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Wang Q, Liu N, Wang Y, Ruckwardt TJ, Xu M, Wu J, Zhang J, Tong X, Zhou J, Lin J, Liang Y, Yang J, Yi L, Chu HY, Yu H. Antibody responses to respiratory syncytial virus: a population-based cross-sectional serological study in Southern China, 2021. Clin Microbiol Infect 2024:S1198-743X(24)00282-9. [PMID: 38852851 DOI: 10.1016/j.cmi.2024.06.005] [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: 01/16/2024] [Revised: 05/25/2024] [Accepted: 06/02/2024] [Indexed: 06/11/2024]
Abstract
OBJECTIVES With remarkable progress in the field of respiratory syncytial virus (RSV) prophylaxis, it is critical to understand population immunity against RSV. We aim to describe the RSV pre-F IgG antibodies across all age groups in Southern China and to evaluate the risk factors associated with lower antibody levels. METHODS We performed a community-based cross-sectional sero-epidemiological study in Anhua County, Hunan Province, Southern China, from July 15, 2021, to November 5, 2021. Serum samples were tested for IgG antibodies against the RSV prefusion F (pre-F) protein using an enzyme-linked immunosorbent assay. We estimated the geometric mean titres (GMTs) and seropositivity rates across all age groups. The generalized linear models were built to identify factors associated with antibody levels. RESULTS A total of 890 participants aged 4 months to older than 89 years were enrolled. The lowest RSV pre-F IgG GMTs were observed in infants and toddlers aged 4 months to younger than 2 years (3.0; 95% CI, 2.6-3.5). With increasing age, the RSV pre-F IgG GMT increased to 4.3 (95% CI, 4.1-4.4) between the ages of 2 and younger than 5 years and then stabilized at high levels throughout life. All the children had serological evidence of RSV infection by the age of 5 years. Age was associated with RSV pre-F antibody levels in children, with an estimated 1.8-fold (95% CI, 1.1-2.9) increase in titre per year before 5 years of age, although it was not significantly associated with antibody levels in adults aged older than 60 years. DISCUSSION Our findings could provide a comprehensive understanding of the gaps in RSV immunity at the population level and inform the prioritization of immunization platforms.
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Affiliation(s)
- Qianli Wang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China; Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
| | - Nuolan Liu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Yan Wang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Tracy J Ruckwardt
- Vaccine Research Centre, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Meng Xu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Jianan Wu
- Anhua County Centre for Disease Control and Prevention, Yiyang, China
| | - Juanjuan Zhang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Xiaofeng Tong
- Anhua County Centre for Disease Control and Prevention, Yiyang, China
| | - Jiaxin Zhou
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Jiqun Lin
- Anhua County Centre for Disease Control and Prevention, Yiyang, China
| | - Yuxia Liang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Juan Yang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Lan Yi
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Helen Y Chu
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, USA
| | - Hongjie Yu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China; Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China.
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Bents SJ, Viboud C, Grenfell BT, Hogan AB, Tempia S, von Gottberg A, Moyes J, Walaza S, Hansen C, Cohen C, Baker RE. Modeling the impact of COVID-19 nonpharmaceutical interventions on respiratory syncytial virus transmission in South Africa. Influenza Other Respir Viruses 2023; 17:e13229. [PMID: 38090227 PMCID: PMC10710953 DOI: 10.1111/irv.13229] [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: 06/12/2023] [Revised: 09/25/2023] [Accepted: 11/11/2023] [Indexed: 12/18/2023] Open
Abstract
Background The South African government employed various nonpharmaceutical interventions (NPIs) to reduce the spread of SARS-CoV-2. Surveillance data from South Africa indicates reduced circulation of respiratory syncytial virus (RSV) throughout the 2020-2021 seasons. Here, we use a mechanistic transmission model to project the rebound of RSV in the two subsequent seasons. Methods We fit an age-structured epidemiological model to hospitalization data from national RSV surveillance in South Africa, allowing for time-varying reduction in RSV transmission during periods of COVID-19 circulation. We apply the model to project the rebound of RSV in the 2022 and 2023 seasons. Results We projected an early and intense outbreak of RSV in April 2022, with an age shift to older infants (6-23 months old) experiencing a larger portion of severe disease burden than typical. In March 2022, government alerts were issued to prepare the hospital system for this potentially intense outbreak. We then assess the 2022 predictions and project the 2023 season. Model predictions for 2023 indicate that RSV activity has not fully returned to normal, with a projected early and moderately intense wave. We estimate that NPIs reduced RSV transmission between 15% and 50% during periods of COVID-19 circulation. Conclusions A wide range of NPIs impacted the dynamics of the RSV outbreaks throughout 2020-2023 in regard to timing, magnitude, and age structure, with important implications in a low- and middle-income countries (LMICs) setting where RSV interventions remain limited. More efforts should focus on adapting RSV models to LMIC data to project the impact of upcoming medical interventions for this disease.
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Affiliation(s)
- Samantha J. Bents
- Fogarty International Center, National Institutes of HealthBethesdaMarylandUSA
| | - Cécile Viboud
- Fogarty International Center, National Institutes of HealthBethesdaMarylandUSA
| | - Bryan T. Grenfell
- Department of Ecology and Evolutionary BiologyPrinceton UniversityPrincetonNew JerseyUSA
| | - Alexandra B. Hogan
- School of Population HealthUniversity of New South WalesSydneyNew South WalesAustralia
| | - Stefano Tempia
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- School of Public Health, Faculty of Health SciencesUniversity of WitwatersrandJohannesburgSouth Africa
| | - Anne von Gottberg
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- School of Pathology, Faculty of Health SciencesUniversity of WitwatersrandJohannesburgSouth Africa
- Department of Pathology, Faculty of Health SciencesUniversity of Cape TownCape TownSouth Africa
| | - Jocelyn Moyes
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- School of Public Health, Faculty of Health SciencesUniversity of WitwatersrandJohannesburgSouth Africa
| | - Sibongile Walaza
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- School of Public Health, Faculty of Health SciencesUniversity of WitwatersrandJohannesburgSouth Africa
| | - Chelsea Hansen
- Fogarty International Center, National Institutes of HealthBethesdaMarylandUSA
- Brotman Baty InstituteUniversity of WashingtonSeattleWashingtonUSA
- PandemiX Center, Department of Science & EnvironmentRoskilde UniversityRoskildeDenmark
| | - Cheryl Cohen
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- School of Public Health, Faculty of Health SciencesUniversity of WitwatersrandJohannesburgSouth Africa
| | - Rachel E. Baker
- School of Public HealthBrown UniversityProvidenceRhode IslandUSA
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Nakajo K, Nishiura H. Age-Dependent Risk of Respiratory Syncytial Virus Infection: A Systematic Review and Hazard Modeling From Serological Data. J Infect Dis 2023; 228:1400-1409. [PMID: 37161934 PMCID: PMC10640776 DOI: 10.1093/infdis/jiad147] [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: 12/20/2022] [Revised: 03/28/2023] [Accepted: 05/09/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND There is no immunization campaign that currently exist for respiratory syncytial virus (RSV). Seroprevalence studies are critical for assessing epidemiological dynamics before and during an immunization program. A systematic literature review was conducted to summarize the evidence from seroprevalence studies on RSV. METHODS A systematic search of age-dependent RSV seroprevalence was conducted using the PubMed database and EMBASE. Age-dependent force of infections (FoI) and the decay rate of immunity were estimated. A mixture finite model was used, estimating the age-dependent disease state and the antibody concentrations in susceptible and infected or recovered populations. RESULTS Twenty-one studies were identified from 15 countries, with studies using enzyme-linked immunosorbent assay being the most represented. Using a catalytic model, the age-dependent force of infection was estimated to be the lowest in infants aged 6 months to 1 year and increased in older age groups. The proportion ever-infected/recovered was estimated to be above 90% by 3 years of age. CONCLUSIONS The number of seroprevalence studies covering a broad range of ages are limited. The age-dependent FoI indicated that the risk of infection was greatest among those aged >5 years. Additional data using valid assays are required to describe the transmission dynamics of RSV infection.
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Affiliation(s)
- K Nakajo
- Kyoto University School of Public Health, Yoshidakonoecho, Sakyoku, Kyoto, Japan
- Sanofi K.K. Tokyo Opera City Tower, Shinjuku-ku, Tokyo, Japan
| | - H Nishiura
- Kyoto University School of Public Health, Yoshidakonoecho, Sakyoku, Kyoto, Japan
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Gunning CE, Rohani P, Mwananyanda L, Kwenda G, Mupila Z, Gill CJ. Young Zambian infants with symptomatic RSV and pertussis infections are frequently prescribed inappropriate antibiotics: a retrospective analysis. PeerJ 2023; 11:e15175. [PMID: 37193027 PMCID: PMC10183159 DOI: 10.7717/peerj.15175] [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: 08/09/2022] [Accepted: 03/13/2023] [Indexed: 05/18/2023] Open
Abstract
Pediatric community-acquired pneumonia (CAP) remains a pressing global health concern, particularly in low-resource settings where diagnosis and treatment rely on empiric, symptoms-based guidelines such as the WHO's Integrated Management of Childhood Illness (IMCI). This study details the delivery of IMCI-based health care to 1,320 young infants and their mothers in a low-resource urban community in Lusaka, Zambia during 2015. Our Southern Africa Mother Infant Pertussis Study (SAMIPS) prospectively monitored a cohort of mother/infant pairs across infants' first four months of life, recording symptoms of respiratory infection and antibiotics prescriptions (predominantly penicillins), and tested nasopharyngeal (NP) samples for respiratory syncytial virus (RSV) and Bordetella pertussis. Our retrospective analysis of the SAMIPS cohort found that symptoms and antibiotics use were more common in infants (43% and 15.7%) than in mothers (16.6% and 8%), while RSV and B. pertussis were observed at similar rates in infants (2.7% and 32.5%) and mothers (2% and 35.5%), albeit frequently at very low levels. In infants, we observed strong associations between symptoms, pathogen detection, and antibiotics use. Critically, we demonstrate that non-macrolide antibiotics were commonly prescribed for pertussis infections, some of which persisted across many weeks. We speculate that improved diagnostic specificity and/or clinician education paired with timely, appropriate treatment of pertussis could substantially reduce the burden of this disease while reducing the off-target use of penicillins.
