Paramyxoviruses respiratory syncytial virus, parainfluenza virus, and human metapneumovirus infection in pediatric hospitalized patients and climate correlation in a subtropical region of southern China: a 7-year survey

Investigating the Distribution and Antibiotic Resistance of Bacterial Pathogens in Clinical Specimens from a Chinese Maternal and Child Hospital: The Role of Environmental Factors

Objective

To analyze bacterial distribution and antibiotic resistance in clinical specimens from a Chinese hospital for evaluating environmental factors' impact on pathogen prevalence.

Methods

From January 2017 to December 2021, we collected 42,854 clinical specimens from hospitalized children and women. The specimens were cultured on various agar plates and incubated at 35°C for 18-48 h. Their identification was performed using standard biochemical methods and Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF), whereas antibiotic susceptibilities were determined using the VITEK 2 system. Concurrent environmental data from Wuhan were analyzed for correlations with pathogen prevalence using multiple linear stepwise regression.

Results

Of the 24,555 bacterial strains isolated, the majority were gram-positive, and sputum was the most common specimen type. Haemophilus influenzae and Escherichia coli were the most prevalent pathogens in sputum and urine samples, respectively. Notably, H. influenzae and Streptococcus pneumoniae affected children under 6 years of age the most. Furthermore, H. influenzae showed high ampicillin resistance but low cefotaxime resistance; S. pneumoniae was sensitive to penicillin G, and E. coli was resistant to ampicillin but sensitive to cefotetan. The prevalence of multidrug-resistant organisms was below national averages. In terms of seasonality, H. influenzae peaked during late winter and early spring, and environmental analysis indicated positive correlations between PM2.5 and PM10, and H. influenzae and S. pneumoniae prevalence. In addition, NO2 levels were positively correlated with increased S. aureus and M. catarrhalis prevalence; E coli prevalence was negatively correlated with ozone levels.

Conclusion

This study provides valuable insights into the distribution and antibiotic resistance patterns of bacterial pathogens in maternal and child healthcare facilities in Wuhan, China. Environmental factors significantly influence the epidemiology of certain bacterial pathogens. Implementing integrated health strategies that combine microbial surveillance with environmental monitoring is needed to effectively manage and prevent bacterial infections.

Epidemiology and diagnosis technologies of human metapneumovirus in China: a mini review

Human metapneumovirus (HMPV) is a newly identified pathogen causing acute respiratory tract infections in young infants worldwide. Since the initial document of HMPV infection in China in 2003, Chinese scientists have made lots of efforts to prevent and control this disease, including developing diagnosis methods, vaccines and antiviral agents against HMPV, as well as conducting epidemiological investigations. However, effective vaccines or special antiviral agents against HMPV are currently not approved, thus developing early diagnosis methods and knowing its epidemiological characteristics will be beneficial for HMPV control. Here, we summarized current research focused on the epidemiological characteristics of HMPV in China and its available detection methods, which will be beneficial to increase the public awareness and disease control in the future.

Molecular epidemiology and characteristics of respiratory syncytial virus among hospitalized children in Guangzhou, China

BACKGROUND

Human respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory tract infection and hospitalization, especially in children. Highly mutagenic nature and antigenic diversity enable the RSV to successfully survive in human population. We conducted a molecular epidemiological study during 2017-2021 to investigate the prevalence and genetic characteristics of RSV.

METHODS

A total of 6499 nasopharyngeal (NP) swabs were collected from hospitalized children at Department of Pediatrics, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong, China. All NP swab specimens were preliminary screened for common respiratory viruses and then tested for RSV using specific PCR assays. Partial G genes of RSV were amplified for phylogenetic analysis and genetic characterization.

