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Nguyen TL, Kim H. Integrating immunoinformatics and computational epitope prediction for a vaccine candidate against respiratory syncytial virus. Infect Dis Model 2024; 9:763-774. [PMID: 38708060 PMCID: PMC11068479 DOI: 10.1016/j.idm.2024.04.005] [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: 02/12/2024] [Revised: 04/04/2024] [Accepted: 04/10/2024] [Indexed: 05/07/2024] Open
Abstract
Respiratory syncytial virus (RSV) poses a significant global health threat, especially affecting infants and the elderly. Addressing this, the present study proposes an innovative approach to vaccine design, utilizing immunoinformatics and computational strategies. We analyzed RSV's structural proteins across both subtypes A and B, identifying potential helper T lymphocyte, cytotoxic T lymphocyte, and linear B lymphocyte epitopes. Criteria such as antigenicity, allergenicity, toxicity, and cytokine-inducing potential were rigorously examined. Additionally, we evaluated the conservancy of these epitopes and their population coverage across various RSV strains. The comprehensive analysis identified six major histocompatibility complex class I (MHC-I) binding, five MHC-II binding, and three B-cell epitopes. These were integrated with suitable linkers and adjuvants to form the vaccine. Further, molecular docking and molecular dynamics simulations demonstrated stable interactions between the vaccine candidate and human Toll-like receptors (TLR4 and TLR5), with a notable preference for TLR4. Immune simulation analysis underscored the vaccine's potential to elicit a strong immune response. This study presents a promising RSV vaccine candidate and offers theoretical support, marking a significant advancement in vaccine development efforts. However, the promising in silico findings need to be further validated through additional in vivo studies.
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Affiliation(s)
- Truc Ly Nguyen
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Sciences, Seoul National University, Seoul, 08826, Republic of Korea
| | - Heebal Kim
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Sciences, Seoul National University, Seoul, 08826, Republic of Korea
- Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, 08826, Republic of Korea
- eGnome, Inc., Seoul, 05836, Republic of Korea
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2
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Sondlane H, Ogunbayo A, Donato C, Mogotsi M, Esona M, Hallbauer U, Bester P, Goedhals D, Nyaga M. Whole genome molecular analysis of respiratory syncytial virus pre and during the COVID-19 pandemic in Free State province, South Africa. Virus Res 2024; 347:199421. [PMID: 38942296 PMCID: PMC11283024 DOI: 10.1016/j.virusres.2024.199421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 05/14/2024] [Accepted: 06/16/2024] [Indexed: 06/30/2024]
Abstract
Respiratory syncytial virus (RSV) is the most predominant viral pathogen worldwide in children with lower respiratory tract infections. The Coronavirus disease 2019 (COVID-19) pandemic and resulting nonpharmaceutical interventions perturbed the transmission pattern of respiratory pathogens in South Africa. A seasonality shift and RSV resurgence was observed in 2020 and 2021, with several infected children observed. Conventional RSV-positive nasopharyngeal swabs were collected from various hospitals in the Free State province, Bloemfontein, South Africa, from children suffering from respiratory distress and severe acute respiratory infection between 2020 to 2021. Overlapping genome fragments were amplified and complete genomes were sequenced using the Illumina MiSeq platform. Maximum likelihood phylogenetic and evolutionary analysis were performed on both RSV-A/-B G-genes with published reference sequences from GISAID and GenBank. Our study strains belonged to the RSV-A GA2.3.2 and RSV-B GB5.0.5a clades. The upsurge of RSV was due to pre-existing strains that predominated in South Africa and circulating globally also driving these off-season RSV outbreaks during the COVID-19 pandemic. The variants responsible for the resurgence were phylogenetically related to pre-pandemic strains and could have contributed to the immune debt resulting from pandemic imposed restrictions. The deviation of the RSV season from the usual pattern affected by the COVID-19 pandemic highlights the need for ongoing genomic surveillance and the identification of genetic variants to prevent unforeseen outbreaks in the future.
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Affiliation(s)
- Hlengiwe Sondlane
- Next Generation Sequencing Unit and Division of Virology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Ayodeji Ogunbayo
- Next Generation Sequencing Unit and Division of Virology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Celeste Donato
- Enteric Diseases Group, Murdoch Children's Research Institute, Parkville, VIC, Australia; Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia; The Centre for Pathogen Genomics, The Doherty Institute, University of Melbourne, Australia
| | - Milton Mogotsi
- Next Generation Sequencing Unit and Division of Virology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Mathew Esona
- Diarrheal Pathogens Research Unit, Sefako Makgatho Health Sciences University, Medunsa 0204, Pretoria, South Africa
| | - Ute Hallbauer
- Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Phillip Bester
- Division of Virology, School of Pathology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Dominique Goedhals
- Division of Virology, School of Pathology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa; PathCare, Pretoria, South Africa
| | - Martin Nyaga
- Next Generation Sequencing Unit and Division of Virology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
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Nuttens C, Moyersoen J, Curcio D, Aponte-Torres Z, Baay M, Vroling H, Gessner BD, Begier E. Differences Between RSV A and RSV B Subgroups and Implications for Pharmaceutical Preventive Measures. Infect Dis Ther 2024; 13:1725-1742. [PMID: 38971918 PMCID: PMC11266343 DOI: 10.1007/s40121-024-01012-2] [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: 10/20/2023] [Accepted: 06/21/2024] [Indexed: 07/08/2024] Open
Abstract
INTRODUCTION Understanding the differences between respiratory syncytial virus (RSV) subgroups A and B provides insights for the development of prevention strategies and public health interventions. We aimed to describe the structural differences of RSV subgroups, their epidemiology, and genomic diversity. The associated immune response and differences in clinical severity were also investigated. METHODS A literature review from PubMed and Google Scholar (1985-2023) was performed and extended using snowballing from references in captured publications. RESULTS RSV has two major antigenic subgroups, A and B, defined by the G glycoprotein. The RSV F fusion glycoprotein in the prefusion conformation is a major target of virus neutralizing antibodies and differs in surface exposed regions between RSV A and RSV B. The subgroups co-circulate annually, but there is considerable debate as to whether clinical severity is impacted by the subgroup of the infecting RSV strain. Large variations between the studies reporting RSV subgroup impact on clinical severity were observed. A tendency for higher disease severity may be attributed to RSV A but no consensus could be reached as to whether infection by one of the subgroup caused more severe outcomes. RSV genotype diversity decreased over the last two decades, and ON and BA have become the sole lineages detected for RSV A and RSV B, since 2014. No studies with data obtained after 2014 reported a difference in disease severity between the two subgroups. RSV F is relatively well conserved and highly similar between RSV A and B, but changes in the amino acid sequence have been observed. Some of these changes led to differences in F antigenic sites compared to reference F sequences (e.g., RSV/A Long strain), which are more pronounced in antigenic sites of the prefusion conformation of RSV B. Initial results from the second season after vaccination suggest specific RSV B efficacy wanes more rapidly than RSV A for RSV PreF-based monovalent vaccines. CONCLUSIONS RSV A and RSV B both contribute substantially to the global RSV burden. Both RSV subgroups cause severe disease and none of the available evidence to date suggests any differences in clinical severity between the subgroups. Therefore, it is important to implement measures effective at preventing disease due to both RSV A and RSV B to ensure impactful public health interventions. Monitoring overtime will be needed to assess the impact of waning antibody levels on subgroup-specific efficacy.
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Affiliation(s)
| | | | | | | | - Marc Baay
- Epidemiology & Pharmacovigilance, P95, Louvain, Belgium
| | - Hilde Vroling
- Epidemiology & Pharmacovigilance, P95, Louvain, Belgium
| | | | - Elizabeth Begier
- Scientific Affairs, Older Adult RSV Vaccine Program, Global Medical Development Scientific and Clinical Affairs, Pfizer Vaccines, 9 Riverwalk, Citywest Business Campus, Dublin 24, Dublin, Ireland.
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4
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Zambrana W, Huang C, Solis D, Sahoo MK, Pinsky BA, Boehm AB. Spatial and temporal variation in respiratory syncytial virus (RSV) subtype RNA in wastewater and relation to clinical specimens. mSphere 2024; 9:e0022424. [PMID: 38926903 PMCID: PMC11288019 DOI: 10.1128/msphere.00224-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 06/08/2024] [Indexed: 06/28/2024] Open
Abstract
Respiratory syncytial virus (RSV) causes a large burden of respiratory illness globally. It has two subtypes, RSV A and RSV B, but little is known regarding the predominance of these subtypes during different seasons and their impact on morbidity and mortality. Using molecular methods, we quantified RSV A and RSV B RNA in wastewater solids across multiple seasons and metropolitan areas to gain insight into the predominance of RSV subtypes. We determined the predominant subtype for each group using the proportion of RSV A to total RSV (RSV A + RSV B) in each wastewater sample (PA,WW) and conducted a comparative analysis temporally, spatially, and against clinical specimens. A median PA,WW of 0.00 in the first season and 0.58 in the second season indicated a temporal shift in the predominant subtype. Spatially, while we observed dominance of the same subtype, PA,WW was higher in some areas (PA,WW = 0.58-0.88). The same subtype predominated in wastewater and clinical samples, but clinical samples showed higher levels of RSV A (RSV A positivity in clinical samples = 0.79, median PA,WW = 0.58). These results suggest that wastewater, alongside clinical data, holds promise for enhanced subtype surveillance.IMPORTANCERespiratory syncytial virus (RSV) causes a large burden of respiratory illness globally. It has two subtypes, RSV A and RSV B, but little is known regarding the predominance of these subtypes during different seasons and their impact on morbidity and mortality. The study illustrates that information on subtype predominance can be gleaned from wastewater. As a biological composite sample from the entire contributing population, wastewater monitoring of RSV A and B can complement clinical surveillance of RSV.
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Affiliation(s)
- Winnie Zambrana
- Department of Civil & Environmental Engineering, Stanford University, Stanford, California, USA
| | - ChunHong Huang
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Daniel Solis
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Malaya K. Sahoo
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Benjamin A. Pinsky
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Alexandria B. Boehm
- Department of Civil & Environmental Engineering, Stanford University, Stanford, California, USA
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5
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Musa AO, Faber SR, Forrest K, Smith KP, Sengupta S, López CB. Identification of distinct genotypes in circulating RSV A strains based on variants in the virus replication-associated genes. J Virol 2024:e0099024. [PMID: 39007617 DOI: 10.1128/jvi.00990-24] [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: 06/06/2024] [Accepted: 06/16/2024] [Indexed: 07/16/2024] Open
Abstract
Respiratory syncytial virus (RSV) is a common cause of respiratory infection that often leads to hospitalization of infected younger children and older adults. RSV is classified into two strains, A and B, each with several subgroups or genotypes. One issue with the definition of these subgroups is the lack of a unified method of identification or genotyping. We propose that genotyping strategies based on the genes coding for replication-associated proteins could provide critical information on the replication capacity of the distinct subgroups, while clearly distinguishing genotypes. Here, we analyzed the virus replication-associated genes N, P, M2, and L from de novo assembled RSV A sequences obtained from 31 newly sequenced samples from hospitalized patients in Philadelphia and 78 additional publicly available sequences from different geographic locations within the United States. In-depth analysis and annotation of variants in the replication-associated proteins identified the polymerase protein L as a robust target for genotyping RSV subgroups. Importantly, our analysis revealed non-synonymous variations in L that were consistently accompanied by conserved changes in its co-factor P or the M2-2 protein, suggesting associations and interactions between specific domains of these proteins. Similar associations were seen among sequences of the related human metapneumovirus. These results highlight L as an alternative to other RSV genotyping targets and demonstrate the value of in-depth analyses and annotations of RSV sequences as it can serve as a foundation for subsequent in vitro and clinical studies on the efficiency of the polymerase and fitness of different virus isolates.IMPORTANCEGiven the historical heterogeneity of respiratory syncytial virus (RSV) and the disease it causes, there is a need to understand the properties of the circulating RSV strains each season. This information would benefit from an informative and consensus method of genotyping the virus. Here, we carried out a variant analysis that shows a pattern of specific variations among the replication-associated genes of RSV A across different seasons. Interestingly, these variation patterns, which were also seen in human metapneumovirus sequences, point to previously defined interactions of domains within these genes, suggesting co-variation in the replication-associated genes. Our results also suggest a genotyping strategy that can prove to be particularly important in understanding the genotype-phenotype correlation in the era of RSV vaccination, where selective pressure on the virus to evolve is anticipated. More importantly, the categorization of pneumoviruses based on these patterns may be of prognostic value.
