{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T14:04:22Z","timestamp":1784642662017,"version":"3.55.0"},"reference-count":45,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"unspecified","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"GSK","award":["NA"],"award-info":[{"award-number":["NA"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,6,24]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Respiratory syncytial virus (RSV) is an important viral pathogen in children, older adults and adults with certain high-risk conditions. In our prospective community-based cohort study of adults 50 years and older before the COVID-19 pandemic, the incidence of RSV acute respiratory infection (ARI) was 48.6 cases\/1000 person-years (PY), which decreased to near zero during the COVID-19 pandemic. Our objective was to determine the incidence of RSV-ARI during the 2 years following the initial phase of the pandemic (2021\u20132022 and 2022\u20132023).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This is a community-based prospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Adults living in southeast Minnesota from October 2021 to September 2022 (year 3) and October 2022 to September 2023 (year 4).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Adults\u226550 years (n=2500).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcomes<\/jats:title>\n                    <jats:p>We calculated incidence and attack rates for RSV-ARI as primary outcome and reported hospitalisations, pneumonia and death following ARI as secondary outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 2500 participants in the study with a mean age of 68.2 years (SD 9.3) at the start of year 3. Participants were predominantly female (60%), non-Hispanic white (96%) and residing in urban areas (76%). The incidence rate of RSV-ARI was 6.12\/1000 PY (95% CI 3.42 to 10.09) in 2021\u20132022 and 16.40\/1000 PY (95% CI 11.66 to 22.42) in 2022\u20132023. We noted higher attack rates of RSV-ARI during the winter months. There were no hospitalisations, pneumonia or deaths within 30 days of RSV-ARI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Compared with the period before the COVID-19 pandemic, RSV-ARI incidence was lower in both 2021\u20132022 and 2022\u20132023 periods. In 2022\u20132023, the incidence increased 2.7-fold compared with the 2021\u20132022 period. The observed incidence rates, particularly the significant increase in the most recent season, underscore the continued public health relevance of RSV-ARI and support the rationale for ongoing RSV vaccination efforts to mitigate its overall burden in the population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-111773","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T13:40:34Z","timestamp":1784641234000},"page":"e111773","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Incidence of respiratory syncytial virus in adults \u226550 years during and following the COVID-19 pandemic in upper midwest USA: a community-based prospective cohort study"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1891-309X","authenticated-orcid":false,"given":"Paul Y","family":"Takahashi","sequence":"first","affiliation":[{"name":"Division of Primary Care Internal Medicine, Geriatrics and Palliative Care, Mayo Clinic Rochester, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pouya","family":"Saeedi","sequence":"additional","affiliation":[{"name":"GSK, Wavre, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung-Il","family":"Wi","sequence":"additional","affiliation":[{"name":"Division of Community Pediatrics and Adolescent Medicine, Mayo Clinic Rochester, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J","family":"Pignolo","sequence":"additional","affiliation":[{"name":"Divisons of Hospital Internal Medicine and Endocrinology and the Kogod Center on Aging, Mayo Clinic Rochester, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendelyn","family":"Bosch","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Mayo Clinic Florida, Jacksonville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine S","family":"King","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Mayo Clinic Rochester, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel","family":"Hickman","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Mayo Clinic Rochester, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Euijung","family":"Ryu","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Mayo Clinic Rochester, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Traci","family":"Natoli","sequence":"additional","affiliation":[{"name":"Division of Community Pediatrics and Adolescent Medicine, Mayo