Characterizing Potential Interaction Between Respiratory Syncytial Virus and Seasonal Influenza in the U.S.

Abstract

AbstractRSV and seasonal influenza are two of the most important causes of respiratory infection that consistently peak during winter months in the U.S. Here, we characterized the circulation of these viruses in the U.S. with weekly positive case reports and genetic surveillance and used a mathematical modeling approach to explore their potential interaction at an HHS regional level. Our analyses showed RSV and seasonal influenza co-circulate with various relatively epidemic sizes and seasonal overlaps across seasons and regions. We found RSV might have different evolutionary dynamics compared to seasonal influenza, with local persistence may play a role in underlying annual epidemics. Our analysis supports a competitive interaction between RSV and seasonal influenza in most HHS regions and we speculate that cross-immunity after infection might be the major driver of viral competition. Together, our work supports the competition between RSV and seasonal influenza across the U.S. at a population level. Our findings are important for the future development of protective strategies against these respiratory viruses.