{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T15:18:36Z","timestamp":1787671116507,"version":"build-2736575974"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Respiratory virus circulation may vary across healthcare settings and age groups, potentially limiting the interpretability of surveillance based on a single source. In Milan, Italy, established community\u2010 and emergency department\u2010based systems coexist with hospital laboratory testing, but hospital ward\u2010level data are not routinely integrated. The aims of this study were to describe respiratory viruses' epidemiology and assess whether ward\u2010based surveillance complements community and ED surveillance. We analyzed molecular test results from respiratory samples collected from January 1, 2024 (W1\/2024) to October 12, 2025 (W41\/2025) in community, ED, and hospital ward settings. Viruses included influenza A (IAV), influenza B (IBV), RSV, and SARS\u2010CoV\u20102 (with extended panels in a subset). Among 8029 samples, overall positivity for \u2265\u20091 virus was 46.8%, highest in ED (51.1%) and community (50.5%) and lower in wards (36.7%) (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). During 2024\u20132025, IAV was first detected in wards (W33\/2024) and peaked earlier in wards (W2\/2025) than community (W3\/2025) and ED (W4\/2025). IBV was first detected in ED (W36\/2024) and peaked in ED (W5\/2025), community (W7\/2025), and wards (W8\/2025). RSV reappeared first in community (W37\/2024) and peaked in community\/ED (W50\/2024) and later in wards (W2\/2025). Respiratory virus positivity and descriptive peak timing differed across healthcare settings and age groups. Ward\u2010based surveillance provided complementary information for hospitalized and older populations, but it was not consistently earlier or superior to community or ED surveillance. Integrated, multi\u2010setting surveillance can improve situational awareness when interpreted alongside differences in tested populations, testing indications, and clinical outcome availability.\n                  <\/jats:p>","DOI":"10.1002\/jmv.71073","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T19:21:31Z","timestamp":1784661691000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Integrated Hospital, Emergency Department, and Community Surveillance for Respiratory Viruses in Milan, Italy"],"prefix":"10.1002","volume":"98","author":[{"given":"Alberto","family":"Rizzo","sequence":"first","affiliation":[{"name":"Laboratory of Clinical Microbiology, Virology and Bioemergencies Luigi Sacco University Hospital, ASST Fatebenefratelli Sacco, Regional Center for Infectious Diseases (CEREMI), Lombardy Region Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Salari","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Microbiology, Virology and Bioemergencies Luigi Sacco University Hospital, ASST Fatebenefratelli Sacco, Regional Center for Infectious Diseases (CEREMI), Lombardy Region Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Galli","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences for Health University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Maffeo","sequence":"additional","affiliation":[{"name":"Directorate General for Health Lombardy Region Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Paduraru","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences for Health University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Villa","sequence":"additional","affiliation":[{"name":"Directorate General for Health Lombardy Region Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Dolci","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Microbiology, Virology and Bioemergencies Luigi Sacco University Hospital, ASST Fatebenefratelli Sacco, Regional Center for Infectious Diseases (CEREMI), Lombardy Region Milan Italy"},{"name":"Department of Biomedical and Clinical Sciences University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Pariani","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences for Health University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danilo","family":"Cereda","sequence":"additional","affiliation":[{"name":"Directorate General for Health Lombardy Region Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Milan Respiratory Viruses Surveillance Working Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/irv.12759"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.70549"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/irv.12387"},{"key":"e_1_2_11_5_1","unstructured":"Istituto Superiore di Sanit\u00e0 RespiVirNet \u2013 Integrated Surveillance of Respiratory Viruses \u2010 Sorveglianza integrata dei virus respiratori(National Institute of Health \u2010 Istituto Superiore di Sanit\u00e0 2025) https:\/\/respivirnet.iss.it\/Default.aspx."},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid3105.241790"},{"key":"e_1_2_11_7_1","unstructured":"National Institue of health \u2010 Istituto Superiore di Sanit\u00e0 RespiVirNet \u2013 Epidemiological and Virological Surveillance of Cases of Flu\u2010like Illness and Respiratory Viruses \u2010 Sorveglianza Epidemiologica e Virologica dei casi di sindromi simil\u2010influenzali e dei virus respiratori. Operational Protocol season 2024\u20102025 \u2010 PROTOCOLLO OPERATIVO Stagione 2024\u20102025(National Institue of Health \u2010 Istituto Superiore di Sanit\u00e0 2024) https:\/\/www.epicentro.iss.it\/influenza\/pdf\/Protocollo%20Operativo%20RespiVirNet%20Stagione%202024-2025.pdf."},{"key":"e_1_2_11_8_1","unstructured":"National Institue of Health \u2010 Istituto Superiore di Sanit\u00e0 RespiVirNet \u2013 Integrated Surveillance of Acute Respiratory Infection (ARI) and Respiratory Viruses \u2010 Sorveglianza Integrata dei casi di infezione respiratoria acuta (ARI) e dei virus respiratori. Operational Protocol season 2025\u20102026 \u2010 PROTOCOLLO OPERATIVO Stagione 2025\u20102026(Istituto Superiore di Sanit\u00e0 2025) https:\/\/respivirnet.iss.it\/pagine\/Documenti.aspx."},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiaf179"},{"key":"e_1_2_11_10_1","unstructured":"European Centre for Disease Prevention and Control Acute Respiratory Infections in the EU\/EEA: Epidemiological Update and Current Public Health Recommendations \u2013 Winter 2024\/2025(European Centre for Disease Prevention and Control 2024) https:\/\/www.ecdc.europa.eu\/en\/news-events\/acute-respiratory-infections-eueea-epidemiological-update-and-current-public-health-0."},{"key":"e_1_2_11_11_1","unstructured":"Posit Team RStudio: Integrated Development Environment for R(Posit Software PBC 2025) http:\/\/www.posit.co\/."},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2025.1502036"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines13040431"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/v17081040"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/irv.70085"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2025.108303"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-020-05670-8"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2025.30.14.2400637"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmicom.2025.105149"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.25059"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiad587"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(25)00188-3"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-85068-7"},{"key":"e_1_2_11_24_1","unstructured":"Lombardy Region \u2013 Regione Lombardia Integrated Model for Microbiological Surveillance and Infection Prevention and Control Measures \u2010 Modello Integrato di Sorveglianza Microbiologica e Misure di Prevenzione e Controllo Infezioni \u2013 PNCAR. DELIBERAZIONE N\u00b0 XII\/2926 (Lombardy Region \u2010 Regione Lombardia 2024) https:\/\/www.regione.lombardia.it\/wps\/portal\/istituzionale\/HP\/istituzione\/Giunta\/sedute-delibere-giunta-regionale\/DettaglioDelibere\/delibera-2926-legislatura-12."},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2025.179706"}],"container-title":["Journal of Medical Virology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmv.71073","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jmv.71073","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmv.71073","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T14:39:06Z","timestamp":1787668746000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jmv.71073"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,21]]},"references-count":24,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/jmv.71073"],"URL":"https:\/\/doi.org\/10.1002\/jmv.71073","archive":["Portico"],"relation":{},"ISSN":["0146-6615","1096-9071"],"issn-type":[{"value":"0146-6615","type":"print"},{"value":"1096-9071","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,21]]},"assertion":[{"value":"2026-03-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71073"}}