Clinic Rochester, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy","family":"Ihrke","sequence":"additional","affiliation":[{"name":"Division of Community Pediatrics and Adolescent Medicine, Mayo Clinic Rochester, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Binnicker","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steph","family":"Sieler","sequence":"additional","affiliation":[{"name":"Division of Community Pediatrics and Adolescent Medicine, Mayo Clinic Rochester, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Speiser","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Mayo Clinic Arizona, Scottsdale, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Hidaka","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Mayo Clinic Health System in Eau Claire, Eau Claire, Wisconsin, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Damaso","sequence":"additional","affiliation":[{"name":"GSK, Wavre, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Yves","family":"Pircon","sequence":"additional","affiliation":[{"name":"GSK, Wavre, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2112-4240","authenticated-orcid":false,"given":"Young","family":"Juhn","sequence":"additional","affiliation":[{"name":"Division of Community Pediatrics and Adolescent Medicine, Mayo Clinic Rochester, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"2026072106402008000_16.7.e111773.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2023.10.046"},{"key":"2026072106402008000_16.7.e111773.2","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.15585\/mmwr.mm7240a1","article-title":"Characteristics and Outcomes Among Adults Aged \u226560 Years Hospitalized with Laboratory-Confirmed Respiratory Syncytial Virus \u2014 RSV-NET, 12 States, July 2022\u2013June 2023","volume":"72","author":"Havers","year":"2022","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2026072106402008000_16.7.e111773.3","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7229a4"},{"key":"2026072106402008000_16.7.e111773.4","doi-asserted-by":"crossref","first-page":"696","DOI":"10.15585\/mmwr.mm7332e1","article-title":"Use of Respiratory Syncytial Virus Vaccines in Adults Aged \u226560 Years: Updated Recommendations of the Advisory Committee on Immunization Practices - United States, 2024","volume":"73","author":"Britton","year":"2024","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2026072106402008000_16.7.e111773.5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043951"},{"key":"2026072106402008000_16.7.e111773.6","doi-asserted-by":"crossref","unstructured":"Chuang Y-C , Lin K-P , Wang L-A , et al . The Impact of the COVID-19 Pandemic on Respiratory Syncytial Virus Infection: A Narrative Review. IDR 2023.","DOI":"10.2147\/IDR.S396434"},{"key":"2026072106402008000_16.7.e111773.7","doi-asserted-by":"crossref","first-page":"134","DOI":"10.3390\/idr14010017","article-title":"The Influence of COVID-19 on Influenza and Respiratory Syncytial Virus Activities","volume":"14","author":"Mondal","year":"2022","journal-title":"Infect Dis Rep"},{"key":"2026072106402008000_16.7.e111773.8","doi-asserted-by":"crossref","DOI":"10.1038\/s41467-024-47757-9","article-title":"Deviations in RSV epidemiological patterns and population structures in the United States following the COVID-19 pandemic","volume":"15","author":"Rios-Guzman","year":"2024","journal-title":"Nat Commun"},{"key":"2026072106402008000_16.7.e111773.9","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1016\/j.mayocp.2020.12.016","article-title":"Adherence to Public Health Measures Mitigates the Risk of COVID-19 Infection in Older Adults: A Community-Based Study","volume":"96","author":"Juhn","year":"2021","journal-title":"Mayo Clin Proc"},{"key":"2026072106402008000_16.7.e111773.10","unstructured":"Administration USFaD, United States Food and Drug Administration . Respiratory syncytial virus. Available: https:\/\/www.fda.gov\/consumers\/covid-19-flu-and-rsv\/respiratory-syncytial-virus-rsv [Accessed 17 Apr 2025]."},{"key":"2026072106402008000_16.7.e111773.11","doi-asserted-by":"publisher","DOI":"10.3934\/publichealth.2023012"},{"key":"2026072106402008000_16.7.e111773.12","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2022.50634","article-title":"Incidence of Respiratory Syncytial Virus Infection in Older Adults Before and During the COVID-19 Pandemic","volume":"6","author":"Juhn","year":"2023","journal-title":"JAMA Netw Open"},{"key":"2026072106402008000_16.7.e111773.13","doi-asserted-by":"crossref","first-page":"1921","DOI":"10.1016\/j.mayocp.2024.05.025","article-title":"Characteristics of an Older Adult Population Without COVID-19 Infection in a Southeast Minnesota Community","volume":"99","author":"Pignolo","year":"2024","journal-title":"Mayo Clin Proc"},{"key":"2026072106402008000_16.7.e111773.14","doi-asserted-by":"crossref","unstructured":"Wi C-I , King KS , Ryu E , et al . Application of Innovative Subject Recruitment System for Batch Enrollment: A Pilot Study. J Prim Care Community Health 2023;14. doi:10.1177\/21501319231194967","DOI":"10.1177\/21501319231194967"},{"key":"2026072106402008000_16.7.e111773.