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Affiliation(s)
- Christian E. Gunning
- Odum School of Ecology, University of Georgia, Athens, GA, United States of America
| | - Pejman Rohani
- Odum School of Ecology, University of Georgia, Athens, GA, United States of America
- Center for the Ecology of Infectious Diseases; Department of Infectious Diseases, University of Georgia, Athens, GA, United States of America
- Department of Infectious Diseases, University of Georgia, Athens, GA, United States of America
| | - Lawrence Mwananyanda
- School of Public Health, Department of Global Health, Boston University, Boston, MA, United States of America
- Right to Care Zambia, Lusaka, Zambia
| | - Geoffrey Kwenda
- School of Health Sciences, Department of Biomedical Science, University of Zambia, Lusaka, Zambia
| | | | - Christopher J. Gill
- School of Public Health, Department of Global Health, Boston University, Boston, MA, United States of America
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High seroprevalence of antibodies against human respiratory syncytial virus and evidence of respiratory syncytial virus reinfection in young children in Thailand. Int J Infect Dis 2022; 125:177-183. [PMID: 36332904 DOI: 10.1016/j.ijid.2022.10.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/11/2022] [Accepted: 10/26/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To investigate the seroprevalence of respiratory syncytial virus (RSV) infections in young children, the correlation between RSV antibody levels in maternal and cord serum, and to provide evidence of RSV reinfection in Thai children after primary infections. METHODS Serum samples were collected from 302 mothers and 291 children between 2015 and 2021. Maternal and cord blood were collected at birth. Serial serum samples of children were collected at the ages of 2, 7, 18, 19, 24, 36, 48, and 60 months and the presence of anti-RSV immunoglobulin G (IgG) was tested using an enzyme-linked immunosorbent assay. RESULTS The cord: maternal serum antibody ratio was 1.09 (95% confidence interval 1.08-1.11). Although >90% of babies at birth were seropositive through transplacental transfer, antibody levels gradually declined, with the highest seronegative rate (91.9%) at 7 months of age. Subsequently, anti-RSV IgG levels increased with age, most likely due to natural infection. One-third of the children showed evidence of reinfection as determined by seroconversion of anti-RSV IgG or increased titers of at least 50 relative units/ml. CONCLUSION Waning of RSV antibodies in infants is rapid, and RSV infection subsequently increases anti-RSV IgG titers. RSV vaccination in children before the age of 7 months should be recommended.
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Nyiro JU, Bukusi E, Mwaengo D, Nyaguara A, Nyawanda B, Otieno N, Bigogo G, Murunga N, Widdowson MA, Verani JR, Chaves SS, Mwangudza H, Odundo C, Berkley JA, Nokes DJ, Munywoki PK. Efficiency of transplacental transfer of respiratory syncytial virus (RSV) specific antibodies among pregnant women in Kenya. Wellcome Open Res 2022; 7:43. [PMID: 35402734 PMCID: PMC8976186 DOI: 10.12688/wellcomeopenres.17636.2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2022] [Indexed: 12/11/2022] Open
Abstract
Background: Maternal immunisation to boost respiratory syncytial virus (RSV) antibodies in pregnant women, is a strategy being considered to enhance infant protection from severe RSV associated disease. However, little is known about the efficiency of transplacental transfer of RSV-specific antibodies in a setting with a high burden of malaria and HIV, to guide the implementation of such a vaccination program. Methods: Using a plaque reduction neutralization assay, we screened 400 pairs of cord and maternal serum specimens from pregnant women for RSV-specific antibodies. Participants were pregnant women of two surveillance cohorts: 200 participants from a hospital cohort in Kilifi, Coastal Kenya and 200 participants from a surveillance cohort in Siaya, Western Kenya. Transplacental transfer efficiency was determined by the cord to maternal titre ratio (CMTR). Logistic regression was used to determine independent predictors of impaired transplacental transfer of RSV-specific antibodies. Results: A total of 800 samples were screened from the 400 participants. At enrollment the median age was 25 years (Interquartile range (IQR): 21-31). Overall, transplacental transfer was efficient and did not differ between Kilifi and Siaya cohort (1.02 vs. 1.02; p=0.946) but was significantly reduced among HIV-infected mothers compared to HIV-uninfected mothers (mean CMTR: 0.98 vs 1.03; p=0.015). Prematurity <33 weeks gestation (Odds ratio [OR]: 0.23, 95% confidence interval [CI] 0.06-0.85; p=0.028), low birth weight <2.5 kgs (OR: 0.25, 95% CI: 0.07-0.94; p=0.041) and HIV infection (OR: 0.47, 95% CI:0.23-0.98; p=0.045) reduced efficiency of transplacental transfer among these women. Conclusions: Transplacental transfer of RSV-specific antibodies among pregnant women in Kenya is efficient. A consideration to integrate other preventive interventions with maternal RSV vaccination targeting infants born premature (<33 weeks gestation), with low birth weight <2.5 kgs, or HIV-infected mothers is likely to improve vaccine outcomes in this setting.
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Affiliation(s)
- Joyce U. Nyiro
- Centre for Geographic Medicine Research-Coast, Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Elizabeth Bukusi
- Centre for Microbiology Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Dufton Mwaengo
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
| | - Amek Nyaguara
- Centre for Geographic Medicine Research-Coast, Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Bryan Nyawanda
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Nancy Otieno
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Godfrey Bigogo
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Nickson Murunga
- Centre for Geographic Medicine Research-Coast, Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Marc-Alain Widdowson
- Division of Global Health Protection, CDC-Kenya, U.S Centers for Disease Control and Prevention (CDC), Nairobi, Kenya
- Institute of Tropical Medicine, Antwerp, Belgium
| | - Jennifer R. Verani
- Influenza Division, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, USA
| | - Sandra S. Chaves
- Division of Global Health Protection, CDC-Kenya, U.S Centers for Disease Control and Prevention (CDC), Nairobi, Kenya
- Influenza Division, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, USA
| | - Hope Mwangudza
- Centre for Geographic Medicine Research-Coast, Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Calleb Odundo
- Centre for Geographic Medicine Research-Coast, Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Kilifi, Kenya
| | - James A. Berkley
- Centre for Geographic Medicine Research-Coast, Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Kilifi, Kenya
| | - D James Nokes
- Centre for Geographic Medicine Research-Coast, Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Kilifi, Kenya
- School of Life Sciences and Zeeman Institute (SBIDER), University of Warwick, Coventry, UK
| | - Patrick K. Munywoki
- Division of Global Health Protection, CDC-Kenya, U.S Centers for Disease Control and Prevention (CDC), Nairobi, Kenya
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7
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Nyiro JU, Bukusi E, Mwaengo D, Nyaguara A, Nyawanda B, Otieno N, Bigogo G, Murunga N, Widdowson MA, Verani JR, Chaves SS, Mwangudza H, Odundo C, Berkley JA, Nokes DJ, Munywoki PK. Efficiency of transplacental transfer of respiratory syncytial virus (RSV) specific antibodies among pregnant women in Kenya. Wellcome Open Res 2022; 7:43. [PMID: 35402734 PMCID: PMC8976186 DOI: 10.12688/wellcomeopenres.17636.1] [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] [Accepted: 01/31/2022] [Indexed: 02/15/2024] Open
Abstract
Background: Maternal immunisation to boost respiratory syncytial virus (RSV) antibodies in pregnant women, is a strategy being considered to enhance infant protection from severe RSV associated disease. However, little is known about the efficiency of transplacental transfer of RSV-specific antibodies in a setting with a high burden of malaria and HIV, to guide the implementation of such a vaccination program. Methods: Using a plaque reduction neutralization assay, we screened 400 pairs of cord and maternal serum specimens from pregnant women for RSV-specific antibodies. Participants were pregnant women of two surveillance cohorts: 200 participants from a hospital cohort in Kilifi, Coastal Kenya and 200 participants from a surveillance cohort in Siaya, Western Kenya. Transplacental transfer efficiency was determined by the cord to maternal transfer ratio (CMTR). Logistic regression was used to determine independent predictors of impaired transplacental transfer of RSV-specific antibodies. Results: A total of 800 samples were screened from the 400 participants. At enrollment the median age was 25 years (Interquartile range (IQR): 21-31). Overall, transplacental transfer was efficient and did not differ between Kilifi and Siaya cohort (1.02 vs. 1.02; p=0.946) but was significantly reduced among HIV-infected mothers compared to HIV-uninfected mothers (mean CMTR: 0.98 vs 1.03; p=0.015). Prematurity <33 weeks gestation (Odds ratio [OR]: 0.23, 95% confidence interval [CI] 0.06-0.85; p=0.028), low birth weight <2.5 kgs (OR: 0.25, 95% CI: 0.07-0.94; p=0.041) and HIV infection (OR: 0.47, 95% CI:0.23-0.98; p=0.045) reduced efficiency of transplacental transfer among these women. Conclusions: Transplacental transfer of RSV-specific antibodies among pregnant women in Kenya is efficient. A consideration to integrate other preventive interventions with maternal RSV vaccination targeting infants born premature (<33 weeks gestation), with low birth weight <2.5 kgs, or HIV-infected mothers is likely to improve vaccine outcomes in this setting.
