1
|
Kim T, Choi SH. Epidemiology and Disease Burden of Respiratory Syncytial Virus Infection in Adults. Infect Chemother 2024; 56:1-12. [PMID: 38527779 PMCID: PMC10990889 DOI: 10.3947/ic.2024.0011] [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: 01/15/2024] [Accepted: 03/01/2024] [Indexed: 03/27/2024] Open
Abstract
Respiratory syncytial virus (RSV) constitutes a significant cause of respiratory illness and mortality among older adults, a demographic that is expanding with considerable impact on healthcare systems worldwide. The actual burden of RSV in this population may still be underestimated, owing to factors such as low awareness and suboptimal diagnostic sensitivity in adults, the lack of robust RSV surveillance systems, and the infrequent use of diagnostic testing. Recent advancements in respiratory virus detection have spurred further exploration into appropriate preventive and therapeutic strategies. The recent approval of two vaccines highlights the critical need for the precise estimation of the RSV disease burden to optimize the effectiveness and cost-efficiency of immunization programs. This narrative review aimed to summarize the existing knowledge of the RSV burden in adults with a particular focus on older adults, incorporating data from Korea. Overall, current estimates indicate that the annual RSV attack rate in the general adult population ranges from 1 - 7%, increasing to approximately 4 - 10% among elderly and high-risk groups. The in-hospital mortality rate can be estimated to be around 7 - 10%, rising up to 40% among intensive care unit-admitted patients. To elucidate RSV's disease burden, further continuing research, including population-based studies, is necessary.
Collapse
Affiliation(s)
- Taeeun Kim
- Division of Infectious Diseases, Department of Medicine, Nowon Eulji University Hospital, Seoul, Korea
| | - Sang-Ho Choi
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| |
Collapse
|
2
|
Suh JH, Ahn B, Song SH, Choi S, Choi SH, Lee H, Han MS, Park JY, Choi EH, Yun KW. Etiology and Clinical Characteristics of Community-Acquired Pneumonia in Korean Children During the Pre-COVID-19 Period, 2015-2020. J Korean Med Sci 2023; 38:e339. [PMID: 37935166 PMCID: PMC10627724 DOI: 10.3346/jkms.2023.38.e339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 07/18/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND There have been many epidemiologic studies on community-acquired pneumonia (CAP) among children, most of which had substantial limitations. This study investigated the etiologic distribution and clinical characteristics of CAP in Korean children for 5 years before the coronavirus disease 2019 (COVID-19) pandemic. METHODS A retrospective analysis of children hospitalized for CAP at 4 referral hospitals during 2015-2020 was performed. Cases in which bronchiolitis was suspected or pulmonary infiltration was not evident on chest radiography (CXR) were excluded. Viruses and atypical bacteria were defined as detected when positive in the polymerase chain reaction test performed for respiratory specimens. Serologic testing result for Mycoplasma pneumoniae was incorporated with strict interpretation. Pyogenic bacteria were included only when cultured in blood, pleural fluid, or bronchoalveolar lavage, but those cultured in endotracheal aspirate or sputum when the case was clinically evident bacterial pneumonia were also included. RESULTS A total of 2,864 cases of suspected pneumonia were selected by diagnosis code and CXR findings. Medical chart and CXR review excluded nosocomial pneumonia and cases without evident infiltration, resulting in 517 (18.1%) CAP cases among 489 children. Regarding clinical symptoms, high fever was present in 59.4% and dyspnea in 19.9% of cases. Respiratory support was required for 29.2% of patients, including mechanical ventilation for 3.9%. Pathogens were detected in 49.9% of cases, with viruses in 32.3%, atypical bacteria in 17.8%, and pyogenic bacteria in 2.3% of cases. As single pathogens, M. pneumoniae (16.8%) and respiratory syncytial virus (RSV, 13.7%) were the most common. Parenteral β-lactam and macrolide antibiotics were administered in 81.6% and 50.7% of cases, respectively. A total of 12 (2.3%) cases resulted in poor outcomes, including 3 deaths. CONCLUSION M. pneumoniae and RSV were the most commonly detected pathogens of pediatric CAP, which was selected by strict clinical and radiologic criteria. It is necessary to carefully decide whether to use parenteral antibiotics based on the epidemiology and clinical features of CAP in children.
