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Sanada A, Kondo K, Takahashi F, Higashide Y, Kunizaki J, Hoshino E, Sakurai N, Mori T. Clinical Characteristics of Pediatric Parainfluenza Virus Infections: A Comparative Analysis of Parainfluenza Virus Serotypes 1-4 From April 2021 to October 2023 in Hokkaido, Japan. Pediatr Infect Dis J 2024:00006454-990000000-00908. [PMID: 38900074 DOI: 10.1097/inf.0000000000004444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
BACKGROUND Parainfluenza virus (PIV) is widely known as a causative virus of acute respiratory tract infections in children, and 4 serotypes (PIV-1-PIV-4) have been identified. The purpose of the present study was to clarify the clinical characteristics of the PIV serotypes in pediatric PIV infections in Japan. METHODS Between April 2021 and October 2023, 8821 children aged <16 years who presented with respiratory symptoms underwent multiplex polymerase chain reaction analyses at the Department of Pediatrics, NTT Medical Center Sapporo. All 1490 cases in which PIV was detected were analyzed for their clinical characteristics by PIV serotypes. RESULTS Of the 1490 cases, 608 were positive for a single PIV serotype: 91 (13.5%) for PIV-1, 54 (4.8%) for PIV-2, 361 (62.1%) for PIV-3 and 102 (19.6%) for PIV-4. The median ages were 3.5 years for PIV-1, 5.4 years for PIV-2, 1.9 years for PIV-3 and 2.2 years for PIV-4, with a significantly older age for PIV-2. Compared with the other serotypes, croup was significantly more common in PIV-1 and lower respiratory tract infection was significantly more common in PIV-4. Of the 608 cases with a single PIV serotype, 114 were hospitalized. The proportion of hospitalized patients was higher for PIV-4 than for the other PIV serotypes, but the difference was not significant. CONCLUSIONS Lower respiratory tract infection was more frequent in PIV-4 than in the other PIV serotypes, and PIV-4 infection may increase the risk of hospitalization.
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Affiliation(s)
- Atsushi Sanada
- From the Department of Pediatrics, NTT Medical Center Sapporo, Sapporo, Hokkaido, Japan
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Han JY, Suh W, Han SB. Seasonal epidemiological and clinical characteristics of pediatric patients with human parainfluenza virus infection by serotype: a retrospective study. Virol J 2022; 19:141. [PMID: 36064562 PMCID: PMC9444704 DOI: 10.1186/s12985-022-01875-2] [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: 07/01/2022] [Accepted: 08/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The development of the polymerase chain reaction (PCR) test promoted the evaluation of the epidemiological and clinical characteristics of human parainfluenza virus (HPIV) type 4, which has been rarely studied using conventional diagnostic methods. This study aimed to determine the seasonal epidemiological and clinical characteristics of all four HPIV serotypes (HPIV-1, HPIV-2, HPIV-3, and HPIV-4) during the era of PCR testing. METHODS The medical records of hospitalized pediatric patients diagnosed with HPIV infections by a multiplex PCR test between 2015 and 2021 were retrospectively reviewed to determine the seasonal distributions of each HPIV serotype. For patients with a single HPIV infection, the clinical characteristics of each HPIV serotype were evaluated and compared with one another. RESULTS Among the 514 cases of HPIV infection, HPIV-1, HPIV-2, HPIV-3, and HPIV-4 were identified in 27.2%, 11.9%, 42.6%, and 18.3% of cases, respectively. HPIV-3 was most prevalent in spring, and the other three serotypes were most prevalent in autumn. For patients with a single HPIV infection, those infected by HPIV-1 and HPIV-3 were younger than those infected by HPIV-2 and HPIV-4 (P < 0.001). Croup and lower respiratory tract infection (LRI) were most frequently diagnosed in patients infected by HPIV-1 (P < 0.001) and HPIV-4 (P = 0.002), respectively. During 2020-2021, HPIV-3 was most prevalent in autumn and caused fewer LRIs (P = 0.009) and more seizures (P < 0.001) than during 2015-2019. CONCLUSIONS Each HPIV serotype exhibited a distinct seasonal predominance, and some differences in the clinical characteristics of the HPIV serotypes were observed. HPIV-4 acted as an important cause of LRI. Considering the recent changes in the epidemiological and clinical characteristics of HPIV-3, more time-series analyses should be conducted.
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Affiliation(s)
- Ji Yoon Han
- Department of Pediatrics, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Republic of Korea.,Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Woosuck Suh
- Department of Pediatrics, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Republic of Korea.,Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seung Beom Han
- Department of Pediatrics, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, 12 Beodeunaru-ro 7-gil, Yeongdeungpo-gu, Seoul, 07247, Republic of Korea.
