{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T14:12:10Z","timestamp":1789049530289,"version":"build-2803163510"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"Supplement_1","funder":[{"name":"Centers for Disease Control and Prevention\u2019s"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Respiratory tract infections are common, often seasonal, and caused by multiple pathogens. We assessed whether seasonal respiratory illness patterns changed during the COVID-19 pandemic.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We categorized emergency department (ED) visits reported to the National Syndromic Surveillance Program according to chief complaints and diagnosis codes, excluding visits with diagnosed SARS-CoV-2 infections. For each week during 1 March 2020 through 26 December 2020 (\u201cpandemic period\u201d), we compared the proportion of ED visits in each respiratory category with the proportion of visits in that category during the corresponding weeks of 2017\u20132019 (\u201cpre\u2013pandemic period\u201d). We analyzed positivity of respiratory viral tests from 2 independent clinical laboratories.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>During March 2020, cough, shortness of breath, and influenza-like illness accounted for twice as many ED visits compared with the pre\u2013pandemic period. During the last 4 months of 2020, all respiratory conditions, except shortness of breath, accounted for a smaller proportion of ED visits than during the pre\u2013pandemic period. Percent positivity for influenza virus, respiratory syncytial virus, human parainfluenza virus, adenoviruses, and human metapneumovirus was lower in 2020 than 2019. Although test volume decreased, percent positivity was higher for rhinovirus\/enterovirus during the final weeks of 2020 compared with 2019, with ED visits similar to the pre\u2013pandemic period.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Broad reductions in respiratory test positivity and respiratory ED visits (excluding COVID-19) occurred during 2020. Interventions for mitigating spread of SARS-CoV-2 likely also reduced transmission of other pathogens. Timely surveillance is needed to understand community health threats, particularly when current trends deviate from seasonal norms.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciab311","type":"journal-article","created":{"date-parts":[[2021,4,9]],"date-time":"2021-04-09T19:27:49Z","timestamp":1617996469000},"page":"S110-S117","source":"Crossref","is-referenced-by-count":115,"title":["Changes in Seasonal Respiratory Illnesses in the United States During the Coronavirus Disease 2019 (COVID-19) Pandemic"],"prefix":"10.1093","volume":"73","author":[{"given":"Loren","family":"Rodgers","sequence":"first","affiliation":[{"name":"Division of Health Informatics and Surveillance, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"},{"name":"US Public Health Service Commissioned Corps, Rockville, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Sheppard","sequence":"additional","affiliation":[{"name":"Division of Health Informatics and Surveillance, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Health Informatics and Surveillance, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"},{"name":"Epidemic Intelligence Service assigned to Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Dietz","sequence":"additional","affiliation":[{"name":"Division of Health Informatics and Surveillance, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Praveena","family":"Jayanthi","sequence":"additional","affiliation":[{"name":"Division of Health Informatics and Surveillance, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"},{"name":"ICF International, Inc, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Yuan","sequence":"additional","affiliation":[{"name":"Division of Health Informatics and Surveillance, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara","family":"Bull","sequence":"additional","affiliation":[{"name":"Division of Health Informatics and Surveillance, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Wotiz","sequence":"additional","affiliation":[{"name":"Division of Health Informatics and Surveillance, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"},{"name":"Deloitte, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tessa","family":"Schwarze","sequence":"additional","affiliation":[{"name":"Office of Safety, Security, and Asset Management, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"},{"name":"Chenega Enterprise Systems