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Affiliation(s)
- Joyce U. Nyiro
- Centre for Geographic Medicine Research-Coast, Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Elizabeth Bukusi
- Centre for Microbiology Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Dufton Mwaengo
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
| | - Amek Nyaguara
- Centre for Geographic Medicine Research-Coast, Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Bryan Nyawanda
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Nancy Otieno
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Godfrey Bigogo
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Nickson Murunga
- Centre for Geographic Medicine Research-Coast, Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Marc-Alain Widdowson
- Division of Global Health Protection, CDC-Kenya, U.S Centers for Disease Control and Prevention (CDC), Nairobi, Kenya
- Institute of Tropical Medicine, Antwerp, Belgium
| | - Jennifer R. Verani
- Influenza Division, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, USA
| | - Sandra S. Chaves
- Division of Global Health Protection, CDC-Kenya, U.S Centers for Disease Control and Prevention (CDC), Nairobi, Kenya
- Influenza Division, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, USA
| | - Hope Mwangudza
- Centre for Geographic Medicine Research-Coast, Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Calleb Odundo
- Centre for Geographic Medicine Research-Coast, Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Kilifi, Kenya
| | - James A. Berkley
- Centre for Geographic Medicine Research-Coast, Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Kilifi, Kenya
| | - D James Nokes
- Centre for Geographic Medicine Research-Coast, Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Kilifi, Kenya
- School of Life Sciences and Zeeman Institute (SBIDER), University of Warwick, Coventry, UK
| | - Patrick K. Munywoki
- Division of Global Health Protection, CDC-Kenya, U.S Centers for Disease Control and Prevention (CDC), Nairobi, Kenya
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8
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Prasad N, Read JM, Jewell C, Waite B, Trenholme AA, Huang QS, Grant CC, Newbern EC, Hogan AB. Modelling the impact of respiratory syncytial virus (RSV) vaccine and immunoprophylaxis strategies in New Zealand. Vaccine 2021; 39:4383-4390. [PMID: 34147296 DOI: 10.1016/j.vaccine.2021.05.100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Mathematical models of respiratory syncytial virus (RSV) transmission can help describe seasonal epidemics and assess the impact of potential vaccines and immunoprophylaxis with monoclonal antibodies (mAb). METHODS We developed a deterministic, compartmental model for RSV transmission, which was fitted to population-based RSV hospital surveillance data from Auckland, New Zealand. The model simulated the introduction of either a maternal vaccine or a seasonal mAb among infants aged less than 6 months and estimated the reduction in RSV hospitalizations for a range of effectiveness and coverage values. RESULTS The model accurately reproduced the annual seasonality of RSV epidemics in Auckland. We found that a maternal vaccine with effectiveness of 30-40% in the first 90 days and 15-20% for the next 90 days could reduce RSV hospitalizations by 18-24% in children younger than 3 months, by 11-14% in children aged 3-5 months, and by 2-3% in children aged 6-23 months. A seasonal infant mAb with 40-60% effectiveness for 150 days could reduce RSV hospitalizations by 30-43%, 34-48% and by 14-21% in children aged 0-2 months, 3-5 months and 6-23 months, respectively. CONCLUSIONS Our results suggest that either a maternal RSV vaccine or mAb would effectively reduce RSV hospitalization disease burden in New Zealand. Overall, a seasonal mAb resulted in a larger disease prevention impact than a maternal vaccine.
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Affiliation(s)
- Namrata Prasad
- National Centre for Biosecurity and Infectious Disease, Institute of Environmental Science and Research, Upper Hutt, Wellington, New Zealand; Department of Paediatrics: Child & Youth Health, University of Auckland, Auckland, New Zealand.
| | - Jonathan M Read
- Centre for Health Informatics, Computing, and Statistics, Lancaster Medical School, Lancaster University, Lancaster, United Kingdom
| | - Christopher Jewell
- Centre for Health Informatics, Computing, and Statistics, Lancaster Medical School, Lancaster University, Lancaster, United Kingdom
| | - Ben Waite
- National Centre for Biosecurity and Infectious Disease, Institute of Environmental Science and Research, Upper Hutt, Wellington, New Zealand
| | - Adrian A Trenholme
- Kidz First Children's Hospital, Counties Manukau District Health Board, Auckland, New Zealand
| | - Q Sue Huang
- National Centre for Biosecurity and Infectious Disease, Institute of Environmental Science and Research, Upper Hutt, Wellington, New Zealand
| | - Cameron C Grant
- Department of Paediatrics: Child & Youth Health, University of Auckland, Auckland, New Zealand; General Paediatrics, Starship Children's Hospital, Auckland, New Zealand
| | - E Claire Newbern
- National Centre for Biosecurity and Infectious Disease, Institute of Environmental Science and Research, Upper Hutt, Wellington, New Zealand
| | - Alexandra B Hogan
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom
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9
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Yildiz M, Kara M, Sutcu M, Mese S, Demircili ME, Sivrikoz TS, Torun SH, Agacfidan A, Coban A, Unuvar E, Somer A. Evaluation of respiratory syncytial virus IgG antibody dynamics in mother-infant pairs cohort. Eur J Clin Microbiol Infect Dis 2020; 39:1279-1286. [PMID: 32060753 PMCID: PMC7223508 DOI: 10.1007/s10096-020-03841-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 02/05/2020] [Indexed: 11/24/2022]
Abstract
RSV is one of the most important agents of lower respiratory infections in childhood. In this study, anti-RSV antibody levels in mother-infant pairs and factors related to antibody transfer ratio were investigated. One hundred and twenty-seven women that had term babies and their babies and 84 mother-infant pairs of them who continued the study after 6 months were enrolled. Anti-RSV IgG antibodies of the mothers and infants were positive in 46.5% and 61.5%, respectively. At the sixth month, anti-RSV antibodies were negative in all infants. Median of the anti-RSV antibody levels of the mothers and infants at birth were 12.08 IU/ml (1.21-119.27) and 13.78 IU/ml (3.99-108.6), respectively. There was a significant correlation between anti-RSV antibody levels of mothers and infants at birth (p: 0.0001, r: 0.667) and anti-RSV antibody levels of infants at birth and at 6th month (p: 0.0001, r: 0.343). Median ratio of infant and mother antibody levels was 1.22 (0.14-6.05). Median ratio that was detected in appropriate for gestational age infants was significantly higher than in small for gestational age or large for gestational age infants. In this study, the significant positive correlation between maternal antibody levels and infants' antibody levels at birth suggests that maternal vaccination strategies may be logical. We showed that antibody transfer rate was highest in appropriate for gestational age infants. It should be kept in mind that maternal vaccination strategies may be less effective in small for gestational age and large for gestational age infants.
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Affiliation(s)
- Mehmet Yildiz
- Department of Pediatrics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
| | - Manolya Kara
- Department of Pediatric Infectious Diseases, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Murat Sutcu
- Department of Pediatric Infectious Diseases, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Sevim Mese
- Department of Medical Microbiology, Division of Virology and Fundamental Immunology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mehmet Emin Demircili
- Department of Medical Microbiology, Division of Virology and Fundamental Immunology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Tugba Sarac Sivrikoz
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Selda Hancerli Torun
- Department of Pediatric Infectious Diseases, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ali Agacfidan
- Department of Medical Microbiology, Division of Virology and Fundamental Immunology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Asuman Coban
- Department of Pediatrics, Division of Neonatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Emin Unuvar
- Department of Pediatrics, Faculty of Medicine, Okan University, Istanbul, Turkey
| | - Ayper Somer
- Department of Pediatric Infectious Diseases, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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10
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Arankalle VA, Kulkarni R, Malshe N, Palkar S, Lalwani S, Mishra AC. Seroepidemiology of respiratory syncytial virus in western India with special reference to appropriate age for infant vaccination. J Med Virol 2019; 91:1566-1570. [PMID: 31012488 DOI: 10.1002/jmv.25489] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 03/23/2019] [Accepted: 04/11/2019] [Indexed: 12/15/2022]
Abstract
Respiratory syncytial virus (RSV) causes significant infant mortality worldwide and a vaccine may be available soon. This study determined age-stratified anti-RSV antibody positivity (enzyme-linked immunosorbent assay [ELISA]) at Pune, India (cord blood-85 years). Antibody positivity declined from 100% at birth to 71.3% (3 months), and 0.7% (6 months). A significant rise was noted at 15 months (16%), 16 to 24 months (64.5%) and 4 years (95.2%) with concomitant IgM-anti-RSV positivity indicative of recent infection. Antibody decline was higher in infants born preterm than full-term. Across subsequent age groups including the elderly, antibody positivity was similar and comparable, suggestive of repeated exposure to the virus. Early protection/vaccination is essential for the infant population.
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Affiliation(s)
- Vidya A Arankalle
- Department of Communicable Diseases, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Pune, India
| | - Ruta Kulkarni
- Department of Communicable Diseases, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Pune, India
| | - Nandini Malshe
- Department of Pediatrics, Bharati Vidyapeeth Medical College, Pune, India
| | - Sonali Palkar
- Department of Pediatrics, Bharati Vidyapeeth Medical College, Pune, India
| | - Sanjay Lalwani
- Department of Pediatrics, Bharati Vidyapeeth Medical College, Pune, India
| | - Akhilesh Chandra Mishra
- Department of Communicable Diseases, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Pune, India
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11
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Sarna M, Ware RS, Lambert SB, Sloots TP, Nissen MD, Grimwood K. Timing of First Respiratory Virus Detections in Infants: A Community-Based Birth Cohort Study. J Infect Dis 2019; 217:418-427. [PMID: 29165576 PMCID: PMC7107408 DOI: 10.1093/infdis/jix599] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 11/16/2017] [Indexed: 11/13/2022] Open
Abstract
Background Determining timing of first virus detection episodes (fVDEs) for different respiratory viruses in infants identifies risk periods and informs preventive interventions, including vaccination. We describe the ages and nature of fVDEs in an infant birth cohort and explore factors associated with increased odds of symptomatic fVDEs. Methods The Observational Research in Childhood Infectious Diseases (ORChID) study is a community-based birth cohort describing acute respiratory infections in infants until their second birthday. Parents recorded daily symptoms and collected nose swabs weekly, which were batch-tested using polymerase chain reaction assays for 17 respiratory viruses. Results One hundred fifty-eight infants participated in ORChID. The median age for fVDEs was 2.9 months for human rhinovirus (HRV) but was ≥13.9 months for other respiratory viruses. Overall, 52% of HRV fVDEs were symptomatic, compared with 57%–83% of other fVDEs. Respiratory syncytial virus and human metapneumovirus fVDEs were more severe than HRV fVDEs. Older age and the winter season were associated with symptomatic episodes. Conclusions Infants do not always experience respiratory symptoms with their fVDE. Predominance of early HRV detections highlights the need for timing any intervention early in life. fVDEs from other respiratory viruses most commonly occur when maternal vaccines may no longer provide protection.