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Zhou S, Mao N, Zhang Y, Cui A, Zhu Z, Hu R, Xu J, Xu W. Genetic analysis of human parainfluenza virus type 4 associated with severe acute respiratory infection in children in Luohe City, Henan Province, China, during 2017-2018. Arch Virol 2021; 166:2585-2590. [PMID: 34231027 PMCID: PMC8321989 DOI: 10.1007/s00705-021-05154-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/14/2021] [Indexed: 11/25/2022]
Abstract
During 2017–2018, nasopharyngeal aspirates (NPAs) from 627 hospitalized patients with severe acute respiratory infection at Luohe Center Hospital were tested by RT-PCR for human parainfluenza virus 4 (HPIV-4). Fourteen (2.2%) of the 627 samples were positive for HPIV-4. The complete HN gene was amplified from nine positive samples and sequenced. Sequence comparisons showed that the HPIV-4 strains circulating in the city of Luohe are closely related to HPIV-4A strains. Our study indicated that there were multiple lineages of HPIV-4 circulating in Henan Province in China during the study period. This will improve our understanding of the epidemiological and clinical characteristics of HPIV-4.
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Affiliation(s)
- Shanshan Zhou
- Inner Mongolia Laboratory of Molecular Biology, Inner Mongolia Medical University, Jinshan Avenue, Jinshan Development Zone, Hohhot, 010059, Inner Mongolia Autonomous Region, China
| | - Naiying Mao
- WHO WPRO Regional Reference Measles/Rubella Laboratory, NHC Key Laboratory of Medical Virology and Viral Diseases (National Institute for Viral Disease Control and Prevention, Chinese Centers for Disease Control and Prevention), 155# Changbai Road, Changping District, Beijing, 102200, China
| | - Yan Zhang
- WHO WPRO Regional Reference Measles/Rubella Laboratory, NHC Key Laboratory of Medical Virology and Viral Diseases (National Institute for Viral Disease Control and Prevention, Chinese Centers for Disease Control and Prevention), 155# Changbai Road, Changping District, Beijing, 102200, China
| | - Aili Cui
- WHO WPRO Regional Reference Measles/Rubella Laboratory, NHC Key Laboratory of Medical Virology and Viral Diseases (National Institute for Viral Disease Control and Prevention, Chinese Centers for Disease Control and Prevention), 155# Changbai Road, Changping District, Beijing, 102200, China
| | - Zhen Zhu
- WHO WPRO Regional Reference Measles/Rubella Laboratory, NHC Key Laboratory of Medical Virology and Viral Diseases (National Institute for Viral Disease Control and Prevention, Chinese Centers for Disease Control and Prevention), 155# Changbai Road, Changping District, Beijing, 102200, China
| | - Ruiping Hu
- Inner Mongolia Laboratory of Molecular Biology, Inner Mongolia Medical University, Jinshan Avenue, Jinshan Development Zone, Hohhot, 010059, Inner Mongolia Autonomous Region, China.
| | - Jin Xu
- Henan Province Center for Disease Control and Prevention, 105# Nongye South Road, Zhengzhou, 450000, Henan, China.
| | - Wenbo Xu
- WHO WPRO Regional Reference Measles/Rubella Laboratory, NHC Key Laboratory of Medical Virology and Viral Diseases (National Institute for Viral Disease Control and Prevention, Chinese Centers for Disease Control and Prevention), 155# Changbai Road, Changping District, Beijing, 102200, China.
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Abstract
Human parainfluenza virus type 3 (HPIV-3) is a significant cause of lower respiratory tract infections, with the most severe disease in young infants, immunocompromised individuals, and the elderly. HPIV-3 infections are currently untreatable with licensed therapeutics, and prophylactic and therapeutic options are needed for patients at risk. To complement existing human airway models of HPIV-3 infection and develop an animal model to assess novel intervention strategies, we evaluated infection and transmission of HPIV-3 in ferrets. A well-characterized human clinical isolate (CI) of HPIV-3 engineered to express enhanced green fluorescent protein (rHPIV-3 CI-1-EGFP) was passaged on primary human airway epithelial cells (HAE) or airway organoids (AO) to avoid tissue culture adaptations. rHPIV3 CI-1-EGFP infection was assessed in vitro in ferret AO and in ferrets in vivo. Undifferentiated and differentiated ferret AO cultures supported rHPIV-3 CI-1-EGFP replication, but the ferret primary airway cells from AO were less susceptible and permissive than HAE. In vivo rHPIV-3 CI-1-EGFP replicated in the upper and lower airways of ferrets and targeted respiratory epithelial cells, olfactory epithelial cells, type I pneumocytes, and type II pneumocytes. The infection efficiently induced specific antibody responses. Taken together, ferrets are naturally susceptible to HPIV-3 infection; however, limited replication was observed that led to neither overt clinical signs nor ferret-to-ferret transmission. However, in combination with ferret AO, the ferret model of HPIV-3 infection, tissue tropism, and neutralizing antibodies complements human ex vivo lung models and can be used as a platform for prevention and treatment studies for this important respiratory pathogen. IMPORTANCE HPIV-3 is an important cause of pediatric disease and significantly impacts the elderly. Increasing numbers of immunocompromised patients suffer from HPIV-3 infections, often related to problems with viral clearance. There is a need to model HPIV-3 infections in vitro and in vivo to evaluate novel prophylaxis and treatment options. Currently existing animal models lack the potential for studying animal-to-animal transmission or the effect of immunosuppressive therapy. Here, we describe the use of the ferret model in combination with authentic clinical viruses to further complement human ex vivo models, providing a platform to study approaches to prevent and treat HPIV-3 infection. Although we did not detect ferret-to-ferret transmission in our studies, these studies lay the groundwork for further refinement of the ferret model to immunocompromised ferrets, allowing for studies of severe HPIV-3-associated disease. Such models for preclinical evaluation of prophylaxis and antivirals can contribute to reducing the global health burden of HPIV-3.
