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Sanz-Muñoz I, Sánchez-de Prada L, Castrodeza-Sanz J, Eiros JM. Microbiological and epidemiological features of respiratory syncytial virus. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2024; 37:209-220. [PMID: 38515332 PMCID: PMC11094634 DOI: 10.37201/req/006.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/09/2024] [Accepted: 02/23/2024] [Indexed: 03/23/2024]
Abstract
The properties of the main surface proteins and the viral cycle of the respiratory syncytial virus (RSV) make it an attractive pathogen from the perspective of microbiology. The virus gets its name from the manner it infects cells, which enables it to produce syncytia, which allow the virus' genetic material to move across cells without having to release viral offspring to the cellular exterior, reducing immune system identification. This causes a disease with a high impact in both children and adults over 60, which has sparked the development of several preventive interventions based on vaccines and monoclonal antibodies for both age groups. The epidemiological characteristics of this virus, which circulates in epidemics throughout the coldest months of the year and exhibits a marked genetic and antigenic drift due to its high mutation capability, must be taken into consideration while using these preventive methods. The most important microbiological and epidemiological elements of RSV are covered in this study, along with how they have affected the creation of preventive medications and their use in the future.
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Affiliation(s)
- I Sanz-Muñoz
- Dr. Iván Sanz-Muñoz, National Influenza Centre, Valladolid, Calle Rondilla de Santa Teresa s/n, Edificio Rondilla, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
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Amjad MN, Wang J, Ashraf MA, Shen B, Din GU, Raza MA, Shoaib M, Yue L, Chen L, Xu H, Dong W, Hu Y. Evolutionary trends of respiratory syncytial viruses: Insights from large-scale surveillance and molecular dynamics of G glycoprotein. Heliyon 2024; 10:e30886. [PMID: 38784562 PMCID: PMC11112325 DOI: 10.1016/j.heliyon.2024.e30886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/28/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
Human respiratory syncytial virus (RSV) is an underlying cause of lower respiratory illnesses in children, elderly and immunocompromised adults. RSV contains multiple structural and non-structural proteins with two major glycoproteins that control the initial phase of infection, fusion glycoprotein and the attachment (G) glycoprotein. G protein attaches to the ciliated cells of airways initiating the infection. The hypervariable G protein plays a vital role in evolution of RSV strains. We employed multiple bioinformatics tools on systematically accessed large-scale data to evaluate mutations, evolutionary history, and phylodynamics of RSV. Mutational analysis of central conserved region (CCR) on G protein-coding sequences between 163 and 189 positions revealed frequent mutations at site 178 in human RSV (hRSV) A while arginine to glutamine substitutions at site 180 positions in hRSV B, remained prevalent from 2009 to 2014. Phylogenetic analysis indicates multiple signature mutations within G protein responsible for diversification of clades. The USA and China have highest number of surveillance records, followed by Kenya. Markov Chain Monte Carlo Bayesian skyline plot revealed that RSV A evolved steadily from 1990 to 2000, and rapidly between 2003 and 2005. Evolution of RSV B continued from 2003 to 2022, with a high evolution stage from 2016 to 2020. Throughout evolution, cysteine residues maintained their strict conserved states while CCR has an entropy value of 0.0039(±0.0005). This study concludes the notion that RSV G glycoprotein is continuously evolving while the CCR region of G protein maintains its conserved state providing an opportunity for CCR-specific monoclonal antibodys (mAbs) and inhibitors as potential candidates for immunoprophylaxis.