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Affiliation(s)
- Mohinder Sarna
- School of Public Health, University of Queensland, Brisbane.,UQ Child Health Research Centre, School of Medicine, University of Queensland, Brisbane
| | - Robert S Ware
- UQ Child Health Research Centre, School of Medicine, University of Queensland, Brisbane.,Menzies Health Institute Queensland, Griffith University, Gold Coast
| | - Stephen B Lambert
- UQ Child Health Research Centre, School of Medicine, University of Queensland, Brisbane
| | - Theo P Sloots
- UQ Child Health Research Centre, School of Medicine, University of Queensland, Brisbane
| | - Michael D Nissen
- UQ Child Health Research Centre, School of Medicine, University of Queensland, Brisbane
| | - Keith Grimwood
- School of Medicine and Menzies Health Institute Queensland, Griffith University, Gold Coast.,Departments of Infectious Diseases and Paediatrics, Gold Coast Health, Queensland, Australia
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12
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Hogan AB, Campbell PT, Blyth CC, Lim FJ, Fathima P, Davis S, Moore HC, Glass K. Potential impact of a maternal vaccine for RSV: A mathematical modelling study. Vaccine 2017; 35:6172-6179. [PMID: 28967522 DOI: 10.1016/j.vaccine.2017.09.043] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 08/14/2017] [Accepted: 09/13/2017] [Indexed: 11/16/2022]
Abstract
Respiratory syncytial virus (RSV) is a major cause of respiratory morbidity and one of the main causes of hospitalisation in young children. While there is currently no licensed vaccine for RSV, a vaccine candidate for pregnant women is undergoing phase 3 trials. We developed a compartmental age-structured model for RSV transmission, validated using linked laboratory-confirmed RSV hospitalisation records for metropolitan Western Australia. We adapted the model to incorporate a maternal RSV vaccine, and estimated the expected reduction in RSV hospitalisations arising from such a program. The introduction of a vaccine was estimated to reduce RSV hospitalisations in Western Australia by 6-37% for 0-2month old children, and 30-46% for 3-5month old children, for a range of vaccine effectiveness levels. Our model shows that, provided a vaccine is demonstrated to extend protection against RSV disease beyond the first three months of life, a policy using a maternal RSV vaccine could be effective in reducing RSV hospitalisations in children up to six months of age, meeting the objective of a maternal vaccine in delaying an infant's first RSV infection to an age at which severe disease is less likely.
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Affiliation(s)
- Alexandra B Hogan
- Research School of Population Health, The Australian National University, 62 Mills Rd, The Australian National University, Acton ACT 2601, Australia.
| | - Patricia T Campbell
- Doherty Epidemiology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Level 5, 792 Elizabeth St, Melbourne, Victoria 3000, Australia; Infection and Immunity, Murdoch Childrens Research Institute, Royal Children's Hospital, Flemington Rd, Parkville 3052, Victoria, Australia
| | - Christopher C Blyth
- School of Medicine, University of Western Australia, Princess Margaret Hospital for Children, Roberts Rd, Subiaco, Perth, WA 6008, Australia; Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, 100 Roberts Rd, Subiaco, Perth, WA 6008, Australia; Department of Infectious Disease and PathWest Department of Microbiology, Princess Margaret Hospital for Children, Roberts Rd, Subiaco, WA 6008, Australia
| | - Faye J Lim
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, 100 Roberts Rd, Subiaco, Perth, WA 6008, Australia
| | - Parveen Fathima
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, 100 Roberts Rd, Subiaco, Perth, WA 6008, Australia
| | - Stephanie Davis
- Research School of Population Health, The Australian National University, 62 Mills Rd, The Australian National University, Acton ACT 2601, Australia
| | - Hannah C Moore
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, 100 Roberts Rd, Subiaco, Perth, WA 6008, Australia
| | - Kathryn Glass
- Research School of Population Health, The Australian National University, 62 Mills Rd, The Australian National University, Acton ACT 2601, Australia
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13
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Heath PT, Culley FJ, Jones CE, Kampmann B, Le Doare K, Nunes MC, Sadarangani M, Chaudhry Z, Baker CJ, Openshaw PJM. Group B streptococcus and respiratory syncytial virus immunisation during pregnancy: a landscape analysis. THE LANCET. INFECTIOUS DISEASES 2017; 17:e223-e234. [PMID: 28433702 DOI: 10.1016/s1473-3099(17)30232-3] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 02/02/2017] [Accepted: 02/07/2017] [Indexed: 12/30/2022]
Abstract
Group B streptococcus and respiratory syncytial virus are leading causes of infant morbidity and mortality worldwide. No licensed vaccines are available for either disease, but vaccines for both are under development. Severe respiratory syncytial virus disease can be prevented by passively administered antibody. The presence of maternal IgG antibody specific to respiratory syncytial virus is associated with reduced prevalence and severity of respiratory syncytial virus disease in the first few weeks of life, whereas maternal serotype-specific anticapsular antibody is associated with protection against both early-onset and late-onset group B streptococcus disease. Therefore, vaccination in pregnancy might protect infants against both diseases. This report describes what is known about immune protection against group B streptococcus and respiratory syncytial virus, identifies knowledge gaps regarding the immunobiology of both diseases, and aims to prioritise research directions in maternal immunisation.
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Affiliation(s)
- Paul T Heath
- Vaccine Institute, Institute for Infection and Immunity, St George's, University of London and St George's University Hospitals NHS Foundation Trust, London, UK.
| | - Fiona J Culley
- Respiratory Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - Christine E Jones
- Faculty of Medicine and Institute for Life Sciences, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Beate Kampmann
- Centre for International Child Health, Department of Paediatrics, Imperial College London, London, UK; Medical Research Council Unit, Serrekunda, The Gambia
| | - Kirsty Le Doare
- Vaccine Institute, Institute for Infection and Immunity, St George's, University of London and St George's University Hospitals NHS Foundation Trust, London, UK; Centre for International Child Health, Department of Paediatrics, Imperial College London, London, UK
| | - Marta C Nunes
- Department of Science and Technology and National Research Foundation, Vaccine Preventable Diseases and Medical Research Council, University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa; Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa
| | - Manish Sadarangani
- Department of Paediatrics, University of Oxford, Oxford, UK; Vaccine Evaluation Centre, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Zain Chaudhry
- Respiratory Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - Carol J Baker
- Department of Pediatrics, Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA
| | - Peter J M Openshaw
- Respiratory Medicine, National Heart and Lung Institute, Imperial College London, London, UK
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14
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Nyiro JU, Kombe IK, Sande CJ, Kipkoech J, Kiyuka PK, Onyango CO, Munywoki PK, Kinyanjui TM, Nokes DJ. Defining the vaccination window for respiratory syncytial virus (RSV) using age-seroprevalence data for children in Kilifi, Kenya. PLoS One 2017; 12:e0177803. [PMID: 28531224 PMCID: PMC5439681 DOI: 10.1371/journal.pone.0177803] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 05/03/2017] [Indexed: 11/19/2022] Open
Abstract
Background Respiratory syncytial virus (RSV) is an important cause of lower respiratory tract disease in early life and a target for vaccine prevention. Data on the age-prevalence of RSV specific antibodies will inform on optimizing vaccine delivery. Methods Archived plasma samples were randomly selected within age strata from 960 children less than 145 months of age admitted to Kilifi County Hospital pediatric wards between 2007 and 2010. Samples were tested for antibodies to RSV using crude virus IgG ELISA. Seroprevalence (and 95% confidence intervals) was estimated as the proportion of children with specific antibodies above a defined cut-off level. Nested catalytic models were used to explore different assumptions on antibody dynamics and estimate the rates of decay of RSV specific maternal antibody and acquisition of infection with age, and the average age of infection. Results RSV specific antibody prevalence was 100% at age 0-<1month, declining rapidly over the first 6 months of life, followed by an increase in the second half of the first year of life and beyond. Seroprevalence was lowest throughout the age range 5–11 months; all children were seropositive beyond 3 years of age. The best fit model to the data yielded estimates for the rate of infection of 0.78/person/year (95% CI 0.65–0.97) and 1.69/person/year (95% CI 1.27–2.04) for ages 0-<1 year and 1-<12 years, respectively. The rate of loss of maternal antibodies was estimated as 2.54/year (95% CI 2.30–2.90), i.e. mean duration 4.7 months. The mean age at primary infection was estimated at 15 months (95% CI 13–18). Conclusions The rate of decay of maternal antibody prevalence and subsequent age-acquisition of infection are rapid, and the average age at primary infection early. The vaccination window is narrow, and suggests optimal targeting of vaccine to infants 5 months and above to achieve high seroconversion.
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Affiliation(s)
- Joyce U. Nyiro
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research-Coast, Kilifi, Kenya
| | - Ivy K. Kombe
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research-Coast, Kilifi, Kenya
- * E-mail:
| | - Charles J. Sande
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research-Coast, Kilifi, Kenya
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - James Kipkoech
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research-Coast, Kilifi, Kenya
| | - Patience K. Kiyuka
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research-Coast, Kilifi, Kenya
| | - Clayton O. Onyango
- Kenya Medical Research Institute/ Centre for Disease Control and Prevention, Kisumu, Kenya
| | - Patrick K. Munywoki
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research-Coast, Kilifi, Kenya
| | | | - D. James Nokes
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research-Coast, Kilifi, Kenya
- School of Life Sciences and WIDER, University of Warwick, Coventry, United Kingdom
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15
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Durigon EL, Botosso VF, de Oliveira DBL. Human Respiratory Syncytial Virus: Biology, Epidemiology, and Control. HUMAN VIROLOGY IN LATIN AMERICA 2017. [PMCID: PMC7121549 DOI: 10.1007/978-3-319-54567-7_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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16
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Chu HY, Steinhoff MC, Magaret A, Zaman K, Roy E, Langdon G, Formica MA, Walsh EE, Englund JA. Respiratory syncytial virus transplacental antibody transfer and kinetics in mother-infant pairs in Bangladesh. J Infect Dis 2014; 210:1582-9. [PMID: 24903663 DOI: 10.1093/infdis/jiu316] [Citation(s) in RCA: 126] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Pneumonia is the leading cause of childhood mortality globally. Respiratory syncytial virus (RSV) is the most important viral cause of pneumonia. Maternal serum antibody protects infants from RSV disease. The objective of our study was to characterize RSV antibody levels in mother-infant pairs. METHODS Serial serum samples were collected from mother-infant pairs in Bangladesh from the third trimester of pregnancy to 72 weeks postpartum and tested using an RSV antibody microneutralization assay. Serologic infection was defined as a 4-fold increase in antibody titer. Maternal antibody half-life was calculated using infant antibody titers from birth to 20 weeks. RESULTS The ratio of infant cord blood to maternal serum RSV antibody titers in 149 mother-infant pairs was 1.01 (95% confidence interval [CI], .99-1.03). Maternal RSV antibody titers in the third trimester and at birth were strongly correlated (R = 0.68). Antibody half-life was 38 days (95% CI, 36-42 days). Higher cord blood RSV antibody titers were associated with a lower risk of serologic infection (P = .01) and maintenance of antibody titer above a potentially protective threshold (P < .001). CONCLUSIONS Efficient transplacental transfer of RSV-specific antibody from mother to the fetus was documented in mother-infant pairs in Asia. Higher cord blood antibody titers were associated with protection from serologic infection.
