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Tudorache R, Jaboyedoff M, Gabet A, Olié V, Angoulvant F, Tuppin P, Lesuffleur T, Kossorotoff M. Infection and Pediatric Arterial Ischemic Stroke Presumably Related to Focal Cerebral Arteriopathy: Data From the COVID-19 Pandemic. Stroke 2024; 55:1672-1675. [PMID: 38787929 DOI: 10.1161/strokeaha.123.045632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 04/09/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Infection may trigger pediatric arterial ischemic stroke (PAIS), notably when related to focal cerebral arteriopathy. Community- and individual-level nonpharmaceutical interventions during the COVID-19 pandemic resulted in a major decrease in pediatric viral infections. We explored the consequences on the incidence of PAIS. METHODS Using national public health databases, we identified children hospitalized between 2015 and 2022 with PAIS. Using an age proxy (29 days to 7 years) and excluding patients with cardiac and hematologic conditions, we focused on children with PAIS presumably related to focal cerebral arteriopathy or with no definite cause. Considering the delay between infection and PAIS occurrence, we compared a prepandemic reference period, a period with nonpharmaceutical interventions, and a post-nonpharmaceutical intervention period. RESULTS Interrupted time-series analyses of the monthly incidence of PAIS in this group showed a significant decrease in the nonpharmaceutical intervention period compared with the prepandemic period: -33.5% (95% CI, -55.2%, -1.3%); P=0.043. CONCLUSIONS These data support the association between infection and PAIS presumably related to focal cerebral arteriopathy.
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Affiliation(s)
- Raluca Tudorache
- French Center for Pediatric Stroke, Pediatric Neurology, APHP University Hospital Necker-Enfants Malades, Paris (R.T., M.K.)
- Pediatric Neurology Department, Prof. Dr. A. Obregia Clinical Hospital and C. Davila University of Medicine and Pharmacy, Bucharest, Romania (R.T.)
| | - Manon Jaboyedoff
- Women-Mother-Child Department, Pediatrics, Lausanne University Hospital, University of Lausanne, Switzerland (M.J., F.A.)
| | - Amélie Gabet
- Department of Non-Communicable Diseases and Injuries, French Public Health Agency, Saint-Maurice, France (A.G., V.O.)
| | - Valérie Olié
- Department of Non-Communicable Diseases and Injuries, French Public Health Agency, Saint-Maurice, France (A.G., V.O.)
| | - François Angoulvant
- Women-Mother-Child Department, Pediatrics, Lausanne University Hospital, University of Lausanne, Switzerland (M.J., F.A.)
| | - Philippe Tuppin
- Department of Strategy, Studies and Statistics, French National Health Insurance Fund (Caisse Nationale de l'Assurance Maladie), Paris (P.T., T.L.)
| | - Thomas Lesuffleur
- Department of Strategy, Studies and Statistics, French National Health Insurance Fund (Caisse Nationale de l'Assurance Maladie), Paris (P.T., T.L.)
| | - Manoelle Kossorotoff
- French Center for Pediatric Stroke, Pediatric Neurology, APHP University Hospital Necker-Enfants Malades, Paris (R.T., M.K.)
- Inserm U1266, Paris, France (M.K.)
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Berry GJ, Jhaveri TA, Larkin PMK, Mostafa H, Babady NE. ADLM Guidance Document on Laboratory Diagnosis of Respiratory Viruses. J Appl Lab Med 2024; 9:599-628. [PMID: 38695489 DOI: 10.1093/jalm/jfae010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 01/12/2024] [Indexed: 06/06/2024]
Abstract
Respiratory viral infections are among the most frequent infections experienced worldwide. The COVID-19 pandemic has highlighted the need for testing and currently several tests are available for the detection of a wide range of viruses. These tests vary widely in terms of the number of viral pathogens included, viral markers targeted, regulatory status, and turnaround time to results, as well as their analytical and clinical performance. Given these many variables, selection and interpretation of testing requires thoughtful consideration. The current guidance document is the authors' expert opinion based on the preponderance of available evidence to address key questions related to best practices for laboratory diagnosis of respiratory viral infections including who to test, when to test, and what tests to use. An algorithm is proposed to help laboratories decide on the most appropriate tests to use for the diagnosis of respiratory viral infections.
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Affiliation(s)
- Gregory J Berry
- Columbia University Vagelos College of Physicians and Surgeons, New York-Presbyterian-Columbia University Irving Medical Center, New York, NY, United States
| | - Tulip A Jhaveri
- Department of Internal Medicine, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, MS, United States
| | - Paige M K Larkin
- University of Chicago Pritzker School of Medicine, NorthShore University Health System, Chicago, IL, United States
| | - Heba Mostafa
- Johns Hopkins School of Medicine, Department of Pathology, Baltimore, MD, United States
| | - N Esther Babady
- Clinical Microbiology and Infectious Disease Services, Department of Pathology and Laboratory Medicine and Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
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Staadegaard L, Dückers M, van Summeren J, van Gameren R, Demont C, Bangert M, Li Y, Casalegno JS, Caini S, Paget J. Determining the timing of respiratory syncytial virus (RSV) epidemics: a systematic review, 2016 to 2021; method categorisation and identification of influencing factors. Euro Surveill 2024; 29. [PMID: 38304952 PMCID: PMC10835753 DOI: 10.2807/1560-7917.es.2024.29.5.2300244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 10/23/2023] [Indexed: 02/03/2024] Open
Abstract
BackgroundThere is currently no standardised approach to estimate respiratory syncytial virus (RSV) epidemics' timing (or seasonality), a critical information for their effective prevention and control.AimWe aimed to provide an overview of methods to define RSV seasonality and identify factors supporting method choice or interpretation/comparison of seasonal estimates.MethodsWe systematically searched PubMed and Embase (2016-2021) for studies using quantitative approaches to determine the start and end of RSV epidemics. Studies' features (data-collection purpose, location, regional/(sub)national scope), methods, and assessment characteristics (case definitions, sampled population's age, in/outpatient status, setting, diagnostics) were extracted. Methods were categorised by their need of a denominator (i.e. numbers of specimens tested) and their retrospective vs real-time application. Factors worth considering when choosing methods and assessing seasonal estimates were sought by analysing studies.ResultsWe included 32 articles presenting 49 seasonality estimates (18 thereof through the 10% positivity threshold method). Methods were classified into eight categories, two requiring a denominator (1 retrospective; 1 real-time) and six not (3 retrospective; 3 real-time). A wide range of assessment characteristics was observed. Several studies showed that seasonality estimates varied when methods differed, or data with dissimilar assessment characteristics were employed. Five factors (comprising study purpose, application time, assessment characteristics, healthcare system and policies, and context) were identified that could support method choice and result interpretation.ConclusionMethods and assessment characteristics used to define RSV seasonality are heterogeneous. Our categorisation of methods and proposed framework of factors may assist in choosing RSV seasonality methods and interpretating results.