RESULTS

The overall detection rate for common respiratory viruses was 16.12% (1048/6499). Among those, 405 specimens (6.20%, 405/6499) were found positive for RSV. The monthly distribution of RSV and other respiratory viruses was variable, and the highest incidence was recorded in Autumn and Winter. Based on the sequencing of hypervariable region of G gene, 93 RSV sequences were sub-grouped into RSV-A (56, 60.2%) and RSV-B (37, 39.8%). There was no coinfection of RSV-A and RSV-B in the tested samples. Phylogenetic analysis revealed that RSV-A and RSV-B strains belonged to ON1 and BA9 genotypes respectively, indicating predominance of these genotypes in Guangzhou. Several substitutions were observed which may likely change the antigenicity and pathogenicity of RSV. Multiple glycosylation sites were noticed, demonstrating high selection pressure on these genotypes.

CONCLUSION

This study illustrated useful information about epidemiology, genetic characteristics, and circulating genotypes of RSV in Guangzhou China. Regular monitoring of the circulating strains of RSV in different parts of China could assist in the development of more effective vaccines and preventive measures.

Pathogenesis of an experimental coinfection of porcine parainfluenza virus 1 and influenza A virus in commercial nursery swine

Porcine parainfluenza virus 1 (PPIV-1) is a recently characterized swine respirovirus. Previous experimental studies reported PPIV-1 replicates in the porcine respiratory tract causing minimal clinical disease or lesions. However, it is unknown if PPIV-1 co-infections with viral respiratory pathogens would cause respiratory disease consistent with natural infections reported in the field. The objective of this study was to evaluate if PPIV-1 increases the severity of influenza A virus respiratory disease in swine. Fifty conventional, five-week-old pigs were assigned to one of three challenge groups (n = 15) or a negative control group (n = 5). Pigs were challenged with a γ-cluster H1N2 influenza A virus in swine (IAV-S; A/Swine/North Carolina/00169/2006), PPIV-1 (USA/MN25890NS/2016), inoculum that contained equivalent titers of IAV-S and PPIV-1 (CO-IN), or negative control. Clinical scores representing respiratory disease and nasal swabs were collected daily and all pigs were necropsied five days post inoculation (DPI). The CO-IN group demonstrated a significantly lower percentage of pigs showing respiratory clinical signs relative to the IAV-S challenge group from 2 to 4 DPI. The IAV-S and CO-IN groups had significantly lower microscopic composite lesion scores in the upper respiratory tract compared to the PPIV-1 group although the IAV-S and CO-IN groups had significantly higher microscopic composite lung lesion scores. Collectively, PPIV-1 did not appear to influence severity of clinical disease, macroscopic lesions, or alter viral loads detected in nasal swabs or necropsy tissues when administered as a coinfection with IAV-S. Studies evaluating PPIV-1 coinfections with different strains of IAV-S, different respiratory pathogens or sequential exposure of PPIV-1 and IAV-S are warranted.

Viral respiratory infections in a rapidly changing climate: the need to prepare for the next pandemic

Viral respiratory infections (VRIs) cause seasonal epidemics and pandemics, with their transmission influenced by climate conditions. Despite the risks posed by novel VRIs, the relationships between climate change and VRIs remain poorly understood. In this review, we synthesized existing literature to explore the connections between changes in meteorological conditions, extreme weather events, long-term climate warming, and seasonal outbreaks, epidemics, and pandemics of VRIs from an interdisciplinary perspective. We proposed a comprehensive conceptual framework highlighting the potential biological, socioeconomic, and ecological mechanisms underlying the impact of climate change on VRIs. Our findings suggested that climate change increases the risk of VRI emergence and transmission by affecting the biology of viruses, host susceptibility, human behavior, and environmental conditions of both society and ecosystems. Further interdisciplinary research is needed to address the dual challenge of climate change and pandemics.