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Human parainfluenza virus circulation, United States, 2011-2019. J Clin Virol 2020; 124:104261. [PMID: 31954277 PMCID: PMC7106518 DOI: 10.1016/j.jcv.2020.104261] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 01/02/2020] [Accepted: 01/08/2020] [Indexed: 02/08/2023]
Abstract
Human parainfluenza virus type 3 is the most commonly reported parainfluenza virus followed by types 1, 2, and 4, respectively. Each parainfluenza virus type exhibited a unique circulation pattern. Parainfluenza type 4 circulated annually and peaked during the winter months. There was no remarkable distinction in regional versus national seasonal circulation patterns. The majority of parainfluenza virus detections with available age data occurred among children aged ≤2 years.
Background Human parainfluenza viruses (HPIVs) cause upper and lower respiratory tract illnesses, most frequently among infants and young children, but also in the elderly. While seasonal patterns of HPIV types 1–3 have been described, less is known about national patterns of HPIV-4 circulation. Objectives To describe patterns of HPIVs circulation in the United States (US). Study design We used data from the National Respiratory and Enteric Virus Surveillance System (NREVSS), a voluntary passive laboratory-based surveillance system, to characterize the epidemiology and circulation patterns of HPIVs in the US during 2011–2019. We summarized the number of weekly aggregated HPIV detections nationally and by US census region, and used a subset of data submitted to NREVSS from public health laboratories and several clinical laboratories during 2015–2019 to analyze differences in patient demographics. Results During July 2011 - June 2019, 2,700,135 HPIV tests were reported; 122,852 (5 %) were positive for any HPIV including 22,446 for HPIV-1 (18 %), 17,474 for HPIV-2 (14 %), 67,649 for HPIV-3 (55 %), and 15,283 for HPIV-4 (13 %). HPIV testing increased substantially each year. The majority of detections occurred in children aged ≤ 2 years (36 %) with fluctuations in the distribution of age by type. Conclusions HPIVs were detected year-round during 2011–2019, with type-specific year-to-year variations in circulation patterns. Among HPIV detections where age was known, the majority were aged ≤ 2 years. HPIV-4 exhibited an annual fall-winter seasonality, both nationally and regionally. Continued surveillance is needed to better understand national patterns of HPIV circulation.
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Gu YE, Park JY, Lee MK, Lim IS. Characteristics of human parainfluenza virus type 4 infection in hospitalized children in Korea. Pediatr Int 2020; 62:52-58. [PMID: 31705838 PMCID: PMC7167709 DOI: 10.1111/ped.14049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 09/09/2019] [Accepted: 11/07/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND The characteristics of human parainfluenza virus type 4 (hPIV4) infection are not thoroughly understood. We therefore clarified the characteristics of hPIV4 in Korea. METHOD From January 2013 to December 2017, children admitted with respiratory tract infection at the Department of Pediatrics in Chung-Ang University Hospital were enrolled in the study. Nasopharyngeal aspirate specimens were obtained from patients and tested for hPIV types by multiplex reverse transcription polymerase chain reaction. We retrospectively reviewed subject medical records, focusing on epidemiological and clinical characteristics. RESULTS Of the 12 423 NPA specimens, 8,406 were positive by multiplex reverse transcription polymerase chain reaction for nine respiratory viruses, and 1,018 were positive for one of the four types of hPIV: 1,018 specimens led to the detection of 1,029 hPIVs; 3ss (31.3%) were positive for hPIV1, 120 (11.7%) were positive for hPIV2, 356 (34.6%) were positive for hPIV3, and 231 (22.4%) were positive for hPIV4. Of the hPIV-positive patients, the mean age was 2.3 years (range, 0.1-12.7 years), 225 (97.4%) had no underlying disease, and 178 (77.1%) had a fever with a duration of 4.1 ± 2.3 days and a peak temperature of 39.0 ± 0.7 ℃. The most common diagnosis in hPIV4 infection was pneumonia (44.2%), followed by bronchiolitis (26.0%) and upper respiratory tract infection (24.3%). Only 2.2% of patients were diagnosed with croup. Although the most prevalent overall type of hPIV was hPIV3, hPIV4 generally caused acute respiratory tract infection in summer and early fall in an irregular annual pattern. CONCLUSIONS Human parainfluenza virus type 4 is an important common pathogen of respiratory tract infections in pediatric patients in Korea.
