National Swedish survey showed that child health services and routine immunisation programmes were resilient during the early COVID-19 pandemic.

AIM: Routine immunisation programmes are at risk of disruption due to the COVID-19 pandemic. This study aimed to investigate the resilience of the Swedish national immunisation programme for children up to the age of five years during the early stages of the pandemic. METHODS: This was a cross-sectional, web-based survey of regional child health offices in Sweden between 10 September and 9 October 2020. It explored the organisation of child health services during the early stages of the pandemic, focusing on routine child immunisation. RESULTS: All 21 Swedish regional child health offices responded. They stated that child immunisation had been prioritised, communication with families had been intensified and there was greater flexibility at all organisational levels of child health services. In addition, the vaccine supply was sustained and child health centres remained open. However, there were periodic staff shortages, increased numbers of health visits cancelled by parents and most parent education groups were paused. CONCLUSION: The Swedish immunisation programme was resilient during the early COVID-19 pandemic, thanks to sustainable organisation co-ordinated by Sweden's network of regional child health offices.

Viral aetiology and clinical outcomes in hospitalised infants presenting with respiratory distress.

AIM: To determine the prevalence of various types of viruses in infants hospitalised due to respiratory distress, compare molecular diagnostic tests and evaluate symptom severity. METHODS: All 136 nasopharyngeal aspirates from infants hospitalised for respiratory distress over a 9-month period were analysed for virus type by in-house respiratory syncytial virus (RSV) polymerase chain reaction (PCR) microarray-based and/or Luminex-based multiplex molecular tests. Medical records were reviewed retrospectively for clinical data. RESULTS: Viral aetiology was confirmed in 126 subjects (92.6%) with 26 infected by more than one virus. RSVA/B was the most common (50.9%), followed by entero/rhinovirus (21.6%), human metapneumovirus (10.5%), parainfluenza virus (5.9%) and influenza (3.3%). RSV-infected infants had significantly lower saturation levels (89% versus 92%, p < 0.001), higher demand for oxygen (42.7% versus 21.6%, p = 0.021) and fluids (28% versus 9.8%; p = 0.014) and longer hospital stays (4 versus 3 days, <0.001) than other viruses. Luminex assays gave repeatable, slightly less sensitive results than in-house RSV PCR. Microarray-based assays were more sensitive, however, producing some unrepeatable results. CONCLUSION: Respiratory syncytial virus dominates as the viral cause in hospitalised infants with respiratory distress in Sweden during the winter season, resulting in a clinical course that is significantly more severe. The multiplex assays produced reasonably concordant results.

Waning infant pertussis during COVID-19 pandemic.

Measures to reduce the spread of COVID-19 have been associated with reduction in other respiratory infections. Results of a national Swedish cohort study of infant pertussis during April 2020-September 2021 were compared with those during January 2014-March 2020. The number of pertussis cases decreased significantly during the COVID-19 pandemic, from an average of 21 infant cases per quarter of a year before the pandemic to an average of 1 case per quarter during the pandemic. Swedish strategies to mitigate the spread of COVID-19 seem to have had an impact on pertussis incidence in infants.