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Affiliation(s)
- Abdulafiz O Musa
- Department of Molecular Microbiology, Washington University School of Medicine, Saint Louis, Missouri, USA
- Center for Women's Infectious Diseases Research, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Sydney R Faber
- Department of Molecular Microbiology, Washington University School of Medicine, Saint Louis, Missouri, USA
- Center for Women's Infectious Diseases Research, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Kaitlyn Forrest
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Kenneth P Smith
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Infectious Disease Diagnostics Laboratory, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Shaon Sengupta
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Carolina B López
- Department of Molecular Microbiology, Washington University School of Medicine, Saint Louis, Missouri, USA
- Center for Women's Infectious Diseases Research, Washington University School of Medicine, Saint Louis, Missouri, USA
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De R, Jiang M, Sun Y, Huang S, Zhu R, Guo Q, Zhou Y, Qu D, Cao L, Lu F, Zhao L. A Scoring System to Predict Severe Acute Lower Respiratory Infection in Children Caused by Respiratory Syncytial Virus. Microorganisms 2024; 12:1411. [PMID: 39065180 PMCID: PMC11278654 DOI: 10.3390/microorganisms12071411] [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: 06/20/2024] [Revised: 07/04/2024] [Accepted: 07/07/2024] [Indexed: 07/28/2024] Open
Abstract
There were several factors associated with respiratory syncytial virus (RSV) severe acute lower respiratory infection (RSV-sALRI) in infants and young children. It is vital to develop a convenient scoring system to predict RSV-sALRI in children. Pediatric patients with RSV-ALRI from January 2009 to December 2021 were recruited retrospectively. Two-third of them were randomly grouped into the development set and one-third to the validation set. In the development set, risk factors for RSV-sALRI were transferred into the logistic regression analysis, then their receiver operating characteristic (ROC) curves were built to obtain the area under the ROC curve (AUC), and regression coefficients for each predictor were converted to points. Finally, the value of the scoring system was evaluated in the validation set. A total of 1 066 children with RSV-ALRI were recruited, including 710 in the development set and 356 in the validation set. By logistic regression analysis, six factors (younger than 2 years, gestational age <37 weeks, have siblings, birth weight ≤2500 g, artificial/mix feeding, CHD) showed statistical difference and then were scored with points according to the coefficient value (OR) in the development set. In the validation set, the sensitivity of the scoring system was 70.25%, the specificity 85.53%, the positive predictive value 71.43%, the negative predictive value 84.81%, and coincidence rate 0.80. The Kolmogorov-Smirnov test showed the distribution of AUC 0.765 (SE = 0.027; 95% CI = 0.713-0.818; p < 0.001). A simplified scoring system was developed in the study with high prediction value for RSV-sALRI in children.
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Affiliation(s)
- Ri De
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China;
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Disease in Children, Capital Institute of Pediatrics, Beijing 100020, China; (M.J.); (Y.S.); (R.Z.); (Q.G.); (Y.Z.)
| | - Mingli Jiang
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Disease in Children, Capital Institute of Pediatrics, Beijing 100020, China; (M.J.); (Y.S.); (R.Z.); (Q.G.); (Y.Z.)
| | - Yu Sun
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Disease in Children, Capital Institute of Pediatrics, Beijing 100020, China; (M.J.); (Y.S.); (R.Z.); (Q.G.); (Y.Z.)
| | - Siyuan Huang
- Department of Intensive Care Unit, Affiliated Children’s Hospital, Capital Institute of Pediatrics, Beijing 100020, China; (S.H.); (D.Q.)
| | - Runan Zhu
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Disease in Children, Capital Institute of Pediatrics, Beijing 100020, China; (M.J.); (Y.S.); (R.Z.); (Q.G.); (Y.Z.)
| | - Qi Guo
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Disease in Children, Capital Institute of Pediatrics, Beijing 100020, China; (M.J.); (Y.S.); (R.Z.); (Q.G.); (Y.Z.)
| | - Yutong Zhou
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Disease in Children, Capital Institute of Pediatrics, Beijing 100020, China; (M.J.); (Y.S.); (R.Z.); (Q.G.); (Y.Z.)
| | - Dong Qu
- Department of Intensive Care Unit, Affiliated Children’s Hospital, Capital Institute of Pediatrics, Beijing 100020, China; (S.H.); (D.Q.)
| | - Ling Cao
- Department of Respiratory Medicine, Affiliated Children’s Hospital, Capital Institute of Pediatrics, Beijing 100020, China;
| | - Fengmin Lu
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China;
| | - Linqing Zhao
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Disease in Children, Capital Institute of Pediatrics, Beijing 100020, China; (M.J.); (Y.S.); (R.Z.); (Q.G.); (Y.Z.)
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Chen D, Ru X, Chen S, Shao Q, Ye Q. Analysis of the prevalence and clinical features of respiratory syncytial virus infection in a pediatric hospital in Zhejiang Province from 2019 to 2023. J Med Virol 2024; 96:e29758. [PMID: 38895781 DOI: 10.1002/jmv.29758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Revised: 05/29/2024] [Accepted: 06/11/2024] [Indexed: 06/21/2024]
Abstract
The aim of this study was to investigate the epidemiological characteristics of respiratory syncytial virus (RSV) infections in children in Zhejiang from 2019 to 2023. Data from pediatric patients who visited the Children's Hospital of Zhejiang University School of Medicine for RSV infection between 2019 and 2023 were analyzed. Nasopharyngeal swabs were collected for RSV antigen detection, and relevant patient information was collected. Factors such as age were analyzed. A total of 673 094 specimens were included from 2019 to 2023, with a rate of positive specimens of 4.74% (31 929/673 094). The highest rate of positive specimens of 10.82%, was recorded in 2021, while the remaining years had a rate of approximately 3%-5%. In terms of seasonal prevalence characteristics, the rate of positive specimens in 2019, 2020, and 2022 peaked in the winter months at approximately 8% and decreased in the summer months, where the rate of positive specimens remained at approximately 0.5%. In contrast, summer is the peak period for RSV incidence in 2021 and 2023, with the rate of positive specimens being as high as 9%-12%. Based on the prevalence characteristics of gender and age, this study found that the detection rate of positive specimens was higher in boys than in girls in 2019-2023. In 2019-2022, among the different age groups, the highest rate of positive specimens was found in children aged 0 to <6 months, and it decreased with age. In 2023, the rate of positive specimens was above 8% in the 0 to <6 months, 6 to <12 months, and 1-2 years age groups, with the highest rate of positive specimens in the 1-2 years age group, and a gradual decrease in the rate of positive specimens with age for children over 3 years of age. Between 2019 and 2023, the epidemiological pattern of RSV changed. A summer peak was observed in 2021 and 2023.
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Affiliation(s)
- Danlei Chen
- Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Medical Technology and Information Engineering, Zhejiang Chinese Medicine University, Hangzhou, China
| | - Xuanwen Ru
- Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Simiao Chen
- Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qingyi Shao
- Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Medical Technology and Information Engineering, Zhejiang Chinese Medicine University, Hangzhou, China
| | - Qing Ye
- Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Toepfer AP, Amarin JZ, Spieker AJ, Stewart LS, Staat MA, Schlaudecker EP, Weinberg GA, Szilagyi PG, Englund JA, Klein EJ, Michaels MG, Williams JV, Selvarangan R, Harrison CJ, Lively JY, Piedra PA, Avadhanula V, Rha B, Chappell J, McMorrow M, Moline H, Halasa NB. Seasonality, Clinical Characteristics, and Outcomes of Respiratory Syncytial Virus Disease by Subtype Among Children Aged <5 Years: New Vaccine Surveillance Network, United States, 2016-2020. Clin Infect Dis 2024; 78:1352-1359. [PMID: 38366649 DOI: 10.1093/cid/ciae085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/06/2024] [Accepted: 02/13/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is a leading cause of acute respiratory illnesses in children. RSV can be broadly categorized into 2 major subtypes: A and B. RSV subtypes have been known to cocirculate with variability in different regions of the world. Clinical associations with viral subtype have been studied among children with conflicting findings such that no conclusive relationships between RSV subtype and severity have been established. METHODS During 2016-2020, children aged <5 years were enrolled in prospective surveillance in the emergency department or inpatient settings at 7 US pediatric medical centers. Surveillance data collection included parent/guardian interviews, chart reviews, and collection of midturbinate nasal plus/minus throat swabs for RSV (RSV-A, RSV-B, and untyped) using reverse transcription polymerase chain reaction. RESULTS Among 6398 RSV-positive children aged <5 years, 3424 (54%) had subtype RSV-A infections, 2602 (41%) had subtype RSV-B infections, and 272 (5%) were not typed, inconclusive, or mixed infections. In both adjusted and unadjusted analyses, RSV-A-positive children were more likely to be hospitalized, as well as when restricted to <1 year. By season, RSV-A and RSV-B cocirculated in varying levels, with 1 subtype dominating proportionally. CONCLUSIONS Findings indicate that RSV-A and RSV-B may only be marginally clinically distinguishable, but both subtypes are associated with medically attended illness in children aged <5 years. Furthermore, circulation of RSV subtypes varies substantially each year, seasonally and geographically. With introduction of new RSV prevention products, this highlights the importance of continued monitoring of RSV-A and RSV-B subtypes.
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Affiliation(s)
- Ariana P Toepfer
- Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Justin Z Amarin
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Andrew J Spieker
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Laura S Stewart
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Mary Allen Staat
- Department of Pediatrics, University of Cincinnati, and Division of Infectious Diseases, Cincinnati Children's Hospital, Cincinnati, Ohio, USA
| | - Elizabeth P Schlaudecker
- Department of Pediatrics, University of Cincinnati, and Division of Infectious Diseases, Cincinnati Children's Hospital, Cincinnati, Ohio, USA
| | - Geoffrey A Weinberg
- Department of Pediatrics, University of Rochester School of Medicine & Dentistry, Rochester, New York, USA
| | - Peter G Szilagyi
- Department of Pediatrics, University of Rochester School of Medicine & Dentistry, Rochester, New York, USA
| | - Janet A Englund
- Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington, USA
| | - Eileen J Klein
- Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington, USA
| | - Marian G Michaels
- Department of Pediatrics, University of Pittsburgh School of Medicine, and UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - John V Williams
- Department of Pediatrics, University of Pittsburgh School of Medicine, and UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Rangaraj Selvarangan
- Department of Pathology and Laboratory Medicine, Children's Mercy, Kansas City, Missouri, USA
| | - Christopher J Harrison
- Department of Pathology and Laboratory Medicine, Children's Mercy, Kansas City, Missouri, USA
| | - Joana Y Lively
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Pedro A Piedra
- Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA
| | - Vasanthi Avadhanula
- Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA
| | - Brian Rha
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - James Chappell
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Meredith McMorrow
- Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- US Public Health Service, Rockville, Maryland, USA
| | - Heidi Moline
- Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- US Public Health Service, Rockville, Maryland, USA
| | - Natasha B Halasa
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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9
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Musa AO, Faber SR, Forrest K, Smith KP, Sengupta S, López CB. Identification of distinct genotypes in circulating RSV A strains based on variants on the virus replication-associated genes. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.22.590570. [PMID: 38712045 PMCID: PMC11071361 DOI: 10.1101/2024.04.22.590570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
Respiratory syncytial virus is a common cause of respiratory infection that often leads to hospitalization of infected younger children and older adults. RSV is classified into two strains, A and B, each with several subgroups or genotypes. One issue with the definition of these subgroups is the lack of a unified method of identification or genotyping. We propose that genotyping strategies based on the genes coding for replication-associated proteins could provide critical information on the replication capacity of the distinct subgroup, while clearly distinguishing genotypes. Here, we analyzed the virus replication-associated genes N, P, M2, and L from de novo assembled RSV A sequences obtained from 31 newly sequenced samples from hospitalized patients in Philadelphia and 78 additional publicly available sequences from different geographic locations within the US. In-depth analysis and annotation of the protein variants in L and the other replication-associated proteins N, P, M2-1, and M2-2 identified the polymerase protein L as a robust target for genotyping RSV subgroups. Importantly, our analysis revealed non-synonymous variations in L that were consistently accompanied by conserved changes in its co-factor P or the M2-2 protein, suggesting associations and interactions between specific domains of these proteins. These results highlight L as an alternative to other RSV genotyping targets and demonstrate the value of in-depth analyses and annotations of RSV sequences as it can serve as a foundation for subsequent in vitro and clinical studies on the efficiency of the polymerase and fitness of different virus isolates.