Quinones as Promising Compounds against Respiratory Viruses: A Review

Respiratory viruses represent a world public health problem, giving rise to annual seasonal epidemics and several pandemics caused by some of these viruses, including the COVID-19 pandemic caused by the novel SARS-CoV-2, which continues to date. Some antiviral drugs have been licensed for the treatment of influenza, but they cause side effects and lead to resistant viral strains. Likewise, aerosolized ribavirin is the only drug approved for the therapy of infections by the respiratory syncytial virus, but it possesses various limitations. On the other hand, no specific drugs are licensed to treat other viral respiratory diseases. In this sense, natural products and their derivatives have appeared as promising alternatives in searching for new compounds with antiviral activity. Besides their chemical properties, quinones have demonstrated interesting biological activities, including activity against respiratory viruses. This review summarizes the activity against respiratory viruses and their molecular targets by the different types of quinones (both natural and synthetic). Thus, the present work offers a general overview of the importance of quinones as an option for the future pharmacological treatment of viral respiratory infections, subject to additional studies that support their effectiveness and safety.

Improving the efficiency and biosafety of respiratory syncytial virus identification using a nucleic acid extraction-free reagent

Respiratory syncytial virus (RSV) is the most important virus that causes lower respiratory tract disease in children; efficient viral identification is an important component of disease prevention and treatment. Here, we developed and evaluated a ready-to-use (RTU) nucleic acid extraction-free direct reagent for identification of RSV (RTU-Direct test) in clinical samples. The limit of detection (LOD) of the RSV RTU-Direct test was consistent with the LOD of the standard test using extracted nucleic acids. The virus inactivation ability of RTU-Direct reagent was confirmed by viral infectivity assays involving RTU-Direct-treated samples containing RSV and human coronavirus OC43. RSV RNA stability was significantly better in RTU-Direct reagent than in conventional virus transport medium (VTM) at room temperature and 4°C (p < 0.05). The clinical performance of the RTU-Direct test was evaluated using 155 respiratory specimens from patients with suspected RSV infection. Positive agreement between the RTU-Direct test and the VTM standard test was 100% (42/42); negative agreement was 99.1% (112/113), and the kappa statistic was 0.968 (p < 0.001). The distributions of Ct values did not significantly differ between the RTU-Direct test and the standard test (p > 0.05). Overall, the RTU-Direct reagent can improve the efficiency and biosafety of RSV detection, while reducing the cost of detection.

Coronavirus seasonality, respiratory infections and weather

Background

The survival of coronaviruses are influenced by weather conditions and seasonal coronaviruses are more common in winter months. We examine the seasonality of respiratory infections in England and Wales and the associations between weather parameters and seasonal coronavirus cases.

Methods

Respiratory virus disease data for England and Wales between 1989 and 2019 was extracted from the Second-Generation Surveillance System (SGSS) database used for routine surveillance. Seasonal coronaviruses from 2012 to 2019 were compared to daily average weather parameters for the period before the patient’s specimen date with a range of lag periods.

Results

The seasonal distribution of 985,524 viral infections in England and Wales (1989–2019) showed coronavirus infections had a similar seasonal distribution to influenza A and bocavirus, with a winter peak between weeks 2 to 8. Ninety percent of infections occurred where the daily mean ambient temperatures were below 10 °C; where daily average global radiation exceeded 500 kJ/m²/h; where sunshine was less than 5 h per day; or where relative humidity was above 80%. Coronavirus infections were significantly more common where daily average global radiation was under 300 kJ/m²/h (OR 4.3; CI 3.9–4.6; p < 0.001); where average relative humidity was over 84% (OR 1.9; CI 3.9–4.6; p < 0.001); where average air temperature was below 10 °C (OR 6.7; CI 6.1–7.3; p < 0.001) or where sunshine was below 4 h (OR 2.4; CI 2.2–2.6; p < 0.001) when compared to the distribution of weather values for the same time period. Seasonal coronavirus infections in children under 3 years old were more frequent at the start of an annual epidemic than at the end, suggesting that the size of the susceptible child population may be important in the annual cycle.