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Affiliation(s)
- Lisa Staadegaard
- Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands
| | - Michel Dückers
- ARQ National Psychotrauma Centre, Diemen, The Netherlands
- Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
- Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands
| | | | - Rob van Gameren
- Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands
| | | | | | - You Li
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom
- National Vaccine Innovation Platform, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Jean-Sebastien Casalegno
- Hospices Civils de Lyon; Hôpital de la Croix-Rousse; Centre de Biologie Nord; Institut des Agents Infectieux; Laboratoire de Virologie, Lyon; France
| | - Saverio Caini
- Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands
| | - John Paget
- Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands
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Farzi R, Pirbonyeh N, Kadivar MR, Moattari A. Prevalence of Influenza Viruses A and B, Adenovirus, Respiratory Syncytial Virus, and Human Metapneumonia Viruses among Children with Acute Respiratory Tract Infection. Adv Virol 2024; 2024:7613948. [PMID: 38292215 PMCID: PMC10824580 DOI: 10.1155/2024/7613948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 10/04/2023] [Accepted: 12/23/2023] [Indexed: 02/01/2024] Open
Abstract
Background Acute respiratory tract infection (ARTI) is a significant cause of morbidity and mortality among children worldwide. The majority of acute respiratory infections in children are caused by viruses, with respiratory syncytial virus (RSV) being the most frequently encountered. Other important viral pathogens include human metapneumovirus, human coronaviruses, adenovirus, and influenza. These infections can lead to complications such as bronchitis and pneumonia. So, this study aimed to evaluate the prevalence of influenza viruses A and B, adenovirus, respiratory syncytial virus (RSV), and human metapneumovirus (HMPV) in children with ARTI. Methods The molecular diagnostic of polymerase chain reaction approach was used to detect influenza (A and B), metapneumovirus, respiratory syncytial virus (RSV), and adenovirus in respiratory samples of children with acute respiratory infection hospitalization in a teaching hospital of the Shiraz University of Medical Sciences in January 2016-March 2017. Results Of the 340 patients examined, 208 (61.20%) were male and the median age was 3.13 ± 2.38 years. Respiratory viruses were found in 179 (52.64%) patients. The male-to-female ratio was 1.63 : 1 in patients who were viral positive. Detection rates for influenza A, adenovirus, influenza B, RSV, and HMPV were 28.23%, 24.70%, 8.52%, 3.23%, and 2.64%, respectively, and coinfections were detected in 24.02%. The most common combination of two-virus coinfections was IFVA/AdV, followed by IFVB/AdV, AdV, IFVB/IFVA, RSV/IFVA, HMPV/AdV, RSV/AdV, and HMPV/IFVA. Conclusion The high prevalence of respiratory viruses in children hospitalized with ARTI suggests that viral infection may play a role in disease pathogenesis. This should be confirmed through the conduct of case-control studies and may inform the role of vaccination to prevent respiratory viral infections.
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Affiliation(s)
- Rana Farzi
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Neda Pirbonyeh
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Burn and Wound Healing Research Center, Microbiology Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Rahim Kadivar
- Department of Pediatrics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Professor Alborzi Clinical Microbiology Research Center, Namazi Hospital, Shiraz Medical University, Shiraz, Iran
| | - Afagh Moattari
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Rector A, Bloemen M, Thijssen M, Pussig B, Beuselinck K, Van Ranst M, Wollants E. Respiratory Viruses in Wastewater Compared with Clinical Samples, Leuven, Belgium. Emerg Infect Dis 2024; 30:141-145. [PMID: 38147067 PMCID: PMC10756384 DOI: 10.3201/eid3001.231011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023] Open
Abstract
In a 2-year study in Leuven, Belgium, we investigated the use of wastewater sampling to assess community spread of respiratory viruses. Comparison with the number of positive clinical samples demonstrated that wastewater data reflected circulation levels of typical seasonal respiratory viruses, such as influenza, respiratory syncytial virus, and enterovirus D68.
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Nieto-Rivera B, Saldaña-Ahuactzi Z, Parra-Ortega I, Flores-Alanis A, Carbajal-Franco E, Cruz-Rangel A, Galaviz-Hernández S, Romero-Navarro B, de la Rosa-Zamboni D, Salazar-García M, Contreras CA, Ortega-Riosvelasco F, López-Martínez I, Barrera-Badillo G, Diaz-Garcia H, Romo-Castillo M, Moreno-Espinosa S, Luna-Pineda VM. Frequency of respiratory virus-associated infection among children and adolescents from a tertiary-care hospital in Mexico City. Sci Rep 2023; 13:19763. [PMID: 37957308 PMCID: PMC10643542 DOI: 10.1038/s41598-023-47035-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 11/08/2023] [Indexed: 11/15/2023] Open
Abstract
Acute respiratory infections (ARIs) are a major cause of morbidity and mortality among children. The causative pathogens show geographic and seasonal variations. We retrospectively evaluated the frequency and seasonality of respiratory pathogens in children and adolescents (age: 0-19 years) with ARIs treated between January 1, 2021, and March 31, 2022, at a single center in Mexico. Out of 2400 patients, 1,603 were diagnosed with SARS-CoV-2 infection and 797 were diagnosed with other common respiratory pathogens (CRPs). Of the 797 patients, 632 were infected with one CRP and 165 with > 2 CRPs. Deaths occurred only in SARS-CoV-2-infected patients. Rhinovirus/Enterovirus, respiratory syncytial virus B, and parainfluenza virus 3 were the most prevalent in cases with single and multiple infections. CRP showed a high frequency between autumn and winter of 2021, with higher incidence of hospitalization compared to COVID-19. The main comorbidities were immunosuppression, cardiovascular disease (CD), and asthma. The frequency of CRPs showed a downward trend throughout the first half of 2021. CRPs increased in single- and co-infection cases between the fourth and fifth waves of COVID-19, probably due to decreased nonpharmaceutical interventions and changes in diagnostic tests. Age, cyanosis (symptom), and immunosuppression (comorbidity) were found to differentiate between SARS-CoV-2 infection and CRP infection.
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Affiliation(s)
- Brenda Nieto-Rivera
- Departamento de Laboratorio Clínico, Hospital Infantil de México Federico Gómez, Ciudad de México, México
| | - Zeus Saldaña-Ahuactzi
- Centro de Investigación en Biotecnología Aplicada, Instituto Politécnico Nacional, Santa Inés Tecuexcomac, Tepetitla de Lardizábal, Tlaxcala, México
| | - Israel Parra-Ortega
- Departamento de Laboratorio Clínico, Hospital Infantil de México Federico Gómez, Ciudad de México, México
| | - Alejandro Flores-Alanis
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Ebzadrel Carbajal-Franco
- Departamento de Laboratorio Clínico, Hospital Infantil de México Federico Gómez, Ciudad de México, México
| | - Armando Cruz-Rangel
- Laboratorio de Bioquímica de Enfermedades Crónicas, Instituto Nacional de Medicina Genómica, Ciudad de México, México
| | | | - Benjamín Romero-Navarro
- Subdirección de Servicios Auxiliares de Diagnóstico, Hospital Infantil de México Federico Gómez, Ciudad de México, México
| | - Daniela de la Rosa-Zamboni
- Subdirección de Atención Integral al Paciente, Hospital Infantil de México Federico Gómez, Ciudad de México, México
| | - Marcela Salazar-García
- Laboratorio de Biología del Desarrollo y Teratogénesis Experimental, Hospital Infantil de México Federico Gómez, Ciudad de México, México
| | - Carmen A Contreras
- Facultad de Medicina, Universidad Privada Antenor Orrego, Trujillo, Peru
| | | | - Irma López-Martínez
- Dirección de Diagnóstico y Referencia, Instituto de Diagnóstico y Referencia Epidemiológicos, Ciudad de México, México
| | - Gisela Barrera-Badillo
- Laboratorio de Virus Respiratorios, Instituto de Diagnóstico y Referencia Epidemiológicos, Ciudad de México, México
| | - Hector Diaz-Garcia
- Centro de Investigación en Malformaciones Congénitas, Hospital Infantil de México Federico Gómez, Ciudad de México, México
- Escuela Superior de Enfermería y Obstetricia, Instituto Politécnico Nacional, Ciudad de México, México
| | - Mariana Romo-Castillo
- Laboratorio de Investigación en COVID-19, Laboratorio de Investigación en Inmunología y Proteomica, Hospital Infantil de México Federico Gómez, Ciudad de México, México
| | | | - Victor M Luna-Pineda
- Laboratorio de Investigación en COVID-19, Laboratorio de Investigación en Inmunología y Proteomica, Hospital Infantil de México Federico Gómez, Ciudad de México, México.