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Affiliation(s)
| | - Mark C Steinhoff
- Department of Global Health, Cincinnati Children's Hospital, Ohio
| | - Amalia Magaret
- Department of Laboratory Medicine, University of Washington
| | - Khalequ Zaman
- International Center for Diarrheal Disease Research, Dhaka, Bangladesh
| | - Eliza Roy
- International Center for Diarrheal Disease Research, Dhaka, Bangladesh
| | - Gretchen Langdon
- Department of Global Health, Cincinnati Children's Hospital, Ohio
| | - Mary Anne Formica
- Department of Medicine, University of Rochester-Rochester General Hospital, New York
| | - Edward E Walsh
- Department of Medicine, University of Rochester-Rochester General Hospital, New York
| | - Janet A Englund
- Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington
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17
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Paynter S, Yakob L, Simões EAF, Lucero MG, Tallo V, Nohynek H, Ware RS, Weinstein P, Williams G, Sly PD. Using mathematical transmission modelling to investigate drivers of respiratory syncytial virus seasonality in children in the Philippines. PLoS One 2014; 9:e90094. [PMID: 24587222 PMCID: PMC3937436 DOI: 10.1371/journal.pone.0090094] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 01/31/2014] [Indexed: 12/02/2022] Open
Abstract
We used a mathematical transmission model to estimate when ecological drivers of respiratory syncytial virus (RSV) transmissibility would need to act in order to produce the observed seasonality of RSV in the Philippines. We estimated that a seasonal peak in transmissibility would need to occur approximately 51 days prior to the observed peak in RSV cases (range 49 to 67 days). We then compared this estimated seasonal pattern of transmissibility to the seasonal patterns of possible ecological drivers of transmissibility: rainfall, humidity and temperature patterns, nutritional status, and school holidays. The timing of the seasonal patterns of nutritional status and rainfall were both consistent with the estimated seasonal pattern of transmissibility and these are both plausible drivers of the seasonality of RSV in this setting.
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Affiliation(s)
- Stuart Paynter
- School of Population Health, University of Queensland, Brisbane, Queensland, Australia
- * E-mail:
| | - Laith Yakob
- School of Population Health, University of Queensland, Brisbane, Queensland, Australia
| | - Eric A. F. Simões
- University of Colorado School of Medicine, Aurora, Colorado, United States of America
- Colorado School of Public Health, University of Colorado, Aurora, Colorado, United States of America
| | - Marilla G. Lucero
- Research Institute for Tropical Medicine, Department of Health, Muntinlupa City, Metro Manila, Philippines
| | - Veronica Tallo
- Research Institute for Tropical Medicine, Department of Health, Muntinlupa City, Metro Manila, Philippines
| | - Hanna Nohynek
- Department of Vaccines and Immune Protection, National Institute for Health and Welfare, Helsinki, Finland
| | - Robert S. Ware
- School of Population Health, University of Queensland, Brisbane, Queensland, Australia
- Queensland Children’s Medical Research Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Philip Weinstein
- Barbara Hardy Institute, University of South Australia, Adelaide, South Australia, Australia
| | - Gail Williams
- School of Population Health, University of Queensland, Brisbane, Queensland, Australia
| | - Peter D. Sly
- Queensland Children’s Medical Research Institute, University of Queensland, Brisbane, Queensland, Australia
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18
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Anderson LJ, Dormitzer PR, Nokes DJ, Rappuoli R, Roca A, Graham BS. Strategic priorities for respiratory syncytial virus (RSV) vaccine development. Vaccine 2013; 31 Suppl 2:B209-15. [PMID: 23598484 PMCID: PMC3919153 DOI: 10.1016/j.vaccine.2012.11.106] [Citation(s) in RCA: 187] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Revised: 10/08/2012] [Accepted: 11/14/2012] [Indexed: 11/10/2022]
Abstract
Although RSV has been a high priority for vaccine development, efforts to develop a safe and effective vaccine have yet to lead to a licensed product. Clinical and epidemiologic features of RSV disease suggest there are at least 4 distinct target populations for vaccines, the RSV naïve young infant, the RSV naïve child ≥ 6 months of age, pregnant women (to provide passive protection to newborns), and the elderly. These target populations raise different safety and efficacy concerns and may require different vaccination strategies. The highest priority target population is the RSV naïve child. The occurrence of serious adverse events associated with the first vaccine candidate for young children, formalin inactivated RSV (FI-RSV), has focused vaccine development for the young RSV naïve child on live virus vaccines. Enhanced disease is not a concern for persons previously primed by a live virus infection. A variety of live-attenuated viruses have been developed with none yet achieving licensure. New live-attenuated RSV vaccines are being developed and evaluated that maybe sufficiently safe and efficacious to move to licensure. A variety of subunit vaccines are being developed and evaluated primarily for adults in whom enhanced disease is not a concern. An attenuated parainfluenza virus 3 vector expressing the RSV F protein was evaluated in RSV naïve children. Most of these candidate vaccines have used the RSV F protein in various vaccine platforms including virus-like particles, nanoparticles, formulated with adjuvants, and expressed by DNA or virus vectors. The other surface glycoprotein, the G protein, has also been used in candidate vaccines. We now have tools to make and evaluate a wide range of promising vaccines. Costly clinical trials in the target population are needed to evaluate and select candidate vaccines for advancement to efficacy trials. Better data on RSV-associated mortality in developing countries, better estimates of the risk of long term sequelae such as wheezing after infection, better measures of protection in target populations, and data on the costs and benefits of vaccines for target populations are needed to support and justify funding this process. Addressing these challenges and needs should improve the efficiency and speed of achieving a safe and effective, licensed RSV vaccine.
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Affiliation(s)
- L J Anderson
- Division of Pediatric Infectious Diseases, Emory University School of Medicine, 2015 Uppergate Dr, Atlanta, GA 30322, USA.
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19
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Ohuma EO, Okiro EA, Ochola R, Sande CJ, Cane PA, Medley GF, Bottomley C, Nokes DJ. The natural history of respiratory syncytial virus in a birth cohort: the influence of age and previous infection on reinfection and disease. Am J Epidemiol 2012; 176:794-802. [PMID: 23059788 PMCID: PMC3481264 DOI: 10.1093/aje/kws257] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
This study aimed to quantify the effect of age, time since last infection, and infection history on the rate of respiratory syncytial virus infection and the effect of age and infection history on the risk of respiratory syncytial virus disease. A birth cohort of 635 children in Kilifi, Kenya, was monitored for respiratory syncytial virus infections from January 31, 2002, to April 22, 2005. Predictors of infection were examined by Cox regression and disease risk by binomial regression. A total of 598 respiratory syncytial virus infections were identified (411 primary, 187 repeat), with 409 determined by antigen assay and 189 by antibody alone (using a “most pragmatic” serologic definition). The incidence decreased by 70% following a primary infection (adjusted hazard ratio = 0.30, 95% confidence interval: 0.21, 0.42; P < 0.001) and by 59% following a secondary infection (hazard ratio = 0.41, 95% confidence interval: 0.22, 0.73; P = 0.003), for a period lasting 6 months. Relative to the age group <6 months, all ages exhibited a higher incidence of infection. A lower risk of severe disease following infection was independently associated with increasing age (P < 0.001) but not reinfection. In conclusion, observed respiratory syncytial virus incidence was lowest in the first 6 months of life, immunity to reinfection was partial and short lived, and disease risk was age related.
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Affiliation(s)
- E O Ohuma
- Kenya Medical Research Institute, Centre for Geographic Medicine Research, Kilifi, Kenya.
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20
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Chapman JD, Chappell MJ, Evans ND. The use of a formal sensitivity analysis on epidemic models with immune protection from maternally acquired antibodies. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2011; 104:37-49. [PMID: 21067842 DOI: 10.1016/j.cmpb.2010.08.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Revised: 08/13/2010] [Accepted: 08/31/2010] [Indexed: 05/30/2023]
Abstract
This paper considers the outcome of a formal sensitivity analysis on a series of epidemic model structures developed to study the population level effects of maternal antibodies. The analysis is used to compare the potential influence of maternally acquired immunity on various age and time domain observations of infection and serology, with and without seasonality. The results of the analysis indicate that time series observations are largely insensitive to variations in the average duration of this protection, and that age related empirical data are likely to be most appropriate for estimating these characteristics.
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Affiliation(s)
- J D Chapman
- School of Engineering, University of Warwick, Coventry, CV4 7AL, United Kingdom.