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Affiliation(s)
- Muhammad Nabeel Amjad
- CAS Key Laboratory of Molecular Virology & Immunology, Institutional Center for Shared Technologies and Facilities, Pathogen Discovery and Big Data Platform, Shanghai Institute of Immunity and Infection, Chinese Academy of Sciences, Yueyang Road 320, Shanghai, 200031, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Jing Wang
- CAS Key Laboratory of Molecular Virology & Immunology, Institutional Center for Shared Technologies and Facilities, Pathogen Discovery and Big Data Platform, Shanghai Institute of Immunity and Infection, Chinese Academy of Sciences, Yueyang Road 320, Shanghai, 200031, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Muhammad Awais Ashraf
- CAS Key Laboratory of Molecular Virology & Immunology, Institutional Center for Shared Technologies and Facilities, Pathogen Discovery and Big Data Platform, Shanghai Institute of Immunity and Infection, Chinese Academy of Sciences, Yueyang Road 320, Shanghai, 200031, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Bei Shen
- CAS Key Laboratory of Molecular Virology & Immunology, Institutional Center for Shared Technologies and Facilities, Pathogen Discovery and Big Data Platform, Shanghai Institute of Immunity and Infection, Chinese Academy of Sciences, Yueyang Road 320, Shanghai, 200031, China
| | - Ghayyas ud Din
- CAS Key Laboratory of Molecular Virology & Immunology, Institutional Center for Shared Technologies and Facilities, Pathogen Discovery and Big Data Platform, Shanghai Institute of Immunity and Infection, Chinese Academy of Sciences, Yueyang Road 320, Shanghai, 200031, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Muhammad Asif Raza
- CAS Key Laboratory of Molecular Virology & Immunology, Institutional Center for Shared Technologies and Facilities, Pathogen Discovery and Big Data Platform, Shanghai Institute of Immunity and Infection, Chinese Academy of Sciences, Yueyang Road 320, Shanghai, 200031, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Muhammad Shoaib
- Key Laboratory of New Animal Drug Project, Gansu Province/Key Laboratory of Veterinary Pharmaceutical Development, Ministry of Agriculture and Rural Affairs, Lanzhou Institute of Husbandry and Pharmaceutical Sciences of CAAS, Lanzhou, 730050, China
| | - Lihuan Yue
- CAS Key Laboratory of Molecular Virology & Immunology, Institutional Center for Shared Technologies and Facilities, Pathogen Discovery and Big Data Platform, Shanghai Institute of Immunity and Infection, Chinese Academy of Sciences, Yueyang Road 320, Shanghai, 200031, China
| | - Lingdie Chen
- CAS Key Laboratory of Molecular Virology & Immunology, Institutional Center for Shared Technologies and Facilities, Pathogen Discovery and Big Data Platform, Shanghai Institute of Immunity and Infection, Chinese Academy of Sciences, Yueyang Road 320, Shanghai, 200031, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Huiting Xu
- Pediatric Department, Nanxiang Branch of Ruijin Hospital, Shanghai, 201802, China
| | - Wei Dong
- Pediatric Department, Nanxiang Branch of Ruijin Hospital, Shanghai, 201802, China
| | - Yihong Hu
- CAS Key Laboratory of Molecular Virology & Immunology, Institutional Center for Shared Technologies and Facilities, Pathogen Discovery and Big Data Platform, Shanghai Institute of Immunity and Infection, Chinese Academy of Sciences, Yueyang Road 320, Shanghai, 200031, China
- University of Chinese Academy of Sciences, Beijing, China
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Presser LD, van den Akker WMR, Meijer A. Respiratory Syncytial Virus European Laboratory Network 2022 Survey: Need for Harmonization and Enhanced Molecular Surveillance. J Infect Dis 2024; 229:S34-S39. [PMID: 37578049 DOI: 10.1093/infdis/jiad341] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/01/2023] [Accepted: 08/10/2023] [Indexed: 08/15/2023] Open
Abstract
Respiratory syncytial virus (RSV) is a common pathogen causing mostly cold-like symptoms, but in very young infants and elderly individuals it can lead to severe disease and even death. There are currently promising developments both in vaccine development and in therapeutics that are expected to be approved soon. To get an impression within European countries of the laboratory diagnostics and surveillance activities, in anticipation of these developments, we queried the members of the European Respiratory Syncytial Virus Laboratory Network (RSV-LabNet, under the umbrella of the PROMISE project) via an online survey. The answers from the consortium members showed scattered monitoring and the application of a broad array of techniques in the laboratories. A majority of the members expressed strong interest in harmonization and collaboration for setting up surveillance programs and the need for sharing laboratory protocols. The additional value of RSV whole-genome sequencing is broadly appreciated, but implementation requires further development and closer collaboration. The RSV-LabNet can have an important responsibility in establishing contacts and exchange of expertise and providing a platform for communication to advance diagnostics, preparedness, and surveillance.
