{
  "abstract": "The COVID-19 pandemic dramatically disrupted the seasonal circulation of RSV, with subsequent heterogeneous global resurgence. We aimed to characterize how pandemic-era disruptions restructured global RSV transmission dynamics, evolutionary patterns, and drivers of reemergence. We show that RSV-A and RSV-B genetic diversity underwent profound pandemic-associated suppression followed by heterogeneous resurgence. The post-pandemic period was characterized by pronounced changes in diversity, with the emergence of novel RSV-A genotypes (A.D.3 and A.D.5.2) and the expansion of the RSV-B, B.D.E.1 genotype. The recovery of RSV-B deviated strongly from neutral expectations and positive selection was detected at 20 sites in the G glycoprotein, F fusion protein, and M2-2 regulatory protein. Phylogeographic reconstruction revealed a sharp decline in international viral spread during the pandemic, followed by increasing persistence. Europe consistently served as the predominant global source, followed by Western Pacific and North America. Air-travel volume was the strongest predictor of dissemination (log coefficient >0.68 for both subtypes). Post-pandemic RSV resurgence represented fundamental epidemiological restructuring shaped by a population bottleneck, positive selection and major impact of air-travel. These findings underscore the need for robust genomic surveillance to track the global circulation of lineages, and to monitor effectiveness of pharmaceutical interventions given the emergence of new genotypes.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Pediatric Infectious Diseases and Immunology, University Medical Center Utrecht, Utrecht, The Netherlands."
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 13,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "E. Gustani-Buss"
    },
    {
      "name": "D. M. Weinberger"
    },
    {
      "name": "N. D. Grubaugh"
    },
    {
      "name": "V. Colizza"
    },
    {
      "name": "Y. Shao"
    },
    {
      "name": "M. Suchard"
    },
    {
      "name": "A. Evers"
    },
    {
      "name": "N. I. Mazur"
    },
    {
      "name": "J. G. Wildenbeest"
    },
    {
      "name": "R. J. Lebbink"
    },
    {
      "name": "H. J. A. A. v. Zoggel"
    },
    {
      "name": "L. Bont"
    },
    {
      "name": "P. Lemey"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/936xyvhcm2d67.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.11.02.26367099",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.11.02.26367099v1.full",
  "id": "936xyvhcm2d67",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.11.02.26367099v1",
  "language": null,
  "licence": "CC-BY-ND",
  "licence_label": "CC BY-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "epidemiology"
    ]
  ],
  "openalex": null,
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.11.02.26367099v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-02",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/936xyvhcm2d67.ris",
  "sources": [
    {
      "first_seen": "2026-11-05T00:20:40Z",
      "native_id": "10.64898/2026.11.02.26367099",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.11.02.26367099v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:epidemiology",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Pandemic-Driven Shifts in RSV Diversity, Evolution, and Global Spread",
  "title_text": "Pandemic-Driven Shifts in RSV Diversity, Evolution, and Global Spread",
  "type": "preprint",
  "updated_at": "2026-11-06T00:20:55Z",
  "url": "https://research.draconitic.com/paper/936xyvhcm2d67",
  "venue": "medRxiv",
  "versions": []
}