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Affiliation(s)
- Young E Gu
- Department of Pediatrics, Chung-Ang University College of Medicine, Seoul, Korea
| | - Ji Y Park
- Department of Pediatrics, Chung-Ang University College of Medicine, Seoul, Korea.,Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Mi K Lee
- Department of Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - In S Lim
- Department of Pediatrics, Chung-Ang University College of Medicine, Seoul, Korea
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Maykowski P, Smithgall M, Zachariah P, Oberhardt M, Vargas C, Reed C, Demmer RT, Stockwell MS, Saiman L. Seasonality and clinical impact of human parainfluenza viruses. Influenza Other Respir Viruses 2018; 12:706-716. [PMID: 30051619 PMCID: PMC6185891 DOI: 10.1111/irv.12597] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 07/05/2018] [Accepted: 07/18/2018] [Indexed: 01/01/2023] Open
Abstract
Background Widespread availability of rapid diagnostic testing for respiratory viruses allows more in‐depth studies of human parainfluenza viruses (HPIV). Objectives This study aimed to assess seasonality of HPIV types 1‐4, clinical outcomes by HPIV type, and risk factors for illness severity. Patients/Methods This retrospective study was performed from January 2013 to December 2015 in children and adults with HPIV, detected by multiplex reverse transcription polymerase chain reaction, participating in a community surveillance study of acute respiratory infections (ARIs) in New York City and patients admitted to a tertiary care center in the same neighborhood. Seasonality trends by HPIV type were compared between the community and hospital groups. The associations between HPIV type, demographics, clinical characteristics, and illness severity were assessed. Results HPIV was detected in 69 (4%) of 1753 community surveillance participants (median age 9.2 years) and 680 hospitalized patients (median age 6.8 years). Seasonality for HPIV types 1‐3 agreed with previously described patterns; HPIV‐4 occurred annually in late summer and fall. In the community cohort, 22 (32%) participants sought medical care, 9 (13%) reported antibiotic use, and 20 (29%) reported ≥1 day of missed work or school. Among hospitalized patients, 24% had ≥4 chronic conditions. Multivariable ordinal logistic regression demonstrated that increased severity of illness was significantly associated with HPIV‐4 and chronic cardiovascular and respiratory conditions in children and with age ≥65 years and chronic respiratory conditions in adults. Conclusions HPIV‐4 presented late summer and early fall annually and was associated with increased severity of illness in hospitalized children.
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Affiliation(s)
- Philip Maykowski
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York.,Department of Pediatrics, Columbia University Medical Center, New York, New York
| | - Marie Smithgall
- Department of Pathology, Columbia University Medical Center, New York, New York
| | - Philip Zachariah
- Department of Pediatrics, Columbia University Medical Center, New York, New York
| | | | - Celibell Vargas
- Department of Pediatrics, Columbia University Medical Center, New York, New York
| | - Carrie Reed
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ryan T Demmer
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Melissa S Stockwell
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York.,Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, New York
| | - Lisa Saiman
- Department of Pediatrics, Columbia University Medical Center, New York, New York.,Department of Infection Prevention and Control, NewYork-Presbyterian Hospital, New York, New York
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Linster M, Do LAH, Minh NNQ, Chen Y, Zhe Z, Tuan TA, Tuan HM, Su YCF, van Doorn HR, Moorthy M, Smith GJD. Clinical and Molecular Epidemiology of Human Parainfluenza Viruses 1-4 in Children from Viet Nam. Sci Rep 2018; 8:6833. [PMID: 29717150 PMCID: PMC5931535 DOI: 10.1038/s41598-018-24767-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 03/20/2018] [Indexed: 11/08/2022] Open
Abstract
HPIVs are serologically and genetically grouped into four species that account for up to 10% of all hospitalizations due to acute respiratory infection in children under the age of five. Genetic and epidemiological data for the four HPIVs derived from two pediatric cohorts in Viet Nam are presented. Respiratory samples were screened for HPIV1-4 by real-time PCR. Demographic and clinical data of patients infected with different HPIV were compared. We used a hemi-nested PCR approach to generate viral genome sequences from HPIV-positive samples and conducted a comprehensive phylogenetic analysis. In total, 170 samples tested positive for HPIV. HPIV3 was most commonly detected in our cohort and 80 co-detections of HPIV with other respiratory viruses were found. Phylogenetic analyses suggest local endemic circulation as well as punctuated introductions of new HPIV lineages. Viral gene flow analysis revealed that Viet Nam is a net importer of viral genetic diversity. Epidemiological analyses imply similar disease severity for all HPIV species. HPIV sequences from Viet Nam formed local clusters and were interspersed with sequences from diverse geographic regions. Combined, this new knowledge will help to investigate global HPIV circulation patterns in more detail and ultimately define more suitable vaccine strains.