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Affiliation(s)
- Lance D Presser
- Centre for Infectious Diseases Research, Diagnostics and Laboratory Surveillance, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Willem M R van den Akker
- Centre for Infectious Diseases Research, Diagnostics and Laboratory Surveillance, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Adam Meijer
- Centre for Infectious Diseases Research, Diagnostics and Laboratory Surveillance, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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Leonardo RODL. Respiratory Syncytial Virus and influenza infections in adults: more in common than meets the eye. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2024; 42:59-61. [PMID: 38336428 DOI: 10.1016/j.eimce.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 01/15/2024] [Indexed: 02/12/2024]
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Langedijk AC, Bont LJ. Respiratory syncytial virus infection and novel interventions. Nat Rev Microbiol 2023; 21:734-749. [PMID: 37438492 DOI: 10.1038/s41579-023-00919-w] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2023] [Indexed: 07/14/2023]
Abstract
The large global burden of respiratory syncytial virus (RSV) respiratory tract infections in young children and older adults has gained increased recognition in recent years. Recent discoveries regarding the neutralization-specific viral epitopes of the pre-fusion RSV glycoprotein have led to a shift from empirical to structure-based design of RSV therapeutics, and controlled human infection model studies have provided early-stage proof of concept for novel RSV monoclonal antibodies, vaccines and antiviral drugs. The world's first vaccines and first monoclonal antibody to prevent RSV among older adults and all infants, respectively, have recently been approved. Large-scale introduction of RSV prophylactics emphasizes the need for active surveillance to understand the global impact of these interventions over time and to timely identify viral mutants that are able to escape novel prophylactics. In this Review, we provide an overview of RSV interventions in clinical development, highlighting global disease burden, seasonality, pathogenesis, and host and viral factors related to RSV immunity.
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Affiliation(s)
- Annefleur C Langedijk
- Department of Paediatric Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Louis J Bont
- Department of Paediatric Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, the Netherlands.
- ReSViNET Foundation, Zeist, the Netherlands.
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Bimouhen A, Regragui Z, El Falaki F, Ihazmade H, Benkerroum S, Barakat A, Rguig A, Benamar T, Triki S, Bakri Y, Oumzil H. Circulation patterns and molecular epidemiology of human respiratory syncytial virus over five consecutive seasons in Morocco. Influenza Other Respir Viruses 2023; 17:e13203. [PMID: 37859975 PMCID: PMC10582604 DOI: 10.1111/irv.13203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 09/05/2023] [Accepted: 09/10/2023] [Indexed: 10/21/2023] Open
Abstract
Background Respiratory syncytial virus (HRSV) is the leading cause of respiratory tract infections in infants and young children. we investigated the prevalence and characteristics of HRSV in Morocco and explored trends in circulating genotypes through partial G gene analysis of HRSV strains prevalent from 2012 to 2017. Methods Respiratory samples were gathered from both outpatients and inpatients meeting ILI or SARI case definitions. The patients' ages varied from 1 month to 99 years old. Nucleic acids were extracted and HRSV type/subtype was detected by RT-qPCR. A subset of positive samples was randomly selected in each epidemic year, the complete viral genome was sequenced, phylogenetic analysis was performed using the MEGA7 program and the genotypes were confirmed. Results The 3679 specimens were collected from 2012 to 2017, of which 726 (19.7%) were positive for HRSV. The 35% (257/726) of HRSV-positives were of the HRSV-A subtype, while the HRSV-B subtype accounted for 61% (442/726). The co-infection rate was 3.7% (27/726). The virus circulates in a periodic pattern, where epidemics occur during the fall months through early spring. HRSV genotype was confirmed in 127 specimens (56 HRSV-A and 71 HRSV-B). Based on phylogenetic analysis, all HRSV-A were ON1 genotype, and HRSV-B were mostly BA9 genotype. HRSV-B belonging to the BA10 genotype was detected in 2012 exclusively. Conclusions BA9, BA10, and ON1 were the only HRSV genotypes detected between 2012 and 2017. Variations in the G gene amino acid chain were identified in local strains, which suggests an increased need for continuous genomic surveillance.
