Leveraging the Global Influenza Surveillance and Response System for global respiratory syncytial virus surveillance—opportunities and challenges

Shobha Broor, Harry Campbell, Siddhivinayak Hirve, Siri Hague, Sandra Jackson, Ann Moen, Harish Nair, Rakhee Palekar, Soatiana Rajatonirina, Peter G. Smith, Marietjie Venter, Niteen Wairagkar, Maria Zambon, Thedi Ziegler, Wenqing Zhang*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)


Background: Respiratory syncytial virus (RSV)-associated acute lower respiratory infection is a common cause for hospitalization and hospital deaths in young children globally. There is urgent need to generate evidence to inform immunization policies when RSV vaccines become available. The WHO piloted a RSV surveillance strategy that leverages the existing capacities of the Global Influenza Surveillance and Response System (GISRS) to better understand RSV seasonality, high-risk groups, validate case definitions, and develop laboratory and surveillance standards for RSV. Methods: The RSV sentinel surveillance strategy was piloted in 14 countries. Patients across all age groups presenting to sentinel hospitals and clinics were screened all year-round using extended severe acute respiratory infection (SARI) and acute respiratory infection (ARI) case definitions for hospital and primary care settings, respectively. Respiratory specimens were tested for RSV at the National Influenza Centre (NIC) using standardized molecular diagnostics that had been validated by an External Quality Assurance program. The WHO FluMart data platform was adapted to receive case-based RSV data and visualize interactive visualization outputs. Results: Laboratory standards for detecting RSV by RT-PCR were developed. A review assessed the feasibility and the low incremental costs for RSV surveillance. Several challenges were addressed related to case definitions, sampling strategies, the need to focus surveillance on young children, and the data required for burden estimation. Conclusions: There was no evidence of any significant adverse impact on the functioning of GISRS which is primarily intended for virologic and epidemiological surveillance of influenza.

Original languageEnglish
Pages (from-to)622-629
Number of pages8
JournalInfluenza and other Respiratory Viruses
Issue number6
Publication statusPublished - 1 Nov 2020

Bibliographical note

Funding Information:
The WHO global RSV surveillance pilot project was supported by an award made to the World Health Organization by the Bill and Melinda Gates Foundation (grant no. OPP1127419). The authors would like to thank all the national and international experts who participated in the informal consultations in March 2015, February 2016, and June 2016 that led to the development of the WHO RSV surveillance strategy. We are grateful to the National Influenza Centres and the Ministries of Health of the participating countries, for piloting the RSV surveillance strategy. We thank the Respiratory Viruses Branch, Division of Viral Diseases, CDC, Atlanta; the Public Health England at Colindale; and the National Institute of Communicable Diseases at Johannesburg for providing support as RSV reference laboratories for this project. We thank colleagues in the Global Influenza Program, Influenza Preparedness and Response, and Dept. of Infectious Hazards Management of the WHO Health Emergencies for supporting this work.

Publisher Copyright:
© 2019 The World Health Organization. Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd.


  • respiratory syncytial virus
  • strategy
  • surveillance


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