and Solutions, LLC, Chesapeake, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roseric","family":"Azondekon","sequence":"additional","affiliation":[{"name":"Division of Health Informatics and Surveillance, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Hartnett","sequence":"additional","affiliation":[{"name":"Division of Health Informatics and Surveillance, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"},{"name":"US Public Health Service Commissioned Corps, Rockville, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Adjemian","sequence":"additional","affiliation":[{"name":"Division of Health Informatics and Surveillance, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"},{"name":"US Public Health Service Commissioned Corps, Rockville, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah L","family":"Kirking","sequence":"additional","affiliation":[{"name":"US Public Health Service Commissioned Corps, Rockville, Maryland, USA"},{"name":"Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Kite-Powell","sequence":"additional","affiliation":[{"name":"Division of Health Informatics and Surveillance, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,7,15]]},"reference":[{"key":"2021071608371528000_CIT0001","author":"Centers for Disease Control and Prevention"},{"key":"2021071608371528000_CIT0002","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1016\/S1473-3099(05)70270-X","article-title":"Understanding the symptoms of the common cold and influenza","volume":"5","author":"Eccles","year":"2005","journal-title":"Lancet Infect Dis"},{"key":"2021071608371528000_CIT0003","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.3201\/eid2206.152023","article-title":"Changes in childhood pneumonia hospitalizations by race and sex associated with pneumococcal conjugate vaccines","volume":"22","author":"Wiese","year":"2016","journal-title":"Emerg Infect Dis"},{"key":"2021071608371528000_CIT0004","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/j.chest.2017.09.041","article-title":"Burden of pneumonia-associated hospitalizations: United States, 2001\u20132014","volume":"153","author":"Hayes","year":"2018","journal-title":"Chest"},{"key":"2021071608371528000_CIT0005","author":"World Health Organization"},{"key":"2021071608371528000_CIT0006","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/S0140-6736(16)30951-5","article-title":"Viral bronchiolitis","volume":"389","author":"Florin","year":"2017","journal-title":"Lancet"},{"key":"2021071608371528000_CIT0007","doi-asserted-by":"crossref","first-page":"344","DOI":"10.3201\/eid1502.081468","article-title":"Viral etiology of common cold in children, Finland","volume":"15","author":"Ruohola","year":"2009","journal-title":"Emerg Infect Dis"},{"key":"2021071608371528000_CIT0008","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/S0140-6736(03)12162-9","article-title":"The common cold","volume":"361","author":"Heikkinen","year":"2003","journal-title":"Lancet"},{"key":"2021071608371528000_CIT0009","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1111\/j.1469-0691.2012.03968.x","article-title":"Seasonality of viral infections: mechanisms and unknowns","volume":"18","author":"Fisman","year":"2012","journal-title":"Clin Microbiol Infect"},{"key":"2021071608371528000_CIT0010","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1038\/s41598-018-37481-y","article-title":"Association between viral seasonality and meteorological factors","volume":"9","author":"Price","year":"2019","journal-title":"Sci Rep"},{"key":"2021071608371528000_CIT0011","first-page":"684","article-title":"Risk factors of influenza transmission in households","volume":"54","author":"Viboud","year":"2004","journal-title":"Br J Gen Pract"},{"key":"2021071608371528000_CIT0012","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1038\/nature06732","article-title":"Estimating the impact of school closure on influenza transmission from Sentinel data","volume":"452","author":"Cauchemez","year":"2008","journal-title":"Nature"},{"key":"2021071608371528000_CIT0013","doi-asserted-by":"crossref","first-page":"e48695","DOI":"10.1371\/journal.pone.0048695","article-title":"A nice day for an infection? Weather conditions and social contact patterns relevant to influenza transmission","volume":"7","author":"Willem","year":"2012","journal-title":"PLoS One"},{"key":"2021071608371528000_CIT0014","doi-asserted-by":"crossref","first-page":"i6583","DOI":"10.1136\/bmj.i6583","article-title":"Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data","volume":"356","author":"Martineau","year":"2017","journal-title":"BMJ"},{"key":"2021071608371528000_CIT0015","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.15585\/mmwr.mm6937a6","article-title":"Decreased