Conclusions

The dynamics of seasonal coronaviruses reflect immunological, weather, social and travel drivers of infection. Evidence from studies on different coronaviruses suggest that low temperature and low radiation/sunlight favour survival. This implies a seasonal increase in SARS-CoV-2 may occur in the UK and countries with a similar climate as a result of an increase in the R₀ associated with reduced temperatures and solar radiation. Increased measures to reduce transmission will need to be introduced in winter months for COVID-19.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12879-021-06785-2.

Mycoplasma genitalium and Mycoplasma hominis infection in south Korea during 2018-2020

BACKGROUND AND OBJECTIVES

Sexually transmitted infections (STIs) can remain undetected and untreated; therefore, rapid diagnosis and treatment of STIs are important. Mycoplasma genitalium (MG), Mycoplasma hominis (MH), and Ureaplasma urealyticum are sexually transmitted pathogens that cause asymptomatic, organ-specific, and chronic infections, thereby posing a threat to community health. Therefore, we investigated the epidemiological trends of MG and MH infections in South Korea for rapid diagnosis and treatment.

MATERIALS AND METHODS

From September 2018 to December 2020, samples (catheter, pus, tissue, swab, and urine) were collected from outpatients of hospitals in South Korea for molecular biological venereal disease testing. DNA was extracted and analyzed using real-time polymerase chain reaction.

RESULTS

Of the 59,381 samples analyzed, 8.78% (n=5,215) were positive for MG and MH. The MH positivity rate (5.51%, n=3,273) was higher than the MG positivity rate (3.27%, n=1,942). MG and MH positivity rates were the highest in patients aged <19 years. Men had higher MG positivity rate, whereas women had higher MH positivity rates. Furthermore, the MG-positivity rate was the highest in the swab samples of both men and women, whereas that of MH was the highest in the urine samples of men and swab samples of women.

CONCLUSION

We identified the differences between MG and MH positivity rates based on sex, specimen, and age. Our findings can provide information for strategies that protect public health and reduce STI incidence and transmission.

Incidence of Medically Attended Acute Respiratory Illnesses Due to Respiratory Viruses Across the Life Course During the 2018/19 Influenza Season

Background

While multiple respiratory viruses circulate in humans, few studies have compared the incidence of different viruses across the life course. We estimated the incidence of outpatient illness due to 12 different viruses during November 2018 through April 2019 in a fully enumerated population.

Methods

We conducted active surveillance for ambulatory care visits for acute respiratory illness (ARI) among members of Kaiser Permanente Washington (KPWA). Enrolled patients provided respiratory swab specimens which were tested for 12 respiratory viruses using RT-PCR. We estimated the cumulative incidence of infection due to each virus overall and by age group.

Results

The KPWA population under surveillance included 202,562 individuals, of whom 2,767 (1.4%) were enrolled in the study. Influenza A(H3N2) was the most commonly detected virus, with an overall incidence 21 medically attended illnesses per 1,000 population; the next most common viruses were influenza A(H1N1) (18 per 1,000), coronaviruses (13 per 1,000), respiratory syncytial virus (RSV, 13 per 1,000), and rhinovirus (9 per 1,000). RSV was the most common cause of medically attended ARI among children aged 1-4 years; coronaviruses were the most common among adults aged ≥65 years.

Conclusions

Consistent with other studies focused on single viruses, we found that influenza and RSV were major causes of acute respiratory illness in persons of all ages. In comparison, coronaviruses and rhinovirus were also important pathogens. Prior to the emergence of SARS-CoV-2, coronaviruses were the second-most common cause of medically attended ARI during the 2018/19 influenza season.

Seasonality of Respiratory Viruses at Northern Latitudes

IMPORTANCE

Every year, respiratory viruses exact a heavy burden on Canadian hospitals during winter months. Generalizable seasonal patterns of respiratory virus transmission may estimate the evolution of SARS-CoV-2 or other emerging pathogens.