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Nielsen LE, Mahlen S, Sutter DE. Will Antigen Testing Remain Relevant in the Point-of-Care Testing Environment? Clin Lab Med 2023; 43:167-179. [PMID: 37169440 DOI: 10.1016/j.cll.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
Before the molecular age, cell culture was the gold standard for confirmatory diagnosis of viral and atypical infectious diseases. Typical cell culture methodologies are costly, require days (or weeks) for results, and require significant technical expertise. As a result, cell culture is impractical for timely diagnostic testing in most of the health care environments. Traditional bacterial culture methods, also have disadvantages due to the need for incubation, subsequent identification of pathogens, and significant technical expertise. This article discusses the general considerations of antigen and molecular assays and the merits and factors to consider when implementing diagnostic assays for several common pathogens.
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Raymenants J, Geenen C, Budts L, Thibaut J, Thijssen M, De Mulder H, Gorissen S, Craessaerts B, Laenen L, Beuselinck K, Ombelet S, Keyaerts E, André E. Indoor air surveillance and factors associated with respiratory pathogen detection in community settings in Belgium. Nat Commun 2023; 14:1332. [PMID: 36898982 PMCID: PMC10005919 DOI: 10.1038/s41467-023-36986-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 02/27/2023] [Indexed: 03/12/2023] Open
Abstract
Currently, the real-life impact of indoor climate, human behaviour, ventilation and air filtration on respiratory pathogen detection and concentration are poorly understood. This hinders the interpretability of bioaerosol quantification in indoor air to surveil respiratory pathogens and transmission risk. We tested 341 indoor air samples from 21 community settings in Belgium for 29 respiratory pathogens using qPCR. On average, 3.9 pathogens were positive per sample and 85.3% of samples tested positive for at least one. Pathogen detection and concentration varied significantly by pathogen, month, and age group in generalised linear (mixed) models and generalised estimating equations. High CO2 and low natural ventilation were independent risk factors for detection. The odds ratio for detection was 1.09 (95% CI 1.03-1.15) per 100 parts per million (ppm) increase in CO2, and 0.88 (95% CI 0.80-0.97) per stepwise increase in natural ventilation (on a Likert scale). CO2 concentration and portable air filtration were independently associated with pathogen concentration. Each 100ppm increase in CO2 was associated with a qPCR Ct value decrease of 0.08 (95% CI -0.12 to -0.04), and portable air filtration with a 0.58 (95% CI 0.25-0.91) increase. The effects of occupancy, sampling duration, mask wearing, vocalisation, temperature, humidity and mechanical ventilation were not significant. Our results support the importance of ventilation and air filtration to reduce transmission.
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Affiliation(s)
- Joren Raymenants
- Laboratory of Clinical Microbiology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.
- Department of General Internal Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
| | - Caspar Geenen
- Laboratory of Clinical Microbiology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Lore Budts
- Department of Laboratory Medicine, National Reference Center of Respiratory Pathogens, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Jonathan Thibaut
- Laboratory of Clinical Microbiology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Marijn Thijssen
- Laboratory of Clinical and Epidemiological Virology (Rega Institute), KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Hannelore De Mulder
- Laboratory of Clinical Microbiology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Sarah Gorissen
- Laboratory of Clinical Microbiology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Bastiaan Craessaerts
- Department of Laboratory Medicine, National Reference Center of Respiratory Pathogens, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Lies Laenen
- Laboratory of Clinical Microbiology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
- Department of Laboratory Medicine, National Reference Center of Respiratory Pathogens, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Kurt Beuselinck
- Department of Laboratory Medicine, National Reference Center of Respiratory Pathogens, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Sien Ombelet
- Department of Laboratory Medicine, National Reference Center of Respiratory Pathogens, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Els Keyaerts
- Department of Laboratory Medicine, National Reference Center of Respiratory Pathogens, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Emmanuel André
- Laboratory of Clinical Microbiology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
- Department of Laboratory Medicine, National Reference Center of Respiratory Pathogens, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
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Illan Montero J, Berger A, Levy J, Busson L, Hainaut M, Goetghebuer T. Retrospective comparison of respiratory syncytial virus and metapneumovirus clinical presentation in hospitalized children. Pediatr Pulmonol 2023; 58:222-229. [PMID: 36202614 DOI: 10.1002/ppul.26188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 09/22/2022] [Accepted: 09/27/2022] [Indexed: 01/11/2023]
Abstract
Respiratory syncytial virus (RSV) and Human metapneumovirus (hMPV), members of Pneumoviridae family are common causes of acute respiratory tract infections (ARTI) among children. Study material includes routine nasopharyngeal samples obtained during 8-year period for hMPV and one single season for RSV in children hospitalized for ARTI between 0 and 15 years at the Center Hospitalier Universitaire (CHU) Saint Pierre in Brussels. Positive samples for RSV or hMPV identified by viral culture, lateral flow chromatography test for RSV or direct fluorescent assay for hMPV were selected retrospectively. Characteristics of children hospitalized for RSV or hMPV infections were compared. Children hospitalized for RSV infection were significantly younger and requiring more respiratory support, longer hospital stay and transfers in Pediatric intensive Care Units than those hospitalized for hMPV infection. Pneumonia diagnostic and antibiotics therapies were more significantly associated with hMPV infections. In conclusion, despite their genetic similarities, RSV, and hMPV present epidemiological and clinical differences in pediatric infections. Our results should be confirmed prospectively.
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Affiliation(s)
- Jonathan Illan Montero
- Department of Pediatrics, Centre Hospitalier Universitaire Saint-Pierre, Université libre de Bruxelles, Brussels, Belgium
| | - Alice Berger
- Division of Internal Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Jack Levy
- Department of Pediatrics, Centre Hospitalier Universitaire Saint-Pierre, Université libre de Bruxelles, Brussels, Belgium
| | - Laurent Busson
- Laboratoire des Hôpitaux Universitaires Bruxellois, Department of Microbiology, Brussels, Belgium
| | - Marc Hainaut
- Department of Pediatrics, Centre Hospitalier Universitaire Saint-Pierre, Université libre de Bruxelles, Brussels, Belgium
| | - Tessa Goetghebuer
- Department of Pediatrics, Centre Hospitalier Universitaire Saint-Pierre, Université libre de Bruxelles, Brussels, Belgium
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Shen DP, Vermeulen F, Debeer A, Lagrou K, Smits A. Impact of COVID-19 on viral respiratory infection epidemiology in young children: A single-center analysis. Front Public Health 2022; 10:931242. [PMID: 36203684 PMCID: PMC9530989 DOI: 10.3389/fpubh.2022.931242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 08/22/2022] [Indexed: 01/24/2023] Open
Abstract
Background The COVID-19 pandemic impacts different health aspects. Concomitant with the adoption of non-pharmaceutical interventions (NPIs) to reduce the spread of SARS-CoV-2, global surveillance studies reported a reduction in occurrence of respiratory pathogens like influenza A and B virus (IAV & IBV) and respiratory syncytial virus (RSV). We hypothesized to observe this collateral benefit on viral respiratory infection epidemiology in young children. Methods Respiratory samples of children aged below 6 years, presenting at the outpatient clinic, emergency department, or pediatric infectious diseases department of the University Hospitals Leuven, between April 2017 and April 2021 were retrospectively analyzed. The occurrence (positivity rate), and seasonal patterns of viral respiratory infections were described. Chi-squared or Fisher's exact test (and Bonferroni correction) were used to explore differences in occurrence between 2020-2021 and previous 12-month (April to April) periods. Results We included 3020 samples (453 respiratory panels, 2567 single SARS-CoV-2 PCR tests). IAV and IBV were not detected from March and January 2020, respectively. For IAV, positivity rate in 2020-2021 (0%, n = 0) was significantly different from 2018-2019 (12.4%, n = 17) (p < 0.001) and 2019-2020 (15.4%, n = 19) (p < 0.001). IBV positivity rate in 2020-2021 (0%, n = 0) was not significantly different from previous periods. RSV occurrence was significantly lower in 2020-2021 (3.2%, n = 3), compared to 2017-2018 (15.0%, n = 15) (p = 0.006), 2018-2019 (16.1%, n = 22) (p = 0.002) and 2019-2020 (22.8%, n = 28) (p < 0.001). The RSV (winter) peak was absent and presented later (March-April 2021). Positivity rate of parainfluenza virus 3 (PIV-3) was significantly higher in 2020-2021 (11.8%, n = 11) than 2017-2018 (1%, n = 1) (p = 0.002). PIV-3 was absent from April 2020 to January 2021, whereas no clear seasonal pattern was distinguished the other years. For the other viruses tested, no significant differences in occurrence were observed between 2020-2021 and previous periods. From March 2020 onwards, 20 cases (0.7%) of SARS-CoV-2 were identified. Conclusion These findings reinforce the hypothesis of NPIs impacting the epidemiology of influenza viruses and RSV in young children. Compared to previous periods, no IAV and IBV cases were observed in the 2020-2021 study period, and the RSV peak occurred later. Since the pandemic is still ongoing, continuation of epidemiological surveillance, even on a larger scale, is indicated.
