{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T21:39:09Z","timestamp":1792705149116,"version":"4.5.0"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,10,20]],"date-time":"2023-10-20T00:00:00Z","timestamp":1697760000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Over time, COVID-19 testing has significantly declined across the world. However, it is critical to monitor the virus through surveillance. In late 2020, WHO released interim guidance advising the use of the existing Global Influenza Surveillance and Response System (GISRS) for the integrated surveillance of influenza and SARS-CoV-2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In July 2021, we initiated a pan-India integrated surveillance for influenza and SARS-CoV-2 through the geographically representative network of Virus Research and Diagnostic Laboratories (VRDLs) across 26 hospital and laboratory sites and 70 community sites. A total of 34,260 cases of influenza-like illness (ILI) and Severe acute respiratory infection (SARI) were enrolled from 4 July 2021 to 31 October 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Influenza A(H3) and B\/Victoria dominated during 2021 monsoon season while A(H1N1)pdm09 dominated during 2022 monsoon season. The SARS-CoV-2 \u201cvariants of concern\u201d (VoC) Delta and Omicron predominated in 2021 and 2022, respectively. Increased proportion of SARI was seen in extremes of age: 90% cases in &amp;lt; 1 year; 68% in 1 to 5\u2009years and 61% in \u2265 8 \u2009years age group. Approximately 40.7% of enrolled cases only partially fulfilled WHO ILI and SARI case definitions. Influenza- and SARS-CoV-2-infected comorbid patients had higher risks of hospitalization, ICU admission, and oxygen requirement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>The results depicted the varying strains and transmission dynamics of influenza and SARS-CoV-2 viruses over time, thus emphasizing the need to continue and expand surveillance across countries for improved decision making. The study also describes important information related to clinical outcomes of ILI and SARI patients and highlights the need to review existing WHO ILI and SARI case definitions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2023.1218292","type":"journal-article","created":{"date-parts":[[2023,10,20]],"date-time":"2023-10-20T11:52:37Z","timestamp":1697802757000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":35,"title":["Pan-India influenza-like illness (ILI) and Severe acute respiratory infection (SARI) surveillance: epidemiological, clinical and genomic analysis"],"prefix":"10.3389","volume":"11","author":[{"given":"Varsha","family":"Potdar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neetu","family":"Vijay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Labanya","family":"Mukhopadhyay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neeraj","family":"Aggarwal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumit Dutt","family":"Bhardwaj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manohar Lal","family":"Choudhary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nivedita","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harmanmeet","family":"Kaur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jitendra","family":"Narayan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prabhat","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harpreet","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rizwan Suliankatchi","family":"Abdulkader","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoj","family":"Murhekar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meena","family":"Mishra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sundararajan","family":"Thangavel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Nagamani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Dhodapkar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bashir Ahmad","family":"Fomda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umesh","family":"Varshney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agniva","family":"Majumdar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanta","family":"Dutta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Vijayachari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jyotirmayee","family":"Turuk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tapan","family":"Majumdar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ganesh Chandra","family":"Sahoo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishna","family":"Pandey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anudita","family":"Bhargava","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay Singh","family":"Negi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prabhat K.","family":"Khatri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Usha","family":"Kalawat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debasis","family":"Biswas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neeta","family":"Khandelwal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biswajyoti","family":"Borkakoty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Manjushree","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mini