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Affiliation(s)
- Abderrahman Bimouhen
- Laboratory of Human Pathologies Biology, Faculty of SciencesMohammed V University in RabatRabatMorocco
- National Influenza Center, Virology DepartmentNational Institute of Hygiene, Ministry of HealthRabatMorocco
| | - Zakia Regragui
- National Influenza Center, Virology DepartmentNational Institute of Hygiene, Ministry of HealthRabatMorocco
| | - Fatima El Falaki
- National Influenza Center, Virology DepartmentNational Institute of Hygiene, Ministry of HealthRabatMorocco
| | - Hassan Ihazmade
- National Influenza Center, Virology DepartmentNational Institute of Hygiene, Ministry of HealthRabatMorocco
| | - Samira Benkerroum
- National Influenza Center, Virology DepartmentNational Institute of Hygiene, Ministry of HealthRabatMorocco
| | - Amal Barakat
- World Health Organization Regional Office for the Eastern MediterraneanCairoEgypt
| | - Ahmed Rguig
- Directorate of Epidemiology and Disease ControlMinistry of HealthRabatMorocco
| | - Touria Benamar
- Directorate of Epidemiology and Disease ControlMinistry of HealthRabatMorocco
| | - Soumia Triki
- World Health Organization Country Office of MoroccoRabatMorocco
| | - Youssef Bakri
- Laboratory of Human Pathologies Biology, Faculty of SciencesMohammed V University in RabatRabatMorocco
- Center of human pathologies genomic, faculty of Medicine and PharmacyMohammed V university in RabatRabatMorocco
| | - Hicham Oumzil
- National Influenza Center, Virology DepartmentNational Institute of Hygiene, Ministry of HealthRabatMorocco
- Pedagogy and Research Unit of Microbiology, School of Medicine and PharmacyMohammed V University in RabatRabatMorocco
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Ruckwardt TJ. The road to approved vaccines for respiratory syncytial virus. NPJ Vaccines 2023; 8:138. [PMID: 37749081 PMCID: PMC10519952 DOI: 10.1038/s41541-023-00734-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/13/2023] [Indexed: 09/27/2023] Open
Abstract
After decades of work, several interventions to prevent severe respiratory syncytial virus (RSV) disease in high-risk infant and older adult populations have finally been approved. There were many setbacks along the road to victory. In this review, I will discuss the impact of RSV on human health and how structure-based vaccine design set the stage for numerous RSV countermeasures to advance through late phase clinical evaluation. While there are still many RSV countermeasures in preclinical and early-stage clinical trials, this review will focus on products yielding long-awaited efficacy results. Finally, I will discuss some challenges and next steps needed to declare a global victory against RSV.
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Affiliation(s)
- Tracy J Ruckwardt
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, 20892, USA.
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Abstract
PURPOSE OF REVIEW Respiratory syncytial virus (RSV) continues to be a major cause of severe lower respiratory tract infection in infants, young children, and older adults. In this review, changes in the epidemiology of RSV during the coronavirus disease 2019 (COVID-19) pandemic are highlighted together with the role which increased molecular surveillance efforts will have in future in assessing the efficacy of vaccines and therapeutics. RECENT FINDINGS The introduction of nonpharmaceutical intervention (NPIs) strategies during the COVID-19 pandemic between 2020 and 2022 resulted in worldwide disruption to the epidemiology of RSV infections, especially with respect to the timing and peak case rate of annual epidemics. Increased use of whole genome sequencing along with efforts to better standardize the nomenclature of RSV strains and discrimination of RSV genotypes will support increased monitoring of relevant antigenic sites in the viral glycoproteins. Several RSV vaccine candidates based on subunit, viral vectors, nucleic acid, or live attenuated virus strategies have shown efficacy in Phase 2 or 3 clinical trials with vaccines using RSVpreF protein currently the closest to approval and use in high-risk populations. Finally, the recent approval and future use of the extended half-life human monoclonal antibody Nirsevimab will also help to alleviate the morbidity and mortality burden caused by annual epidemics of RSV infections. SUMMARY The ongoing expansion and wider coordination of RSV molecular surveillance efforts via whole genome sequencing will be crucial for future monitoring of the efficacy of a new generation of vaccines and therapeutics.
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Affiliation(s)
- Martin Ludlow
- Research Center for Emerging Infections and Zoonoses, University of Veterinary Medicine Hannover, Hannover, Germany
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Teirlinck AC, Johannesen CK, Broberg EK, Penttinen P, Campbell H, Nair H, Reeves RM, Bøås H, Brytting M, Cai W, Carnahan A, Casalegno JS, Danis K, De Gascun C, Ellis J, Emborg HD, Gijon M, Guiomar R, Hirve SS, Jiřincová H, Nohynek H, Oliva JA, Osei-Yeboah R, Paget J, Pakarna G, Pebody R, Presser L, Rapp M, Reiche J, Rodrigues AP, Seppälä E, Socan M, Szymanski K, Trebbien R, Večeřová J, van der Werf S, Zambon M, Meijer A, Fischer TK. New perspectives on respiratory syncytial virus surveillance at the national level: lessons from the COVID-19 pandemic. Eur Respir J 2023; 61:2201569. [PMID: 37012081 PMCID: PMC10069872 DOI: 10.1183/13993003.01569-2022] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 02/10/2023] [Indexed: 04/05/2023]
Abstract
