Detection of Influenza A virus in Covid-19 negative contacts during the Malaysia outbreak

The COVID-19 infection outbreak caused by SARS-CoV-2 has become a global public health problem. The first three cases of COVID-19 in Malaysia were imported cases, confirmed on January 25, 2020. Various reports have shown that even during the ongoing COVID-19 outbreak, common respiratory viruses still accounted for a large proportion of hospitalisations, and the clinical symptoms of common respiratory virus infections were not significantly different from SARS-CoV-2. Influenza is the most common pathogen that causes human acute respiratory diseases worldwide. Influenza A (H1N1) being the main epidemic strain in Malaysia. However, in Malaysia, the epidemiology of influenza A virus infection among COVID-19 negative contacts remains unclear. Based on this, it is hypothesised that the COVID-19 outbreak will have a certain influence on influenza A virus epidemic trends. Therefore, this study focused on exploring the prevalence of the influenza A virus among COVID-19 negative contacts during the outbreak in Malaysia. We also evaluated the prevalence of influenza A infection in different age groups among our study population. This is a preliminary study included a total of 323 archived samples and extracted RNA from COVID -19 negative contacts. The extracted RNA samples were randomly selected from April 7 to April 30, 2020. RT-PCR was used to detect the influenza A virus in the COVID-19 negative contact cases. The study cohort consisted of 218 (67.5%) males and 105 (32.5%) females. In this study, there were more males than females among COVID-19 negative contacts in Malaysia. The age group of contacts varied from infants (0–2 years; n =5), children (3–16 years; n =22), young adults (ages 17–39 years; n =185), middle-aged adults (ages 40–59 years, n =89), and older adults (aged older than 60 years, n =22). Among the age groups of contacts, the majority of them were young adults, followed by middle-aged adults, children, and older adults. There was no influenza infection detected among the study cohort that consisted of 323 COVID -19 negative contacts. The study showed that there was no influenza A virus infection among negative contacts during the early stage of the COVID-19 outbreak in Malaysia. It was possibly the result of the fact that the prevalence of influenza A had decreased during the COVID-19 pandemic. The spread of COVID-19 and influenza A are caused by respiratory viruses sharing similar route, thus the surveillance towards COVID-19 is contributed to reducing influenza A infections. As for another COVID-19 outbreak to prevent the COVID-19 pandemic and influenza A, mandatory public use of masks, regular hand-sanitizing and hand-washing, social distancing, etc. should be implemented. Adherence to these health protocols to prevent COVID-19 could help to reduce the incidence of other infectious diseases, such as influenza. Thus, the results from our preliminary study may provide important inputs for surveillance data, evaluating interventions, and implementing public health policies. Further studies are needed to demonstrate the detection rate of other common respiratory viruses, such as the influenza B virus, respiratory syncytial virus, and human coronavirus in COVID-19-negative contacts.

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