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Affiliation(s)
- Abdulafiz O. Musa
- Department of Molecular Microbiology, Washington University School of Medicine, Saint Louis, Missouri, USA
- Center for Womeńs Infectious Diseases Research, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Sydney R. Faber
- Department of Molecular Microbiology, Washington University School of Medicine, Saint Louis, Missouri, USA
- Center for Womeńs Infectious Diseases Research, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Kaitlyn Forrest
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Division of Neonatology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Kenneth P. Smith
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Infectious Disease Diagnostics Laboratory, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Shaon Sengupta
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Division of Neonatology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Carolina B. López
- Department of Molecular Microbiology, Washington University School of Medicine, Saint Louis, Missouri, USA
- Center for Womeńs Infectious Diseases Research, Washington University School of Medicine, Saint Louis, Missouri, USA
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10
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Zulli A, Varkila MR, Parsonnet J, Wolfe MK, Boehm AB. Observations of Respiratory Syncytial Virus (RSV) Nucleic Acids in Wastewater Solids Across the United States in the 2022-2023 Season: Relationships with RSV Infection Positivity and Hospitalization Rates. ACS ES&T WATER 2024; 4:1657-1667. [PMID: 38633368 PMCID: PMC11019535 DOI: 10.1021/acsestwater.3c00725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/13/2024] [Accepted: 02/14/2024] [Indexed: 04/19/2024]
Abstract
Respiratory syncytial virus (RSV) is a leading cause of respiratory illness and hospitalization, but clinical surveillance detects only a minority of cases. Wastewater surveillance could determine the onset and extent of RSV circulation in the absence of sensitive case detection, but to date, studies of RSV in wastewater are few. We measured RSV RNA concentrations in wastewater solids from 176 sites during the 2022-2023 RSV season and compared those to publicly available RSV infection positivity and hospitalization rates. Concentrations ranged from undetectable to 107 copies per gram. RSV RNA concentration aggregated at state and national levels correlated with infection positivity and hospitalization rates. RSV season onset was determined using both wastewater and clinical positivity rates using independent algorithms for 14 states where both data were available at the start of the RSV season. In 4 of 14 states, wastewater and clinical surveillance identified RSV season onset during the same week; in 3 states, wastewater onset preceded clinical onset, and in 7 states, wastewater onset occurred after clinical onset. Wastewater concentrations generally peaked in the same week as hospitalization rates but after case positivity rates peaked. Differences in onset and peaks in wastewater versus clinical data may reflect inherent differences in the surveillance approaches.
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Affiliation(s)
- Alessandro Zulli
- Department
of Civil and Environmental Engineering, Stanford University, 473 Via Ortega, Stanford, California 94305, United States
| | - Meri R.J. Varkila
- Division
of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, 300 Pasteur Drive, Stanford, California 94305, United States
| | - Julie Parsonnet
- Division
of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, 300 Pasteur Drive, Stanford, California 94305, United States
- Department
of Epidemiology and Population Health, Stanford
University, 300 Pasteur Drive, Stanford, California 94305, United States
| | - Marlene K. Wolfe
- Gangarosa
Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, Georgia 30322, United States
| | - Alexandria B. Boehm
- Department
of Civil and Environmental Engineering, Stanford University, 473 Via Ortega, Stanford, California 94305, United States
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11
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Marsall P, Fandrich M, Griesbaum J, Harries M, Lange B, Ascough S, Dayananda P, Chiu C, Remppis J, Ganzenmueller T, Renk H, Strengert M, Schneiderhan-Marra N, Dulovic A. Development and validation of a respiratory syncytial virus multiplex immunoassay. Infection 2024; 52:597-609. [PMID: 38332255 PMCID: PMC10954859 DOI: 10.1007/s15010-024-02180-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 01/07/2024] [Indexed: 02/10/2024]
Abstract
PURPOSE Respiratory syncytial virus (RSV) is one of the leading causes of severe respiratory disease in infants and adults. While vaccines and monoclonal therapeutic antibodies either are or will shortly become available, correlates of protection remain unclear. For this purpose, we developed an RSV multiplex immunoassay that analyses antibody titers toward the post-F, Nucleoprotein, and a diverse mix of G proteins. METHODS A bead-based multiplex RSV immunoassay was developed, technically validated to standard FDA bioanalytical guidelines, and clinically validated using samples from human challenge studies. RSV antibody titers were then investigated in children aged under 2 and a population-based cohort. RESULTS Technical and clinical validation showed outstanding performance, while methodological developments enabled identification of the subtype of previous infections through use of the diverse G proteins for approximately 50% of samples. As a proof of concept to show the suitability of the assay in serosurveillance studies, we then evaluated titer decay and age-dependent antibody responses within population cohorts. CONCLUSION Overall, the developed assay shows robust performance, is scalable, provides additional information on infection subtype, and is therefore ideally suited to be used in future population cohort studies.
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Affiliation(s)
- Patrick Marsall
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Madeleine Fandrich
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Johanna Griesbaum
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Manuela Harries
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Berit Lange
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- German Centre for Infection Research (DZIF), TI BBD, Partner Site Hannover-Braunschweig, Braunschweig, Germany
| | - Stephanie Ascough
- Department of Infectious Disease, Imperial College London, London, UK
| | - Pete Dayananda
- Department of Infectious Disease, Imperial College London, London, UK
| | - Christopher Chiu
- Department of Infectious Disease, Imperial College London, London, UK
| | - Jonathan Remppis
- Department of Pediatric Neurology and Developmental Medicine, University Children's Hospital, Tübingen, Germany
| | - Tina Ganzenmueller
- Institute for Medical Virology and Epidemiology of Viral Diseases, University Hospital Tübingen, Tübingen, Germany
| | - Hanna Renk
- Department of Pediatric Neurology and Developmental Medicine, University Children's Hospital, Tübingen, Germany
| | - Monika Strengert
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | | | - Alex Dulovic
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany.
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12
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Bøås H, Havdal LB, Størdal K, Døllner H, Leegaard TM, Bekkevold T, Flem E, Inchley C, Nordbø SA, Rojahn AE, Debes S, Barstad B, Haarr E, Kran AMB. No association between disease severity and respiratory syncytial virus subtypes RSV-A and RSV-B in hospitalized young children in Norway. PLoS One 2024; 19:e0298104. [PMID: 38466702 PMCID: PMC10927124 DOI: 10.1371/journal.pone.0298104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 01/13/2024] [Indexed: 03/13/2024] Open
Abstract
OBJECTIVE There is conflicting evidence whether subtypes of Respiratory syncytial virus have different seasonality or are differentially associated with clinical severity. We aimed to explore the associations between disease severity and RSV subtypes RSV-A and RSV-B and to describe the circulation of RSV subtypes pattern by season and age. METHODS Active prospective hospital surveillance for RSV-A and RSV-B in children <59 months of age was conducted during 2015-2018. All febrile children 12-59 months of age were enrolled, whereas children <12 months were eligible if presenting with fever or respiratory symptoms. Risk factors and upper and lower respiratory tract infection was identified by linkage to national registry data and analyzed using penalized maximum likelihood logistic regression. RESULTS Both RSV-A and B were found to co-circulate throughout all three study seasons, and no clear seasonal pattern was identified. Likewise, we found no association between sex or measures of severity with RSV-A or RSV-B. There was significantly more RSV-A than RSV-B among children with comorbidities. CONCLUSIONS No association was found between disease severity or sex and RSV subtypes RSV-A and RSV-B in hospitalized young children in Norway.
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Affiliation(s)
- Håkon Bøås
- Norwegian Institute of Public Health, Oslo, Norway
| | - Lise Beier Havdal
- Norwegian Institute of Public Health, Oslo, Norway
- Department of Paediatric and Adolescent Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Ketil Størdal
- Department of Pediatrics, Østfold Hospital, Grålum, Norway
- Division of Paediatric and Adolescent Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Henrik Døllner
- Department of Pediatrics, St. Olavs University Hospital, Trondheim, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Truls Michael Leegaard
- Department of Microbiology and Infection Control, Akershus University Hospital, Lørenskog, Norway
- Division of Medicine and Laboratory Sciences, Institute of Clinical Medicine - Campus Ahus, University of Oslo, Oslo, Norway
| | | | - Elmira Flem
- Norwegian Institute of Public Health, Oslo, Norway
| | - Christopher Inchley
- Department of Paediatric and Adolescent Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Svein Arne Nordbø
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Medical Microbiology, St. Olavs University Hospital, Trondheim, Norway
| | | | - Sara Debes
- Department of Medical Microbiology, Østfold Hospital, Grålum, Norway
| | - Bjørn Barstad
- Department of Pediatrics, Stavanger University Hospital, Stavanger, Norway
| | - Elisebet Haarr
- Department of Medical Microbiology, Stavanger University Hospital, Stavanger, Norway
| | - Anne-Marte Bakken Kran
- Norwegian Institute of Public Health, Oslo, Norway
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
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13
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Meier K, Riepl A, Voitl P, Lischka L, Voitl JJM, Langer K, Kuzio U, Redlberger-Fritz M, Diesner-Treiber SC. Characterisation of RSV infections in children without chronic diseases aged 0-36 months during the post-COVID-19 winter season 2022/2023. Front Pediatr 2024; 12:1342399. [PMID: 38379907 PMCID: PMC10876782 DOI: 10.3389/fped.2024.1342399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/25/2024] [Indexed: 02/22/2024] Open
Abstract
Background Respiratory syncytial virus (RSV) is one of the leading causes of hospitalisation, morbidity, and mortality due to respiratory infection in the first years of life. This longitudinal prospective study outlines the 2022/23 season's viral patterns in Austria after the epidemiological changes determined by public health measures. We aimed to highlight differences within the RSV subtypes and genotypes in 0-36-month-old children without chronic diseases in the outpatient setting. Methods From November 2022 to March 2023 children younger than 36 months admitted to Vienna's largest paediatric primary healthcare centre with an acute respiratory infection were enrolled in this study. Nasal swabs and multiplex PCR panels detected 20 viruses including RSV subtypes and genotypes. Clinical presentation, features, and treatment of the participants were documented and analysed using the Modified Tal Score (MTS). Patients were scheduled for a telemedical follow-up one week after the initial appointment. Analysis was done using descriptive statistics, including Cramér V and binominal logarithmic regression. Results Among the 345 samples from 329 children, RSV was the most common virus (31.9%), followed by influenza (17.5%) and rhinovirus infections (20.58%). Of the RSV positive samples, only 13 cases were RSV subtype A (11.8%), whereas 97 were of subtype B (87.3%); ON1 and BA9 were the only detectable RSV genotypes (ON1: BA9 = 1:9.25). RSV was the main predictor of hospitalisation (OR: 7.5, 95% CI: (1.46-38.40), and age had a significant but smaller effect (OR: 0.89, 95% CI: (0.81-0.99). Almost all patients' clinical status improved within the first days. Conclusion RSV cases showed a rapid onset in late November 2022, and subtype B was predominant throughout the season. RSV infection was associated with higher hospitalisation rates, even after excluding high-risk patients (preterm and severe chronic diseases population).Further testing in the upcoming winter seasons will improve our knowledge of the dominant subtype and its association with disease severity, especially with the development of novel RSV vaccine candidates.
