JMIR Publications

ABSTRACT

Background:

Acute respiratory infections caused by influenza, respiratory syncytial virus (RSV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remain a major public health challenge in Europe. Although surveillance systems for these pathogens are well established, the past two decades have seen a rapid diversification of data streams supporting surveillance and research. This expanding and increasingly complex data landscape, combined with fragmentation across institutions, sectors, and countries, may limit timely evidence synthesis and effective public health decision-making.

Objective:

This scoping review aimed to identify and characterize data sources used for surveillance and research on influenza, RSV, and SARS-CoV-2 across 12 European countries over the past 20 years, and to examine their evolution over time, their alignment with research objectives, and geographic variation in data availability and use.

Methods:

We conducted a scoping review using an objective-driven analytical framework. Empirical reports published between January 2005 and September 2025 were identified in Medline, Web of Science, and Embase. Eligible reports focused on influenza, RSV, or SARS-CoV-2 and included data from Western (France, Belgium, Germany, Netherlands), Northern (Denmark, England, Finland, Sweden), Southern (Italy, Spain), and Eastern Europe (Poland, Romania). Clinical and interventional studies were excluded. Reports were classified according to four research objectives: epidemiological monitoring; evaluation of interventions; assessment of disease burden and health outcomes; and analyses of population adherence and trust toward public health measures. Data sources were grouped into nine categories, including surveillance systems, electronic health records (EHRs), registries, claims, surveys, digital, environmental, and integrated datasets.

Results:

A total of 2,564 empirical reports were included. Over time, respiratory virus research relied on an increasingly diverse set of data streams. While surveillance systems remained central, particularly for epidemiological monitoring, their relative dominance declined. From 2020 onward, there was a marked expansion in the use of EHRs, registries, claims data, digital sources, and linked or integrated datasets, alongside increased use of open-access data. Data source use varied by research objective: surveillance data predominated in monitoring and intervention evaluation; EHRs in studies of risk factors and treatment effectiveness; surveys in seroprevalence and public trust analyses; and claims data in assessments of economic burden. Substantial geographic disparities were observed. Northern European countries more frequently used linked and multi-source datasets, whereas Western and Southern Europe relied more often on open-access or single-source data.

Conclusions:

Respiratory virus surveillance and research in Europe have expanded and diversified substantially over the past two decades, particularly after the Coronavirus disease 2019 (COVID-19) pandemic. However, access to advanced and integrated data streams remains uneven across countries. Strengthening preparedness for future respiratory virus threats will require sustained investment in interoperable data infrastructures, improved data governance, and the responsible use of artificial intelligence to integrate heterogeneous data sources.