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Debur MC, Vidal LR, Stroparo E, Nogueira MB, Almeida SM, Takahashi GA, Rotta I, Pereira LA, Silveira CS, Delfraro A, Nakatani SM, Skraba I, Raboni SM. Impact of human metapneumovirus infection on in and outpatients for the years 2006-2008 in Southern Brazil. Mem Inst Oswaldo Cruz 2011; 105:1010-8. [PMID: 21225198 DOI: 10.1590/s0074-02762010000800010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2010] [Accepted: 08/26/2010] [Indexed: 11/22/2022] Open
Abstract
The human metapneumovirus (hMPV), member of the Paramyxoviridae family, has been reported as an important agent involved with acute respiratory infections (ARIs). The aim of this study is to identify hMPV as the etiological agent of ARIs on in and outpatients in the city of Curitiba, Southern Brazil, and describe clinical data of hMPV subtyping. A retrospective study was performed in 1,572 respiratory samples over a period of three years. hMPV was detected by reverse transcription-polymerase chain reaction and subtyping was performed by nucleotide sequencing. hMPV was present in 61 (3.9%) samples and subtypes A1, A2a, B1 and B2 were detected. The incidence of hMPV was higher in outpatients (5.9%), whose mean age was 19.7 years (range 6 months-75 years old), than in inpatients (3%), whose mean age was 7.6 months (range 1 month-26 years old). The outpatients had upper respiratory tract infections with flu-like symptoms and all hospitalized children had lower respiratory tract infections. A pediatric patient died from complications associated with hMPV A2a infection. hMPV has been reported as a respiratory pathogen in all age groups. No correlation was observed between viral subtype and disease severity in the samples of this study.
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Affiliation(s)
- Maria C Debur
- Laboratório de Virologia, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brasil, 82060-240
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Lu G, Gonzalez R, Guo L, Wu C, Wu J, Vernet G, Paranhos-Baccalà G, Wang J, Hung T. Large-scale seroprevalence analysis of human metapneumovirus and human respiratory syncytial virus infections in Beijing, China. Virol J 2011; 8:62. [PMID: 21310026 PMCID: PMC3046927 DOI: 10.1186/1743-422x-8-62] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2010] [Accepted: 02/10/2011] [Indexed: 11/10/2022] Open
Abstract
Background Human metapneumovirus (hMPV), a recently identified virus, causes acute respiratory tract infections (ARTIs) in infants and children. However, studies on the seroepidemeology of hMPV are very limited in China. To assess the seroprevalence of hMPV infection in China, we tested a total of 1,156 serum specimens for the presence of anti-hMPV IgG antibody in children and adults free of acute respiratory illness in Beijing, China by using hMPV nucleocapsid (N) protein as an antigen. As a control, we used the human serum antibody against the N protein of human respiratory syncytial virus (hRSV), the most important viral agent responsible for ARIs in children. Results The seropositive rate for hMPV increased steadily with age from 67% at 1-6 mo to 100% at age 20. However, the rate dropped slightly between 6 mo and 1 yr of age. The seropositive rate for hRSV also increased steadily with age from 71% at 1-6 mo to 100% at age 20. In children aged six months to six years, the seropositive rates for the anti-hRSV IgG antibody were significantly higher than those for hMPV. Additionally, IgG antibody titers to hMPV and hRSV were significantly higher in adults than in young children. Consistent with the seropositive rates, the geometric mean titer of anti-hMPV IgG antibody was lower than that of anti-hRSV IgG antibody in children aged six months to six years. Conclusions Our results indicate that similar to hRSV, exposure to hMPV is ubiquitous in the Beijing population. However, the seroprevalence of anti-hMPV IgG antibody is lower than that of hRSV in children between six months and six years old, which suggests a different number of repeat infections or a different response to infections.
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Affiliation(s)
- Guilan Lu
- State Key Laboratory of Molecular Virology and Genetic Engineering, Institute of Pathogen Biology (IPB), Peking Union Medical College (PUMC) & Chinese Academy of Medical Sciences (CAMS), Beijing 100730, China
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The level and duration of RSV-specific maternal IgG in infants in Kilifi Kenya. PLoS One 2009; 4:e8088. [PMID: 19956576 PMCID: PMC2779853 DOI: 10.1371/journal.pone.0008088] [Citation(s) in RCA: 124] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2009] [Accepted: 09/29/2009] [Indexed: 11/29/2022] Open
Abstract
Background Respiratory syncytial virus (RSV) is the major cause of lower respiratory tract infection in infants. The rate of decay of RSV-specific maternal antibodies (RSV-matAb), the factors affecting cord blood levels, and the relationship between these levels and protection from infection are poorly defined. Methods A birth cohort (n = 635) in rural Kenya, was studied intensively to monitor infections and describe age-related serological characteristics. RSV specific IgG antibody (Ab) in serum was measured by the enzyme linked immunosorbent assay (ELISA) in cord blood, consecutive samples taken 3 monthly, and in paired acute and convalescent samples. A linear regression model was used to calculate the rate of RSV-matAb decline. The effect of risk factors on cord blood titres was investigated. Results The half-life of matAb in the Kenyan cohort was calculated to be 79 days (95% confidence limits (CL): 76–81 days). Ninety seven percent of infants were born with RSV-matAb. Infants who subsequently experienced an infection in early life had significantly lower cord titres of anti-RSV Ab in comparison to infants who did not have any incident infection in the first 6 months (P = 0.011). RSV infections were shown to have no effect on the rate of decay of RSV-matAb. Conclusion Maternal-specific RSV Ab decline rapidly following birth. However, we provide evidence of protection against severe disease by RSV-matAb during the first 6–7 months. This suggests that boosting maternal-specific Ab by RSV vaccination may be a useful strategy to consider.
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Amaku M, Azevedo RS, Castro RMD, Massad E, Coutinho FAB. Relationship among epidemiological parameters of six childhood infections in a non-immunized Brazilian community. Mem Inst Oswaldo Cruz 2009; 104:897-900. [DOI: 10.1590/s0074-02762009000600013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2009] [Accepted: 07/09/2009] [Indexed: 11/21/2022] Open
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Emerging genotypes of human respiratory syncytial virus subgroup A among patients in Japan. J Clin Microbiol 2009; 47:2475-82. [PMID: 19553576 DOI: 10.1128/jcm.00115-09] [Citation(s) in RCA: 115] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Human respiratory syncytial virus (HRSV) is a common etiological agent of acute lower respiratory tract disease in infants. We report the molecular epidemiology of HRSV in Niigata, Japan, over six successive seasons (from 2001 to 2007) and the emerging genotypes of HRSV subgroup A (HRSV-A) strains. A total of 488 HRSV samples were obtained from 1,103 screened cases in a pediatric clinic in Niigata. According to the phylogenetic analysis, among the PCR-positive samples, 338 HRSV-A strains clustered into the previously reported genotypes GA5 and GA7 and two novel genotypes, NA1 and NA2, which were genetically close to GA2 strains. One hundred fifty HRSV-B strains clustered into three genotypes, namely, GB3, SAB3, and BA, which has a 60-nucleotide insertion in the second hypervariable region of the G protein. The NA1 strains emerged first, in the 2004-2005 season, and subsequently, the NA2 strain emerged in the 2005-2006 season. Both strains caused large epidemics in the 2005-2006 and 2006-2007 seasons. The average age of children who were infected with NA2 strains was significantly higher than that of those infected with GA5 and the frequency of reinfection by NA2 was the highest among all genotypes, suggesting that this genotype possessed new antigenicity for evading past host immunity. This is the first paper to show a possible correlation between an emerging genotype, NA2, and large outbreaks of HRSV in Japan. Continuing studies to follow up the genetic changes and to clarify the mechanism of reinfection in HRSV are important steps to understand HRSV infections.
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Vidal LR, Siqueira MM, Nogueira MB, Raboni SM, Pereira LA, Takahashi GR, Rotta I, Debur MDC, Dalla-Costa LM. The epidemiology and antigenic characterization of influenza viruses isolated in Curitiba, South Brazil. Mem Inst Oswaldo Cruz 2008; 103:180-5. [PMID: 18425270 DOI: 10.1590/s0074-02762008000200009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2007] [Accepted: 03/25/2008] [Indexed: 11/22/2022] Open
Abstract
Several studies conducted all over the world have reported that the influenza virus is associated with great morbidity and mortality rates. In this study, we analyzed the incidence of the influenza virus between 2000 and 2003 in Curitiba. We studied 1621 samples obtained from outpatients and hospitalized patients of both sexes and all ages. The study was conducted at the local primary care health units (outpatients) and at the tertiary care unit (hospitalized) of the General Hospital of the Federal University in the state of Paraná, Brazil. Nasopharyngeal aspirates and, eventually, bronchoalveolar lavage were assayed for the presence of viral antigens, either by indirect immunofluorescence or cell culture. Of the samples studied, 135 (8.3%) were positive for influenza virus, and of those, 103 (76.3%) were positive for type A and 32 (23.7%) for type B. Additionally, positive samples were analyzed by reverse transcription followed by polymerase chain reaction and subtypes H1 and H3 were identified from this group. A high incidence of positive samples was observed mainly in the months with lower temperatures. Furthermore, outpatients showed a higher incidence of influenza viruses than hospitalized patients.
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Affiliation(s)
- Luine Rr Vidal
- Laboratório de Biologia Molecular para Doenças Infecciosa, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, 80060-240, Brasil.