The emergence of SARS-CoV-2 and the resulting coronavirus disease 2019 (COVID-19) pandemic has led to the reconsideration of surveillance strategies for respiratory syncytial virus (RSV) and other respiratory viruses. The COVID-19 pandemic and the non-pharmaceutical interventions for COVID-19 had a substantial impact on RSV transmission in many countries, with close to no transmission detected during parts of the usual season of 2020–2021. Subsequent relaxation of social restrictions has resulted in unusual out-of-season resurgences of RSV in several countries, causing a higher healthcare burden and often a higher proportion of hospitalisations than usual among children older than 1 year in age [1]. In case of an emerging infectious disease with pandemic potential, preparedness to scale up surveillance for the emerging disease while continuing the maintenance of surveillance activities of pre-existing seasonal diseases is necessary. Learning from the COVID-19 pandemic and considering the effects of this pandemic, we provide recommendations that can guide towards sustainable RSV surveillance with the potential to be integrated into the broader perspective of respiratory surveillance. https://bit.ly/40TsO0G
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Affiliation(s)
- Anne C Teirlinck
- National Institute for Public Health and the Environment (RIVM) - Centre for Infectious Disease Control, Bilthoven, The Netherlands
| | - Caroline K Johannesen
- Statens Serum Institut, Copenhagen, Denmark
- Department of Clinical Research, Nordsjaellands Hospital, and University of Copenhagen, Department of Public Health, Copenhagen, Denmark
| | - Eeva K Broberg
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | | | - Harish Nair
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | | | - Håkon Bøås
- Norwegian Institute of Public Health, Oslo, Norway
| | - Mia Brytting
- Public Health Agency of Sweden, Stockholm, Sweden
| | - Wei Cai
- Robert Koch Institute, Berlin, Germany
| | | | - Jean-Sebastien Casalegno
- Centre National de Référence des virus des infections respiratoires dont la grippe, Hospices Civils de Lyon, Lyon, France
| | - Kostas Danis
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | | | | | | | | | - Raquel Guiomar
- National Institute of Health Ricardo Jorge, Lisbon, Portugal
| | | | | | - Hanna Nohynek
- Finnish National Institute for Health and Welfare, Helsinki, Finland
| | - Jesus Angel Oliva
- Instituto de Salud Carlos III Madrid, CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - John Paget
- Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands
| | | | - Richard Pebody
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Lance Presser
- National Institute for Public Health and the Environment (RIVM) - Centre for Infectious Disease Control, Bilthoven, The Netherlands
| | - Marie Rapp
- Public Health Agency of Sweden, Stockholm, Sweden
| | | | | | | | - Maja Socan
- National Institute of Public Health, Ljubljana, Slovenia
| | - Karol Szymanski
- National Institute of Public Health NIH National Research Institute, Warsaw, Poland
| | | | | | | | | | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM) - Centre for Infectious Disease Control, Bilthoven, The Netherlands
| | - Thea K Fischer
- Statens Serum Institut, Copenhagen, Denmark
- Department of Clinical Research, Nordsjaellands Hospital, and University of Copenhagen, Department of Public Health, Copenhagen, Denmark
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Williams T, Jackson S, Barr I, Bi S, Bhiman J, Ellis J, von Gottberg A, Lindstrom S, Peret T, Rughooputh S, Viegas M, Hirve S, Zambon M, Zhang W. Results from the second WHO external quality assessment for the molecular detection of respiratory syncytial virus, 2019-2020. Influenza Other Respir Viruses 2023; 17:e13073. [PMID: 36824313 PMCID: PMC9849090 DOI: 10.1111/irv.13073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/27/2022] [Accepted: 10/29/2022] [Indexed: 01/20/2023] Open
Abstract
Background External quality assessments (EQAs) for the molecular detection of human respiratory syncytial virus (RSV) are necessary to ensure the standardisation of reliable results. The Phase II, 2019-2020 World Health Organization (WHO) RSV EQA included 28 laboratories in 26 countries. The EQA panel evaluated performance in the molecular detection and subtyping of RSV-A and RSV-B. This manuscript describes the preparation, distribution, and analysis of the 2019-2020 WHO RSV EQA. Methods Panel isolates underwent whole genome sequencing and in silico primer matching. The final panel included nine contemporary, one historical virus and two negative controls. The EQA panel was manufactured and distributed by the UK National External Quality Assessment Service (UK NEQAS). National laboratories used WHO reference assays developed by the United States Centers for Disease Control and Prevention, an RSV subtyping assay developed by the Victorian Infectious Diseases Reference Laboratory (Australia), or other in-house or commercial assays already in use at their laboratories. Results An in silico analysis of isolates showed a good match to assay primer/probes. The panel was distributed to 28 laboratories. Isolates were correctly identified in 98% of samples for detection and 99.6% for subtyping. Conclusions The WHO RSV EQA 2019-2020 showed that laboratories performed at high standards. Updating the composition of RSV molecular EQAs with contemporary strains to ensure representation of circulating strains, and ensuring primer matching with EQA panel viruses, is advantageous in assessing diagnostic competencies of laboratories. Ongoing EQAs are recommended because of continued evolution of mismatches between current circulating strains and existing primer sets.
