1–12.8) thereafter, or no change in susceptibility following infection. We estimate that co-infection increased the probability for an infection in <2y old children to be reported 7.2 fold (95% CrI 5.0–11.4); or 16.6 fold (95%CrI 14.5–18.4) in the moderate or low interaction scenarios. Absence of either pathogen was not to the detriment of the other. We find stronger evidence for severity enhancing than for acquisition limiting interaction. In this setting vaccination against either pathogen is unlikely to have a major detrimental effect on the burden of disease caused by the other.

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Evidence for influenza and RSV interaction from 10 years of enhanced surveillance in Nha Trang, Vietnam, a modelling study

Abstract

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