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2020.104417"},{"key":"2026072106402008000_16.7.e111773.16","unstructured":"Health SoMDo . Medical records information. n.d. Available: https:\/\/www.health.state.mn.us\/facilities\/insurance\/clearinghouse\/medrecords.html#:~:text=The%20Minnesota%20Health%20Records%20Act%20is%20in%20Minnesota,Section%20144.293%20release%20or%20disclosure%20of%20health%20records"},{"key":"2026072106402008000_16.7.e111773.17","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.0040296","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational Studies","volume":"4","author":"von Elm","year":"2007","journal-title":"PLoS Med"},{"key":"2026072106402008000_16.7.e111773.18","doi-asserted-by":"crossref","first-page":"2191","DOI":"10.1001\/jama.2013.281053","article-title":"World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects","volume":"310","author":"World Medical","year":"2013","journal-title":"JAMA Nov"},{"key":"2026072106402008000_16.7.e111773.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2011.11.009"},{"key":"2026072106402008000_16.7.e111773.20","unstructured":"Bureau UC . Urban and rural. 2024. Available: https:\/\/www.census.gov\/programs-surveys\/geography\/guidance\/geo-areas\/urban-rural.html"},{"key":"2026072106402008000_16.7.e111773.21","doi-asserted-by":"publisher","DOI":"10.1007\/s11524-011-9572-7"},{"key":"2026072106402008000_16.7.e111773.22","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2015-205925"},{"key":"2026072106402008000_16.7.e111773.23","unstructured":"Evaluation IfHMa . Mask usage. 2025. Available: https:\/\/covid19.healthdata.org\/united-states-of-america?view=mask-use&tab=trend"},{"key":"2026072106402008000_16.7.e111773.24","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofae597","article-title":"Incidence of Respiratory Syncytial Virus in Community-Dwelling Adults Aged 18-64 Years Over 2 Seasons, 2022-2024, in a North American Community","volume":"11","author":"Bosch","year":"2024","journal-title":"Open Forum Infect Dis"},{"key":"2026072106402008000_16.7.e111773.25","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1007\/s40121-024-01080-4","article-title":"Burden of Acute Respiratory Infections Caused by Influenza Virus, Respiratory Syncytial Virus, and SARS-CoV-2 with Consideration of Older Adults: A Narrative Review","volume":"14","author":"Hanage","year":"2025","journal-title":"Infect Dis Ther"},{"key":"2026072106402008000_16.7.e111773.26","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.mayocpiqo.2021.12.002","article-title":"Minnesota COVID-19 Lockdowns: The Effect on Acute Myocardial Infarctions and Revascularizations in the Community","volume":"6","author":"Lopes","year":"2022","journal-title":"Mayo Clin Proc Innov Qual Outcomes"},{"key":"2026072106402008000_16.7.e111773.27","article-title":"The impact of the COVID-19 pandemic on influenza, respiratory syncytial virus, and other seasonal respiratory virus circulation in Canada: A population-based study","volume":"1","author":"Groves","year":"2021","journal-title":"The Lancet Reg Health Am"},{"key":"2026072106402008000_16.7.e111773.28","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1093\/infdis\/jiac434","article-title":"Perturbations in Respiratory Syncytial Virus Activity During the SARS-CoV-2 Pandemic","volume":"227","author":"Falsey","year":"2022","journal-title":"J Infect Dis"},{"key":"2026072106402008000_16.7.e111773.29","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":"2026072106402008000_16.7.e111773.30","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2024.44756","article-title":"Burden of Respiratory Syncytial Virus-Associated Hospitalizations in US Adults, October 2016 to September 2023","volume":"7","author":"Havers","year":"2024","journal-title":"JAMA Netw Open"},{"key":"2026072106402008000_16.7.e111773.31","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1111\/irv.13043","article-title":"Change in functional status associated with respiratory syncytial virus infection in hospitalized older adults","volume":"16","author":"Branche","year":"2022","journal-title":"Influenza Other Respir