P.","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jyoti","family":"Iravane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Kaveri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. B.","family":"Shantala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megha","family":"Brijwal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aashish","family":"Choudhary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lalit","family":"Dar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bharti","family":"Malhotra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amita","family":"Jain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"ILI-SARI Surveillance Team","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,10,20]]},"reference":[{"key":"ref1","article-title":"H1N1 pandemic (H1N1pdm09 virus)","year":"2009"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"105924","DOI":"10.1016\/j.ijantimicag.2020.105924","article-title":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): the epidemic and the challenges","volume":"55","author":"Lai","year":"2020","journal-title":"Int J Antimicrob Agents"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"3286","DOI":"10.1016\/j.vaccine.2022.04.074","article-title":"COVID-19 and seasonal influenza: the potential 2021\u201322 \u201ctwindemic\u201d","volume":"40","author":"Bellizzi","year":"2022","journal-title":"Vaccine"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1038\/s41577-020-00434-6","article-title":"Immunological considerations for COVID-19 vaccine strategies","volume":"20","author":"Jeyanathan","year":"2020","journal-title":"Nat Rev Immunol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1097\/ID9.0000000000000027","article-title":"Reinfection and breakthrough infection of SARS-CoV-2: an emerging challenge that is threatening our world","volume":"2","author":"Gao","year":"2021","journal-title":"Infect Dis Immun"},{"key":"ref6","article-title":"End-to-end integration of SARS-CoV-2 and influenza sentinel surveillance: revised interim guidance","year":"2022"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"627","DOI":"10.3390\/v14030627","article-title":"SARS-CoV-2 and influenza virus co-infection cases identified through ILI\/SARI sentinel surveillance: a pan-India report","volume":"14","author":"Aggarwal","year":"2022","journal-title":"Viruses"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e053768","DOI":"10.1136\/bmjopen-2021-053768","article-title":"SARS-CoV-2 and influenza virus coinfection among patients with severe acute respiratory infection during the first wave of COVID-19 pandemic in Bangladesh: a hospital-based descriptive study","volume":"11","author":"Akhtar","year":"2021","journal-title":"BMJ Open"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"207","DOI":"10.11648\/j.sjph.20221005.12","article-title":"Integration of COVID-19 into the sentinel influenza and other acute respiratory infections network","volume":"10","author":"Socan","year":"2022","journal-title":"Sci J Public Health"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"7497500","DOI":"10.1155\/2022\/7497500","article-title":"Epidemiology, disease severity and outcome of severe acute respiratory syndrome coronavirus 2 and influenza viruses coinfection seen at Egypt integrated acute respiratory infections surveillance, 2020\u20132022","volume":"2022","author":"Fahim","year":"2022","journal-title":"Can J Infect Dis Med Microbiol"},{"key":"ref11","article-title":"Establishment of a network of laboratories for managing epidemics and natural calamities (VRDL)","year":""},{"key":"ref12","article-title":"Influenza specimen collection","year":""},{"key":"ref13","article-title":"ILI-SARI surveillance","year":""},{"key":"ref14","article-title":"Information on rapid molecular assays, RT-PCR, and other molecular assays for diagnosis of influenza virus infection|CDC","year":"2021"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"181","DOI":"10.4103\/2224-3151.206765","article-title":"Oseltamivir-resistant influenza a(H1N1) pdm09 virus: first reported case from India","volume":"2","author":"Potdar","year":"2013","journal-title":"WHO South East Asia J Public Health"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1111\/j.1750-2659.2011.00293.x","article-title":"Multisite virological influenza surveillance in India: 2004\u20132008","volume":"6","author":"Chadha","year":"2012","journal-title":"Influenza Other Respir Viruses"},{"key":"ref17","article-title":"WHO information for the molecular detection of influenza viruses","year":""},{"key":"ref18","doi-asserted-by":"publisher","first-page":"e9693","DOI":"10.1371\/journal.pone.0009693","article-title":"Genetic characterization of the influenza a pandemic (H1N1) 2009 virus isolates from India","volume":"5","author":"Potdar","year":"2010","journal-title":"PLoS