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Affiliation(s)
| | - François Vermeulen
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium,Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Anne Debeer
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium,Neonatal Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
| | - Katrien Lagrou
- Department of Laboratory Medicine and National Reference Centre for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium,Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Anne Smits
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium,Neonatal Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium,L-C&Y, KU Leuven Child & Youth Institute, Leuven, Belgium,*Correspondence: Anne Smits
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Proesmans M, Rector A, Keyaerts E, Vandendijck Y, Vermeulen F, Sauer K, Reynders M, Verschelde A, Laffut W, Garmyn K, Fleischhackl R, Bollekens J, Ispas G. Risk factors for disease severity and increased medical resource utilization in respiratory syncytial virus (+) hospitalized children: A descriptive study conducted in four Belgian hospitals. PLoS One 2022; 17:e0268532. [PMID: 35666728 PMCID: PMC9170098 DOI: 10.1371/journal.pone.0268532] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 05/02/2022] [Indexed: 11/18/2022] Open
Abstract
Background We aimed to provide regional data on clinical symptoms, medical resource utilization (MRU), and risk factors for increased MRU in hospitalized respiratory syncytial virus (RSV)-infected Belgian pediatric population. Methods This prospective, multicenter study enrolled RSV (+) hospitalized children (aged ≤5y) during the 2013–2015 RSV seasons. RSV was diagnosed within 24h of hospitalization. Disease severity of RSV (+) patients was assessed until discharge or up to maximum six days using a Physical Examination Score (PES) and a derived score based on ability to feed, dyspnea and respiratory effort (PES3). MRU (concomitant medications, length of hospitalization [LOH], and oxygen supplementation) was evaluated. Kaplan-Meier survival analysis was performed to compare MRU by age and presence of risk factors for severe disease. Association between baseline covariates and MRU was analyzed using Cox regression models. Results In total, 75 children were included, Median (range) age was 4 (0–41) months, risk factors were present in 18.7%, and early hospitalization (≤3 days of symptom onset) was observed in 57.3% of patients. Cough (100%), feeding problems (82.2%), nasal discharge (87.8%), and rales and rhonchi (82.2%) were frequently observed. Median (range) LOH and oxygen supplementation was 5 (2–7) and 3 (1–7) days. Oxygen supplementation, bronchodilators, and antibiotics were administered to 58.7%, 64.0%, and 41.3% of the patients, respectively. Age <3 months and baseline total PES3 score were associated with probability and the duration of receiving oxygen supplementation. LOH was not associated with any covariate. Conclusion RSV is associated with high disease burden and MRU in hospitalized children. Oxygen supplementation but not length of hospitalization was associated with very young age and the PES3 score. These results warrant further assessment of the PES3 score as a predictor for the probability of receiving and length of oxygen supplementation in RSV hospitalized children. Registration NCT02133092
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Affiliation(s)
- Marijke Proesmans
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Annabel Rector
- KU Leuven Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory of Clinical and Epidemiological Virology, Leuven, Belgium
| | - Els Keyaerts
- KU Leuven Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory of Clinical and Epidemiological Virology, Leuven, Belgium
| | | | | | - Kate Sauer
- Department of Pediatrics, AZ Sint-Jan Brugge—Oostende, Campus Brugge, Brugge, Belgium
| | - Marijke Reynders
- Department of Microbiology, AZ Sint-Jan Brugge—Oostende, Campus Brugge, Brugge, Belgium
| | - Ann Verschelde
- Department of Pediatrics, AZ Sint-Jan Brugge–Oostende, Campus Henri Serruys, Oostende, Belgium
| | - Wim Laffut
- Department of Microbiology, Heilig-Hartziekenhuis, Lier, Belgium
| | - Kristien Garmyn
- Department of Pediatrics, Heilig-Hartziekenhuis, Lier, Belgium
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12
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Santos RKO, Borges IC, Souza ML, Bouzas ML, Nascimento-Carvalho CM. Seasonality of distinct respiratory viruses in a tropical city: implications for prophylaxis. Trop Med Int Health 2021; 26:672-679. [PMID: 33666303 DOI: 10.1111/tmi.13571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The frequency and seasonality of viruses in tropical regions are scarcely reported. We estimated the frequency of seven respiratory viruses and assessed seasonality of respiratory syncytial virus (RSV) and influenza viruses in a tropical city. METHODS Children (age ≤ 18 years) with acute respiratory infection were investigated in Salvador, Brazil, between July 2014 and June 2017. Respiratory viruses were searched by direct immunofluorescence and real-time polymerase chain reaction for detection of RSV, influenza A virus, influenza B virus, adenovirus (ADV) and parainfluenza viruses (PIV) 1, 2 and 3. Seasonal distribution was evaluated by Prais-Winsten regression. Due to similar distribution, influenza A and influenza B viruses were grouped to analyse seasonality. RESULTS The study group comprised 387 cases whose median (IQR) age was 26.4 (10.5-50.1) months. Respiratory viruses were detected in 106 (27.4%) cases. RSV (n = 76; 19.6%), influenza A virus (n = 11; 2.8%), influenza B virus (n = 7; 1.8%), ADV (n = 5; 1.3%), PIV 1 (n = 5; 1.3%), PIV 3 (n = 3; 0.8%) and PIV 2 (n = 1; 0.3%) were identified. Monthly count of RSV cases demonstrated seasonal distribution (b3 = 0.626; P = 0.003). More than half (42/76 [55.3%]) of all RSV cases were detected from April to June. Monthly count of influenza cases also showed seasonal distribution (b3 = -0.264; P = 0.032). Influenza cases peaked from November to January with 44.4% (8/18) of all influenza cases. CONCLUSIONS RSV was the most frequently detected virus. RSV and influenza viruses showed seasonal distribution. These data may be useful to plan the best time to carry out prophylaxis and to increase the number of hospital beds.