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Affiliation(s)
| | - Angela Riepl
- First Vienna Pediatric Medical Center, Vienna, Austria
| | - Peter Voitl
- First Vienna Pediatric Medical Center, Vienna, Austria
- Sigmund Freud University Vienna, Vienna, Austria
| | - Lena Lischka
- First Vienna Pediatric Medical Center, Vienna, Austria
| | | | - Klara Langer
- First Vienna Pediatric Medical Center, Vienna, Austria
| | - Ulrike Kuzio
- First Vienna Pediatric Medical Center, Vienna, Austria
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14
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Chen CL, Lin YC, Tseng HY, Chen WC, Liang SJ, Tu CY, Hsueh PR. High mortality of patients with severe pneumonia caused by respiratory syncytial virus, August 2021-June 2023, Taiwan. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2024; 57:184-188. [PMID: 38151433 DOI: 10.1016/j.jmii.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/05/2023] [Accepted: 12/13/2023] [Indexed: 12/29/2023]
Abstract
Among the 14 patients with respiratory syncytial virus pneumonia, the majority (n = 8, 57.1 %) were older than 65 years and had health care-associated pneumonia (57.1 %). Over 70 % (n = 10) of them exhibited bacterial co-infection, with a high proportion (64.3 %) requiring mechanical ventilation. The hospital mortality rate was 50 %.
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Affiliation(s)
- Chieh-Lung Chen
- Division of Pulmonary and Critical Care, Department of Internal Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Yu-Chao Lin
- Division of Pulmonary and Critical Care, Department of Internal Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan
| | - How-Yang Tseng
- Division of Pulmonary and Critical Care, Department of Internal Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Wei-Cheng Chen
- Division of Pulmonary and Critical Care, Department of Internal Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Shinn-Jye Liang
- Division of Pulmonary and Critical Care, Department of Internal Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Chih-Yen Tu
- Division of Pulmonary and Critical Care, Department of Internal Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan
| | - Po-Ren Hsueh
- Departments of Laboratory Medicine and Internal Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan; PhD Program for Aging, School of Medicine, China Medical University, Taichung, Taiwan; Department of Laboratory Medicine, School of Medicine, China Medical University, Taichung, Taiwan.
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15
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Attaianese F, Guiducci S, Trapani S, Barbati F, Lodi L, Indolfi G, Azzari C, Ricci S. Reshaping Our Knowledge: Advancements in Understanding the Immune Response to Human Respiratory Syncytial Virus. Pathogens 2023; 12:1118. [PMID: 37764926 PMCID: PMC10536346 DOI: 10.3390/pathogens12091118] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/24/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
Human respiratory syncytial virus (hRSV) is a significant cause of respiratory tract infections, particularly in young children and older adults. In this review, we aimed to comprehensively summarize what is known about the immune response to hRSV infection. We described the innate and adaptive immune components involved, including the recognition of RSV, the inflammatory response, the role of natural killer (NK) cells, antigen presentation, T cell response, and antibody production. Understanding the complex immune response to hRSV infection is crucial for developing effective interventions against this significant respiratory pathogen. Further investigations into the immune memory generated by hRSV infection and the development of strategies to enhance immune responses may hold promise for the prevention and management of hRSV-associated diseases.
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Affiliation(s)
- Federica Attaianese
- Postgraduate School of Pediatrics, University of Florence, Meyer Children’s Hospital IRCCS, 50139 Florence, Italy;
| | - Sara Guiducci
- Postgraduate School of Immunology, University of Florence, Meyer Children’s Hospital IRCCS, 50139 Florence, Italy;
| | - Sandra Trapani
- Pediatric Unit, Meyer Children’s Hospital IRCCS, Viale Pieraccini 24, 50139 Florence, Italy; (S.T.); (G.I.)
- Department of Health Sciences, University of Florence, 50139 Florence, Italy; (L.L.); (C.A.)
| | - Federica Barbati
- Postgraduate School of Pediatrics, University of Florence, Meyer Children’s Hospital IRCCS, 50139 Florence, Italy;
| | - Lorenzo Lodi
- Department of Health Sciences, University of Florence, 50139 Florence, Italy; (L.L.); (C.A.)
- Division of Immunology, Meyer Children’s Hospital IRCCS, Viale Pieraccini 24, 50139 Florence, Italy
| | - Giuseppe Indolfi
- Pediatric Unit, Meyer Children’s Hospital IRCCS, Viale Pieraccini 24, 50139 Florence, Italy; (S.T.); (G.I.)
- NEUROFARBA Department, University of Florence, 50139 Florence, Italy
| | - Chiara Azzari
- Department of Health Sciences, University of Florence, 50139 Florence, Italy; (L.L.); (C.A.)
- Division of Immunology, Meyer Children’s Hospital IRCCS, Viale Pieraccini 24, 50139 Florence, Italy
| | - Silvia Ricci
- Department of Health Sciences, University of Florence, 50139 Florence, Italy; (L.L.); (C.A.)
- Division of Immunology, Meyer Children’s Hospital IRCCS, Viale Pieraccini 24, 50139 Florence, Italy
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16
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Umemoto S, Nakahashi-Ouchida R, Yuki Y, Kurokawa S, Machita T, Uchida Y, Mori H, Yamanoue T, Shibata T, Sawada SI, Ishige K, Hirano T, Fujihashi K, Akiyoshi K, Kurashima Y, Tokuhara D, Ernst PB, Suzuki M, Kiyono H. Cationic-nanogel nasal vaccine containing the ectodomain of RSV-small hydrophobic protein induces protective immunity in rodents. NPJ Vaccines 2023; 8:106. [PMID: 37488116 PMCID: PMC10366164 DOI: 10.1038/s41541-023-00700-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 06/22/2023] [Indexed: 07/26/2023] Open
Abstract
Respiratory syncytial virus (RSV) is a leading cause of upper and lower respiratory tract infection, especially in children and the elderly. Various vaccines containing the major transmembrane surface proteins of RSV (proteins F and G) have been tested; however, they have either afforded inadequate protection or are associated with the risk of vaccine-enhanced disease (VED). Recently, F protein-based maternal immunization and vaccines for elderly patients have shown promising results in phase III clinical trials, however, these vaccines have been administered by injection. Here, we examined the potential of using the ectodomain of small hydrophobic protein (SHe), also an RSV transmembrane surface protein, as a nasal vaccine antigen. A vaccine was formulated using our previously developed cationic cholesteryl-group-bearing pullulan nanogel as the delivery system, and SHe was linked in triplicate to pneumococcal surface protein A as a carrier protein. Nasal immunization of mice and cotton rats induced both SHe-specific serum IgG and mucosal IgA antibodies, preventing viral invasion in both the upper and lower respiratory tracts without inducing VED. Moreover, nasal immunization induced greater protective immunity against RSV in the upper respiratory tract than did systemic immunization, suggesting a critical role for mucosal RSV-specific IgA responses in viral elimination at the airway epithelium. Thus, our nasal vaccine induced effective protection against RSV infection in the airway mucosa and is therefore a promising vaccine candidate for further development.
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Affiliation(s)
- Shingo Umemoto
- Division of Mucosal Immunology, IMSUT Distinguished Professor Unit, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Department of Otorhinolaryngology & Head and Neck Surgery, Faculty of Medicine, Oita University, Oita, Japan
- Chiba University-University of California San Diego Center for Mucosal Immunology, Allergy and Vaccine (CU-UCSD cMAV), Department of Medicine, School of Medicine, San Diego, CA, USA
| | - Rika Nakahashi-Ouchida
- Division of Mucosal Immunology, IMSUT Distinguished Professor Unit, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Division of Mucosal Vaccines, International Research and Development Center for Mucosal Vaccines, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Department of Human Mucosal Vaccinology, Chiba University Hospital, Chiba, Japan
- Chiba University Synergy Institute for Futuristic Mucosal Vaccine Research and Development, Chiba University, Chiba, Japan
| | - Yoshikazu Yuki
- Division of Mucosal Vaccines, International Research and Development Center for Mucosal Vaccines, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Department of Human Mucosal Vaccinology, Chiba University Hospital, Chiba, Japan
- HanaVax Inc, Tokyo, Japan
| | - Shiho Kurokawa
- Division of Mucosal Vaccines, International Research and Development Center for Mucosal Vaccines, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Department of Human Mucosal Vaccinology, Chiba University Hospital, Chiba, Japan
| | - Tomonori Machita
- Division of Mucosal Vaccines, International Research and Development Center for Mucosal Vaccines, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Department of Human Mucosal Vaccinology, Chiba University Hospital, Chiba, Japan
| | - Yohei Uchida
- Division of Mucosal Vaccines, International Research and Development Center for Mucosal Vaccines, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Department of Human Mucosal Vaccinology, Chiba University Hospital, Chiba, Japan
| | - Hiromi Mori
- Division of Mucosal Vaccines, International Research and Development Center for Mucosal Vaccines, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Department of Human Mucosal Vaccinology, Chiba University Hospital, Chiba, Japan
| | - Tomoyuki Yamanoue
- Division of Mucosal Vaccines, International Research and Development Center for Mucosal Vaccines, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Department of Human Mucosal Vaccinology, Chiba University Hospital, Chiba, Japan
| | - Takehiko Shibata
- Department of Microbiology, Tokyo Medical University, Tokyo, Japan
- Department of Immunology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Shin-Ichi Sawada
- Department of Polymer Chemistry, Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | - Kazuya Ishige
- Biochemicals Division, Yamasa Corporation, Chiba, Japan
| | - Takashi Hirano
- Department of Otorhinolaryngology & Head and Neck Surgery, Faculty of Medicine, Oita University, Oita, Japan
| | - Kohtaro Fujihashi
- Department of Human Mucosal Vaccinology, Chiba University Hospital, Chiba, Japan
- Chiba University Synergy Institute for Futuristic Mucosal Vaccine Research and Development, Chiba University, Chiba, Japan
- Division of Mucosal Vaccines, International Vaccine Design Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Department of Pediatric Dentistry, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kazunari Akiyoshi
- Department of Polymer Chemistry, Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | - Yosuke Kurashima
- Division of Mucosal Immunology, IMSUT Distinguished Professor Unit, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Chiba University-University of California San Diego Center for Mucosal Immunology, Allergy and Vaccine (CU-UCSD cMAV), Department of Medicine, School of Medicine, San Diego, CA, USA
- Department of Human Mucosal Vaccinology, Chiba University Hospital, Chiba, Japan
- Chiba University Synergy Institute for Futuristic Mucosal Vaccine Research and Development, Chiba University, Chiba, Japan
- Division of Mucosal Vaccines, International Vaccine Design Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Institute for Advanced Academic Research, Chiba University, Chiba, Japan
- Department of Innovative Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Daisuke Tokuhara
- Chiba University-University of California San Diego Center for Mucosal Immunology, Allergy and Vaccine (CU-UCSD cMAV), Department of Medicine, School of Medicine, San Diego, CA, USA
- Department of Pediatrics, Wakayama Medical University, Wakayama, Japan
| | - Peter B Ernst
- Chiba University-University of California San Diego Center for Mucosal Immunology, Allergy and Vaccine (CU-UCSD cMAV), Department of Medicine, School of Medicine, San Diego, CA, USA
- Division of Comparative Pathology and Medicine, Department of Pathology, University of California, San Diego, CA, USA
- Center for Veterinary Sciences and Comparative Medicine, University of California, San Diego, CA, USA
- Future Medicine Education and Research Organization, Chiba University, Chiba, Japan
| | - Masashi Suzuki
- Department of Otorhinolaryngology & Head and Neck Surgery, Faculty of Medicine, Oita University, Oita, Japan
| | - Hiroshi Kiyono
- Division of Mucosal Immunology, IMSUT Distinguished Professor Unit, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
- Chiba University-University of California San Diego Center for Mucosal Immunology, Allergy and Vaccine (CU-UCSD cMAV), Department of Medicine, School of Medicine, San Diego, CA, USA.
- Department of Human Mucosal Vaccinology, Chiba University Hospital, Chiba, Japan.
- Chiba University Synergy Institute for Futuristic Mucosal Vaccine Research and Development, Chiba University, Chiba, Japan.
- HanaVax Inc, Tokyo, Japan.
- Future Medicine Education and Research Organization, Chiba University, Chiba, Japan.
- Mucosal Immunology and Allergy Therapeutics, Institute for Global Prominent Research, Chiba University, Chiba, Japan.