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Affiliation(s)
| | | | - Ian Barr
- Peter Doherty Institute for Infection and ImmunityWHO Collaborating Centre for Reference and Research on Influenza, Victorian Infectious Disease Reference Laboratory (VIDRL)MelbourneVictoriaAustralia
- Department of Microbiology and ImmunologyUniversity of MelbourneMelbourneVictoriaAustralia
| | - Shabana Bi
- United Kingdom Health Security Agency (UKHSA)LondonUK
- United Kingdom National External Quality Assessment Service (UK NEQAS) for MicrobiologyLondonUK
| | - Jinal Bhiman
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases (NICD) of the National Health Laboratory ServiceJohannesburgSouth Africa
- School of Pathology, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Joanna Ellis
- United Kingdom Health Security Agency (UKHSA)LondonUK
| | - Anne von Gottberg
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases (NICD) of the National Health Laboratory ServiceJohannesburgSouth Africa
- School of Pathology, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Stephen Lindstrom
- Respiratory Virus Branch, Division of Viral DiseasesCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Teresa Peret
- Division of Infectious Diseases, Department of Internal MedicineUniversity of Texas Medical BranchGalvestonTexasUSA
- Institute for Human Infections and ImmunityUniversity of Texas Medical BranchGalvestonTexasUSA
| | - Sanjiv Rughooputh
- United Kingdom Health Security Agency (UKHSA)LondonUK
- United Kingdom National External Quality Assessment Service (UK NEQAS) for MicrobiologyLondonUK
| | - Mariana Viegas
- Virology LaboratoryRicardo Gutiérrez Children's HospitalBuenos AiresArgentina
- National Council for Scientific and Technological Research (CONICET)Buenos AiresArgentina
| | | | - Maria Zambon
- United Kingdom Health Security Agency (UKHSA)LondonUK
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Mohebi L, Karami H, Mirsalehi N, Ardestani NH, Yavarian J, Mard‐Soltani M, Mokhatri‐Azad T, Salimi V. A delayed resurgence of respiratory syncytial virus (RSV) during the COVID-19 pandemic: An unpredictable outbreak in a small proportion of children in the Southwest of Iran, April 2022. J Med Virol 2022; 94:5802-5807. [PMID: 35961780 PMCID: PMC9538802 DOI: 10.1002/jmv.28065] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/27/2022] [Accepted: 08/10/2022] [Indexed: 01/06/2023]
Abstract
The global outbreak of coronavirus disease 2019 (COVID-19), an emerging disease caused by severe acute respiratory syndrome virus-2 (SARS-CoV-2), and strict restrictions implemented to control the infection have impacted the circulation and transmission of common seasonal viruses worldwide and subsequently the rate of hospitalizations in children at young ages. Respiratory syncytial virus (RSV) surprisingly disappeared in 2020-2021 in many countries due to lockdown and precautions were taken because of the COVID-19 pandemic. Herein, we showed a notable change in the rate of hospitalization and reported an unpredictable outbreak of RSV in a small proportion of children admitted to a children's hospital in Dezful (a city in Southwest Iran) in the early spring of 2022. We performed a descriptive study of hospitalized young children (aged ≤ 5 years) with acute respiratory infections. Together with clinical information, 30 nasopharyngeal swabs were prospectively collected and 3 important respiratory viruses (RSV, influenza viruses, and SARS-CoV-2) were tested through the real-time polymerase chain reaction (real-time PCR) method. The age distribution of 30 hospital-admitted children was 1 month to 5 years old and males were the most included subjects 18/30 (60%) in this study. Although the viral genome of SARS-CoV-2 and influenza viruses was not detected, the presence of RSV was confirmed in 16/30 (53.33%) patients. Results showed that the majority of RSV-infected cases were males 10/16 (62.5%), within 12 months of life, and had changes in parameters of the complete blood count. Almost all patients with RSV infection had a cough as the most common clinical manifestation and had no history of past medical conditions as a risk factor. The presented study is the first investigation that documented an outbreak of RSV infection in young children reported since the onset of the COVID-19 outbreak in Iran. Our cases highlight the potential threats of important but neglected pathogens during the ongoing pandemic as described here for RSV, which would be challenging by easing the preimposed restrictions.
