An increase of average 1000 domestic and international airline passenger arrivals during the previous 1–2 months was associated with a 3.8 × 10 − 4% ( p < 0.001) and 1.2 × 10 − 3% ( p < 0.001) increase in the monthly number of HRSV infections, respectively. For every average ¥1 billion (approximately £680,000/$9,000,000) spent on hand hygiene products during the current month and 1 month before there was a 0.29% ( p = 0.003) decrease in HRSV infections. The average number of monthly HRSV case notifications in 2020 decreased by approximately 85% ( p < 0.001) compared to those in the preceding 6 years (2014–2019). A generalized linear gamma regression model was used to regress the time-series of the monthly HRSV activity against NPI indicators, including sale of hand hygiene products and the number of domestic and international airline passengers, while controlling for meteorological conditions (monthly average temperature and relative humidity) and seasonal variations between years (2014–2020). The monthly number of HRSV cases per sentinel site (HRSV activity) in 2020 was compared with the average of the corresponding period in the previous 6 years (from January 2014 to December 2020) using a monthly paired t-test. We aimed to quantify the contribution of the sales of hand hygiene products and the number of international and domestic airline passenger arrivals on HRSV epidemic in Japan. Non-pharmaceutical interventions (NPIs), such as sanitary measures and travel restrictions, aimed at controlling the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), may affect the transmission dynamics of human respiratory syncytial virus (HRSV).
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