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Affiliation(s)
- Martin Linster
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore
| | - Lien Anh Ha Do
- Oxford University Clinical Research Unit-Viet Nam, Ho Chi Minh City, Vietnam
- Murdoch's Children Research Institute, Melbourne, Australia
| | - Ngo Ngoc Quang Minh
- Oxford University Clinical Research Unit-Viet Nam, Ho Chi Minh City, Vietnam
- Children's Hospital 1, Ho Chi Minh City, Vietnam
| | - Yihui Chen
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore
| | - Zhu Zhe
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore
| | | | - Ha Manh Tuan
- Children's Hospital 2, Ho Chi Minh City, Vietnam
| | - Yvonne C F Su
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore
| | - H Rogier van Doorn
- Oxford University Clinical Research Unit-Viet Nam, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Mahesh Moorthy
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore.
- Department of Clinical Virology, Christian Medical College, Vellore, India.
| | - Gavin J D Smith
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
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Etiology and Clinical Characteristics of Single and Multiple Respiratory Virus Infections Diagnosed in Croatian Children in Two Respiratory Seasons. J Pathog 2016; 2016:2168780. [PMID: 27656298 PMCID: PMC5021477 DOI: 10.1155/2016/2168780] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 07/20/2016] [Accepted: 08/16/2016] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to determine the causative agent of acute respiratory infection (ARI) in hospitalized children, as well as investigate the characteristics of ARIs with single and multiple virus detection in two respiratory seasons. In 2010 and 2015, nasopharyngeal and pharyngeal swabs from a total of 134 children, admitted to the hospital due to ARI, were tested using multiplex PCR. Viral etiology was established in 81.3% of the patients. Coinfection with two viruses was diagnosed in 27.6% of the patients, and concurrent detection of three or more viruses was diagnosed in 12.8% of the patients. The most commonly diagnosed virus in both seasons combined was respiratory syncytial virus (RSV) (28.6%), followed by parainfluenza viruses (PIVs) types 1–3 (18.4%), rhinovirus (HRV) (14.3%), human metapneumovirus (10.1%), adenovirus (AdV) (7.1%), influenza viruses types A and B (4.8%), and coronaviruses (4.2%). In 2015, additional pathogens were investigated with the following detection rate: enterovirus (13.2%), bocavirus (HBoV) (10.5%), PIV-4 (2.6%), and parechovirus (1.3%). There were no statistical differences between single and multiple virus infection regarding patients age, localization of infection, and severity of disease (P > 0.05). AdV, HRV, HBoV, and PIVs were significantly more often detected in multiple virus infections compared to the other respiratory viruses (P < 0.001).
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Salvatore M, Satlin MJ, Jacobs SE, Jenkins SG, Schuetz AN, Moss RB, Van Besien K, Shore T, Soave R. DAS181 for Treatment of Parainfluenza Virus Infections in Hematopoietic Stem Cell Transplant Recipients at a Single Center. Biol Blood Marrow Transplant 2016; 22:965-70. [PMID: 26904972 DOI: 10.1016/j.bbmt.2016.02.011] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 02/12/2016] [Indexed: 11/29/2022]
Abstract
Parainfluenza virus (PIV) causes severe respiratory infections in hematopoietic stem cell transplant (HSCT) recipients. Currently, no effective therapies are available. DAS181 is a novel antiviral agent that inhibits attachment of PIV to respiratory cells, but clinical data on the use of DAS181 for PIV infection are limited to case reports. We report the clinical manifestations and outcomes of 16 HSCT recipients who received DAS181 daily for the treatment of PIV infection through a compassionate-use protocol or a single-arm clinical trial. Of the 16 patients (clinical trial: 9; compassionate use: 7), 13 were allogeneic HSCT recipients and 8 had graft-versus-host disease. PIV types were 3 (n = 7), 4 (n = 5), 1 (n = 3), and type 3 and 4 coinfection (n = 1). Fourteen patients had pneumonia. All patients presented with cough, 14 had dyspnea, 11 had hypoxia, and 8 had a fever. Patients received 5 to 10 days of treatment. Nine patients (56%) had a complete clinical response after DAS181 therapy and 4 (25%) had a partial response. The 3 patients without a clinical response had coinfections with other pathogens. Of the 7 patients with virologic and spirometric data, 5 had >1-log reduction in nasopharyngeal swab PIV viral load and 4 had improved forced expiratory volumes by the end of treatment. Three patients (19%) died within 30 days and 2 of these deaths were related to PIV infection. Our data suggest that DAS181 may be an effective therapy for PIV pneumonia in HSCT recipients. Randomized placebo-controlled trials are needed to better evaluate its efficacy.