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Affiliation(s)
- Ruth-Kelly O Santos
- Postgraduate Program in Health Sciences, Federal University of Bahia School of Medicine, Salvador, Brazil.,Epidemiology Unit, Health Secretariat, Salvador, Brazil
| | - Igor C Borges
- Postgraduate Program in Health Sciences, Federal University of Bahia School of Medicine, Salvador, Brazil
| | | | - Maiara L Bouzas
- Postgraduate Program in Health Sciences, Federal University of Bahia School of Medicine, Salvador, Brazil
| | - Cristiana M Nascimento-Carvalho
- Postgraduate Program in Health Sciences, Federal University of Bahia School of Medicine, Salvador, Brazil.,Department of Pediatrics, Federal University of Bahia School of Medicine, Salvador, Brazil
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13
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[Virological diagnosis of lower respiratory tract infections]. Rev Mal Respir 2021; 38:58-73. [PMID: 33461842 DOI: 10.1016/j.rmr.2020.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 08/06/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The etiological diagnosis of bronchopulmonary infections cannot be assessed with clinical, radiological and epidemiological data alone. Viruses have been demonstrated to cause a large proportion of these infections, both in children and adults. BACKGROUND The diagnosis of viral bronchopulmonary infections is based on the analysis of secretions, collected from the lower respiratory tract when possible, by techniques that detect either influenza and respiratory syncytial viruses, or a large panel of viruses that can be responsible for respiratory disease. The latter, called multiplex PCR assays, allow a syndromic approach to respiratory infection. Their high cost for the laboratory raises the question of their place in the management of patients in terms of antibiotic economy and isolation. In the absence of clear recommendations, the strategy and equipment are very unevenly distributed in France. OUTLOOK Medico-economic analyses need to be performed in France to evaluate the place of these tests in the management of patients. The evaluation of the role of the different viruses often detected in co-infection, especially in children, also deserves the attention of virologists and clinicians. CONCLUSIONS The availability of new diagnostic technologies, the recent emergence of SARS-CoV-2, together with the availability of new antiviral drugs are likely to impact future recommendations for the management of viral bronchopulmonary infections.
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14
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Zhu G, Xu D, Zhang Y, Wang T, Zhang L, Gu W, Shen M. Epidemiological characteristics of four common respiratory viral infections in children. Virol J 2021; 18:10. [PMID: 33407659 PMCID: PMC7787583 DOI: 10.1186/s12985-020-01475-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 12/21/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Viruses are the main infectious agents of acute respiratory infections in children. We aim to describe the epidemiological characteristics of viral pathogens of acute respiratory tract infections in outpatient children. METHODS From April 2018 to March 2019, the results of viral detection using oral pharyngeal swabs from 103,210 children with acute respiratory tract infection in the outpatient department of the Children's Hospital, Zhejiang University School of Medicine, were retrospectively analyzed. Viral antigens, including adenovirus (ADV), influenza A (FLUA), influenza B (FLUB) and respiratory syncytial virus (RSV), were detected by the colloidal gold method. RESULTS At least one virus was detected in 38,355 cases; the positivity rate was 37.2%. A total of 1910 cases of mixed infection with two or more viruses were detected, and the positivity rate of multiple infection was 1.9%. The ADV positivity rate was highest in the 3-6-year-old group (18.7%), the FLUA positivity rate was highest in the > 6-year-old group (21.6%), the FLUB positivity rate was highest in the > 6-year-old group (6.6%), and the RSV positivity rate was highest in the < 1-year-old group (10.6%). There was a significant difference in the positivity rate of viral infection among different age groups (χ2 = 1280.7, P < 0.001). The rate of positive viral infection was highest in winter (47.1%). The ADV infection rate was highest in spring (18.2%). The rates of FLUA and FLUB positivity were highest in winter (28.8% and 3.6%, respectively). The rate of RSV positivity was highest in autumn (17.4%). The rate of positive viral infection in different seasons was significantly different (χ2 = 6459.1, P < 0.001). CONCLUSIONS Viral infection rates in children differ for different ages and seasons. The positivity rate of ADV is highest in the preschool period and that of RSV is highest in infants; that of FLU increases with age. The total positive rate of viral infection in different seasons is highest in winter, as is the rate of FLU positivity.
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Affiliation(s)
- Guohong Zhu
- Department of Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, 3333, Binsheng Road, Hangzhou, Zhejiang Province, China
| | - Dan Xu
- Department of Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, 3333, Binsheng Road, Hangzhou, Zhejiang Province, China.
| | - Yuanyuan Zhang
- Department of Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, 3333, Binsheng Road, Hangzhou, Zhejiang Province, China
| | - Tianlin Wang
- Department of Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, 3333, Binsheng Road, Hangzhou, Zhejiang Province, China
| | - Lingyan Zhang
- Department of Internal Medicine, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang Province, China
| | - Weizhong Gu
- Department of Pathology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang Province, China
| | - Meiping Shen
- Nursing Department, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang Province, China
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15
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Diesner-Treiber SC, Voitl P, Voitl JJM, Langer K, Kuzio U, Riepl A, Patel P, Mühl-Riegler A, Mühl B. Respiratory Infections in Children During a Covid-19 Pandemic Winter. Front Pediatr 2021; 9:740785. [PMID: 34733808 PMCID: PMC8558488 DOI: 10.3389/fped.2021.740785] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 09/21/2021] [Indexed: 01/03/2023] Open
Abstract
Background: The Covid-19 pandemic compelled the implementation of measures to curb the SARS CoV-2 spread, such as social distancing, wearing FFP2 masks, and frequent hand hygiene. One anticipated ramification of these measures was the containment of other pathogens. This prospective, longitudinal study aimed to investigate the spread of 22 common seasonal non-SARS-CoV-2 pathogens, such as RSV and influenza, among children with an acute respiratory infection during a pandemic. Methods: Three hundred ninety children (0-24 months) admitted to Vienna's largest pediatric center with acute respiratory infection (November 2020-April 2021) were included in this study. The researchers tested nasal swabs for 22 respiratory pathogens by Multiplex PCR, documented clinical features and treatment, and evaluated data for a potential connection with the lockdown measures then in force. Results: The 448 smears revealed the most common pathogens to be rhino-/enterovirus (41.4%), adenovirus (2.2%), and coronavirus NL63 (13.6%). While the first two were active throughout the entire season, coronaviruses peaked in the first trimester of 2021 in conjunction with the lift of the lockdown period (OR 4.371, 95%CI 2.34-8.136, P < 0.001). RSV, metapneumovirus, and influenza were absent. Conclusion: This prospective, longitudinal study shows that Covid-19 measures suppressed the seasonal activity of influenza, RSV, and metapneumovirus among very young children, but not of rhino-/enterovirus and adenovirus. The 0-24 month-olds are considered the lowest risk group and were only indirectly affected by the public health measures. Lockdowns were negatively associated with coronaviruses infections.
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Affiliation(s)
- Susanne C Diesner-Treiber
- First Vienna Pediatric Medical Center, Vienna, Austria.,Medical University of Vienna, Vienna, Austria
| | - Peter Voitl
- First Vienna Pediatric Medical Center, Vienna, Austria.,Medical University of Vienna, Vienna, Austria.,Sigmund Freud University Vienna, Vienna, Austria
| | | | - Klara Langer
- First Vienna Pediatric Medical Center, Vienna, Austria
| | - Ulrike Kuzio
- First Vienna Pediatric Medical Center, Vienna, Austria
| | - Angela Riepl
- First Vienna Pediatric Medical Center, Vienna, Austria
| | - Pia Patel
- First Vienna Pediatric Medical Center, Vienna, Austria
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16
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Ramaekers K, Rector A, Cuypers L, Lemey P, Keyaerts E, Van Ranst M. Towards a unified classification for human respiratory syncytial virus genotypes. Virus Evol 2020; 6:veaa052. [PMID: 33072402 PMCID: PMC7552823 DOI: 10.1093/ve/veaa052] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Since the first human respiratory syncytial virus (HRSV) genotype classification in 1998, inconsistent conclusions have been drawn regarding the criteria that define HRSV genotypes and their nomenclature, challenging data comparisons between research groups. In this study, we aim to unify the field of HRSV genotype classification by reviewing the different methods that have been used in the past to define HRSV genotypes and by proposing a new classification procedure, based on well-established phylogenetic methods. All available complete HRSV genomes (>12,000 bp) were downloaded from GenBank and divided into the two subgroups: HRSV-A and HRSV-B. From whole-genome alignments, the regions that correspond to the open reading frame of the glycoprotein G and the second hypervariable region (HVR2) of the ectodomain were extracted. In the resulting partial alignments, the phylogenetic signal within each fragment was assessed. Maximum likelihood phylogenetic trees were reconstructed using the complete genome alignments. Patristic distances were calculated between all pairs of tips in the phylogenetic tree and summarized as a density plot in order to determine a cutoff value at the lowest point following the major distance peak. Our data show that neither the HVR2 fragment nor the G gene contains sufficient phylogenetic signal to perform reliable phylogenetic reconstruction. Therefore, whole-genome alignments were used to determine HRSV genotypes. We define a genotype using the following criteria: a bootstrap support of ≥70 per cent for the respective clade and a maximum patristic distance between all members of the clade of ≤0.018 substitutions per site for HRSV-A or ≤0.026 substitutions per site for HRSV-B. By applying this definition, we distinguish twenty-three genotypes within subtype HRSV-A and six genotypes within subtype HRSV-B. Applying the genotype criteria on subsampled data sets confirmed the robustness of the method.