OBJECTIVE

To describe the annual and biennial variation in respiratory virus seasonality in a northern climate.

DESIGN, SETTING, AND PARTICIPANTS

This cohort study is an epidemiological assessment using population-based surveillance of patients with medically attended respiratory tract infection from 2005 through 2017 in Alberta, Canada. Incident cases of respiratory virus infection and infant respiratory syncytial virus (RSV) hospitalizations in Alberta were extracted from the Data Integration for Alberta Laboratories platform and Alberta Health Services Discharge Abstract Database, respectively. A deterministic susceptible-infected-recovered-susceptible mathematical model with seasonal forcing function was fitted to the data for each virus. The possible future seasonal course of SARS-CoV-2 in northern latitudes was modeled on the basis of these observations. The analysis was conducted between December 15, 2020, and February 10, 2021.

EXPOSURES

Seasonal respiratory pathogens.

MAIN OUTCOMES AND MEASURES

Incidence (temporal pattern) of respiratory virus infections and RSV hospitalizations.

RESULTS

A total of 37 719 incident infections with RSV, human metapneumovirus, or human coronaviruses 229E, NL63, OC43, or HKU1 among 35 375 patients (18 069 [51.1%] male; median [interquartile range], 1.29 [0.42-12.2] years) were documented. A susceptible-infected-recovered-susceptible model mirrored the epidemiological data, including a striking biennial variation with alternating severe and mild winter peaks. Qualitative description of the model and numerical simulations showed that strong seasonal contact rate and temporary immunity lasting 6 to 12 months were sufficient to explain biennial seasonality in these various respiratory viruses. The seasonality of 10 212 hospitalizations among children younger than 5 years with RSV was also explored. The median (interquartile range) rate of hospitalizations per 1000 live births was 18.6 (17.6-19.9) and 11.0 (10.4-11.7) in alternating even (severe) and odd (less-severe) seasons, respectively (P = .001). The hazard of admission was higher for children born in severe (even) seasons compared with those born in less-severe (odd) seasons (hazard ratio, 1.68; 95% CI, 1.61-1.75; P < .001).

CONCLUSIONS AND RELEVANCE

In this modeling study of respiratory viruses in Alberta, Canada, the seasonality followed a pattern estimated by simple mathematical models, which may be informative for anticipating future waves of pandemic SARS-CoV-2.

Effects of climatic factors and particulate matter on Rotavirus A infections in Cheonan, Korea, in 2010-2019

Rotavirus A is the most common cause of infectious diarrhea worldwide. This study aimed to retrospectively study and analyze 4009 stool samples that were tested for viruses causing diarrhea, using multiplex reverse transcription PCR at Dankook University Hospital between 2010 and 2019. Furthermore, we determined the correlation between these factors and various climatic factors, including wind-chill temperature, relative humidity, rate of sunshine, and particulate matter. Rotavirus A infections occurred frequently in February, March, and April on an annual basis. Furthermore, during the study, the detection rate was highest at 17.0% (n=61/359) in 2011. Based on an analysis of weather big data, patient age, and period-specific infection during the summer, when the wind-chill temperature and relative humidity were high, the Rotavirus A infection rate was very low. Relative humidity (p=0.020) and particulate matter (p=0.049) were associated with the average number of monthly cases of Rotavirus A infection. However, wind chill temperature (p=0.074) and rate of sunshine (p=0.993) were not associated with the average monthly distribution of Rotavirus A cases. These results indicate that Rotavirus A infection was correlated with relative humidity and particulate matter during the study period and further the current understanding of the distribution of Rotavirus A infections resulting from climatic factors and particulate matter. This could help establish climate-related health policies to reduce the incidence of diarrhea and guide the development of vaccines against Rotavirus A.

Epidemiological and clinical characteristics of respiratory viruses in 4403 pediatric patients from multiple hospitals in Guangdong, China

Background

Acute respiratory infections (ARI) cause considerable morbidity and mortality worldwide, especially in children. Unfortunately, there are limited multi-center data on common viral respiratory infections in south China.