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17
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Oey A, McClure M, Symons JA, Chanda S, Fry J, Smith PF, Luciani K, Fayon M, Chokephaibulkit K, Uppala R, Bernatoniene J, Furuno K, Stanley T, Huntjens D, Witek J. Lumicitabine, an orally administered nucleoside analog, in infants hospitalized with respiratory syncytial virus (RSV) infection: Safety, efficacy, and pharmacokinetic results. PLoS One 2023; 18:e0288271. [PMID: 37467213 PMCID: PMC10355467 DOI: 10.1371/journal.pone.0288271] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/25/2023] [Indexed: 07/21/2023] Open
Abstract
Respiratory syncytial virus (RSV) infection is the leading cause of infant hospitalizations and mortality. Lumicitabine, an oral nucleoside analog was studied for the treatment of RSV. The phase 1b and phase 2b studies reported here assessed the safety, pharmacokinetics, and pharmacodynamics of lumicitabine in infants/neonates hospitalized with RSV. In the phase 1b study, infants (≥1 to ≤12 months) and neonates (<28 days) received a single-ascending or multiple-ascending doses (single loading dose [LD] then 9 maintenance doses [MD] of lumicitabine, or placebo [3:1]). In the phase 2b study, infants/children (28 days to ≤36 months old) received lumicitabine 40/20 mg/kg, 60/40 mg/kg LD/MD twice-daily or placebo (1:1:1) for 5 days. Safety, pharmacokinetics, and efficacy parameters were assessed over 28 days. Lumicitabine was associated with a dose-related increase in the incidence and severity of reversible neutropenia. Plasma levels of ALS-008112, the active nucleoside analog, were dose-proportional with comparable mean exposure levels at the highest doses in both studies. There were no significant differences between the lumicitabine groups and placebo in reducing viral load, time to viral non-detectability, and symptom resolution. No emergent resistance-associated substitutions were observed at the RSV L-gene positions of interest. In summary, lumicitabine was associated with a dose-related increase in the incidence and severity of reversible neutropenia and failed to demonstrate antiviral activity in RSV-infected hospitalized infants. This contrasts with the findings of the previous RSV-A adult challenge study where significant antiviral activity was noted, without incidence of neutropenia. Trial registration ClinicalTrials.gov Identifier: NCT02202356 (phase 1b); NCT03333317 (phase 2b).
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Affiliation(s)
- Abbie Oey
- Janssen Research & Development, LLC, South San Francisco, California, United States of America
| | - Matthew McClure
- Janssen Research & Development, LLC, South San Francisco, California, United States of America
| | - Julian A. Symons
- Janssen Research & Development, LLC, South San Francisco, California, United States of America
| | - Sushmita Chanda
- Janssen Research & Development, LLC, South San Francisco, California, United States of America
| | - John Fry
- Janssen Research & Development, LLC, South San Francisco, California, United States of America
| | - Patrick F. Smith
- Certara Strategic Consulting, Parsippany, New Jersey, United States of America
| | - Kathia Luciani
- Department of Infectious Diseases Hospital de Especialidades Pediátricas Omar Torrijos Herrera, Panama City, Panama
| | - Michael Fayon
- CHU de Bordeaux, Pneumologie pédiatrique, CIC 1401 (INSERM), Hôpital Pellegrin-Enfants, Bordeaux Cedex, France
| | - Kulkanya Chokephaibulkit
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Rattapon Uppala
- Department of Pediatrics, Khon Kaen University, Khon Kaen, Thailand
| | - Jolanta Bernatoniene
- Paediatric Infectious Disease and Immunology Department, Bristol Royal Hospital for Children, Bristol, United Kingdom
| | - Kenji Furuno
- General Pediatrics & Interdisciplinary Medicine Fukuoka Children’s Hospital, Fukuoka, Japan
| | - Thorsten Stanley
- Department of Paediatrics, University of Otago, Wellington, New Zealand
| | | | - James Witek
- Janssen Research & Development, LLC, Titusville, New Jersey, United States of America
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18
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Divarathna MVM, Rafeek RAM, Morel AJ, Aththanayake C, Noordeen F. Epidemiology and risk factors of respiratory syncytial virus associated acute respiratory tract infection in hospitalized children younger than 5 years from Sri Lanka. Front Microbiol 2023; 14:1173842. [PMID: 37434712 PMCID: PMC10330818 DOI: 10.3389/fmicb.2023.1173842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 06/09/2023] [Indexed: 07/13/2023] Open
Abstract
Background Respiratory syncytial virus (RSV) is the leading cause of acute respiratory tract infections (ARTI) and a major cause of morbidity and mortality in children worldwide. Aim This study aimed to describe the prevalence and seasonal patterns of RSV and to determine the actual and predictive association of RSV-associated ARTI and clinical, socio-demographic, and climatic risk factors in children < 5 years. Methods Nasopharyngeal aspirates were collected from 500 children < 5 years admitted to the Kegalle General Hospital, Sri Lanka between May 2016 to July 2018. RSV and RSV subtypes were detected using immunofluorescence assay and real time RT-PCR, respectively. Descriptive and inferential statistics were done for the data analysis using Chi-square, Fisher's exact, Kruskal-Wallis test, and multiple binary logistic regression in the statistical package for social sciences (SPSS), version 16.0. Results Prevalence of RSV-associated ARTI was 28% in children < 5 years. Both RSV subtypes were detected throughout the study period. RSV-B was the dominant subtype detected with a prevalence of 72.14%. RSV infection in general caused severe respiratory disease leading to hypoxemia. Compared to RSV-B, RSV-A infection had more symptoms leading to hypoxemia. Factors increasing the risk of contracting RSV infection included number of people living (n > 6), having pets at home and inhaling toxic fumes. The inferential analysis predicts RSV infection in children < 5 years with ARTI, with a 75.4% probability with clinical and socio-demographic characteristics like age < 1 year, fever for > 4 days, cough, conjunctivitis, stuffiness, fatigue, six or more people at home, having pets at home and inhaling toxic fumes. Climatic factors like increases in temperature (°C), wind speed (Km/h), wind gust (Km/h), rainfall (mm) and atmospheric pressure (mb) showed a strong correlation with the RSV infection in children.
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Affiliation(s)
- Maduja V. M. Divarathna
- Department of Microbiology, Faculty of Medicine, Diagnostic and Research Virology Laboratory, University of Peradeniya, Peradeniya, Sri Lanka
| | - Rukshan A. M. Rafeek
- Department of Microbiology, Faculty of Medicine, Diagnostic and Research Virology Laboratory, University of Peradeniya, Peradeniya, Sri Lanka
| | | | | | - Faseeha Noordeen
- Department of Microbiology, Faculty of Medicine, Diagnostic and Research Virology Laboratory, University of Peradeniya, Peradeniya, Sri Lanka
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19
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Moin AT, Ullah MA, Patil RB, Faruqui NA, Araf Y, Das S, Uddin KMK, Hossain MS, Miah MF, Moni MA, Chowdhury DUS, Islam S. A computational approach to design a polyvalent vaccine against human respiratory syncytial virus. Sci Rep 2023; 13:9702. [PMID: 37322049 PMCID: PMC10272159 DOI: 10.1038/s41598-023-35309-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 05/16/2023] [Indexed: 06/17/2023] Open
Abstract
Human Respiratory Syncytial Virus (RSV) is one of the leading causes of lower respiratory tract infections (LRTI), responsible for infecting people from all age groups-a majority of which comprises infants and children. Primarily, severe RSV infections are accountable for multitudes of deaths worldwide, predominantly of children, every year. Despite several efforts to develop a vaccine against RSV as a potential countermeasure, there has been no approved or licensed vaccine available yet, to control the RSV infection effectively. Therefore, through the utilization of immunoinformatics tools, a computational approach was taken in this study, to design a multi-epitope polyvalent vaccine against two major antigenic subtypes of RSV, RSV-A and RSV-B. Potential predictions of the T-cell and B-cell epitopes were followed by extensive tests of antigenicity, allergenicity, toxicity, conservancy, homology to human proteome, transmembrane topology, and cytokine-inducing ability. The peptide vaccine was modeled, refined, and validated. Molecular docking analysis with specific Toll-like receptors (TLRs) revealed excellent interactions with suitable global binding energies. Additionally, molecular dynamics (MD) simulation ensured the stability of the docking interactions between the vaccine and TLRs. Mechanistic approaches to imitate and predict the potential immune response generated by the administration of vaccines were determined through immune simulations. Subsequent mass production of the vaccine peptide was evaluated; however, there remains a necessity for further in vitro and in vivo experiments to validate its efficacy against RSV infections.
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Affiliation(s)
- Abu Tayab Moin
- Department of Genetic Engineering and Biotechnology, Faculty of Biological Sciences, University of Chittagong, Chattogram, Bangladesh.
| | - Md Asad Ullah
- Department of Biotechnology and Genetic Engineering, Faculty of Biological Sciences, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Rajesh B Patil
- Department of Pharmaceutical Chemistry, Sinhgad Technical Education Society's, Sinhgad College of Pharmacy, Pune, Maharashtra, India
| | - Nairita Ahsan Faruqui
- Biotechnology Program, Department of Mathematics and Natural Sciences, School of Data and Sciences, BRAC University, Dhaka, Bangladesh
| | - Yusha Araf
- Department of Genetic Engineering and Biotechnology, School of Life Sciences, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Sowmen Das
- Department of Computer Science and Engineering, School of Physical Sciences, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Khaza Md Kapil Uddin
- Department of Genetic Engineering and Biotechnology, Faculty of Biological Sciences, University of Chittagong, Chattogram, Bangladesh
| | - Md Shakhawat Hossain
- Department of Genetic Engineering and Biotechnology, Faculty of Biological Sciences, University of Chittagong, Chattogram, Bangladesh
| | - Md Faruque Miah
- Department of Genetic Engineering and Biotechnology, School of Life Sciences, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Mohammad Ali Moni
- Bone Biology Division, The Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
- WHO Collaborating Centre on eHealth, UNSW Digital Health, School of Public Health and Community Medicine, Faculty of Medicine, UNSW Sydney, Sydney, Australia
- Artificial Intelligence and Data Science, Faculty of Health and Behavioural Sciences, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Dil Umme Salma Chowdhury
- Department of Genetic Engineering and Biotechnology, Faculty of Biological Sciences, University of Chittagong, Chattogram, Bangladesh.
| | - Saiful Islam
- Bangladesh Council of Scientific and Industrial Research (BCSIR), Chattogram Laboratories, Chattogram, Bangladesh.
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20
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Roy Á, Polazzi S, Ploin D, Gillet Y, Javouhey E, Lina B, Myard-Dury AF, Couray-Targe S, Duclos A, Casalegno JS. The increasing age of respiratory syncytial virus-related hospitalisation during COVID-19 pandemic in Lyon was associated with reduced hospitalisation costs. Vaccine 2023:S0264-410X(23)00548-0. [PMID: 37198017 DOI: 10.1016/j.vaccine.2023.05.021] [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: 02/20/2023] [Revised: 05/03/2023] [Accepted: 05/05/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND Preventive measures applied during the COVID-19 pandemic have modified the age distribution, the clinical severity and the incidence of Respiratory Syncytial Virus (RSV) hospitalisations during the 2020/21 RSV season. The aim of the present study was to estimate the impact of these aspects on RSV-associated hospitalisations (RSVH) costs stratified by age group between pre-COVID-19 seasons and 2020/21 RSV season. METHODS We compared the incidence, the median costs, and total RSVH costs from the national health insurance perspective in children < 24 months of age during the COVID-19 period (2020/21 RSV season) with a pre-COVID-19 period (2014/17 RSV seasons). Children were born and hospitalised in the Lyon metropolitan area. RSVH costs were extracted from the French medical information system (Programme de Médicalisation des Systémes d'Information). RESULTS The RSVH-incidence rate per 1000 infants aged < 3 months decreased significantly from 4.6 (95 % CI [4.1; 5.2]) to 3.1 (95 % CI [2.4; 4.0]), and increased in older infants and children up to 24 months of age during the 2020/21 RSV season. Overall, RSVH costs for RSVH cases aged below 2 years old decreased by €201,770 (31 %) during 2020/21 RSV season compared to the mean pre-COVID-19 costs. CONCLUSIONS The sharp reduction in costs of RSVH in infants aged < 3 months outweighed the modest increase in costs observed in the 3-24 months age group. Therefore, conferring a temporal protection through passive immunisation to infants aged < 3 months should have a major impact on RSVH costs even if it results in an increase of RSVH in older children infected later in life. Nevertheless, stakeholders should be aware of this potential increase of RSVH in older age groups presenting with a wider range of disease to avoid any bias in estimating the cost-effectiveness of passive immunisation strategies.