Collapse
Affiliation(s)
- Jung Ho Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Bin Ahn
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Seung Ha Song
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Sujin Choi
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sung Hwan Choi
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Hyunju Lee
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Mi Seon Han
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
- Department of Pediatrics, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Ji Young Park
- Department of Pediatrics, Chung-Ang University College of Medicine, Seoul, Korea
| | - Eun Hwa Choi
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Ki Wook Yun
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea.
| |
Collapse
|
3
|
Tramuto F, Maida CM, Mazzucco W, Costantino C, Amodio E, Sferlazza G, Previti A, Immordino P, Vitale F. Molecular Epidemiology and Genetic Diversity of Human Respiratory Syncytial Virus in Sicily during Pre- and Post-COVID-19 Surveillance Seasons. Pathogens 2023; 12:1099. [PMID: 37764907 PMCID: PMC10534943 DOI: 10.3390/pathogens12091099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/23/2023] [Accepted: 08/26/2023] [Indexed: 09/29/2023] Open
Abstract
Human respiratory syncytial virus (hRSV) is an important pathogen of acute respiratory tract infection of global significance. In this study, we investigated the molecular epidemiology and the genetic variability of hRSV over seven surveillance seasons between 2015 and 2023 in Sicily, Italy. hRSV subgroups co-circulated through every season, although hRSV-B mostly prevailed. After the considerable reduction in the circulation of hRSV due to the widespread implementation of non-pharmaceutical preventive measures during the COVID-19 pandemic, hRSV rapidly re-emerged at a high intensity in 2022-2023. The G gene was sequenced for genotyping and analysis of deduced amino acids. A total of 128 hRSV-A and 179 hRSV-B G gene sequences were obtained. The phylogenetic analysis revealed that the GA2.3.5a (ON1) and GB5.0.5a (BA9) genotypes were responsible for the hRSV epidemics in Sicily.; only one strain belonged to the genotype GB5.0.4a. No differences were observed in the circulating genotypes during pre- and post-pandemic years. Amino acid sequence alignment revealed the continuous evolution of the G gene, with a combination of amino acid changes specifically appearing in 2022-2023. The predicted N-glycosylation sites were relatively conserved in ON1 and BA9 genotype strains. Our findings augment the understanding and prediction of the seasonal evolution of hRSV at the local level and its implication in the monitoring of novel variants worth considering in better design of candidate vaccines.
Collapse
Affiliation(s)
- Fabio Tramuto
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”—Hygiene Section, University of Palermo, 90134 Palermo, Italy; (C.M.M.); (W.M.); (C.C.); (E.A.); (P.I.); (F.V.)
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90127 Palermo, Italy; (G.S.); (A.P.)
| | - Carmelo Massimo Maida
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”—Hygiene Section, University of Palermo, 90134 Palermo, Italy; (C.M.M.); (W.M.); (C.C.); (E.A.); (P.I.); (F.V.)
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90127 Palermo, Italy; (G.S.); (A.P.)
| | - Walter Mazzucco
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”—Hygiene Section, University of Palermo, 90134 Palermo, Italy; (C.M.M.); (W.M.); (C.C.); (E.A.); (P.I.); (F.V.)
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90127 Palermo, Italy; (G.S.); (A.P.)
| | - Claudio Costantino
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”—Hygiene Section, University of Palermo, 90134 Palermo, Italy; (C.M.M.); (W.M.); (C.C.); (E.A.); (P.I.); (F.V.)
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90127 Palermo, Italy; (G.S.); (A.P.)
| | - Emanuele Amodio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”—Hygiene Section, University of Palermo, 90134 Palermo, Italy; (C.M.M.); (W.M.); (C.C.); (E.A.); (P.I.); (F.V.)
| | - Giuseppe Sferlazza
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90127 Palermo, Italy; (G.S.); (A.P.)
| | - Adriana Previti
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90127 Palermo, Italy; (G.S.); (A.P.)
| | - Palmira Immordino
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”—Hygiene Section, University of Palermo, 90134 Palermo, Italy; (C.M.M.); (W.M.); (C.C.); (E.A.); (P.I.); (F.V.)
| | - Francesco Vitale
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”—Hygiene Section, University of Palermo, 90134 Palermo, Italy; (C.M.M.); (W.M.); (C.C.); (E.A.); (P.I.); (F.V.)