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Affiliation(s)
- Kaat Ramaekers
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Laboratory of Clinical and Epidemiological Virology, Herestraat 49 box 1040, BE-3000 Leuven, Belgium
| | - Annabel Rector
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Laboratory of Clinical and Epidemiological Virology, Herestraat 49 box 1040, BE-3000 Leuven, Belgium
| | - Lize Cuypers
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Laboratory of Clinical and Epidemiological Virology, Herestraat 49 box 1040, BE-3000 Leuven, Belgium.,University Hospitals Leuven, Department of Laboratory Medicine and National Reference Centre for Respiratory Pathogens, Herestraat 49, BE-3000 Leuven, Belgium
| | - Philippe Lemey
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Laboratory of Clinical and Epidemiological Virology, Herestraat 49 box 1040, BE-3000 Leuven, Belgium
| | - Els Keyaerts
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Laboratory of Clinical and Epidemiological Virology, Herestraat 49 box 1040, BE-3000 Leuven, Belgium.,University Hospitals Leuven, Department of Laboratory Medicine and National Reference Centre for Respiratory Pathogens, Herestraat 49, BE-3000 Leuven, Belgium
| | - Marc Van Ranst
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Laboratory of Clinical and Epidemiological Virology, Herestraat 49 box 1040, BE-3000 Leuven, Belgium.,University Hospitals Leuven, Department of Laboratory Medicine and National Reference Centre for Respiratory Pathogens, Herestraat 49, BE-3000 Leuven, Belgium
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17
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Monge S, Duijster J, Kommer GJ, van de Kassteele J, Krafft T, Engelen P, Valk JP, de Waard J, de Nooij J, Riezebos-Brilman A, van der Hoek W, van Asten L. Ambulance dispatch calls attributable to influenza A and other common respiratory viruses in the Netherlands (2014-2016). Influenza Other Respir Viruses 2020; 14:420-428. [PMID: 32410358 PMCID: PMC7298355 DOI: 10.1111/irv.12731] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 02/04/2020] [Accepted: 02/08/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Ambulance dispatches could be useful for syndromic surveillance of severe respiratory infections. We evaluated whether ambulance dispatch calls of highest urgency reflect the circulation of influenza A virus, influenza B virus, respiratory syncytial virus (RSV), rhinovirus, adenovirus, coronavirus, parainfluenzavirus and human metapneumovirus (hMPV). METHODS We analysed calls from four ambulance call centres serving 25% of the population in the Netherlands (2014-2016). The chief symptom and urgency level is recorded during triage; we restricted our analysis to calls with the highest urgency and identified those compatible with a respiratory syndrome. We modelled the relation between respiratory syndrome calls (RSC) and respiratory virus trends using binomial regression with identity link function. RESULTS We included 211 739 calls, of which 15 385 (7.3%) were RSC. Proportion of RSC showed periodicity with winter peaks and smaller interseasonal increases. Overall, 15% of RSC were attributable to respiratory viruses (20% in out-of-office hour calls). There was large variation by age group: in <15 years, only RSV was associated and explained 11% of RSC; in 15-64 years, only influenza A (explained 3% of RSC); and in ≥65 years adenovirus explained 9% of RSC, distributed throughout the year, and hMPV (4%) and influenza A (1%) mainly during the winter peaks. Additionally, rhinovirus was associated with total RSC. CONCLUSION High urgency ambulance dispatches reflect the burden of different respiratory viruses and might be useful to monitor the respiratory season overall. Influenza plays a smaller role than other viruses: RSV is important in children while adenovirus and hMPV are the biggest contributors to emergency calls in the elderly.
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Affiliation(s)
- Susana Monge
- Centre for Infectious Disease Control Netherlands (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.,European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, (ECDC), Stockholm, Sweden
| | - Janneke Duijster
- Centre for Infectious Disease Control Netherlands (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Geert Jan Kommer
- Centre for Nutrition, Prevention and Health Services (VPZ), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Jan van de Kassteele
- Centre for Infectious Disease Control Netherlands (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Thomas Krafft
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht Centre for Global Health, Maastricht, The Netherlands
| | | | - Jens P Valk
- Dispatch Center Regional Ambulance Services Noord Nederland, Leiden, The Netherlands.,Department of Anesthesiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jan de Waard
- Regional Ambulance Service Hollands Midden, Leiden, The Netherlands
| | - Jan de Nooij
- Regional Ambulance Service Hollands Midden, Leiden, The Netherlands
| | - Annelies Riezebos-Brilman
- Department of Microbiology, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Wim van der Hoek
- Centre for Infectious Disease Control Netherlands (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Liselotte van Asten
- Centre for Infectious Disease Control Netherlands (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
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18
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Choe YJ, Smit MA, Mermel LA. Comparison of Common Respiratory Virus Peak Incidence Among Varying Age Groups in Rhode Island, 2012-2016. JAMA Netw Open 2020; 3:e207041. [PMID: 32401314 PMCID: PMC7221508 DOI: 10.1001/jamanetworkopen.2020.7041] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This case series study assesses the seasonality of respiratory viral infections among different age groups in Rhode Island from 2012 to 2016.
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Affiliation(s)
- Young June Choe
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, Rhode Island
- Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, South Korea
| | - Michael A. Smit
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, Rhode Island
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, California
- Keck School of Medicine, University of Southern California, Los Angeles
| | - Leonard A. Mermel
- Department of Epidemiology and Infection Control, Division of Infectious Diseases, Rhode Island Hospital, Providence
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island
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19
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Wen S, Yu M, Zheng G, Lv F, Chen X, Lin L, Li C, Zhang H. Changes in the etiology of viral lower respiratory tract infections in hospitalized children in Wenzhou, China: 2008-2017. J Med Virol 2020; 92:982-987. [PMID: 31889316 DOI: 10.1002/jmv.25660] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 12/26/2019] [Indexed: 01/01/2023]
Abstract
This study investigated the seasonality and secular trends in the etiology of viral lower respiratory tract infections (LRTIs) among hospitalized children in Wenzhou, southeastern China. A retrospective review was conducted concerning viral LRTIs in children hospitalized at a university hospital between January 1, 2008 and December 31, 2017. Direct immunofluorescence was used to detect respiratory syncytial virus (RSV), adenovirus (AdV), influenza A virus (Inf A), influenza B virus (Inf B), and human parainfluenza virus types 1 to 3 (hPIV1-3). Of 89 898 children tested, at least one viral respiratory pathogen was identified in 25.6% and multiple pathogens were identified in 0.4%. RSV (17.6%), hPIV3 (4.0%), and AdV (2.2%) were the most frequently detected pathogens. The proportion of positive samples varied with age and was the highest in children aged <6 months (36.2%). Seasonal differences were observed in RSV, AdV, Inf A, Inf B, hPIV1, and hPIV3 infections. There was a declining trend in the proportion of positive samples over time, primarily due to a decrease in RSV and hPIV3 infections. RSV, hPIV3, and AdV were the most common viral respiratory pathogens identified among hospitalized children with LRTIs. The distribution of viruses varied with age and season.