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Affiliation(s)
| | - Michael J Satlin
- Department of Medicine, Weill Cornell Medicine, New York, New York
| | | | - Stephen G Jenkins
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York
| | - Audrey N Schuetz
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York
| | - Ronald B Moss
- Ansun Pharmaceuticals, Ansun BioPharma, San Diego, California
| | - Koen Van Besien
- Department of Medicine, Weill Cornell Medicine, New York, New York
| | - Tsiporah Shore
- Department of Medicine, Weill Cornell Medicine, New York, New York
| | - Rosemary Soave
- Department of Medicine, Weill Cornell Medicine, New York, New York
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12
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Villaran MV, García J, Gomez J, Arango AE, Gonzales M, Chicaiza W, Alemán W, Lorenzana de Rivera I, Sanchez F, Aguayo N, Kochel TJ, Halsey ES. Human parainfluenza virus in patients with influenza-like illness from Central and South America during 2006-2010. Influenza Other Respir Viruses 2013; 8:217-27. [PMID: 24286248 PMCID: PMC4186470 DOI: 10.1111/irv.12211] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2013] [Indexed: 11/29/2022] Open
Abstract
Background Human parainfluenza viruses (HPIVs) are common viral causes of community-acquired pneumonia, particularly in children. The four types of HPIV have world-wide distribution; however, limited information exists about the epidemiological profile of HPIV in Latin-America. Objective Provide epidemiologic and phylogenetic information about HPIVs that circulated in Latin America between 2006 and 2010 to better characterize the extent and variability of this respiratory virus in the region. Methods Oropharyngeal swabs, demographic data and clinical characteristics were obtained from individuals with influenza-like illness in 10 Latin-American countries between 2006–2010. Specimens were analyzed with culture and molecular methods. Results A total of 30 561 individuals were enrolled; 991 (3·2%) were HPIV positive. Most infected participants were male (53·7%) and under 5 years of age (68·7%). The HPIV type most frequently isolated was HPIV-3 (403, 40·7%). In 66/2007 (3·3%) hospitalized individuals, HPIV was identified. The most frequent symptoms at enrollment were cough and rhinorrhea. We identified certain patterns for HPIV-1, -2 and -3 in specific cities. Phylogenetic analysis revealed a homogeneous distribution in the region. Conclusions In the current scenario, no vaccine or treatment is available for this pathogen. Our results contribute to the scarce epidemiologic and phylogenetic information of HPIV in the region that could support the development of specific management.
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Frost HM, Robinson CC, Dominguez SR. Epidemiology and clinical presentation of parainfluenza type 4 in children: a 3-year comparative study to parainfluenza types 1-3. J Infect Dis 2013; 209:695-702. [PMID: 24133181 PMCID: PMC3923541 DOI: 10.1093/infdis/jit552] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background. Human parainfluenza viruses (HPIVs) are among the most common causes of respiratory tract infections in children. Little is known about the epidemiology and clinical presentation of HPIV type 4. Methods. A retrospective chart review and comparison of patients positive for HPIV types 1–4 by multiplex polymerase chain reaction between 2009 and 2012 at Children's Hospital Colorado was performed. Patients who had only direct fluorescent antibody testing performed or concurrent viral infections were excluded. Results. Of 11 533 samples, 752 (6.5%) were positive for HPIV. After exclusion criteria, 316 samples were included in the study. HPIV-4 had year-round prevalence with biennial peaks in odd-numbered years. HPIV-4 and HPIV-3 had similar clinical presentations. 50.8% and 51.5% of patients with HPIV-3–4 had hypoxia compared to 20.3% and 33.3% of patients with HPIV-1–2 (P < .01). HPIV-1 (23.6%) and HPIV-2 (24.2%) were more associated with stridor than HPIV-3 (6.6%) and HPIV-4 (0%) (P < .01). No patients with HPIV-4 had croup. Patients with HPIV-4 had similar lengths of stay and mortality as those with HPIV-1–3. Conclusions. This is the first large-scale analysis of HPIV-4 clinical and epidemiologic features. HPIV-4 was most similar to HPIV-3 in clinical presentation. HPIV-4 had year-round prevalence with peaks in the autumn of odd-numbered years. HPIV-4 is a common respiratory pathogen capable of causing significant morbidity in children.