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90127 Palermo, Italy; (G.S.); (A.P.)
| |
Collapse
|
4
|
Cantú-Flores K, Rivera-Alfaro G, Muñoz-Escalante JC, Noyola DE. Global distribution of respiratory syncytial virus A and B infections: a systematic review. Pathog Glob Health 2022; 116:398-409. [PMID: 35156555 PMCID: PMC9518599 DOI: 10.1080/20477724.2022.2038053] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Respiratory syncytial virus (RSV) is the main cause of severe respiratory infections in young children. The need for global epidemiologic data regarding RSV has been increasingly recognized. RSV A infections are reported more frequently than RSV B. Nonetheless, the temporal distribution of infections caused by both RSV groups has not been investigated globally. A systematic review was carried out regarding published studies on RSV A and B epidemiology, as well as RSV G gene ectodomain sequence data available at GenBank. A total of 76,668 [45,990 (60%) RSV A and 30,678 (40%) RSV B] positive samples from 83 countries were identified and included in the analysis. Genotype assignment was obtained in 5,340 RSV A and 2,518 RSV B sequences. Two patterns of RSV circulation were observed: continuous seasons with RSV A predominance and alternate predominance of RSV A and B. These patterns were observed in all regions, but the predominant RSV group seldom coincided in all continents during a given year or season. The most frequently identified RSV A genotype was NA1 (including ON1 viruses) (76.30%), and the most frequently identified RSV B genotype was BA (70.65%). Multiple genotypes circulated simultaneously throughout the evolutionary history of RSV, but genotype diversity decreased after the year 2000. The classification of RSV group and genotype is important for the development of vaccines, as well as to understand viral dynamics. This study displays the global and continental RSV circulation patterns from the first report of human RSV infection until the end of 2020.
Collapse
Affiliation(s)
- Karla Cantú-Flores
- Microbiology Department, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico
| | - Gerardo Rivera-Alfaro
- Microbiology Department, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico
| | - Juan Carlos Muñoz-Escalante
- Microbiology Department, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico
| | - Daniel E. Noyola
- Microbiology Department, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico,CONTACT Daniel E. Noyola Microbiology Department, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, Avenida Venustiano Carranza 2405, San Luis Potosí78210, México
| |
Collapse
|
5
|
Tabatabai J, Ihling CM, Rehbein RM, Schnee SV, Hoos J, Pfeil J, Grulich-Henn J, Schnitzler P. Molecular epidemiology of respiratory syncytial virus in hospitalised children in Heidelberg, Southern Germany, 2014-2017. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2022; 98:105209. [PMID: 35032683 DOI: 10.1016/j.meegid.2022.105209] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 01/06/2022] [Accepted: 01/08/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is the leading cause of hopitalisation in young children with respiratory tract infections (RTI). The aim of this research project was to analyse RSV genotypes and the diversification of RSV strains among hospitalised children in Heidelberg, Germany. METHODS We prospectively analysed nasopharyngeal swabs (NPS) from children who were hospitalised with acute RTI at the University Hospital Heidelberg, Germany, during winter seasons 2014 to 2017. RSV RT-PCR and RSV sequence analysis of the G gene coding for the attachment glycoprotein were performed. Clinical data was obtained using a standardised questionnaire. RESULTS RSV was detected in 405 out of 946 samples from hospitalised children. Most RSV positive children were below the age of two years (84.4%) and had a lower RTI (78.8%). The majority of RSV positive children was male, significantly younger than RSV negative children with a median age of 0.39 years and with more severe respiratory symptoms. Out of 405 positive samples, 317 RSV strains were successfully sub-grouped into RSV subtypes A (57.4%; 182/317) and B (42.6%; 135/317). Both RSV subtypes cocirculated in all analysed winter seasons. Phylogenetic analysis of 317 isolates revealed that the majority of RSV-A strains (180/182) belonged to the ON1 genotype, most RSV-B strains could be attributed to the BAIX genotype (132/135). ON1 and BAIX strains showed a sub-differentiation into different lineages and we were able to identify new (sub)genotypes. CONCLUSION Analysis of the molecular epidemiology of RSV from different seasons revealed the cocirculation and diversification of RSV genotypes ON1 and BAIX.