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Affiliation(s)
- Álvaro Roy
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Centre de Biologie Nord, Institut des Agents Infectieux, Laboratoire de Virologie, Lyon 69004, France; ECDC Fellowship Programme, Public Health Microbiology Path (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Solna 169 73, Sweden.
| | - Stéphanie Polazzi
- Hospices Civils de Lyon, Service des Données de Santé, Lyon 69003, France
| | - Dominique Ploin
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Service de Réanimation Pédiatrique et d'Accueil des Urgences, Bron 69500, France
| | - Yves Gillet
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Service de Réanimation Pédiatrique et d'Accueil des Urgences, Bron 69500, France
| | - Etienne Javouhey
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Service de Réanimation Pédiatrique et d'Accueil des Urgences, Bron 69500, France
| | - Bruno Lina
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Centre de Biologie Nord, Institut des Agents Infectieux, Laboratoire de Virologie, Lyon 69004, France
| | | | | | - Antoine Duclos
- Hospices Civils de Lyon, Service des Données de Santé, Lyon 69003, France
| | - Jean-Sébastien Casalegno
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Centre de Biologie Nord, Institut des Agents Infectieux, Laboratoire de Virologie, Lyon 69004, France
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21
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Kim HN, Hwang J, Yoon SY, Lim CS, Cho Y, Lee CK, Nam MH. Molecular characterization of human respiratory syncytial virus in Seoul, South Korea, during 10 consecutive years, 2010-2019. PLoS One 2023; 18:e0283873. [PMID: 37023101 PMCID: PMC10079039 DOI: 10.1371/journal.pone.0283873] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 03/19/2023] [Indexed: 04/07/2023] Open
Abstract
Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infections and hospitalization in infants and young children. Here, we analyzed the genetic diversity of RSV using partial G gene sequences in 84 RSV-A and 78 RSV- B positive samples collected in Seoul, South Korea, for 10 consecutive years, from 2010 to 2019. Our phylogenetic analysis revealed that RSV-A strains were classified into either the ON1 (80.9%) or NA1 (19.0%) genotypes. On the other hand, RSV-B strains demonstrated diversified clusters within the BA genotype. Notably, some sequences designated as BA-SE, BA-SE1, and BA-DIS did not cluster with previously identified BA genotypes in the phylogenetic trees. Despite this, they did not meet the criteria for the assignment of a new genotype based on recent classification methods. Selection pressure analysis identified three positive selection sites (amino acid positions 273, 274, and 298) in RSV-A, and one possible positive selection site (amino acid position 296) in RSV-B, respectively. The mean evolutionary rates of Korean RSV-A from 1999 to 2019 and RSV-B strains from 1991 and 2019 were estimated at 3.51 × 10-3 nucleotides (nt) substitutions/site/year and 3.32 × 10-3 nt substitutions/site/year, respectively. The population dynamics in the Bayesian skyline plot revealed fluctuations corresponding to the emergence of dominant strains, including a switch of the dominant genotype from NA1 to ON1. Our study on time-scaled cumulative evolutionary analysis contributes to a better understanding of RSV epidemiology at the local level in South Korea.
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Affiliation(s)
- Ha Nui Kim
- Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jinha Hwang
- Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Korea
| | - Soo-Young Yoon
- Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Korea
| | - Chae Seung Lim
- Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Korea
| | - Yunjung Cho
- Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Korea
| | - Chang-Kyu Lee
- Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Korea
| | - Myung-Hyun Nam
- Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Korea
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22
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Cox F, Saeland E, Thoma A, van den Hoogen W, Tettero L, Drijver J, Vaneman C, van Polanen Y, Ritschel T, Bastian AR, Callendret B, Zahn R, van der Fits L. RSV A2-Based Prefusion F Vaccine Candidates Induce RSV A and RSV B Cross Binding and Neutralizing Antibodies and Provide Protection against RSV A and RSV B Challenge in Preclinical Models. Vaccines (Basel) 2023; 11:vaccines11030672. [PMID: 36992257 DOI: 10.3390/vaccines11030672] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023] Open
Abstract
RSV is divided into two antigenic subtypes, RSV A and RSV B, which is largely based on the variation in the G protein, while the fusion protein F is more conserved and a target for antibody-mediated neutralization. Here we evaluate the breadth of the protective immune responses across RSV A and RSV B subtypes, induced by vaccines based on the RSV A-based fusion protein, stabilized in the prefusion conformation (preF) in preclinical models. Immunization of naïve cotton rats with preF subunit or preF encoded by a replication incompetent Adenoviral 26, induced antibodies capable of neutralizing recent RSV A and RSV B clinical isolates, as well as protective efficacy against a challenge with RSV A and RSV B strains. Similarly, induction of cross-neutralizing antibodies was observed after immunization with Ad26-encoded preF, preF protein or a mix of both (Ad26/preF protein) in RSV pre-exposed mice and African Green Monkeys. Transfer of serum of human subjects immunized with Ad26/preF protein into cotton rats provide protection against challenges with both RSV A and RSV B, with complete protection against both strains observed in the lower respiratory tract. In contrast, almost no protection against RSV A and B infection was observed after the transfer of a human serum pool isolated pre-vaccination. These results collectively show that the RSV A-based monovalent Ad26/preF protein vaccine induced neutralizing antibodies, as well as protection against both RSV A and RSV B subtypes in animals, including by passive transfer of human antibodies alone, suggesting that clinical efficacy against both subtypes can be achieved.
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Affiliation(s)
- Freek Cox
- Janssen Vaccines & Prevention B.V. Archimedesweg 4-6, 2333 CN Leiden, The Netherlands
| | - Eirikur Saeland
- Janssen Vaccines & Prevention B.V. Archimedesweg 4-6, 2333 CN Leiden, The Netherlands
| | - Anne Thoma
- Janssen Vaccines & Prevention B.V. Archimedesweg 4-6, 2333 CN Leiden, The Netherlands
| | - Ward van den Hoogen
- Janssen Vaccines & Prevention B.V. Archimedesweg 4-6, 2333 CN Leiden, The Netherlands
| | - Lisanne Tettero
- Janssen Vaccines & Prevention B.V. Archimedesweg 4-6, 2333 CN Leiden, The Netherlands
| | - Joke Drijver
- Janssen Vaccines & Prevention B.V. Archimedesweg 4-6, 2333 CN Leiden, The Netherlands
| | - Cornelis Vaneman
- Janssen Vaccines & Prevention B.V. Archimedesweg 4-6, 2333 CN Leiden, The Netherlands
| | - Yolinda van Polanen
- Janssen Vaccines & Prevention B.V. Archimedesweg 4-6, 2333 CN Leiden, The Netherlands
| | - Tina Ritschel
- Janssen Vaccines & Prevention B.V. Archimedesweg 4-6, 2333 CN Leiden, The Netherlands
| | | | - Benoit Callendret
- Janssen Vaccines & Prevention B.V. Archimedesweg 4-6, 2333 CN Leiden, The Netherlands
| | - Roland Zahn
- Janssen Vaccines & Prevention B.V. Archimedesweg 4-6, 2333 CN Leiden, The Netherlands
| | - Leslie van der Fits
- Janssen Vaccines & Prevention B.V. Archimedesweg 4-6, 2333 CN Leiden, The Netherlands
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23
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Biagi C, Betti L, Manieri E, Dondi A, Pierantoni L, Ramanathan R, Zama D, Gennari M, Lanari M. Different Pediatric Acute Care Settings Influence Bronchiolitis Management: A 10-Year Retrospective Study. Life (Basel) 2023; 13:life13030635. [PMID: 36983790 PMCID: PMC10056632 DOI: 10.3390/life13030635] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/13/2023] [Accepted: 02/21/2023] [Indexed: 02/26/2023] Open
Abstract
Bronchiolitis is the main cause of hospitalization in infants. Diagnosis is clinical, and treatment is based on hydration and oxygen therapy. Nevertheless, unnecessary diagnostic tests and pharmacological treatments are still very common. This retrospective study aimed to evaluate whether the setting of bronchiolitis care influences diagnostic and therapeutic choices. The management of 3201 infants, referred to our Italian Tertiary Care Center for bronchiolitis between 2010 and 2020, was analyzed by comparing children discharged from the pediatric emergency department (PEDd group) undergoing short-stay observation (SSO group) and hospitalization. Antibiotic use in PEDd, SSO, and ward was 59.3% vs. 51.6% vs. 49.7%, respectively (p < 0.001); inhaled salbutamol was mainly administered in PEDd and during SSO (76.1% and 82.2% vs. 38.3% in ward; p < 0.001); the use of corticosteroids was higher during SSO and hospitalization (59.6% and 49.1% vs. 39.0% in PEDd; p < 0.001); inhaled adrenaline was administered mostly in hospitalized infants (53.5% vs. 2.5% in SSO and 0.2% in PEDd; p < 0.001); chest X-ray use in PEDd, SSO, and ward was 30.3% vs. 49.0% vs. 70.5%, respectively (p < 0.001). In a multivariate analysis, undergoing SSO was found to be an independent risk factor for the use of systemic corticosteroid and salbutamol; being discharged at home was found to be a risk factor for antibiotic prescription; undergoing SSO and hospitalization resulted as independent risk factors for the use of CXR. Our study highlights that different pediatric acute care settings could influence the management of bronchiolitis. Factors influencing practice may include a high turnover of PED medical staff, personal reassurance, and parental pressure.
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Affiliation(s)
- Carlotta Biagi
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Correspondence: (C.B.); (L.B.)
| | - Ludovica Betti
- Specialty School of Pediatrics, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
- Correspondence: (C.B.); (L.B.)
| | - Elisa Manieri
- Specialty School of Pediatrics, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
| | - Arianna Dondi
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Luca Pierantoni
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Ramsiya Ramanathan
- Infectious Diseases Unit, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, 20122 Milano, Italy
| | - Daniele Zama
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Monia Gennari
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Marcello Lanari
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
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24
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Influence of Sex on Respiratory Syncytial Virus Genotype Infection Frequency and Nasopharyngeal Microbiome. J Virol 2023; 97:e0147222. [PMID: 36815771 PMCID: PMC10062153 DOI: 10.1128/jvi.01472-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
Respiratory syncytial virus (RSV) has a significant health burden in children, older adults, and the immunocompromised. However, limited effort has been made to identify emergence of new RSV genotypes' frequency of infection and how the combination of nasopharyngeal microbiome and viral genotypes impact RSV disease outcomes. In an observational cohort designed to capture the first infant RSV infection, we employed multi-omics approaches to sequence 349 RSV complete genomes and matched nasopharyngeal microbiomes, during which the 2012/2013 season was dominated by RSV-A, whereas 2013 and 2014 was dominated by RSV-B. We found non-G-72nt-duplicated RSV-A strains were more frequent in male infants (P = 0.02), whereas G-72nt-duplicated genotypes (which is ON1 lineage) were seen equally in both males and females. DESeq2 testing of the nasal microbiome showed Haemophilus was significantly more abundant in infants with RSV-A infection compared to infants with RSV-B infection (adjusted P = 0.002). In addition, the broad microbial clustering of the abundant genera was significantly associated with infant sex (P = 0.03). Overall, we show sex differences in infection by RSV genotype and host nasopharyngeal microbiome, suggesting an interaction between host genetics, virus genotype, and associated nasopharyngeal microbiome. IMPORTANCE Respiratory syncytial virus (RSV) is one of the leading causes of lower respiratory tract infections in young children and is responsible for high hospitalization rates and morbidity in infants and the elderly. To understand how the emergence of RSV viral genotypes and viral-respiratory microbiome interactions contribute to infection frequency and severity, we utilized an observational cohort designed to capture the first infant RSV infection we employed multi-omics approaches to sequence 349 RSV complete genomes and matched nasopharyngeal microbiomes. We found non-G-72nt-duplicated RSV-A genotypes were more frequent in male infants, whereas G-72nt-duplicated RSV-A strains (ON1 lineage) were seen equally in both males and females. Microbiome analysis show Haemophilus was significantly more abundant in infants with RSV-A compared to infants with RSV-B infection and the microbial clustering of the abundant genera was associated with infant sex. Overall, we show sex differences in RSV genotype-nasopharyngeal microbiome, suggesting an interaction host genetics-virus-microbiome interaction.