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Affiliation(s)
- Holly M Frost
- Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado
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Martin ET, Fairchok MP, Stednick ZJ, Kuypers J, Englund JA. Epidemiology of multiple respiratory viruses in childcare attendees. J Infect Dis 2013; 207:982-9. [PMID: 23288925 PMCID: PMC7107308 DOI: 10.1093/infdis/jis934] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Background. The identification of multiple viruses during respiratory illness is increasing with advances in rapid molecular testing; however, the epidemiology of respiratory viral coinfections is not well known. Methods. In total, 225 childcare attendees were prospectively followed for up to 2 years. Nasal swabs were collected at respiratory illness onset and every 7–10 days until illness resolution. Swabs were tested by polymerase chain reaction for 15 respiratory viruses and subtypes. Results. At least 1 virus was detected in 382 (84%) of 455 new-onset illnesses with multiple viruses identified in 212 (46%). The proportion of subject swabs with multiple viruses detected changed as respiratory illnesses progressed from week to week, as did the prevalence of individual viruses. Children with multiple viruses detected at the time of illness onset had less frequent fever (odds ratio [OR], 0.56; 95% confidence interval [CI], 0.35, 0.90), however, these children more often had illness symptoms lasting over 7 days (OR, 1.94; 95% CI, 1.20, 3.14). Conclusions. A high proportion of daycare attendees had multiple viruses detected during respiratory illnesses. Delay between onset of illness and viral detection varied by virus, indicating that some viruses may be underrepresented in studies of virus epidemiology that rely on only a single test at symptom onset.
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Affiliation(s)
- Emily T Martin
- Department of Pharmacy Practice, Wayne State University, Detroit, Michigan, USA.
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Alquezar-Planas DE, Mourier T, Bruhn CAW, Hansen AJ, Vitcetz SN, Mørk S, Gorodkin J, Nielsen HA, Guo Y, Sethuraman A, Paxinos EE, Shan T, Delwart EL, Nielsen LP. Discovery of a divergent HPIV4 from respiratory secretions using second and third generation metagenomic sequencing. Sci Rep 2013; 3:2468. [PMID: 24002378 PMCID: PMC3760282 DOI: 10.1038/srep02468] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Accepted: 07/26/2013] [Indexed: 11/13/2022] Open
Abstract
Molecular detection of viruses has been aided by high-throughput sequencing, permitting the genomic characterization of emerging strains. In this study, we comprehensively screened 500 respiratory secretions from children with upper and/or lower respiratory tract infections for viral pathogens. The viruses detected are described, including a divergent human parainfluenza virus type 4 from GS FLX pyrosequencing of 92 specimens. Complete full-genome characterization of the virus followed, using Single Molecule, Real-Time (SMRT) sequencing. Subsequent "primer walking" combined with Sanger sequencing validated the RS platform's utility in viral sequencing from complex clinical samples. Comparative genomics reveals the divergent strain clusters with the only completely sequenced HPIV4a subtype. However, it also exhibits various structural features present in one of the HPIV4b reference strains, opening questions regarding their lifecycle and evolutionary relationships among these viruses. Clinical data from patients infected with the strain, as well as viral prevalence estimates using real-time PCR, is also described.
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Affiliation(s)
- David E. Alquezar-Planas
- Centre for GeoGenetics, Natural History Museum of Denmark, University of Copenhagen, Øster Voldgade 5-7, 1350 Copenhagen, Denmark
- Department of Virology, Statens Serum Institut, Artillerivej 5, 2300 Copenhagen, Denmark
| | - Tobias Mourier
- Centre for GeoGenetics, Natural History Museum of Denmark, University of Copenhagen, Øster Voldgade 5-7, 1350 Copenhagen, Denmark
| | - Christian A. W. Bruhn
- Centre for GeoGenetics, Natural History Museum of Denmark, University of Copenhagen, Øster Voldgade 5-7, 1350 Copenhagen, Denmark
| | - Anders J. Hansen
- Centre for GeoGenetics, Natural History Museum of Denmark, University of Copenhagen, Øster Voldgade 5-7, 1350 Copenhagen, Denmark
| | - Sarah Nathalie Vitcetz
- Centre for GeoGenetics, Natural History Museum of Denmark, University of Copenhagen, Øster Voldgade 5-7, 1350 Copenhagen, Denmark
| | - Søren Mørk
- Center for non-coding RNA in Technology and Health, Department of Veterinary Clinical and Animal Science, University of Copenhagen, Grønnegårdsvej 3, 1870 Frederiksberg C, Denmark
| | - Jan Gorodkin
- Center for non-coding RNA in Technology and Health, Department of Veterinary Clinical and Animal Science, University of Copenhagen, Grønnegårdsvej 3, 1870 Frederiksberg C, Denmark
| | | | - Yan Guo
- Pacific Biosciences, Menlo Park, California, USA
| | | | | | - Tongling Shan
- Department of Swine Infectious Disease, Shanghai Veterinary Research Institute (SHVRI), Chinese Academy of Agricultural Sciences (CAAS)
- Blood Systems Research Institute, San Francisco, California
| | - Eric L. Delwart
- Blood Systems Research Institute, San Francisco, California
- Department of Laboratory Medicine, University of California at San Francisco, San Francisco, California
| | - Lars P. Nielsen
- Department of Virology, Statens Serum Institut, Artillerivej 5, 2300 Copenhagen, Denmark
- Department of Clinical Microbiology, Odense University Hospital, Denmark
- Aalborg University, Department of Health Sciences, Aalborg, Denmark
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Abstract
PURPOSE OF REVIEW The global significance of cryptosporidiosis is widespread and far-reaching. In this review, we present recent data about strain diversity and the burden of disease, along with developments in therapeutic and preventive strategies. RECENT FINDINGS Cryptosporidium is an emerging pathogen that disproportionately affects children in developing countries and immunocompromised individuals. Without a diagnostic tool amenable for use in developing countries, the burden of infection and its relationship to growth faltering, malnutrition, and diarrheal mortality remain underappreciated. Disease incidence is also increasing in industrialized countries largely as a result of outbreaks in recreational water facilities. Advances in molecular methods, including subtyping analysis, have yielded new insights into the epidemiology of cryptosporidiosis. However, without practical point-of-care diagnostics, an effective treatment for immunocompromised patients, and a promising vaccine candidate, the ability to reduce the burden of disease in the near future is limited. This is compounded by inadequate coverage with antiretroviral therapy in developing countries, the only current means of managing HIV-infected patients with cryptosporidiosis. SUMMARY Cryptosporidiosis is one of the most important diarrheal pathogens affecting people worldwide. Effective methods to control and treat cryptosporidiosis among high-risk groups present an ongoing problem in need of attention.