Collapse
Affiliation(s)
- J Tabatabai
- Centre for Infectious Diseases, Virology, Heidelberg University Hospital, Heidelberg, Germany; German Centre for Infectious Diseases (DZIF), Heidelberg, Germany; Centre for Paediatric and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany.
| | - C M Ihling
- Centre for Infectious Diseases, Virology, Heidelberg University Hospital, Heidelberg, Germany; German Centre for Infectious Diseases (DZIF), Heidelberg, Germany; Dr. von Haunersches Kinderspital, University Hospital of the LMU Munich, Munich, Germany
| | - R M Rehbein
- Centre for Infectious Diseases, Virology, Heidelberg University Hospital, Heidelberg, Germany; German Centre for Infectious Diseases (DZIF), Heidelberg, Germany; Centre for Paediatric and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - S V Schnee
- Centre for Infectious Diseases, Virology, Heidelberg University Hospital, Heidelberg, Germany; German Centre for Infectious Diseases (DZIF), Heidelberg, Germany
| | - J Hoos
- Centre for Infectious Diseases, Virology, Heidelberg University Hospital, Heidelberg, Germany; German Centre for Infectious Diseases (DZIF), Heidelberg, Germany; Centre for Paediatric and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - J Pfeil
- Centre for Paediatric and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - J Grulich-Henn
- Centre for Paediatric and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - P Schnitzler
- Centre for Infectious Diseases, Virology, Heidelberg University Hospital, Heidelberg, Germany
| |
Collapse
|
6
|
Lee CY, Fang YP, Wang LC, Chou TY, Liu HF. Genetic Diversity and Molecular Epidemiology of Circulating Respiratory Syncytial Virus in Central Taiwan, 2008-2017. Viruses 2021; 14:v14010032. [PMID: 35062237 PMCID: PMC8777914 DOI: 10.3390/v14010032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 12/17/2021] [Accepted: 12/20/2021] [Indexed: 12/22/2022] Open
Abstract
In this study, we investigated the molecular evolution and phylodynamics of respiratory syncytial virus (RSV) over 10 consecutive seasons (2008–2017) and the genetic variability of the RSV genotypes ON1 and BA in central Taiwan. The ectodomain region of the G gene was sequenced for genotyping. The nucleotide and deduced amino acid sequences of the second hypervariable region of the G protein in RSV ON1 and BA were analyzed. A total of 132 RSV-A and 81 RSV-B isolates were obtained. Phylogenetic analysis revealed that the NA1, ON1, and BA9 genotypes were responsible for the RSV epidemics in central Taiwan in the study period. For RSV-A, the NA1 genotype predominated during the 2008–2011 seasons. The ON1 genotype was first detected in 2011 and replaced NA1 after 2012. For RSV-B, the BA9 and BA10 genotypes cocirculated from 2008 to 2010, but the BA9 genotype has predominated since 2012. Amino acid sequence alignments revealed the continuous evolution of the G gene in the ectodomain region. The predicted N-glycosylation sites were relatively conserved in the ON1 (site 237 and 318) and BA9 (site 296 and 310) genotype strains. Our results contribute to the understanding and prediction of the temporal evolution of RSV at the local level.
Collapse
Affiliation(s)
- Chun-Yi Lee
- Department of Pediatrics, Chang Bing Show Chwan Memorial Hospital, Changhua 505029, Taiwan; (C.-Y.L.); (Y.-P.F.)
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan;
| | - Yu-Ping Fang
- Department of Pediatrics, Chang Bing Show Chwan Memorial Hospital, Changhua 505029, Taiwan; (C.-Y.L.); (Y.-P.F.)