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25
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Regassa BT, Gebrewold LA, Mekuria WT, Kassa NA. Molecular epidemiology of respiratory syncytial virus in children with acute respiratory illnesses in Africa: A systematic review and meta-analysis. J Glob Health 2023; 13:04001. [PMID: 36637855 PMCID: PMC9840062 DOI: 10.7189/jogh.13.04001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background Globally, the respiratory syncytial virus (RSV) is the most common etiologic agent of acute respiratory illnesses in children. However, its burden has not been well addressed in developing countries. We aimed to estimate the molecular epidemiology of RSV in children less than 18 years of age with acute respiratory infections in Africa by conducting a systematic review and meta-analysis. Methods We systematically searched PubMed, Scopus, CINAHL, and Global Index Medicus databases to identify studies published from January 1, 2002, to April 27, 2022, following the PRISMA 2020 guideline. We assessed the study quality using the Joanna Brigg's Institute (JBI) critical appraisal checklists. We conducted a qualitative synthesis by describing the characteristics of included studies and performed the quantitative synthesis with random effects model using STATA-14. We checked for heterogeneity with Q statistics, quantified by I2, and determined the prediction interval. We performed subgroup analyses to explain the sources of heterogeneity and assessed publication biases by funnel plots augmented with Egger's test. Results Eighty-eight studies with 105 139 participants were included in the review. The overall pooled prevalence of RSV in children <18 years of age was 23% (95% confidence interval (CI) = 20, 25%). Considerable heterogeneity was present across the included studies. The adjusted prediction interval was found to be 19%-27%. Heterogeneities were explained by subgroups analyses. The highest prevalence of RSV was found among inpatients, 28% (95% CI = 25, 31%) compared with inpatients/outpatients and outpatients, with statistically significant differences (P < 0.01). The RSV estimate was also highest among those with acute lower respiratory tract illnesses (ALRTIs), 28% (95% CI = 25, 31%) compared with acute upper respiratory tract illnesses (AURTIs) and both acute upper/lower respiratory manifestations, with statistically different prevalence (P < 0.01). RSV infection estimates in each sub-region of Africa were statistically different (P < 0.01). There were no statistically significant differences in RSV infections by designs, specimen types, and specimen conditions, despite them contributing to heterogeneity. Conclusions We found a high prevalence of RSV in pediatric populations with acute respiratory tract illnesses in Africa, highlighting that the prevention and control of RSV infections in children deserve more attention. Registration PROSPERO CRD42022327054.
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Affiliation(s)
- Belay Tafa Regassa
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Ambo University, Ethiopia
| | - Lami Abebe Gebrewold
- Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ethiopia
| | - Wagi Tosisa Mekuria
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Ambo University, Ethiopia
| | - Nega Assefa Kassa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Ethiopia
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Guo YJ, Wang BH, Li L, Li YL, Chu XL, Li W. Epidemiological and genetic characteristics of respiratory syncytial virus infection in children from Hangzhou after the peak of COVID-19. J Clin Virol 2023; 158:105354. [PMID: 36525852 PMCID: PMC9747354 DOI: 10.1016/j.jcv.2022.105354] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/04/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is one of the main pathogens that causes acute lower respiratory tract infection (ARTI) in infants. During the Coronavirus Disease 2019 (COVID-19) pandemic, although strict interventions have been implemented, RSV infection has not decreased. OBJECTIVES To study the epidemiological and genetic characteristics of RSV circulating in Hangzhou after the peak of COVID-19. METHODS A total of 1225 nasopharyngeal swabs were collected from outpatients with ARTIs from July 2021 to January 2022 in The Children's Hospital, Zhejiang University School of Medicine. RESULTS A total of 267 (21.79%) of the 1225 samples were RSV positive. There was no gender bias. However, an obvious age preference for infection was observed, and children aged 3-6 years were more susceptible, which was very different from previous RSV pandemic seasons. Phylogenetic analysis of 115 sequenced RSV isolates showed that all the RSV-A viruses belong to the ON1 subtype, which could be clustered into three clusters. While all the RSV-B viruses belong to BA9. Further analysis of the mutations highlights the fixation of ten mutations, which should be given extra attention regarding their biological properties. CONCLUSION The incidence of RSV infection in preschool children reported in this study is high. Phylogenetic analysis showed that the subtype A ON1 genotype was the dominant strain in Hangzhou from July 2021 to January 2022.
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Affiliation(s)
- Ya-jun Guo
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health. Hangzhou 310052, PR China
| | - Bing-han Wang
- School of Public Health, Zhejiang University School of Medicine, Hangzhou 310052, PR China
| | - Lin Li
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health. Hangzhou 310052, PR China
| | | | - Xiao-li Chu
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health. Hangzhou 310052, PR China
| | - Wei Li
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health. Hangzhou 310052, PR China.
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Human Respiratory Syncytial Virus Infections among Hospitalized Children in Poland during 2010-2020: Study Based on the National Hospital Registry. J Clin Med 2022; 11:jcm11216451. [PMID: 36362679 PMCID: PMC9656302 DOI: 10.3390/jcm11216451] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/23/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
Background: Human respiratory syncytial virus (RSV) is responsible for infections mainly affecting the lower respiratory tract in infants and young children after the first exposure. The aim of the study is to show up-to-date information on RSV hospitalization cases in Poland in children aged < 5 years. Methods: A retrospective, population-based study was conducted using data from hospital discharge records of patients hospitalized from 2010−2020. Results: The study group consisted of 57,552 hospitalizations of RSV children. The mean and median ages were 232 (95% CI: 230−234) and 132 (IQR 63−271) days. The mean annual hospitalization rate for patients with RSV infection was estimated to be 267.5 per 100,000, and the highest was observed in children < 1 year (1132.1 per 100,000). The mean annual hospitalization rate was significantly higher in patients living in urban than rural regions (p < 0.001). A statistically significant increase in the number of hospitalizations was observed (p < 0.0001) during the analyzed period. The seasonal pattern was found with the highest rates of hospitalizations in the January−March period. Conclusions: The increasing RSV hospitalization rate requires further research and may be the basis for urgent healthcare measures. The results may be helpful in comparative analyses in the European and global context.
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Ozeki S, Kawada JI, Yamashita D, Yasufuku C, Akano T, Kato M, Suzuki K, Tano C, Matsumoto K, Mizutani SH, Mori A, Nishio N, Kidokoro H, Yasui Y, Takahashi Y, Sato Y. Impact of the COVID-19 pandemic on the clinical features of pediatric RSV infection in Japan. Open Forum Infect Dis 2022; 9:ofac562. [PMCID: PMC9620303 DOI: 10.1093/ofid/ofac562] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 10/21/2022] [Indexed: 11/16/2022] Open
Abstract
Background Mitigation measures implemented during the coronavirus disease 2019 (COVID-19) pandemic remarkably reduced the incidence of infectious diseases among children. However, a reemergence of respiratory syncytial virus (RSV) infection was observed in 2021 in Japan. We compared the clinical characteristics of hospitalized patients with RSV infection before and during COVID-19. Methods We retrospectively enrolled children aged <6 years who were hospitalized with RSV infection in 18 hospitals and compared their clinical characteristics before (January 2019 to April 2020, 1,675 patients) and during COVID-19 (September 2020 to December 2021, 1,297 patients). Results The mean age of patients with RSV infection was significantly higher during COVID-19 than before (17.4 vs. 13.7 months, P < .001). Compared with before COVID-19, a 2.6-fold increase in RSV cases in the 2–5 years age group was observed from sentinel surveillance during COVID-19, while a 1.2-fold increase was noted in the same age group among hospitalized patients. On average for all patients, consolidation shadows obtained on radiography were less frequently observed (26.1 vs. 29.6%, P = .04) and reduced respiratory assistance (42.2% vs. 48.7%, P < .001) and hospitalization stay (5.7 vs. 6.0 days, P < .001) was required in patients with RSV infection during COVID-19. Conclusions COVID-19 and social activity restriction caused epidemiological changes in pediatric RSV infections, and a majority of patients with RSV infection aged ≥2 years did not develop severe symptoms requiring hospitalization. The RSV symptoms during the COVID-19 outbreak were equivalent to or milder than in the previous seasons.
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Affiliation(s)
- Shoko Ozeki
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Jun-ichi Kawada
- Corresponding author: Jun-ichi Kawada, MD, PhD Department of Pediatrics Nagoya University Graduate School of Medicine 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Daiki Yamashita
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Chika Yasufuku
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takuya Akano
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masahiro Kato
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Konomi Suzuki
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Chihiro Tano
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazuki Matsumoto
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shu-hei Mizutani
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ayumi Mori
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuhiro Nishio
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan,Department of Advanced Medicine, Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan
| | - Hiroyuki Kidokoro
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshihiro Yasui
- Department of Surveillance and Information, Aichi Prefectural Institute of Public Health, Nagoya, Japan
| | - Yoshiyuki Takahashi
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshiaki Sato
- Alternate corresponding author: Yoshiaki Sato, MD, PhD Nagoya University Graduate School of Medicine 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
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I G Giamberardino H, O Pacheco AP, Pereira LA, Debur MDC, Genehold G, Raboni SM. Respiratory syncytial virus: host genetic susceptibility and factors associated with disease severity in a cohort of pediatric patients. J Trop Pediatr 2022; 68:6794268. [PMID: 36323460 DOI: 10.1093/tropej/fmac091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) infections are the leading cause of hospitalization in young children. We assessed the epidemiology, severity, clinical characteristics, molecular profile and genetic factors of RSV infections compared to acute respiratory illness (ARI) caused by other respiratory viruses. METHODS Prospective cohort study was conducted from 2017 to 2018 with children under 2 years old hospitalized with ARI. Detection of respiratory viruses was carried out using RT-PCR. RSVs were genotyped via nucleotide sequencing, and host interleukin 28B (IL28B) single nucleotide polymorphisms (SNPs) were determined using SNP TaqMan® Genotyping Assays. RESULTS A total of 468 children were included; 288 (61.5%) had an infection by a single virus: 202 (70.1%) cases by RSV followed by rhinovirus 36 (12.5%) and influenza 16 (5.6%). Of the RSV cases, 36% were genotyped with a higher prevalence of RSV B (62.1%). The RSV group presented median age of 2.7 months (1.6-6.8), higher frequency in: intensive care unit admission (p = 0.004), mechanical ventilation use (p = 0.018), wheezing (p < 0.001), antimicrobial use (p < 0.001) and low oxygen saturation (p < 0.001). Prematurity (27.2%) was the most frequent comorbidity. RSV patients without comorbidities demonstrated a higher frequency in the combination of IL28B rs12979860 CT/IL28B rs8099917 TG and IL28B rs12979860 TT/IL28B rs8099917 TT genotypes. Viral coinfection was detected in 27 (5.7%) children, with the most frequent being RSV and rhinovirus (14.2%). CONCLUSIONS This study highlighted the burden of RSV infection in children under 2 years of age, without comorbidities, with a higher need for pediatric ICU admission. Some IL28B allele combinations had a significant association with RSV frequency of infections.