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Braun LE, Renaud C, Fairchok MP, Kuypers J, Englund JA, Martin ET. Human Parechovirus and Other Enteric Viruses in Childcare Attendees in the Era of Rotavirus Vaccines. J Pediatric Infect Dis Soc 2012; 1:136-43. [PMID: 26619166 DOI: 10.1093/jpids/pis005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Accepted: 01/02/2012] [Indexed: 11/13/2022]
Abstract
OBJECTIVE We studied the prevalence of enteric viruses, including rotavirus, enterovirus, norovirus, adenovirus, and human parechovirus (HPeV), in stool samples of childcare attendees. The prevalence of enteric viruses was described in children with and those without gastroenteritis. METHODS Children aged 1-19 months were recruited from 2 childcare centers in Tacoma, Washington, from October 2008 through June 2009. Stool samples were obtained at enrollment and during diarrheal illnesses for enteric virus testing. A symptom diary was completed by parents. RESULTS One hundred six children (mean age, 10 months) were followed for an average of 170 days. At enrollment, 78 asymptomatic children had stool samples available. Forty-eight illnesses with acute diarrhea (stool samples were available for 24 illnesses) occurred in 37 children. Rotavirus was not detected in samples from symptomatic or asymptomatic children. HPeV was present in 21% and adenovirus in 46% of symptomatic children. At least 1 virus was detected in 78% of samples from asymptomatic children, including HPeV in 27% and adenovirus in 55%. No differences were found in symptom prevalence between HPeV-positive and HPeV-negative diarrheal illnesses. Molecular analysis revealed a diversity of HPeV types. CONCLUSIONS Our study highlights the high level of HPeV circulation in childcare. The lack of rotavirus detected in this study supports the impact of rotavirus vaccine and emphasizes the need for a greater focus on the epidemiology of non-rotavirus etiologies of gastroenteritis.
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Affiliation(s)
| | - Christian Renaud
- Department of Laboratory Medicine, University of Washington, Seattle
| | | | - Jane Kuypers
- Department of Laboratory Medicine, University of Washington, Seattle
| | - Janet A Englund
- Pediatric Infectious Diseases, Seattle Children's Hospital Department of Pediatrics, University of Washington, Seattle, Washington
| | - Emily T Martin
- Department of Pharmacy Practice, Wayne State University, Detroit, Michigan
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Schomacker H, Schaap-Nutt A, Collins PL, Schmidt AC. Pathogenesis of acute respiratory illness caused by human parainfluenza viruses. Curr Opin Virol 2012; 2:294-9. [PMID: 22709516 DOI: 10.1016/j.coviro.2012.02.001] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2012] [Accepted: 02/03/2012] [Indexed: 12/15/2022]
Abstract
Human parainfluenza viruses (HPIVs) are a common cause of acute respiratory illness throughout life. Infants, children, and the immunocompromised are the most likely to develop severe disease. HPIV1 and HPIV2 are best known to cause croup while HPIV3 is a common cause of bronchiolitis and pneumonia. HPIVs replicate productively in respiratory epithelial cells and do not spread systemically unless the host is severely immunocompromised. Molecular studies have delineated how HPIVs evade and block cellular innate immune responses to permit efficient replication, local spread, and host-to-host transmission. Studies using ex vivo human airway epithelium have focused on virus tropism, cellular pathology and the epithelial inflammatory response, elucidating how events early in infection shape the adaptive immune response and disease outcome.
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Affiliation(s)
- Henrick Schomacker
- Laboratory of Infectious Diseases, RNA Viruses Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
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