| | - Li-Chung Wang
- Department of Pathology and Laboratory Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan;
| | - Teh-Ying Chou
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan;
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan
| | - Hsin-Fu Liu
- Department of Medical Research, Mackay Memorial Hospital, Taipei 25160, Taiwan
- Institute of Bioscience and Biotechnology, National Taiwan Ocean University, Keelung 202301, Taiwan
- Institute of Biomedical Sciences, MacKay Medical College, New Taipei City 25245, Taiwan
- Correspondence:
| |
Collapse
|
7
|
Robertson M, Eden JS, Levy A, Carter I, Tulloch RL, Cutmore EJ, Horsburgh BA, Sikazwe CT, Dwyer DE, Smith DW, Kok J. The spatial-temporal dynamics of respiratory syncytial virus infections across the east-west coasts of Australia during 2016-17. Virus Evol 2021; 7:veab068. [PMID: 34532066 PMCID: PMC8438877 DOI: 10.1093/ve/veab068] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 04/19/2021] [Accepted: 07/22/2021] [Indexed: 01/03/2023] Open
Abstract
Respiratory syncytial virus (RSV) is an important human respiratory pathogen. In temperate regions, a distinct seasonality is observed, where peaks of infections typically occur in early winter, often preceding the annual influenza season. Infections are associated with high rates of morbidity and mortality and in some populations exceed that of influenza. Two subtypes, RSV-A and RSV-B, have been described, and molecular epidemiological studies have shown that both viruses mostly co-circulate. This trend also appears to be the case for Australia; however, previous genomic studies have been limited to cases from one Eastern state—New South Wales. As such, the broader spatial patterns and viral traffic networks across the continent are not known. Here, we conducted a whole-genome study of RSV comparing strains across eastern and Western Australia during the period January 2016 to June 2017. In total, 96 new RSV genomes were sequenced, compiled with previously generated data, and examined using a phylodynamic approach. This analysis revealed that both RSV-A and RSV-B strains were circulating, and each subtype was dominated by a single genotype, RSV-A ON1-like and RSV-B BA10-like viruses. Some geographical clustering was evident in strains from both states with multiple distinct sub-lineages observed and relatively low mixing across jurisdictions, suggesting that endemic transmission was likely seeded from imported, unsampled locations. Overall, the RSV phylogenies reflected a complex pattern of interactions across multiple epidemiological scales from fluid virus traffic across global and regional networks to fine-scale local transmission events.
Collapse
Affiliation(s)
- Mark Robertson
- NSW Health Pathology-Institute for Clinical Pathology and Medical Research, NSW Health Pathology, Redbank Road, Westmead Hospital, Westmead, NSW 2145, Australia
| | - John-Sebastian Eden
- Centre for Virus Research, Westmead Institute for Medical Research, 176 Hawkesbury Road, Westmead, NSW 2145, Australia
| | - Avram Levy
- Department of Microbiology, PathWest Laboratory Medicine WA, Hospital Ave, Nedlands, WA 6009, Australia
| | - Ian Carter
- NSW Health Pathology-Institute for Clinical Pathology and Medical Research, NSW Health Pathology, Redbank Road, Westmead Hospital, Westmead, NSW 2145, Australia
| | - Rachel L Tulloch
- Centre for Virus Research, Westmead Institute for Medical Research, 176 Hawkesbury Road, Westmead, NSW 2145, Australia
| | - Elena J Cutmore
- Centre for Virus Research, Westmead Institute for Medical Research, 176 Hawkesbury Road, Westmead, NSW 2145, Australia
| | - Bethany A Horsburgh
- Centre for Virus Research, Westmead Institute for Medical Research, 176 Hawkesbury Road, Westmead, NSW 2145, Australia
| | - Chisha T Sikazwe
- Department of Microbiology, PathWest Laboratory Medicine WA, Hospital Ave, Nedlands, WA 6009, Australia
| | - Dominic E Dwyer
- NSW Health Pathology-Institute for Clinical Pathology and Medical Research, NSW Health Pathology, Redbank Road, Westmead Hospital, Westmead, NSW 2145, Australia
| | - David W Smith