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Affiliation(s)
- Leila Mohebi
- Department of HealthDezful University of Medical SciencesDezfulIran
| | - Hassan Karami
- Department of Virology, School of Public HealthTehran University of Medical SciencesTehranIran
| | - Negar Mirsalehi
- Department of Virology, School of Public HealthTehran University of Medical SciencesTehranIran
| | - Nima Hoveidi Ardestani
- Department of Virology, School of Public HealthTehran University of Medical SciencesTehranIran
| | - Jila Yavarian
- Department of Virology, School of Public HealthTehran University of Medical SciencesTehranIran
| | - Maysam Mard‐Soltani
- Infectious and Tropical Diseases Research CenterDezful University of Medical SciencesDezfulIran
| | - Talat Mokhatri‐Azad
- Department of Virology, School of Public HealthTehran University of Medical SciencesTehranIran
| | - Vahid Salimi
- Department of Virology, School of Public HealthTehran University of Medical SciencesTehranIran
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12
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Barr IG, Williams TC, Salimi V, Buchholz UJ. Addendum to Proposal for Human Respiratory Syncytial Virus Nomenclature below the Species Level. Emerg Infect Dis 2022; 28:764. [PMID: 35202531 PMCID: PMC8888225 DOI: 10.3201/eid2803.212438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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13
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Letafati A, Aghamirmohammadali FS, Rahimi-Foroushani A, Hasani SA, Mokhtari-Azad T, Yavarian J. No Human Respiratory Syncytial Virus but SARS-CoV-2 in children under 5 years old referred to Children Medical Center in 2021, Tehran, Iran. J Med Virol 2022; 94:3096-3100. [PMID: 35229318 PMCID: PMC9088699 DOI: 10.1002/jmv.27685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/06/2022] [Accepted: 02/26/2022] [Indexed: 11/16/2022]
Abstract
Acute respiratory infections (ARIs) are one of the leading causes of illness and death among community members worldwide. Viral infections are the most common agents estimated to be involved in these patients. This study aimed to investigate the prevalence of human respiratory syncytial virus (hRSV) and severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) among children with ARIs. This study evaluated the presence of SARS‐CoV‐2 and hRSV in 168 throat and nasopharyngeal swab samples using real‐time RT‐PCR. All samples were collected from children under 5 years old with ARIs who attended Children's Medical Center, Tehran, Iran, and sent to the Iranian National Influenza Center with appropriate conditions in 2021. Chi‐square and Fisher's exact tests were used for comparison of the data of the prevalence of hRSV and SARS‐CoV‐2 infections among children. Of 168 patients examined, 95 (57%) were male and 73 (43%) female. Out of them, 47 (28%) cases were younger than 1 year old and 121 cases (72%) were 1–5 years old. The most common clinical manifestations of patients were cough (78%), nausea (31%), diarrhea (27%), and fever (18%). Among 168 patients, no hRSV was detected, while the SARS‐CoV‐2 genome was identified in 16 (9.5%) patients. Among 16 positive cases of SARS‐CoV‐2, 8 (50%) were under 1 year old and 8 positive cases were 1–5 years old. This study was performed at cold months of the year but due to the coronavirus disease 2019 pandemic and adherence to health protocols, school closures, and virtual classes, no cases of hRSV infections were identified.
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Affiliation(s)
- Arash Letafati
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Abbas Rahimi-Foroushani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Abbas Hasani
- Department of Pediatrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Talat Mokhtari-Azad
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Jila Yavarian
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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14
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Rios Guzman E, Hultquist JF. Clinical and biological consequences of respiratory syncytial virus genetic diversity. Ther Adv Infect Dis 2022; 9:20499361221128091. [PMID: 36225856 PMCID: PMC9549189 DOI: 10.1177/20499361221128091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 08/30/2022] [Indexed: 11/17/2022] Open
Abstract
Respiratory syncytial virus (RSV) is one of the most common etiological agents of global acute respiratory tract infections with a disproportionate burden among infants, individuals over the age of 65, and immunocompromised populations. The two major subtypes of RSV (A and B) co-circulate with a predominance of either group during different epidemic seasons, with frequently emerging genotypes due to RSV's high genetic variability. Global surveillance systems have improved our understanding of seasonality, disease burden, and genomic evolution of RSV through genotyping by sequencing of attachment (G) glycoprotein. However, the integration of these systems into international infrastructures is in its infancy, resulting in a relatively low number (~2200) of publicly available RSV genomes. These limitations in surveillance hinder our ability to contextualize RSV evolution past current canonical attachment glycoprotein (G)-oriented understanding, thus resulting in gaps in understanding of how genetic diversity can play a role in clinical outcome, therapeutic efficacy, and the host immune response. Furthermore, utilizing emerging RSV genotype information from surveillance and testing the impact of viral evolution using molecular techniques allows us to establish causation between the clinical and biological consequences of arising genotypes, which subsequently aids in informed vaccine design and future vaccination strategy. In this review, we aim to discuss the findings from current molecular surveillance efforts and the gaps in knowledge surrounding the consequence of RSV genetic diversity on disease severity, therapeutic efficacy, and RSV-host interactions.