One"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1596","DOI":"10.1093\/molbev\/msm092","article-title":"MEGA4: molecular evolutionary genetics analysis (MEGA) software version 4.0","volume":"24","author":"Tamura","year":"2007","journal-title":"Mol Biol Evol"},{"key":"ref20","year":""},{"key":"ref21","doi-asserted-by":"publisher","first-page":"723850","DOI":"10.3389\/fmicb.2021.723850","article-title":"The burden of respiratory viruses and their prevalence in different geographical regions of India: 1970\u20132020","volume":"12","author":"Waghmode","year":"2021","journal-title":"Front Microbiol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"010433","DOI":"10.7189\/jogh.09.010433","article-title":"Epidemiology of viral acute lower respiratory infections in a community-based cohort of rural north Indian children","volume":"9","author":"Krishnan","year":"2019","journal-title":"J Glob Health"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"e0124122","DOI":"10.1371\/journal.pone.0124122","article-title":"Dynamics of influenza seasonality at sub-regional levels in India and implications for vaccination timing","volume":"10","author":"Chadha","year":"2015","journal-title":"PLoS One"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1093\/pubmed\/fdz053","article-title":"Epidemiology of severe acute respiratory infection (SARI) cases at a sentinel site in Egypt, 2013\u201315","volume":"42","author":"Elhakim","year":"2020","journal-title":"J Public Health"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.26633\/RPSP.2019.1","article-title":"Severe acute respiratory infections (SARI) from influenza in adult patients in Chile: the experience of a sentinel hospital","volume":"43","author":"Fica","year":"2019","journal-title":"Rev Panam Salud Publica"},{"key":"ref26","article-title":"Guidelines for vaccination with influenza vaccine","year":""},{"key":"ref27","doi-asserted-by":"publisher","first-page":"2346","DOI":"10.3390\/v13122346","article-title":"Comparative susceptibility of Madin-Darby canine kidney (MDCK) derived cell lines for isolation of swine origin influenza a viruses from different clinical specimens","volume":"13","author":"Suderman","year":"2021","journal-title":"Viruses"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"8418","DOI":"10.1128\/JVI.77.15.8418-8425.2003","article-title":"Overexpression of the alpha-2,6-sialyltransferase in MDCK cells increases influenza virus sensitivity to neuraminidase inhibitors","volume":"77","author":"Matrosovich","year":"2003","journal-title":"J Virol"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1268","DOI":"10.1038\/s41564-019-0433-6","article-title":"A humanized MDCK cell line for the efficient isolation and propagation of human influenza viruses","volume":"4","author":"Takada","year":"2019","journal-title":"Nat Microbiol"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"e75014","DOI":"10.1371\/journal.pone.0075014","article-title":"Heterogeneity of the MDCK cell line and its applicability for influenza virus research","volume":"8","author":"Lugovtsev","year":"2013","journal-title":"PLoS One"},{"key":"ref31","year":""},{"key":"ref32","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1186\/s12879-020-05724-x","article-title":"Performance of case definitions and clinical predictors for influenza surveillance among patients followed in a rural cohort in Senegal","volume":"21","author":"Barry","year":"2021","journal-title":"BMC Infect Dis"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"95","DOI":"10.3390\/v12010095","article-title":"Usefulness of clinical definitions of influenza for public health Surveillance purposes","volume":"12","author":"Dom\u00ednguez","year":"2020","journal-title":"Viruses"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"510.e1","DOI":"10.1016\/j.ajog.2020.11.022","article-title":"Pregnant women with severe or critical coronavirus disease 2019 have increased composite morbidity compared with nonpregnant matched controls","volume":"224","author":"DeBolt","year":"2021","journal-title":"Am J Obstet Gynecol"},{"key":"ref35","article-title":"Sustainable surveillance for respiratory viruses of pandemic potential: a strategy to advance from existing systems and to address critical gaps","year":""},{"key":"ref36","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1016\/j.ijid.2022.05.032","article-title":"Global respiratory virus surveillance: strengths, gaps, and way forward","volume":"121","author":"Gupta","year":"2022","journal-title":"Int J Infect Dis"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2023.1218292\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,20]],"date-time":"2023-10-20T11:52:41Z","timestamp":1697802761000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2023.1218292\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,20]]},"references-count":36,"alternative-id":["10.3389\/fpubh.2023.1218292"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2023.1218292","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,20]]},"article-number":"1218292"}}