- Department of Microbiology, PathWest Laboratory Medicine WA, Hospital Ave, Nedlands, WA 6009, Australia
| | - Jen Kok
- NSW Health Pathology-Institute for Clinical Pathology and Medical Research, NSW Health Pathology, Redbank Road, Westmead Hospital, Westmead, NSW 2145, Australia
| |
Collapse
|
8
|
Molecular epidemiology of respiratory syncytial virus among children and adults in India 2016 to 2018. Virus Genes 2021; 57:489-501. [PMID: 34524602 PMCID: PMC8440155 DOI: 10.1007/s11262-021-01859-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 06/25/2021] [Indexed: 11/21/2022]
Abstract
Respiratory syncytial virus (RSV) is a common cause of respiratory tract infections among children less than 5 years of age and the elderly. This study intended to determine the circulating genotypes of RSV among severe acute respiratory illness (SARI) cases during the period 2016–2018 in India, among hospitalized acute febrile illness cases of age ranging from 1 to 65 years. Throat/nasopharyngeal swab samples were subjected for testing RSV and subgroups by real-time reverse transcriptase polymerase chain reaction (RT-PCR), further sequencing and phylogenetic analysis were performed for the second hypervariable region of the G gene. RSV-A and B subtypes co-circulated during the years 2016, 2017, and 2018, with RSV-A as the dominant subtype in 2016, and RSV-B as the dominant subgroup in 2017 and 2018. Phylogenetic analysis revealed that the circulating genotypes of RSV were GA2 (16/16), of RSV-A, and GB5 (23/23) of RSV-B in the South, North, and Northeast region of India during the period between 2016 and 2018. Here we report the first study comprising the distribution of RSV-A and B genotypes in the different geographic regions of India among children and adults during the year 2016 to 2018. We also report GA2.3.7 lineage of GA2 genotype for the first time in India to the best of our knowledge.
Collapse
|
9
|
Evolutionary analysis of human respiratory syncytial virus collected in Myanmar between 2015 and 2018. INFECTION GENETICS AND EVOLUTION 2021; 93:104927. [PMID: 34020068 DOI: 10.1016/j.meegid.2021.104927] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 05/13/2021] [Accepted: 05/15/2021] [Indexed: 12/24/2022]
Abstract
We studied genetic variation in the second hypervariable region (HVR) of the G gene of human respiratory syncytial virus (HRSV) from 1701 nasal swab samples collected from outpatients with acute respiratory infections at two general hospitals in the cities Yangon and Pyinmana in Myanmar from 2015 to 2018. HRSV genotypes were characterized using phylogenetic trees constructed using the maximum likelihood method. Time-scale phylogenetic tree analyses were performed using the Bayesian Markov chain Monte Carlo method. In total, 244 (14.3%) samples were HRSV-positive and were classified as HRSV-A (n = 84, 34.4%), HRSV-B (n = 158, 64.8%), and co-detection of HRSV-A/HRSV-B (n = 2, 0.8%). HRSV epidemics occurred seasonally between July (1.9%, 15/785) and August (10.5%, 108/1028), with peak infections in September (35.8%, 149/416) and October (58.2%, 89/153). HRSV infection rate was higher in children ≥1 year of age than in those <1 year of age (70.5% vs. 29.5%). The most common HRSV symptoms in children were cough (80%-90%) and rhinorrhea (70%-100%). The predominant genotypes were ON1for HRSV-A (78%) and BA9 for HRSV-B (64%). Time to the most recent common ancestor was 2014 (95% highest posterior density [HPD], 2012-2015) for HRSV-A ON1 and 2009 (95% HPD, 2004-2012) for HRSV-B BA9. The mean evolutionary rate (substitutions/site/year) for HRSV-B (2.12 × 10-2, 95% HPD, 8.53 × 10-3-3.63 × 10-2) was slightly higher than that for HRSV-A (1.39 × 10-2, 95% HPD, 6.03 × 10-3-2.12 × 10-2). The estimated effective population size (diversity) for HRSV-A increased from 2015 to 2016 and declined in mid-2018, whereas HRSV-B diversity was constant in 2015 and 2016 and increased in mid-2017. In conclusion, the dominant HRSV-A and HRSV-B genotypes in Myanmar were ON1 and BA9, respectively, between 2015 and 2018. HRSV-B evolved slightly faster than HRSV-A and exhibited unique phylogenetic characteristics.