influenza activity during the COVID-19 pandemic\u2014United States, Australia, Chile, and South Africa, 2020","volume":"69","author":"Olsen","year":"2020","journal-title":"Morb Mortal Wkly Rep"},{"key":"2021071608371528000_CIT0016","doi-asserted-by":"crossref","first-page":"552","DOI":"10.15585\/mmwr.mm7015a3","volume":"70","author":"Adjemian","year":"2021","journal-title":"Morb Mortal Wkly Rep"},{"key":"2021071608371528000_CIT0017","author":"Centers for Disease Control and Prevention"},{"key":"2021071608371528000_CIT0018","author":"Centers for Disease Control and Prevention"},{"key":"2021071608371528000_CIT0019","author":"Centers for Disease Control and Prevention"},{"key":"2021071608371528000_CIT0020","first-page":"68","article-title":"Automated syndromic classification of chief complaint records","volume":"25","author":"Sniegoski","year":"2004","journal-title":"Johns Hopkins Apl Technical Digest"},{"key":"2021071608371528000_CIT0021","first-page":"26303","article-title":"ESSENCE, the electronic surveillance system for the early notification of community-based epidemics: overview, components, and Public Health Applications","author":"Burkom","journal-title":"JMIR Public Health and Surveillance"},{"key":"2021071608371528000_CIT0022","author":"Regenstrief Institute"},{"key":"2021071608371528000_CIT0023","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1007\/BF00145641","article-title":"Transmission and control of rhinovirus colds","volume":"3","author":"Jennings","year":"1987","journal-title":"Eur J Epidemiol"},{"key":"2021071608371528000_CIT0024","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1093\/infdis\/156.3.442","article-title":"Aerosol transmission of rhinovirus colds","volume":"156","author":"Dick","year":"1987","journal-title":"J Infect Dis"},{"key":"2021071608371528000_CIT0025","doi-asserted-by":"crossref","first-page":"e92","DOI":"10.1016\/S2213-2600(20)30502-6","article-title":"Physical distancing in schools for SARS-CoV-2 and the resurgence of rhinovirus","volume":"8","author":"Poole","year":"2020","journal-title":"Lancet Respir Med"},{"key":"2021071608371528000_CIT0026","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1038\/s41591-020-0843-2","article-title":"Respiratory virus shedding in exhaled breath and efficacy of face masks","volume":"26","author":"Leung","year":"2020","journal-title":"Nat Med"},{"key":"2021071608371528000_CIT0027","doi-asserted-by":"crossref","first-page":"7142","DOI":"10.1073\/pnas.1911083116","article-title":"Virus-virus interactions impact the population dynamics of influenza and the common cold","volume":"116","author":"Nickbakhsh","year":"2019","journal-title":"Proc Natl Acad Sci USA"},{"key":"2021071608371528000_CIT0028","doi-asserted-by":"crossref","first-page":"2","DOI":"10.2807\/ese.14.40.19354-en","article-title":"Does viral interference affect spread of influenza?","volume":"14","author":"Linde","year":"2009","journal-title":"Euro Surveill"},{"key":"2021071608371528000_CIT0029","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1111\/j.1469-0691.2010.03167.x","article-title":"Rhinoviruses delayed the circulation of the pandemic influenza A (H1N1) 2009 virus in France","volume":"16","author":"Casalegno","year":"2010","journal-title":"Clin Microbiol Infect"},{"key":"2021071608371528000_CIT0030","volume-title":"New ICD-10-CM code for the 2019 novel coronavirus (COVID-19), April 1, 2020","author":"Centers for Disease Control and Prevention","year":"2020"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciab311\/37541305\/ciab311.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/cid\/article-pdf\/73\/Supplement_1\/S110\/39066922\/ciab311.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/cid\/article-pdf\/73\/Supplement_1\/S110\/39066922\/ciab311.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,16]],"date-time":"2021-07-16T08:37:52Z","timestamp":1626424672000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/73\/Supplement_1\/S110\/6257582"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,15]]},"references-count":30,"journal-issue":{"issue":"Supplement_1","published-online":{"date-parts":[[2021,7,15]]},"published-print":{"date-parts":[[2021,7,15]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciab311","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,7,15]]},"published":{"date-parts":[[2021,7,15]]}}}