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von Linstow ML, Høgh M, Nordbø SA, Eugen-Olsen J, Koch A, Høgh B. A community study of clinical traits and risk factors for human metapneumovirus and respiratory syncytial virus infection during the first year of life. Eur J Pediatr 2008; 167:1125-33. [PMID: 18172683 PMCID: PMC7086915 DOI: 10.1007/s00431-007-0643-4] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2007] [Revised: 11/20/2007] [Accepted: 11/20/2007] [Indexed: 12/01/2022]
Abstract
Human metapneumovirus (hMPV) and respiratory syncytial virus (RSV) are important respiratory pathogens with similar symptomatology. The aim of this prospective birth cohort study was to identify risk factors for an hMPV or RSV infection during the first year of life in unselected healthy children. We followed 217 children from birth to 1 year of age. Nasal swabs and symptom diaries were collected monthly. Anti-hMPV and anti-RSV IgG antibodies by age 1 year were detected by ELISA, and nasal swabs were analysed for hMPV and RSV by RT-PCR. Logistic regression was used for risk factor analysis. Anti-hMPV IgG was found in 38 children (17.5%), and anti-RSV IgG in 172 children (79%). Risk factors for being anti-hMPV IgG-positive were: (1) being born in the spring (OR = 2.36; 95% CI:1.06-5.27), and (2) having older siblings (OR = 3.82; 95% CI:1.75-8.34). Risk factors for being anti-RSV IgG-positive were: (1) gestational age <38 weeks (OR = 3.39; 95% CI:1.42-8.05), (2) increasing paternal age (OR = 1.85 per 5 yrs; 95% CI:1.28-2.68), and (3) wall-to-wall carpeting (OR = 3.15; 95% CI:1.29-7.68). Being born in the spring was associated with decreased odds of being anti-RSV IgG-positive (OR = 0.27, 95% CI:0.09-0.85). Risk factors for RSV hospitalisation (n = 11) were: (1) older siblings (OR = 4.49; 95% CI: 1.08-18.73) and (2) smoking in the household (OR = 5.06; 95% CI: 1.36-18.76). Exclusive breastfeeding for the first 14 days of life protected against hospitalisation (OR = 0.21; 95% CI:0.06-0.79). In conclusion, this study identifies risk factors for mild and asymptomatic hMPV infections in infancy.
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Affiliation(s)
- Marie-Louise von Linstow
- Department of Paediatrics 531, Hvidovre University Hospital, Kettegård Allé 30, DK-2650, Hvidovre, Copenhagen, Denmark.
| | - Mette Høgh
- Department of Clinical Microbiology, Hvidovre University Hospital, Copenhagen, Denmark
| | - Svein Arne Nordbø
- Department of Medical Microbiology, Trondheim University Hospital, Trondheim, Norway
| | - Jesper Eugen-Olsen
- Clinical Research Centre, Hvidovre University Hospital, Copenhagen, Denmark
| | - Anders Koch
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Birthe Høgh
- Department of Paediatrics 531, Hvidovre University Hospital, Kettegård Allé 30, DK - 2650 Hvidovre, Copenhagen, Denmark
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Vieira SE, Gilio AE, Durigon EL, Ejzenberg B. Lower respiratory tract infection caused by respiratory syncytial virus in infants: the role played by specific antibodies. Clinics (Sao Paulo) 2007; 62:709-16. [PMID: 18209912 DOI: 10.1590/s1807-59322007000600009] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2007] [Accepted: 08/30/2007] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Respiratory syncytial virus (RSV) is a major etiological agent of lower respiratory tract infection in infants. Genotypes of this virus and the role of the infants' serum antibodies have yet to be fully clarified. This knowledge is important for the development of effective therapeutic and prophylactic measures. OBJECTIVES To evaluate the types and genotypes of RSV causing respiratory tract infection in infants, to analyze the association of subtype-specific serum antibodies with the occurrence of infection and to evaluate the presence of subtype-specific antibodies in the infants' mothers and their association with the profile of the childrens' serum antibodies. METHODS This was a prospective study on infants hospitalized with respiratory infection. Nasopharyngeal secretions were collected for viral investigation using indirect immunofluorescence and viral culture and blood was collected to test for antibodies using the Luminex Multiplex system. RESULTS 192 infants were evaluated, with 60.9% having RSV (73.5%- A and 20.5% B). Six genotypes of the virus were identified: A5, A2, B3, B5, A7 and B4. The seroprevalence of the subtype-specific serum antibodies was high. The presence and levels of subtype-specific antibodies were similar, irrespective of the presence of infection or the viral type or genotype. The mothers' antibody profiles were similar to their infants'. CONCLUSIONS Although the prevalence of subtype-specific antibodies was elevated, these antibodies did not provide protection independently of virus type/genotype. The similarity in the profiles of subtype-specific antibodies presented by the mothers and their children was consistent with transplacental passage.
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Affiliation(s)
- Sandra E Vieira
- Department of Pediatrics, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil.
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Viet AF, Medley GF. Stochastic dynamics of immunity in small populations: A general framework. Math Biosci 2006; 200:28-43. [PMID: 16466754 DOI: 10.1016/j.mbs.2005.12.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2004] [Revised: 12/08/2005] [Accepted: 12/22/2005] [Indexed: 11/17/2022]
Abstract
Assessment of immunological status is a powerful tool in the surveillance and control of infectious pathogens in livestock and human populations. The distribution of immunity levels in the population provides information on time and age dependent transmission. A stochastic model is developed for a livestock population which relates the dynamics of the distribution of immunity levels at the population level to those of pathogen transmission. A general model with K immunity level categories is first proposed, taking into account the increase of the immunity level due to an infection or a re-exposure, the decrease of the immunity level with time since infection or exposure, and the effect of immunity level on the susceptibility and the infectivity of individuals. Numerical results are presented in the particular cases with K=2 and K=3 immunity level categories. We demonstrate that for a given distribution of the immunity levels at the population level, the model can be used to identify quantities such as most likely periods of time since introduction of infection. We discuss this approach in relation to analysis of serological data.
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Affiliation(s)
- A-F Viet
- Ecology and Epidemiology Group, Department of Biological Sciences, University of Warwick, Coventry CV4 7AL, United Kingdom; Unit of Animal Health Management, Veterinary School - INRA, BP 40706, 44307 Nantes Cedex 03, France.
| | - G F Medley
- Ecology and Epidemiology Group, Department of Biological Sciences, University of Warwick, Coventry CV4 7AL, United Kingdom
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Viegas M, Mistchenko AS. Molecular epidemiology of human respiratory syncytial virus subgroup A over a six-year period (1999-2004) in Argentina. J Med Virol 2005; 77:302-10. [PMID: 16121371 DOI: 10.1002/jmv.20457] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Human respiratory syncytial virus (HRSV) is the main viral cause of acute lower respiratory tract infections in children. Little information about the molecular epidemiology of HRSV in developing countries, such as Argentina, is available. By RT-PCR, we subgrouped 353 HRSV isolates over six consecutive epidemic seasons (1999-2004) and few isolates from 1997. Between them, 232 (65.7%) belonged to subgroup A and 121 (34.3%) to subgroup B. Therefore, the nucleotide, amino-acid variability and phylogenetic relations of 78 HRSV subgroup A isolates, were analyzed using RFLP and sequence analysis of the G-protein gene. The results showed that there were two main restriction patterns (PA1 and PA2) and two previously described genotypes (GA2 and GA5) cocirculating in Buenos Aires, without evidence of alternation between them during the studied period. The Argentine sequences were compared with previously reported molecular data from other countries. It showed that viruses genetically related circulated the same years within neighboring countries and the sequences from long-distant places were closely related to Argentine sequences, but they belonged to different sampling years. The data reported here support the growing database on the molecular diversity of HRSVA circulating in Latin America in children under 2 years of age and contributes to describe the pattern of global spread of this virus.
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Affiliation(s)
- Mariana Viegas
- Laboratorio de Virología, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires, Argentina.
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Kotaniemi-Syrjänen A, Laatikainen A, Waris M, Reijonen TM, Vainionpää R, Korppi M. Respiratory syncytial virus infection in children hospitalized for wheezing: virus-specific studies from infancy to preschool years. Acta Paediatr 2005; 94:159-65. [PMID: 15981748 DOI: 10.1111/j.1651-2227.2005.tb01884.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To evaluate whether the presence of immunoglobulin G (IgG) antibodies against respiratory syncytial virus (RSV) in early childhood is associated with later asthma, and to evaluate a new diagnostic test for RSV, reverse-transcription polymerase chain reaction (RT-PCR), comparing it to the antigen and antibody assays initially used in RSV diagnostics in the present cohort. METHODS At the start of the study in 1992-1993, RSV was studied by antigen detection (using time-resolved fluoroimmunoassay) and complement-fixing antibody assay. Advances in methodology allowed us to supplement RSV studies by RT-PCR in frozen nasopharyngeal aspirates obtained on admission, and by specific IgG antibodies (using enzyme immunoassay) in frozen serum samples obtained during the follow-up. RESULTS On admission, 29 of the 100 children hospitalized for wheezing at <2 y of age were RSV positive. When compared with conventional methods, the sensitivity of RT-PCR was 83% (100% w.r.t. antigen detection) and its specificity was 92% in diagnosing RSV infection. RSV-specific IgG antibody concentrations rose with age, but were not predictive of asthma at any age. In the present cohort, wheezing without RSV was particularly associated with increased risk for later childhood asthma. CONCLUSION Hospitalization for wheezing in infancy is associated with increased risk for later childhood asthma, particularly in children without RSV infection on admission, although children with RSV have also slightly increased risk for later asthma. However, mere serological evidence of RSV infection is not associated with the development of asthma. In addition to RSV, more attention should be paid to less virulent agents in order to find those wheezing infants who are at particular risk of later childhood asthma.
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Affiliation(s)
- Anne Kotaniemi-Syrjänen
- Department of Paediatrics, University of Kuopio and Kuopio University Hospital, Kuopio, Finland.
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Tsuchiya LRRV, Costa LMD, Raboni SM, Nogueira MB, Pereira LA, Rotta I, Takahashi GRA, Coelho M, Siqueira MM. Viral respiratory infection in Curitiba, Southern Brazil. J Infect 2005; 51:401-7. [PMID: 16321652 DOI: 10.1016/j.jinf.2004.12.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2004] [Accepted: 12/04/2004] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Viral infection is the major cause of respiratory tract pathology affecting individuals of all ages, especially children and immunocompromised patients. There is a paucity of data on etiological and epidemiological infection caused by virus, in Southern Brazil. The aim of this study was to evaluate the seasonality, and the incidence of the viruses involved in respiratory infections in Curitiba, South Brazil. METHODS Two hundred seventy-three nasopharyngeal aspirates (NPA) from primary care health units and 1348 NPA or bronchoalveolar lavages from a tertiary-care teaching hospital were studied. Viruses were identified by indirect immunofluorescence and cellular culture. RESULTS Thirty percent of tested samples scored positive for the presence of virions. The percentages of infection for each virus from outpatients and hospitalized, respectively, were 3.3, 19.3 for respiratory syncytial virus; 13.9, 3.5 for influenza A, 3.0, 1.7 for influenza B; 3.3, 5.6 for parainfluenza virus and 2.2, 0.8 for adenovirus. A higher incidence of positive results was found during the winter season, thus showing a pattern of seasonality. CONCLUSION Viral agents are one of the main etiologies of respiratory tract pathology in the population studied.
