Designing resilience for overlapping respiratory epidemics: A one health perspective from seasonal influenza

Recent European winter seasons have been characterized by the simultaneous circulation of influenza A virus, SARS-CoV-2, respiratory syncytial virus, Mycoplasma pneumoniae, and an unusual rise in group A streptococcal infections, including invasive disease. This overlap has transformed seasonal influenza from a largely predictable event into a complex clinical and epidemiological scenario where viral–bacterial interactions amplify disease severity, extend risk to previously healthy individuals, and stress both surveillance and diagnostic systems. We analyse this evolving landscape through an integrated One Health perspective, examining how local epidemiology, rapid multiplex diagnostics, adaptive antimicrobial stewardship, occupational health surveillance, and infection-prevention-oriented architectural design converge to mitigate the impact of overlapping respiratory epidemics. Such multidimensional preparedness is essential to prevent avoidable mortality, protect healthcare workers, and ensure the resilience of healthcare infrastructures facing concurrent viral and bacterial outbreaks.