Collapse
|
10
|
Reverse genetics systems for contemporary isolates of respiratory syncytial virus enable rapid evaluation of antibody escape mutants. Proc Natl Acad Sci U S A 2021; 118:2026558118. [PMID: 33811145 DOI: 10.1073/pnas.2026558118] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Human respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory infection in children under 5 y of age. In the absence of a safe and effective vaccine and with limited options for therapeutic interventions, uncontrolled epidemics of RSV occur annually worldwide. Existing RSV reverse genetics systems have been predominantly based on older laboratory-adapted strains such as A2 or Long. These strains are not representative of currently circulating genotypes and have a convoluted passage history, complicating their use in studies on molecular determinants of viral pathogenesis and intervention strategies. In this study, we have generated reverse genetics systems for clinical isolates of RSV-A (ON1, 0594 strain) and RSV-B (BA9, 9671 strain) in which the full-length complementary DNA (cDNA) copy of the viral antigenome is cloned into a bacterial artificial chromosome (BAC). Additional recombinant (r) RSVs were rescued expressing enhanced green fluorescent protein (EGFP), mScarlet, or NanoLuc luciferase from an additional transcription unit inserted between the P and M genes. Mutations in antigenic site II of the F protein conferring escape from palivizumab neutralization (K272E, K272Q, S275L) were investigated using quantitative cell-fusion assays and rRSVs via the use of BAC recombineering protocols. These mutations enabled RSV-A and -B to escape palivizumab neutralization but had differential impacts on cell-to-cell fusion, as the S275L mutation resulted in an almost-complete ablation of syncytium formation. These reverse genetics systems will facilitate future cross-validation efficacy studies of novel RSV therapeutic intervention strategies and investigations into viral and host factors necessary for virus entry and cell-to-cell spread.
Collapse
|
11
|
Kang HM, Park KC, Park J, Kil HR, Yang EA. Circulating Respiratory Syncytial Virus Genotypes and Genetic Variability of the G Gene during 2017 and 2018/2019 Seasonal Epidemics Isolated from Children with Lower Respiratory Tract Infections in Daejeon, Korea. J Korean Med Sci 2020; 35:e422. [PMID: 33350185 PMCID: PMC7752254 DOI: 10.3346/jkms.2020.35.e422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 10/08/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is a major pathogen causing respiratory tract infections in infants and young children. The aim of this study was to confirm the genetic evolution of RSV causing respiratory infections in children at Daejeon in Korea, through G gene analysis of RSV-A and RSV-B strains that were prevalent from 2017 to 2019. METHODS Pediatric patients admitted for lower respiratory tract infections at The Catholic University of Korea Daejeon St. Mary's Hospital in the 2017 and 2018/2019 RSV seasonal epidemics, who had RSV detected via multiplex polymerase chain reaction (PCR) were included. The nucleic acid containing RSV-RNA isolated from each of the patients' nasal discharge during standard multiplex PCR testing was stored. The G gene was sequenced and phylogenetic analysis was performed using MEGA X program and the genotype was confirmed. RESULTS A total of 155 specimens including 49 specimens from 2017 and 106 specimens from 2018-2019 were tested. The genotype was confirmed in 18 specimens (RSV-A:RSV-B = 4:14) from 2017 and 8 specimens (RSV-A:RSV-B = 7:1) from 2018/2019. In the phylogenetic analysis, all RSV-A type showed ON1 genotype and RSV-B showed BA9 genotype. CONCLUSION RSV-B belonging to BA9 in 2017, and RSV-A belonging to ON1 genotype in 2018/2019 was the most prevalent circulating genotypes during the two RSV seasons in Daejeon, Korea.
Collapse
Affiliation(s)
- Hyun Mi Kang
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ki Cheol Park
- Clinical Research Institute, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Korea
| | - Joonhong Park
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hong Ryang Kil
- Department of Pediatrics, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Eun Ae Yang
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Pediatrics, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Korea.
