An integrated surveillance study of SARS-CoV-2, influenza virus, and respiratory syncytial virus infections

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Objectives We aimed to describe recent epidemiological trends of SARS-CoV-2, influenza virus (A/B), and respiratory syncytial virus (RSV) in the canton of Geneva, Switzerland, using data from the Sentinella network for primary care consultations, hospital-based surveillance at Geneva University Hospitals and municipal wastewater surveillance conducted by Eawag, the Swiss Federal Institute of Aquatic Science and Technology. Methods We described the temporal trends in weekly SARS-CoV-2, influenza virus (A/B), and RSV infections among primary care consultations, hospitalized patients and the mean normalized viral load per week for SARS-CoV-2, influenza virus (A/B), and RSV from wastewater samples between 1 July 2022 and 30 April 2025. We used Kendall's rank correlation (τ) to assess the correlation between the viral RNA loads in wastewater and SARS-CoV-2, influenza A, and RSV infections among hospitalized patients between 1 September 2024 and 30 April 2025. Results The period from September 2024 to April 2025 was the first extended winter season since the beginning of the COVID-19 pandemic, during which SARS-CoV-2 activity remained consistently lower than previous seasons across all surveillance systems. In contrast, influenza activity was higher than in recent prior winter seasons. There was a decrease in the number of RSV hospitalizations during the 2024–2025 winter season. The associations between wastewater loads and infections were significant and positive for SARS-CoV-2 (τ = 0.75; p <0.01), influenza A (τ = 0.80; p <0.01), and RSV (τ = 0.68; p <0.01). Conclusions Our findings contribute to understanding the evolving epidemiology of COVID-19 in relation to the two other respiratory viruses (influenza and RSV) across complementary surveillance systems.

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