Viruses"},{"key":"2026072106402008000_16.7.e111773.32","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmaa040"},{"key":"2026072106402008000_16.7.e111773.33","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-017-4177-z","article-title":"Estimates of hospitalization attributable to influenza and RSV in the US during 1997-2009, by age and risk status","volume":"17","author":"Matias","year":"2017","journal-title":"BMC Public Health"},{"key":"2026072106402008000_16.7.e111773.34","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2017.09.001"},{"key":"2026072106402008000_16.7.e111773.35","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofab491","article-title":"Risk Factors and Medical Resource Utilization of Respiratory Syncytial Virus, Human Metapneumovirus, and Influenza-Related Hospitalizations in Adults-A Global Study During the 2017-2019 Epidemic Seasons (Hospitalized Acute Respiratory Tract Infection [HARTI] Study)","volume":"8","author":"Falsey","year":"2021","journal-title":"Open Forum Infect Dis"},{"key":"2026072106402008000_16.7.e111773.36","doi-asserted-by":"crossref","DOI":"10.3390\/vaccines10122092","article-title":"Rate of Hospitalizations and Mortality of Respiratory Syncytial Virus Infection Compared to Influenza in Older People: A Systematic Review and Meta-Analysis","volume":"10","author":"Maggi","year":"2022","journal-title":"Vaccines (Basel)"},{"key":"2026072106402008000_16.7.e111773.37","doi-asserted-by":"crossref","first-page":"14680","DOI":"10.3390\/ijerph192214680","article-title":"Impact of Respiratory Syncytial Virus and Influenza Virus Infection in the Adult Population in Spain between 2012 and 2020","volume":"19","author":"Heppe-Montero","year":"2012","journal-title":"IJERPH"},{"key":"2026072106402008000_16.7.e111773.38","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2024.4954","article-title":"Severity of Respiratory Syncytial Virus vs COVID-19 and Influenza Among Hospitalized US Adults","volume":"7","author":"Surie","year":"2024","journal-title":"JAMA Netw Open"},{"key":"2026072106402008000_16.7.e111773.39","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1001\/jamainternmed.2024.0212","article-title":"Acute Cardiac Events in Hospitalized Older Adults With Respiratory Syncytial Virus Infection","volume":"184","author":"Woodruff","year":"2024","journal-title":"JAMA Intern Med"},{"key":"2026072106402008000_16.7.e111773.40","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1038\/s41577-022-00764-7","article-title":"Respiratory syncytial virus after the SARS-CoV-2 pandemic - what next?","volume":"22","author":"Mosscrop","year":"2022","journal-title":"Nat Rev Immunol"},{"key":"2026072106402008000_16.7.e111773.41","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.15585\/mmwr.mm7240a2","article-title":"Disease Severity of Respiratory Syncytial Virus Compared with COVID-19 and Influenza Among Hospitalized Adults Aged \u226560 Years \u2014 IVY Network, 20 U.S. States, February 2022\u2013May 2023","volume":"72","author":"Surie","year":"2022","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2026072106402008000_16.7.e111773.42","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.41.1.149-154.2003"},{"key":"2026072106402008000_16.7.e111773.43","doi-asserted-by":"crossref","first-page":"1593","DOI":"10.1007\/s40121-023-00805-1","article-title":"Diagnosis of Respiratory Syncytial Virus in Adults Substantially Increases When Adding Sputum, Saliva, and Serology Testing to Nasopharyngeal Swab RT-PCR","volume":"12","author":"Ramirez","year":"2023","journal-title":"Infect Dis Ther"},{"key":"2026072106402008000_16.7.e111773.44","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1093\/infdis\/jiab023","article-title":"Feasibility and Performance of Self-Collected Nasal Swabs for Detection of Influenza Virus, Respiratory Syncytial Virus, and Human Metapneumovirus","volume":"224","author":"Suntarattiwong","year":"2021","journal-title":"J Infect Dis"},{"key":"2026072106402008000_16.7.e111773.45","doi-asserted-by":"crossref","DOI":"10.3390\/v16060958","article-title":"Epidemiological and Genetic Characteristics of Respiratory Viral Coinfections with Different Variants of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)","volume":"16","author":"Trifonova","year":"2024","journal-title":"Viruses"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-111773","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T13:40:47Z","timestamp":1784641247000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-111773"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":45,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,21]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/bmjopen-2025-111773"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-111773","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}