Methods

A total of 4403 nasal swabs were collected from children in 10 cities in Guangdong, China in 2019. Seven respiratory viruses, influenza A virus (IFA), influenza B virus (IFB), respiratory syncytial virus (RSV), adenoviruses (ADV) and parainfluenza virus types 1–3 (PIV1, PIV2 and PIV3), were detected by direct immunofluorescence antibody assay. The personal information and clinical characteristics were recorded and analyzed.

Results

The results showed that at least one virus was detected in 1099 (24.96 %) samples. The detection rates of RSV, IFA, ADV, PIV3, PIV1 and PIV2 were 7.13 % (314/4403), 5.31 % (234/4403), 4.02 % (177/4403), 3.04 % (134/4403), 1.70 % (75/4403) and 1.16 % (51/4403), respectively. The detection rate of RSV was highest in 0–6-month-old children at 18.18 % (106/583), while the detection rate of IFA was highest in 12–18-year-old children at 20.48 % (17/83). The total detection rates in winter and spring were 35.67 % (219/614) and 34.56 % (403/1166), higher than those in summer, 17.41 % (284/1631), and autumn, 19.46 % (193/992).

Conclusions

RSV and IFA were the main respiratory viruses in children. With increasing age the detection rate of RSV decreased in children, but the trends for the detection rates of IFA and IFB were the opposite. This study provided the viral etiology and epidemiology of pediatric patients with ARI in Guangdong, China.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12887-021-02759-0.

Evolutionary dynamics of group A and B respiratory syncytial virus in China, 2009-2018

Respiratory syncytial virus (RSV) is a major cause of acute respiratory tract infections in children and is a public health threat globally. To investigate the spatiotemporal dynamics of RSV evolution, we performed systematic phylogenetic analysis using all available sequences from the GenBank database, together with sequences from Shanghai, China. Both RSV-A and RSV-B appear to have originated in North America, with an inferred origin time of 1954.0 (1938.7-1967.6) and 1969.7 (1962.6-1975.5), respectively. BA-like strains of RSV-B, with a 60-nt insertion, and the ON1 strain of RSV-A, with a 72-nt insertion, emerged in 1997.6 (1996.2-1998.6) and 2010.1 (2009.1-2010.3), respectively. Since their origin, both genotypes have gradually replaced the former circulating genotypes to become the dominant strain. The population dynamic of RSV-A showed a seasonal epidemic pattern with obvious expansion in the periods of 2006-2007, 2010-2011, 2011-2012, and 2013-2014. Thirty fixed amino acid substitutions were identified during the divergence of NA4 from GA1 genotypes of RSV-A, and 13 were found during the divergence of SAB4 from GB1 of RSV-B. Importantly, ongoing evolution has occurred since the emergence of ON1, including four amino acid substitutions (I208L, E232G, T253K, and P314L). RSV-A genotypes GA5, NA4, NA1, and ON1 and RSV-B genotypes CB1, SAB4, BA-C, BA10, BA7, and BA9 were co-circulating in China from 2005 to 2015. In particular, RSV-A genotype ON1 was first detected in China in 2011, and it completely replaced GA2 to become the predominant strain after 2016. These data provide important insights into the evolution and epidemiology of RSV.