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Affiliation(s)
- Estefany Rios Guzman
- Department of Medicine, Division of Infectious
Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL,
USA
- Center for Pathogen Genomics and Microbial
Evolution, Institute for Global Health, Northwestern University Feinberg
School of Medicine, Chicago, IL, USA
| | - Judd F. Hultquist
- Robert H. Lurie Medical Research Center,
Northwestern University, 9-141, 303 E. Superior St., Chicago, IL 60611,
USA
- Department of Medicine, Division of Infectious
Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL,
USA
- Center for Pathogen Genomics and Microbial
Evolution, Institute for Global Health, Northwestern University Feinberg
School of Medicine, Chicago, IL, USA
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15
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Determination of genetic characterization and circulation pattern of Respiratory Syncytial Virus (RSV) in children with a respiratory infection, Tehran, Iran, during 2018-2019. Virus Res 2021; 305:198564. [PMID: 34530047 DOI: 10.1016/j.virusres.2021.198564] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/01/2021] [Accepted: 09/05/2021] [Indexed: 11/21/2022]
Abstract
The RSV-associated disease accounts for a significant health burden particularly in infants and young children who need to be hospitalized. Since continuous surveillance of circulating RSV genotypes is crucial worldwide, this study aimed to investigate the genetic diversity of RSV circulating strains causing upper or lower acute respiratory infection. Our attention was geared towards studying the cases hospitalized or outpatient in children younger than 2 years of age in Iran during 2018/2019. In this study, nasopharyngeal swabs collected from 206 children who presented with respiratory infection symptoms, were admitted to the referral pediatric ward of Bahrami children's hospital in Tehran, Iran. RSV-positive samples were detected via Nested RT-PCR. The glycoprotein gene was sequenced, and virus genotypes were confirmed through phylogenetic analysis by the MEGA X program. A total of 74 (35.92%) samples tested positive for RSV. Among them, sequencing was done in 10 specimens from 2018 (RSV-A: RSV-B=4:6) and 19 specimens from 2019 (RSV-A: RSV-B=16:3). According to phylogenetic analysis, all RSV-A strains were assigned as ON1 genotype and RSV-B strains were assigned as BA9 genotype. A new N-glycosylation site in Iranian BA9 and positive selection in ON1 genotype was observed. Phylogenetic characterization of strains in the current study revealed co-circulation of ON1 and BA9 as the only prevalent genotypes of both RSV-A and -B groups.
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16
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Williams TC, Sinha I, Barr IG, Zambon M. Transmission of paediatric respiratory syncytial virus and influenza in the wake of the COVID-19 pandemic. Euro Surveill 2021; 26:2100186. [PMID: 34296673 PMCID: PMC8299749 DOI: 10.2807/1560-7917.es.2021.26.29.2100186] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 07/04/2021] [Indexed: 11/20/2022] Open
Abstract
The non-pharmaceutical interventions implemented to slow the spread of SARS-CoV-2 have had consequences on the transmission of other respiratory viruses, most notably paediatric respiratory syncytial virus (RSV) and influenza. At the beginning of 2020, lockdown measures in the southern hemisphere led to a winter season with a marked reduction in both infections. Intermittent lockdowns in the northern hemisphere also appeared to interrupt transmission during winter 2020/21. However, a number of southern and northern hemisphere countries have now seen delayed RSV peaks. We examine the implications of these unpredictable disease dynamics for health service delivery in Europe, such as paediatric hospital and intensive care bed space planning, or palivizumab prophylaxis. We discuss the challenges for RSV vaccine trials and influenza immunisation campaigns, and highlight the considerable research opportunities that have arisen with the SARS-CoV-2 pandemic. We argue that the rapid advances in viral whole genome sequencing, phylogenetic analysis, and open data sharing during the pandemic are applicable to the ongoing surveillance of RSV and influenza. Lastly, we outline actions to prepare for forthcoming influenza seasons and for future implementation of RSV vaccines.
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Affiliation(s)
- Thomas C Williams
- MRC Human Genetics Unit, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, United Kingdom
| | - Ian Sinha
- University of Liverpool, Liverpool, United Kingdom
| | - Ian G Barr
- WHO Collaborating Centre for Reference and Research on Influenza, Doherty Institute, Melbourne, Australia
| | - Maria Zambon
- Virus Reference Department, Public Health England, Colindale, United Kingdom
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