{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T16:11:58Z","timestamp":1786983118227,"version":"build-2736575974"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T00:00:00Z","timestamp":1765238400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004697","name":"Hamadan University of Medical Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004697","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Epidemiol Glob Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aimed to characterize the incidence, seasonality, and co-infection patterns of respiratory syncytial virus (RSV), influenza A and B, and SARS-CoV-2 among hospitalized children aged 0\u20135 years in Hamedan Province, a semi-arid region in western Iran, from April 2023 to March 2024. Key research questions included assessing post-pandemic shifts in viral seasonality, evaluating the extent of RSV circulation, and determining the frequency of co-infections in a resource-limited pediatric setting where regional data remain scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 586 nasopharyngeal\/oropharyngeal samples were collected from children aged 0\u20135 years hospitalized with acute respiratory symptoms (\u2265\u20092 of: fever\u2009\u2265\u200938\u00a0\u00b0C, cough, dyspnea, oxygen saturation\u2009&lt;\u200995%). Multiplex real-time PCR (sensitivity 95%, specificity 98%) was used to detect RSV, SARS-CoV-2, and influenza A (H1N1, H3N2) and B. Statistical analysis included chi-square and Fisher\u2019s exact tests, and generalized linear models (binomial distribution, logit link).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 586 inpatients (mean age: 2.8 years; 62.5% male), 27.0% tested positive for influenza (60% influenza A [35% H1N1, 25% H3N2], 40% influenza B), 6.0% for RSV, and 6.3% for SARS-CoV-2. Influenza peaked in autumn (41.3%, p &lt; 0.001), RSV in winter (18.2%, p &lt; 0.001), and SARS-CoV-2 in spring (15.3%, p = 0.005). Co-infections were rare (0.9%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Findings reveal altered post-pandemic seasonality, reduced RSV activity, and low co-infection rates, suggesting potential ecological and immunological shifts. These trends highlight the need for sustained virus-specific surveillance and recalibrated vaccination strategies\u2014particularly influenza vaccination in autumn and RSV prophylaxis in winter\u2014in resource-limited pediatric settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s44197-025-00497-5","type":"journal-article","created":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T18:36:10Z","timestamp":1765305370000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Post-COVID-19 Seasonality of Influenza, Respiratory Syncytial Virus, and SARS-CoV-2 Among Hospitalized Children in Western Iran: A Molecular Surveillance Study (2023\u20132024)"],"prefix":"10.1007","volume":"15","author":[{"given":"Ensieh","family":"Masoorian","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Teimoori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Somaye","family":"Bakhtiari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farid Azizi","family":"Jalilian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roya Najafi","family":"Vosough","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0233-6494","authenticated-orcid":false,"given":"Nastaran","family":"Ansari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,9]]},"reference":[{"issue":"Suppl 1","key":"497_CR1","first-page":"S1","volume":"76","author":"H Nair","year":"2023","unstructured":"Nair H, Sim\u00f5es EAF, Rudan I, Gessner BD, Azziz-Baumgartner E, Zhang JSF, et al. 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