{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T17:09:20Z","timestamp":1788455360697,"version":"build-2803163510"},"reference-count":25,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T00:00:00Z","timestamp":1756944000000},"content-version":"unspecified","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["222574\/Z\/21\/Z"],"award-info":[{"award-number":["222574\/Z\/21\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Global Emerging Infections Surveillance Program","award":["P0153_21_N2"],"award-info":[{"award-number":["P0153_21_N2"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,8,18]]},"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Globally, the circulation of influenza and other seasonal respiratory viruses changed dramatically during the COVID-19 pandemic. This study aims to determine the trends of acute respiratory infections (ARIs) caused by SARS-CoV-2, influenza A, influenza B and respiratory syncytial viruses (RSVs) in patients presenting to hospitals in the Lao People\u2019s Democratic Republic (PDR) (Laos).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Prospective surveillance study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Four provincial hospitals across Laos between March 2021 and July 2023.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>Participants of all ages who met our case definition for an ARI (axillary temperature \u226537.5\u00b0C or history of fever AND cough or other respiratory symptoms\/signs OR loss of smell and\/or taste) presenting to the hospital less than 10 days after symptom onset were eligible to be enrolled in the study. Combined nasopharyngeal and throat swabs were tested for SARS-CoV-2, influenza A, influenza B and human RSV (hRSV) using probe-based real-time RT (Reverse transcription)-PCR assays.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Primary outcome measure<\/jats:title>\n                  <jats:p>The proportion of patients in whom SARS-CoV-2, influenza A, influenza B and hRSV was detected.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were 4203 patients recruited, of whom 898 (21%) were children aged under 5 years. SARS-CoV-2 was detected in 16.9% of patients, followed by influenza A, influenza B and hRSV (8.4%, 7.2% and 4.7%, respectively). 98 patients (2.3%) were diagnosed with probable co-infection, with at least two viruses detected. After May 2022, the number of cases of influenza A, influenza B and hRSV increased rapidly. Six per cent of patients (263) had a quick Sequential Organ Failure Assessment score of \u22652,\u2009and 34 (0.8%) patients died, of whom 11 tested positive for a respiratory virus.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>During the COVID-19 pandemic in Laos, few respiratory viruses were detected by passive surveillance until the relaxation of non-pharmaceutical interventions implemented for infection control. After restrictions were lifted, influenza A, influenza B and hRSV emerged rapidly, showing the importance of continuous surveillance.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-098006","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T15:23:06Z","timestamp":1756999386000},"page":"e098006","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Influenza and respiratory syncytial virus dynamics in Lao PDR during the COVID-19 pandemic: a hospital-based surveillance study"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3814-0522","authenticated-orcid":false,"given":"Koukeo","family":"Phommasone","sequence":"first","affiliation":[{"name":"Microbiology Laboratory, Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Mahosot Hospital, Vientiane, Lao People\u2019s Democratic 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Hospital-Wellcome Trust Research Unit, Mahosot Hospital, Vientiane, Lao People\u2019s Democratic Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patsalin","family":"Keomoukda","sequence":"additional","affiliation":[{"name":"Microbiology Laboratory, Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Mahosot Hospital, Vientiane, Lao People\u2019s Democratic Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sompong","family":"Thammavong","sequence":"additional","affiliation":[{"name":"Microbiology Laboratory, Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Mahosot Hospital, Vientiane, Lao People\u2019s Democratic Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thipsavanh","family":"Bounphiengsy","sequence":"additional","affiliation":[{"name":"Microbiology Laboratory, Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Mahosot Hospital, Vientiane, Lao People\u2019s Democratic 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Review of global influenza circulation, late 2019 to 2020, and the impact of the COVID-19 pandemic on influenza circulation: World Health Organization. 2021."},{"key":"2025090408151404000_15.9.e098006.2","doi-asserted-by":"crossref","first-page":"2357","DOI":"10.1002\/jmv.27653","article-title":"The impact of the COVID-19 pandemic on the global burden of influenza","volume":"94","author":"Lampejo","year":"2022","journal-title":"J Med Virol"},{"key":"2025090408151404000_15.9.e098006.3","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.26964"},{"key":"2025090408151404000_15.9.e098006.4","first-page":"195","article-title":"The effects of the COVID-19 pandemic on community respiratory virus activity","volume":"21","author":"Chow","year":"2023","journal-title":"Nat Rev Microbiol"},{"key":"2025090408151404000_15.9.e098006.5","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-021-00642-4"},{"key":"2025090408151404000_15.9.e098006.6","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S396434"},{"key":"2025090408151404000_15.9.e098006.7","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.ijid.2021.07.005","article-title":"Respiratory syncytial virus and influenza epidemics disappearance in Korea during the 2020-2021 season of COVID-19","volume":"110","author":"Kim","year":"2021","journal-title":"Int J Infect Dis"},{"key":"2025090408151404000_15.9.e098006.8","doi-asserted-by":"crossref","first-page":"1394","DOI":"10.1093\/infdis\/jiad282","article-title":"Year-Round Respiratory Syncytial Virus Transmission in The Netherlands Following the COVID-19 Pandemic: A Prospective Nationwide Observational and Modeling Study","volume":"228","author":"L\u00f6wensteyn","year":"2023","journal-title":"J Infect Dis"},{"key":"2025090408151404000_15.9.e098006.9","doi-asserted-by":"crossref","first-page":"284","DOI":"10.4103\/ijph.ijph_1334_22","article-title":"The impact of coronavirus disease 2019 pandemic on bronchiolitis (lower respiratory tract infection) due to respiratory syncytial virus: A systematic review and meta-analysis","volume":"67","author":"Sabeena","year":"2023","journal-title":"Indian J Public Health"},{"key":"2025090408151404000_15.9.e098006.10","doi-asserted-by":"crossref","DOI":"10.1016\/j.eclinm.2023.102089","article-title":"Why has the epidemiology of RSV changed during the COVID-19 pandemic?","volume":"61","author":"Abu-Raya","year":"2023","journal-title":"EClinicalMedicine"},{"key":"2025090408151404000_15.9.e098006.11","unstructured":"World Health Organization . Global influenza surveillance and response system (GISRS). 2024. 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