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Affiliation(s)
- Luine R R V Tsuchiya
- Laboratory of Virology, Hospital de Clínicas da Universidade Federal do Paraná, Brazil.
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Ebihara T, Endo R, Kikuta H, Ishiguro N, Ishiko H, Kobayashi K. Comparison of the seroprevalence of human metapneumovirus and human respiratory syncytial virus. J Med Virol 2004; 72:304-6. [PMID: 14695674 DOI: 10.1002/jmv.10572] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Human metapneumovirus (hMPV) is a virus that induces human respiratory syncytial virus (hRSV)-like illnesses, ranging from upper respiratory tract infection to severe bronchiolitis and pneumonia. The 100 serum samples from children aged 1 month to 5 years were tested for the presence of hMPV and hRSV antibodies using an indirect immunofluorescence assay and a neutralizing-antibody assay, respectively. The seroprevalence of hMPV was significantly lower than that of hRSV in children over 4-months-old (43% vs. 60%, P < 0.025), and the difference was particularly notable between the ages of 4 months and 1 year (11% vs. 48%, P = 0.006). The results suggest that primary infection with hMPV occurs somewhat later than that with hRSV.
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Affiliation(s)
- Takashi Ebihara
- Department of Pediatrics, Hokkaido University School of Medicine, Sapporo, Japan
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Abstract
Neonates and young children remain susceptible to many serious infectious diseases preventable through vaccination. In general, current vaccines strategies to prevent infectious diseases are unable to induce protective levels of antibodies in the first 6 months of life. Women vaccinated during pregnancy are capable of producing immunoglobulin antibodies that are transported actively to the fetus, and maternal immunization can benefit both the mother and the child. With few exceptions, maternal immunization is not a routine, because of the concerns related to the safety of this intervention. Ethical and cultural issues make the studies on maternal immunization difficult; however, in the last decade, the development of new vaccines, which are very immunogenic and safe has reactivated the discussions on maternal immunization. In this paper we present a review of the literature about maternal immunization based on MEDLINE data (1990 to 2002). The most important conclusions are: 1) there is no evidence of risk to the fetus by immunizing pregnant women with toxoids, polysaccharide, polysaccharide conjugated and inactive viral vaccines; 2) most viral attenuated vaccines are probably safe too, but data is still insufficient to demonstrate their safety; therefore these vaccines should be avoided in pregnant women; 3) in Brazil, there is a need for a maternal immunization program against tetanus. Many new candidate vaccines for maternal immunization are available, but studies should be conducted to evaluate their safety and efficacy, as well as regional priorities based on epidemiological data.
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Affiliation(s)
- Lucia Ferro Bricks
- Children's Institute, Hospital das Clínicas, Faculty of Medicine, University of São Paulo, São Paulo/SP, Brazil
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Queiróz DAO, Durigon EL, Botosso VF, Ejzemberg B, Vieira SE, Mineo JR, Yamashita C, Hein N, Lopes CL, Cacharo AL, Stewien KE. Immune response to respiratory syncytial virus in young Brazilian children. Braz J Med Biol Res 2002; 35:1183-93. [PMID: 12424491 DOI: 10.1590/s0100-879x2002001000011] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
We have evaluated the cellular and humoral immune response to primary respiratory syncytial virus (RSV) infection in young infants. Serum specimens from 65 patients <=12 months of age (39 males and 26 females, 28 cases <3 months and 37 cases > or = 3 months; median 3 3.9 months) were tested for anti-RSV IgG and IgG subclass antibodies by EIA. Flow cytometry was used to characterize cell surface markers expressed on peripheral blood mononuclear cells (PBMC) from 29 RSV-infected children. There was a low rate of seroconversion in children <3 months of age, whose acute-phase PBMC were mostly T lymphocytes (63.0 +/- 9.0%). In contrast, a higher rate of seroconversion was observed in children >3 months of age, with predominance of B lymphocytes (71.0 +/- 17.7%). Stimulation of PBMC with RSV (2 x 10(5) TCID50) for 48 h did not induce a detectable increase in intracellular cytokines and only a few showed a detectable increase in RSV-specific secreted cytokines. These data suggest that age is an important factor affecting the infants' ability to develop an immune response to RSV.
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Affiliation(s)
- D A O Queiróz
- Departamento de Imunologia, Microbiologia e Parasitologia, Instituto de Ci ncias Biom dicas, Universidade Federal de Uberl ndia, Uberl ndia, MG, Brasil.
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Abstract
Respiratory syncytial virus is the most important cause of viral lower respiratory illness in infants and children worldwide. By the age of 2 years, nearly every child has become infected with respiratory syncytial virus and re-infections are common throughout life. Most infections are mild and can be managed at home, but this virus causes serious diseases in preterm children, especially those with bronchopulmonary dysplasia. Respiratory syncytial virus has also been recognized as an important pathogen in people with immunossupressive and other underlying medical problems and institutionalizated elderly, causing thousands of hospitalizations and deaths every year. The burden of these infections makes the development of vaccines for respiratory syncytial virus highly desirable, but the insuccess of a respiratory syncytial virus formalin-inactivated vaccine hampered the progress in this field. To date, there is no vaccine available for preventing respiratory syncytial virus infections, however, in the last years, there has been much progress in the understanding of immunology and immunopathologic mechanisms of respiratory syncytial virus diseases, which has allowed the development of new strategies for passive and active prophylaxis. In this article, the author presents a review about novel approaches to the prevention of respiratory syncytial virus infections, such as: passive immunization with human polyclonal intravenous immune globulin and humanized monoclonal antibodies (both already licensed for use in premature infants and children with bronchopulmonary dysplasia), and many different vaccines that are potential candidates for active immunization against respiratory syncytial virus.
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Affiliation(s)
- L F Bricks
- Department of Pediatrics, Hospital das Clínicas, Faculty of Medicine, University of São Paulo
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38
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Vieira SE, Stewien KE, Queiroz DA, Durigon EL, Török TJ, Anderson LJ, Miyao CR, Hein N, Botosso VF, Pahl MM, Gilio AE, Ejzenberg B, Okay Y. Clinical patterns and seasonal trends in respiratory syncytial virus hospitalizations in São Paulo, Brazil. Rev Inst Med Trop Sao Paulo 2001; 43:125-31. [PMID: 11452319 DOI: 10.1590/s0036-46652001000300002] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The respiratory viruses are recognized as the most frequent lower respiratory tract pathogens for infants and young children in developed countries but less is known for developing populations. The authors conducted a prospective study to evaluate the occurrence, clinical patterns, and seasonal trends of viral infections among hospitalized children with lower respiratory tract disease (Group A). The presence of respiratory viruses in children's nasopharyngeal was assessed at admission in a pediatric ward. Cell cultures and immunofluorescence assays were used for viral identification. Complementary tests included blood and pleural cultures conducted for bacterial investigation. Clinical data and radiological exams were recorded at admission and throughout the hospitalization period. To better evaluate the results, a non- respiratory group of patients (Group B) was also constituted for comparison. Starting in February 1995, during a period of 18 months, 414 children were included- 239 in Group A and 175 in Group B. In Group A, 111 children (46.4%) had 114 viruses detected while only 5 children (2.9%) presented viruses in Group B. Respiratory Syncytial Virus was detected in 100 children from Group A (41.8%), Adenovirus in 11 (4.6%), Influenza A virus in 2 (0.8%), and Parainfluenza virus in one child (0.4%). In Group A, aerobic bacteria were found in 14 cases (5.8%). Respiratory Syncytial Virus was associated to other viruses and/or bacteria in six cases. There were two seasonal trends for Respiratory Syncytial Virus cases, which peaked in May and June. All children affected by the virus were younger than 3 years of age, mostly less than one year old. Episodic diffuse bronchial commitment and/or focal alveolar condensation were the clinical patterns more often associated to Respiratory Syncytial Virus cases. All children from Group A survived. In conclusion, it was observed that Respiratory Syncytial Virus was the most frequent pathogen found in hospitalized children admitted for severe respiratory diseases. Affected children were predominantly infants and boys presenting bronchiolitis and focal pneumonias. Similarly to what occurs in other subtropical regions, the virus outbreaks peak in the fall and their occurrence extends to the winter, which parallels an increase in hospital admissions due to respiratory diseases.
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Affiliation(s)
- S E Vieira
- Pediatrics Division, University Hospital, University of São Paulo, São Paulo, SP, Brazil
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39
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Abstract
Human respiratory syncytial virus (RSV) is the major cause of lower respiratory tract disease in infants. It is unusual in that it causes repeated infections throughout life. Despite considerable efforts there is as yet no satisfactory vaccine available. This paper reviews the molecular epidemiology of the RSV and describes the complex genotypic structure of RSV epidemics. The evolution of the virus is discussed, with particular reference to the antigenic and genetic variability of the attachment glycoprotein.
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Affiliation(s)
- P A Cane
- Division of Immunity and Infection, University of Birmingham Medical School, Birmingham B15 2TT, UK.
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40
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Abstract
A mathematical model is presented for the transmission of a microparasite where the hosts occupy one of two states, uninfected or infected. In each state, the hosts are distributed over a continuous range of immunity. The immune levels vary within hosts due to the processes of waning of immunity (when uninfected), and increasing immunity (when infected), eventually resulting in recovery. Immunity level also influences the host's ability to infect or be infected. Thus the proposed model incorporates both inter- and intra-host dynamics. It is shown from equilibrium results that this model is a general form of the susceptible-infected-resistant (SIR) and susceptible-infected-susceptible (SIS) family of models, a development that is useful for exploring multistrain pathogen transmission and use of vaccines which confer temporary protection.
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Affiliation(s)
- L J White
- Department of Biological Sciences, University of Warwick, Coventry, UK.
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