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Affiliation(s)
- Shunhang Wen
- Department of Children's Respiratory Disease, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Mengfei Yu
- Department of Children's Respiratory Disease, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Guifeng Zheng
- Department of Children's Respiratory Disease, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Fangfang Lv
- Department of Children's Respiratory Disease, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiaofang Chen
- Department of Children's Respiratory Disease, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Li Lin
- Department of Children's Respiratory Disease, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Changchong Li
- Department of Children's Respiratory Disease, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hailin Zhang
- Department of Children's Respiratory Disease, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
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20
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Immunoglobulin M profile of viral and atypical pathogens among children with community acquired lower respiratory tract infections in Luzhou, China. BMC Pediatr 2019; 19:280. [PMID: 31409320 PMCID: PMC6691653 DOI: 10.1186/s12887-019-1649-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 07/29/2019] [Indexed: 11/19/2022] Open
Abstract
Background Community-acquired lower respiratory tract infections (CA-LRTIs) are the primary cause of hospitalization among children globally. A better understanding of the role of atypical pathogen infections in native conditions is essential to improve clinical management and preventive measures. The main objective of this study was to detect the presence of 7 respiratory viruses and 2 atypical pathogens among hospitalized infants and children with community-acquired lower respiratory tract infections in Luzhou via an IgM test. Methods Overall, 6623 cases of local hospitalized children with 9 pathogen-IgM results from 1st July 2013 to 31st Dec 2016 were included; multidimensional analysis was performed. Results 1) Out of 19,467 hospitalized children with lower respiratory tract infections, 6623 samples were collected, for a submission ratio of 33.96% (6623 /19467). Of the total 6623 serum samples tested, 5784 IgM stains were positive, for a ratio of 87.33% (5784 /6623). Mycoplasma pneumoniae (MP) was the dominant pathogen (2548 /6623, 38.47%), with influenza B (INFB) (1606 /6623, 24.25%), Legionella pneumophila serogroup 1 (LP1) (485 /6623, 7.32%) and parainfluenza 1, 2 and 3(PIVs) (416 /6623, 6.28%) ranking second, third and fourth, respectively. 2) The distribution of various pathogen-IgM by age group was significantly different (χ2 = 455.039, P < 0.05). 3) Some pathogens were found to be associated with a certain age of children and seasons statistically. Conclusions The dominant positive IgM in the area was MP, followed by INFB, either of which prefers to infect children between 2 years and 5 years in autumn. The presence of atypical pathogens should not be underestimated clinically as they were common infections in the respiratory tract of children in the hospital.
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21
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Cattoir L, Vankeerberghen A, Boel A, Van Vaerenbergh K, De Beenhouwer H. Epidemiology of RSV and hMPV in Belgium: a 10-year follow-up. Acta Clin Belg 2019; 74:229-235. [PMID: 30029583 DOI: 10.1080/17843286.2018.1492509] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objectives: Respiratory syncytial virus (RSV) and human metapneumovirus (hMPV) are important respiratory pathogens. Both viral pathogens have similar clinical manifestations. The epidemiology of RSV is well known, that of hMPV is less clear. We reviewed the results of 10 consecutive years of molecular testing for RSV and hMPV in respiratory samples of Flemish patients. Methods: In the laboratory of the OLV hospital Aalst, Belgium, multiplex RT-PCR assays are used for the detection of RSV and hMPV. The lab receives invasive and noninvasive respiratory samples of patients from all over Flanders. Results: Between September 2006 and August 2016, 16,826 respiratory samples were analyzed for RSV and hMPV. Of these samples, 18% tested positive for RSV and 7.3% for hMPV. RSV consistently peaked in November/December each year within a very narrow time frame. The occurrence of hMPV was less predictable and spreaded more widely throughout the winter and spring. Both viruses were mainly found in samples from young children. RSV was most frequently detected in samples from infants <3 months, while hMPV peaked between 6 and 9 months. After the age of 1 year, RSV rapidly dropped. hMPV dropped a little later and slower. Both viruses slightly increased again at older age (>50 years). Conclusions: Despite their similarities, some of the epidemiologic characteristics of hMPV and RSV differ. The most striking difference is the annual distribution of RSV and hMPV infections.
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Affiliation(s)
- Lien Cattoir
- Clinical Laboratory of Microbiology, OLVZ Aalst, Aalst, Belgium
| | | | - An Boel
- Clinical Laboratory of Microbiology, OLVZ Aalst, Aalst, Belgium
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22
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Jeon JH, Han M, Chang HE, Park SS, Lee JW, Ahn YJ, Hong DJ. Incidence and seasonality of respiratory viruses causing acute respiratory infections in the Northern United Arab Emirates. J Med Virol 2019; 91:1378-1384. [PMID: 30900750 PMCID: PMC7166826 DOI: 10.1002/jmv.25464] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 10/16/2018] [Accepted: 10/25/2018] [Indexed: 01/29/2023]
Abstract
Background The data on the seasonality of respiratory viruses helps to ensure the optimal vaccination period and to monitor the possible outbreaks of variant type. Objectives This study was designed to describe the molecular epidemiology and seasonality of acute respiratory infection (ARI)‐related respiratory viruses in the United Arab Emirates (UAE). Methods Both upper and lower respiratory specimens were collected for the analysis from all the patients who visited the Sheikh Khalifa Specialty Hospital (SKSH) with ARI for over 2 years. The multiplex real‐time reverse transcription polymerase chain reaction (rRT‐PCR) test was used to detect respiratory viruses, which include human adenovirus, influenza virus (FLU) A and B, respiratory syncytial virus, parainfluenza viruses, human rhinovirus (HRV), human metapneumovirus, human enterovirus, human coronavirus, and human bocavirus. Results A total of 1,362 respiratory samples were collected from 733 (53.8%) male and 629 (46.2%) female patients with ARI who visited the SKSH between November 2015 and February 2018. The rRT‐PCR test revealed an overall positivity rate of 37.2% (507/1362). The positive rate increased during winter; it was highest in December and lowest in September. FLU was the most frequently detected virus (273/1362 [20.0%]), followed by human rhinovirus (146/1362 [10.7%]). The FLU positivity rate showed two peaks, which occurred in August and December. The peak‐to‐low ratio for FLU was 2.26 (95% confidence interval: 1.52‐3.35). Conclusions The pattern of FLU in the UAE parallels to that of temperate countries. The trend of the small peak of FLU in the summer suggests a possibility of semi‐seasonal pattern in the UAE.
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Affiliation(s)
- Jae-Hyun Jeon
- Department of Infectious Disease, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, UAE.,Department of Infectious Disease, Division of Internal Medicine, Veterans Health System Medical Center, Seoul, Republic of Korea
| | - Minje Han
- Department of Laboratory Medicine, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, UAE.,Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Ho-Eun Chang
- Department of Laboratory Medicine, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, UAE.,Department of Laboratory Medicine, Seoul National University Bundang Hospital, Kyunggi-do, Republic of Korea
| | - Sung-Soo Park
- Division of Intensive Care Medicine, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, UAE.,Division of Intensive Care Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jae-Woong Lee
- Division of Intensive Care Medicine, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, UAE.,Division of Intensive Care Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Young-Joon Ahn
- Division of Intensive Care Medicine, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, UAE.,Division of Intensive Care Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Duck-Jin Hong
- Department of Laboratory Medicine, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, UAE.,Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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23
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Rahman MZ, Sumiya M, Sahabuddin M, Pell LG, Gubbay JB, Rahman R, Momtaz F, Azmuda N, Shanta SS, Jahan I, Rahman M, Mahmud AA, Roth DE, Morris SK. Genetic characterization of human metapneumovirus identified through community and facility-based surveillance of infants in Dhaka, Bangladesh. J Med Virol 2018; 91:549-554. [PMID: 30372530 DOI: 10.1002/jmv.25351] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 10/16/2018] [Indexed: 11/09/2022]
Abstract
BACKGROUND Acute respiratory infection (ARI) is a leading cause of morbidity and mortality in children in low and middle-income countries. Human metapneumovirus (hMPV) is one of the most common viral etiological agents for ARIs in children. OBJECTIVES In this study, we explored the genotypic diversity and the epidemiology of hMPV among infants in Dhaka, Bangladesh. STUDY DESIGN Between December 2014 and August 2016, a total of 3810 mid-turbinate nasal swab samples were collected from infants (0 to 6 months of age) who met clinical ARI criteria, as a part of a prospective ARI cohort study. hMPV was detected using polymerase chain reaction, and genotyped by sequencing and phylogenetic analysis. RESULTS hMPV was identified in 206 (5.4%) nasal swab specimens. One-tenth of the hMPV-positive swabs (n = 19) were also positive for other respiratory viruses. hMPV activity peaked in January and September in 2015; however, no seasonal pattern of hMPV infection was detected. Phylogenetic analyses of the N and F gene-fragments revealed that the hMPV strains circulating in Dhaka, Bangladesh, belonged to three genotypes: A2b, A2c, and B1. Genotype A (57%) was the predominant hMPV genotype circulating in Bangladesh during the study period. CONCLUSION This study describes both the epidemiology of hMPV infection and its genotypic strain diversity in Dhaka, Bangladesh.