| |
Collapse
|
12
|
Jackson S, Peret TCT, Ziegler TT, Thornburg NJ, Besselaar T, Broor S, Barr I, Baumeister E, Chadha M, Chittaganpitch M, Darmaa B, Ellis J, Fasce R, Herring B, Herve K, Hirve S, Li Y, Pisareva M, Moen A, Naguib A, Palekar R, Potdar V, Siqueira M, Treurnicht F, Tivane A, Venter M, Wairagkar N, Zambon M, Zhang W. Results from the WHO external quality assessment for the respiratory syncytial virus pilot, 2016-17. Influenza Other Respir Viruses 2020; 14:671-677. [PMID: 32730685 PMCID: PMC7578327 DOI: 10.1111/irv.12771] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 05/19/2020] [Accepted: 05/24/2020] [Indexed: 12/21/2022] Open
Abstract
Background External quality assessments (EQAs) for the molecular detection of respiratory syncytial virus (RSV) are necessary to ensure the provision of reliable and accurate results. One of the objectives of the pilot of the World Health Organization (WHO) Global RSV Surveillance, 2016‐2017, was to evaluate and standardize RSV molecular tests used by participating countries. This paper describes the first WHO RSV EQA for the molecular detection of RSV. Methods The WHO implemented the pilot of Global RSV Surveillance based on the WHO Global Influenza Surveillance and Response System (GISRS) from 2016 to 2018 in 14 countries. To ensure standardization of tests, 13 participating laboratories were required to complete a 12 panel RSV EQA prepared and distributed by the Centers for Disease Control and Prevention (CDC), USA. The 14th laboratory joined the pilot late and participated in a separate EQA. Laboratories evaluated a RSV rRT‐PCR assay developed by CDC and compared where applicable, other Laboratory Developed Tests (LDTs) or commercial assays already in use at their laboratories. Results Laboratories performed well using the CDC RSV rRT‐PCR in comparison with LDTs and commercial assays. Using the CDC assay, 11 of 13 laboratories reported correct results. Two laboratories each reported one false‐positive finding. Of the laboratories using LDTs or commercial assays, results as assessed by Ct values were 100% correct for 1/5 (20%). With corrective actions, all laboratories achieved satisfactory outputs. Conclusions These findings indicate that reliable results can be expected from this pilot. Continued participation in EQAs for the molecular detection of RSV is recommended.
Collapse
Affiliation(s)
- Sandra Jackson
- Global Influenza Programme, World Health Organization, Geneva, Switzerland
| | - Teresa C T Peret
- Division of Viral Diseases, Respiratory Viruses Branch, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Thedi T Ziegler
- Research Center for Child Psychiatry, University of Turku, Turku, Finland
| | - Natalie J Thornburg
- Division of Viral Diseases, Respiratory Viruses Branch, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Terry Besselaar
- Global Influenza Programme, World Health Organization, Geneva, Switzerland
| | - Shobha Broor
- Medicine and Health Sciences, Shree Guru Gobind Singh Tricentenaryl University, Gurugram, India
| | - Ian Barr
- Victorian Infectious Diseases Reference Laboratory, Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Elsa Baumeister
- Departamento Virologia, INEI-ANLIS Carlos G Malbrán, Buenos Aires, Argentina
| | - Mandeep Chadha
- National Institute of Virology, Indian Council of Medical Research, Pune, India
| | | | - Badarch Darmaa
- Virology Laboratory, National Center for Communicable Diseases, Ulanbaatar, Mongolia
| | - Joanna Ellis
- Virus Reference Department, Public Health England, London, UK
| | - Rodrigo Fasce
- Sub-department of Viral Diseases, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Belinda Herring
- African Region Office, World Health Organization, Brazzaville, Republic of Congo
| | - Kadjo Herve
- Department of Epidemic Viruses, Institut Pasteur de Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | | | - Yan Li
- Influenza and Respiratory Viruses Section, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Maria Pisareva
- Laboratory of Molecular Virology, Smorodintsev Research Institute of Influenza, St. Petersburg, Russian Federation
| | - Ann Moen
- Global Influenza Programme, World Health Organization, Geneva, Switzerland
| | - Amel Naguib
- Central Public Health Laboratory, Ministry of Health, Cairo, Egypt
| | | | - Varsha Potdar
- National Institute of Virology, Indian Council of Medical Research, Pune, India
| | | | - Florette Treurnicht
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Almiro Tivane
- Laboratório de Isolamento Viral, Instituto Nacional de Saúde, Maputo, Mozambique
| | - Marietjie Venter
- Center for Viral Zoonosis, Department of Medical Virology, University of Pretoria, Pretoria, South Africa
| | | | - Maria Zambon
- Virus Reference Department, Public Health England, London, UK
| | - Wenqing Zhang
- Global Influenza Programme, World Health Organization, Geneva, Switzerland
| |
Collapse
|