Effects of climatic factors on human parainfluenza 1, 2, and 3 infections in Cheonan, Republic of Korea

Studying relationships between meteorological conditions and respiratory virus infections may help interpret the causality of disease outbreaks and provide a better understanding of the seasonal distribution of viruses. Therefore, in this study, we analyzed the correlations between meteorological data and the trends of infection by human parainfluenza virus-1 (HPIV-1; also known as human respirovirus 1), human parainfluenza virus-2 (human orthorubulavirus 2), and human parainfluenza virus-3 (human respirovirus 3) using 9010 viral samples collected at Dankook University Hospital from January 1, 2012, to December 31, 2018. Infection frequency data were used to detect the seasonal patterns of HPIV-1, HPIV-2, and HPIV-3 infections, and these patterns were compared with local weather data over the same period. We performed descriptive statistical analysis, frequency analysis, t test, and binomial logistic regression analysis to examine the relationships of weather and particulate matter conditions with the incidence of HPIV-1, HPIV-2, and HPIV-3 infections. The highest average infection rate with one of these three viruses (88.17%) was found in children aged 1-9 years. Specifically, the infection rate of HPIV-1 was 91.9% in children aged 1-9 years, whereas that of HPIV-2 and HPIV-3 was 86.3%. HPIV infection exhibited a meaningful relationship with climatic factors, such as temperature, wind-chill temperature, and atmospheric pressure. Our results suggest that climate changes might affect the rate of infection by HPIV. These findings may help in predicting the effectiveness of preventive strategies of HPIV infection.

Epidemiological characteristics of respiratory viruses in patients with acute respiratory infections during 2009-2018 in southern China

BACKGROUND

Acute respiratory infections (ARIs) remain a significant public threat with high morbidity and mortality worldwide; viruses are significant pathogens that cause ARIs. This study was conducted to better understand the epidemiological characteristics of respiratory viruses circulating in southern China.

METHODS

We collected 22,680 respiratory samples from ARI patients in 18 hospitals in southern China during 2009-2018; seven common respiratory viruses including Flu, RSV, PIV, hMPV, ADV, HCoV, and HBoV were screened using in-house real-time PCR.

RESULTS

Of all samples, 9760 ARI cases (9760/22680, 43.03%) tested positive for the seven common respiratory viruses. The most detected virus was Flu (14.15%), followed by RSV (10.33%) and PIV (5.43%); Flu-A, PIV3, and HCoV-OC43 were the predominant subtypes. Although most of the viruses were detected in male inpatients, Flu was more likely detected in female outpatients. Flu infection was more likely to cause URTI (upper respiratory tract infection), whereas RSV infection was more likely to cause pneumonia and bronchitis. The prevalence of Flu was particularly high in 2009. The epidemic level was found notably high in 2014-2018 for RSV, in 2016-2018 for PIV, in the summer of 2018 for ADV, in the summer of 2016 and winter of 2018 for HCoV, and in the summer of 2011 and autumn of 2018 for HBoV. The co-detection rate of the seven viruses was 4.70%; RSV, PIV, and Flu were the most commonly co-detected viruses.

CONCLUSIONS

This work demonstrates the epidemiological characteristics of seven common respiratory viruses in ARI patients in southern China.

HMPV in Immunocompromised Patients: Frequency and Severity in Pediatric Oncology Patients

Cancer is the first cause of death by disease in childhood globally. The most frequent types of cancers in children and adolescents are leukemias, followed by brain and central nervous system tumors and lymphomas. The recovery rate of cancer in children is around 80% in developed countries and up to 30% in developing countries. Some of the main causes of complications in children and adolescents with cancer are respiratory viral infections, mainly in bone marrow-transplanted patients. Respiratory viruses have been detected in the bronchoalveolar lavage or nasal wash specimens from cancer patients with or without respiratory illness symptoms. Human metapneumovirus (HMPV) is within the ten most common viruses that are encountered in samples from pediatric patients with underlying oncology conditions. In most of cases, HMPV is found as the only viral agent, but co-infection with other viruses or with bacterial agents has also been reported. The discrepancies between the most prevalent viral agents may be due to the different populations studied or the range of viral agents tested. Some of the cases of infection with HMPV in cancer patients have been fatal, especially in those who have received a hematopoietic stem cell transplant. This review seeks to show a general view of the participation of HMPV in respiratory illness as a complication of cancer in childhood and adolescence.