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Affiliation(s)
| | - Mariya Sumiya
- Infectious Diseases Division (IDD), icddr,b, Dhaka, Bangladesh
| | | | - Lisa G Pell
- Centre for Global Child Health and Child Health Evaluative Sciences, Sick Kids Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jonathan B Gubbay
- Department of Pediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.,Public Health Ontario, Toronto, Ontario, Canada
| | - Rajibur Rahman
- Infectious Diseases Division (IDD), icddr,b, Dhaka, Bangladesh
| | - Farhana Momtaz
- Infectious Diseases Division (IDD), icddr,b, Dhaka, Bangladesh
| | - Nafisa Azmuda
- Department of Microbiology, Jahangirnagar University, Dhaka, Bangladesh
| | - Shaila S Shanta
- Nutrition and Clinical Services Division (NCSD), icddr,b, Dhaka, Bangladesh
| | - Ishrat Jahan
- Maternal and Child Health Training Institute (MCHTI), Ministry of Health and Family Welfare, Government of Bangladesh, Dhaka, Bangladesh
| | | | - Abdullah A Mahmud
- Nutrition and Clinical Services Division (NCSD), icddr,b, Dhaka, Bangladesh
| | - Daniel E Roth
- Centre for Global Child Health and Child Health Evaluative Sciences, Sick Kids Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Pediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Shaun K Morris
- Centre for Global Child Health and Child Health Evaluative Sciences, Sick Kids Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Pediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
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24
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Gaymard A, Bouscambert-Duchamp M, Pichon M, Frobert E, Vallee J, Lina B, Casalegno JS, Morfin F. Genetic characterization of respiratory syncytial virus highlights a new BA genotype and emergence of the ON1 genotype in Lyon, France, between 2010 and 2014. J Clin Virol 2018; 102:12-18. [PMID: 29471266 DOI: 10.1016/j.jcv.2018.02.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 01/11/2018] [Accepted: 02/04/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is a well-recognized cause of respiratory tract infections. Based on G gene variations, 11 RSV-A and 36 RSV-B genotypes have been described to date. The ON1 genotype was detected in Ontario in 2010 and subsequently reported in several countries. OBJECTIVES The objective of the present study was to investigate for the first time the RSV epidemiology and genotype diversity in France between 2010 and 2014. STUDY DESIGN All respiratory samples received from patients with influenza-like illness or respiratory tract infection were screened for RSV infection by RT-PCR. The results were stratified according to winter season. Among the RSV-positive cases, 117 samples were further investigated for phylogenetic analysis out of 150 randomly selected for sequencing. RESULTS Among the 20,359 cases screened, 14% of the cases were RSV-positive. RSV-A was predominant during the four winter seasons. The first ON1 variant was detected during the 2010-2011 winter and reached 85% of all RSV-A-positive cases in 2013-2014. Most RSV-B was classified as BA9 and BA10 genotypes but a new genotype (BA-Ly) was described. CONCLUSION As reported in different countries, ON1 variants were firstly detected in 2011 and became the predominant RSV-A genotype in Lyon. Among RSV-B, BA9 was predominant but detected alongside BA10 or a transient genotype (BA-Ly).
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Affiliation(s)
- Alexandre Gaymard
- Hospices Civils de Lyon, Laboratoire de Virologie, Institut des Agents Infectieux (IAI) de Lyon, Centre National de Référence des virus respiratoires France Sud, Centre de Biologie et de Pathologie Nord, Groupement Hospitalier Nord, F-69317 Lyon, France; Université de Lyon, Virpath, CIRI, INSERM U1111, CNRS UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, F-69372 Lyon, France.
| | - Maude Bouscambert-Duchamp
- Hospices Civils de Lyon, Laboratoire de Virologie, Institut des Agents Infectieux (IAI) de Lyon, Centre National de Référence des virus respiratoires France Sud, Centre de Biologie et de Pathologie Nord, Groupement Hospitalier Nord, F-69317 Lyon, France; Université de Lyon, Virpath, CIRI, INSERM U1111, CNRS UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, F-69372 Lyon, France
| | - Maxime Pichon
- Hospices Civils de Lyon, Laboratoire de Virologie, Institut des Agents Infectieux (IAI) de Lyon, Centre National de Référence des virus respiratoires France Sud, Centre de Biologie et de Pathologie Nord, Groupement Hospitalier Nord, F-69317 Lyon, France; Université de Lyon, Virpath, CIRI, INSERM U1111, CNRS UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, F-69372 Lyon, France
| | - Emilie Frobert
- Hospices Civils de Lyon, Laboratoire de Virologie, Institut des Agents Infectieux (IAI) de Lyon, Centre National de Référence des virus respiratoires France Sud, Centre de Biologie et de Pathologie Nord, Groupement Hospitalier Nord, F-69317 Lyon, France; Université de Lyon, Virpath, CIRI, INSERM U1111, CNRS UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, F-69372 Lyon, France
| | - Julien Vallee
- Hospices Civils de Lyon, Laboratoire de Virologie, Institut des Agents Infectieux (IAI) de Lyon, Centre National de Référence des virus respiratoires France Sud, Centre de Biologie et de Pathologie Nord, Groupement Hospitalier Nord, F-69317 Lyon, France
| | - Bruno Lina
- Hospices Civils de Lyon, Laboratoire de Virologie, Institut des Agents Infectieux (IAI) de Lyon, Centre National de Référence des virus respiratoires France Sud, Centre de Biologie et de Pathologie Nord, Groupement Hospitalier Nord, F-69317 Lyon, France; Université de Lyon, Virpath, CIRI, INSERM U1111, CNRS UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, F-69372 Lyon, France
| | - Jean-Sébastien Casalegno
- Hospices Civils de Lyon, Laboratoire de Virologie, Institut des Agents Infectieux (IAI) de Lyon, Centre National de Référence des virus respiratoires France Sud, Centre de Biologie et de Pathologie Nord, Groupement Hospitalier Nord, F-69317 Lyon, France; Université de Lyon, Virpath, CIRI, INSERM U1111, CNRS UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, F-69372 Lyon, France
| | - Florence Morfin
- Hospices Civils de Lyon, Laboratoire de Virologie, Institut des Agents Infectieux (IAI) de Lyon, Centre National de Référence des virus respiratoires France Sud, Centre de Biologie et de Pathologie Nord, Groupement Hospitalier Nord, F-69317 Lyon, France; Université de Lyon, Virpath, CIRI, INSERM U1111, CNRS UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, F-69372 Lyon, France
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