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Affiliation(s)
- Heloisa I G Giamberardino
- Graduate Program in Internal Medicine and Health Science, Universidade Federal do Paraná, Curitiba, Paraná 80060-900, Brazil.,Epidemiology, Immunization and Infection Control Department, Hospital Pequeno Principe, Curitiba, Paraná 80250-060, Brazil
| | - Ana P O Pacheco
- Epidemiology, Immunization and Infection Control Department, Hospital Pequeno Principe, Curitiba, Paraná 80250-060, Brazil
| | - Luciane A Pereira
- Graduate Program in Internal Medicine and Health Science, Universidade Federal do Paraná, Curitiba, Paraná 80060-900, Brazil.,Research and Molecular Biology of Microorganisms Laboratory, Infectious Diseases Department, Universidade Federal do Paraná, Curitiba, Paraná 80060-900, Brazil
| | - Maria do Carmo Debur
- Health Public Laboratory, Health State Secretary, Curitiba, Paraná 80045-155, Brazil
| | - Gustavo Genehold
- Research and Molecular Biology of Microorganisms Laboratory, Infectious Diseases Department, Universidade Federal do Paraná, Curitiba, Paraná 80060-900, Brazil
| | - Sonia M Raboni
- Research and Molecular Biology of Microorganisms Laboratory, Infectious Diseases Department, Universidade Federal do Paraná, Curitiba, Paraná 80060-900, Brazil.,Infectious Diseases Department, Universidade Federal do Paraná, Curitiba, Paraná 80060-900, Brazil
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A multi-center study to determine genetic variations in the fusion gene of respiratory syncytial virus (RSV) from children <2 years of age in the U.S. J Clin Virol 2022; 154:105223. [DOI: 10.1016/j.jcv.2022.105223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/25/2022] [Accepted: 06/26/2022] [Indexed: 11/29/2022]
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31
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Gori L, Amendolea A, Buonsenso D, Salvadori S, Supino MC, Musolino AM, Adamoli P, Coco AD, Trobia GL, Biagi C, Lucherini M, Leonardi A, Limoli G, Giampietri M, Sciacca TV, Morello R, Tursi F, Soldati G. Prognostic Role of Lung Ultrasound in Children with Bronchiolitis: Multicentric Prospective Study. J Clin Med 2022; 11:jcm11144233. [PMID: 35887997 PMCID: PMC9316238 DOI: 10.3390/jcm11144233] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 07/12/2022] [Accepted: 07/18/2022] [Indexed: 02/06/2023] Open
Abstract
There is increasing recognition of the role of lung ultrasound (LUS) to assess bronchiolitis severity in children. However, available studies are limited to small, single-center cohorts. We aimed to assess a qualitative and quantitative LUS protocol to evaluate the course of bronchiolitis at diagnosis and during follow-up. This is a prospective, multicenter study. Children with bronchiolitis were stratified according to clinical severity and underwent four LUS evaluations at set intervals. LUS was classified according to four models: (1) positive/negative; (2) main LUS pattern (normal/interstitial/consolidative/mixed) (3) LUS score; (4) LUS score with cutoff. Two hundred and thirty-three children were enrolled. The baseline LUS was significantly associated with bronchiolitis severity, using both the qualitative (positive/negative LUS p < 0.001; consolidated/normal LUS pattern or mixed/normal LUS p < 0.001) and quantitative models (cutoff score > 9 p < 0.001; LUS mean score p < 0.001). During follow-up, all LUS results according to all LUS models improved (p < 0.001). Better cut off value was declared at a value of >9 points. Conclusions: Our study supports the role of a comprehensive qualitative and quantitative LUS protocol for the identification of severe cases of bronchiolitis and provides data on the evolution of lung aeration during follow-up.
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Affiliation(s)
- Laura Gori
- Pediatric Unit, Valle del Serchio General Hospital, 55051 Barga, Italy
- Correspondence: (L.G.); (D.B.); Tel.: +39-050-996690 (L.G.); +39-06-30154390 (D.B.)
| | | | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A, Gemelli IRCCS, 00168 Rome, Italy;
- Correspondence: (L.G.); (D.B.); Tel.: +39-050-996690 (L.G.); +39-06-30154390 (D.B.)
| | | | - Maria Chiara Supino
- Department of Pediatric Emergency, Bambin Gesù Children’s Hospital IRCCS, 00165 Rome, Italy; (M.C.S.); (A.M.M.)
| | - Anna Maria Musolino
- Department of Pediatric Emergency, Bambin Gesù Children’s Hospital IRCCS, 00165 Rome, Italy; (M.C.S.); (A.M.M.)
| | - Paolo Adamoli
- Pediatric Unit, Moriggia Pelascini Hospital, Gravedona et Uniti, 22015 Como, Italy; (P.A.); (A.D.C.)
| | - Alfina Domenica Coco
- Pediatric Unit, Moriggia Pelascini Hospital, Gravedona et Uniti, 22015 Como, Italy; (P.A.); (A.D.C.)
| | - Gian Luca Trobia
- Pediatric and Pediatric Emergency Room Unit, Cannizzaro Emergency Hospital, 95126 Catania, Italy; (G.L.T.); (T.V.S.)
| | - Carlotta Biagi
- Pediatric Emergency Unit, Sant’Orsola Hospital IRCCS, 40138 Bologna, Italy;
| | - Marco Lucherini
- Pediatric Unit, Nottola Hospital, Montepulciano, 53045 Siena, Italy;
| | - Alberto Leonardi
- Pediatric Clinic, Department of Surgical and Biomedical Sciences, University of Perugia, 06132 Perugia, Italy;
| | | | - Matteo Giampietri
- Department of Maternal and Child Health, Division of Neonatology and Neonatal Intensive Care Unit, S. Chiara Hospital, University of Pisa, 56100 Pisa, Italy;
| | - Tiziana Virginia Sciacca
- Pediatric and Pediatric Emergency Room Unit, Cannizzaro Emergency Hospital, 95126 Catania, Italy; (G.L.T.); (T.V.S.)
| | - Rosa Morello
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A, Gemelli IRCCS, 00168 Rome, Italy;
| | - Francesco Tursi
- Pneumology Unit, Civil Hospital, Codogno, 26845 Lodi, Italy;
| | - Gino Soldati
- Diagnostic and Interventional Ultrasound Unit, Valle del Serchio General Hospital, Castelnuovo Garfagnana, 55032 Lucca, Italy;
| | - Ecobron Group
- Pediatric Unit and Pediatric Emergency Unit, Azienda Ospedaliera Universitaria Policlinico San Marco, University of Catania, 95121 Catania, Italy
- Pneumology Unit, Fondazione Policlinico Universitario A, Gemelli IRCCS, 00168 Rome, Italy
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Genetic Diversity and Epidemiological Features of Respiratory Syncytial Virus, Beijing, 2015–2019: A Multicenter and All-Age Groups Study. J Infect 2022; 85:75-85. [DOI: 10.1016/j.jinf.2022.04.046] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 04/26/2022] [Accepted: 04/30/2022] [Indexed: 11/19/2022]
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Esposito S, Abu Raya B, Baraldi E, Flanagan K, Martinon Torres F, Tsolia M, Zielen S. RSV Prevention in All Infants: Which Is the Most Preferable Strategy? Front Immunol 2022; 13:880368. [PMID: 35572550 PMCID: PMC9096079 DOI: 10.3389/fimmu.2022.880368] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 03/28/2022] [Indexed: 11/30/2022] Open
Abstract
Respiratory syncytial virus (RSV) causes a spectrum of respiratory illnesses in infants and young children that may lead to hospitalizations and a substantial number of outpatient visits, which result in a huge economic and healthcare burden. Most hospitalizations happen in otherwise healthy infants, highlighting the need to protect all infants against RSV. Moreover, there is evidence on the association between early-life RSV respiratory illness and recurrent wheezing/asthma-like symptoms As such, RSV is considered a global health priority. However, despite this, the only prevention strategy currently available is palivizumab, a monoclonal antibody (mAb) indicated in a subset of preterm infants or those with comorbidities, hence leaving the majority of the infant population unprotected against this virus. Therefore, development of prevention strategies against RSV for all infants entering their first RSV season constitutes a large unmet medical need. The aim of this review is to explore different immunization approaches to protect all infants against RSV. Prevention strategies include maternal immunization, immunization of infants with vaccines, immunization of infants with licensed mAbs (palivizumab), and immunization of infants with long-acting mAbs (e.g., nirsevimab, MK-1654). Of these, palivizumab use is restricted to a small population of infants and does not offer a solution for all-infant protection, whereas vaccine development in infants has encountered various challenges, including the immaturity of the infant immune system, highlighting that future pediatric vaccines will most likely be used in older infants (>6 months of age) and children. Consequently, maternal immunization and immunization of infants with long-acting mAbs represent the two feasible strategies for protection of all infants against RSV. Here, we present considerations regarding these two strategies covering key areas which include mechanism of action, "consistency" of protection, RSV variability, duration of protection, flexibility and optimal timing of immunization, benefit for the mother, programmatic implementation, and acceptance of each strategy by key stakeholders. We conclude that, based on current data, immunization of infants with long-acting mAbs might represent the most effective approach for protecting all infants entering their first RSV season.
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Affiliation(s)
- Susanna Esposito
- Pediatric Clinic, Pietro Barilla Children’s Hospital, University of Parma, Parma, Italy
| | - Bahaa Abu Raya
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Eugenio Baraldi
- Neonatal Intensive Care Unit, Department of Woman’s and Child’s Health, Padova University Hospital, Padova, Italy
| | - Katie Flanagan
- School of Medicine, Faculty of Health Sciences, University of Tasmania, Launceston, TAS, Australia
- School of Health and Biomedical Science, RMIT University, Melbourne, VIC, Australia
- Department of Immunology and Pathology, Monash University, Melbourne, VIC, Australia
- Tasmanian Vaccine Trial Centre, Clifford Craig Foundation, Launceston General Hospital, Launceston, TAS, Australia
| | - Federico Martinon Torres
- Genetics, Vaccines, Infections and Pediatrics Research group (GENVIP), Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Maria Tsolia
- Second Department of Pediatrics, National and Kapodistrian University of Athens, “A&P Kyriakou” Children’s Hospital, Athens, Greece
| | - Stefan Zielen
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, Goethe-University Hospital, Frankfurt am Main, Germany
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Watanabe RAS, Cruz JS, de Souza Luna LK, Alves VRG, Conte DD, Lyra L, Nishiyama F, Camargo BS, Bellei N. Respiratory syncytial virus: viral load, viral decay, and disease progression in children with bronchiolitis. Braz J Microbiol 2022; 53:1241-1247. [PMID: 35362939 PMCID: PMC9433556 DOI: 10.1007/s42770-022-00742-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 03/21/2022] [Indexed: 11/26/2022] Open
Abstract
Acute viral bronchiolitis is the major cause of hospital admissions in children under 2 years of age, and respiratory syncytial virus (RSV) can be responsible for up to 80% of these infections. We aimed to describe RSV dynamics among hospitalized children with bronchiolitis. Upper respiratory samples of 101 hospitalized patients were collected and submitted to RSV detection by a quantitative real-time RT-PCR to assess viral load (Log10 RNA copies/mL). Seventy-two patients were positive for RSV infection, of which 38 (52.7%) could be followed up until RSV was no longer detected. The first RSV RT-qPCR was carried out on average on the 5th day of symptom onset. Thirty-six patients (94.7%) were still shedding RSV after 7 days, and 9 (23.6%) after 14 days of symptoms onset. Only 2 patients (5.2%) were still shedding RSV after 21 days. Only 7 of the followed patients (18.9%) were submitted to intubation. There was no difference between the viral load of the first collected sample and the viral persistence of patients with comorbidities, who needed intensive care unit and who needed intubation. These data could help understand RSV dynamics and future studies and treatments to come.
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Affiliation(s)
- Raí André Silva Watanabe
- Clinical Virology Laboratory, Infectious Diseases Unit, Medicine Department, São Paulo Federal University, Rua Pedro de Toledo, 781 - Vila Clementino, 15° andar frente, São Paulo, SP 04039-032 Brazil
| | - Jessica Santiago Cruz
- Clinical Virology Laboratory, Infectious Diseases Unit, Medicine Department, São Paulo Federal University, Rua Pedro de Toledo, 781 - Vila Clementino, 15° andar frente, São Paulo, SP 04039-032 Brazil
| | - Luciano Kleber de Souza Luna
- Clinical Virology Laboratory, Infectious Diseases Unit, Medicine Department, São Paulo Federal University, Rua Pedro de Toledo, 781 - Vila Clementino, 15° andar frente, São Paulo, SP 04039-032 Brazil
| | - Vitória Rodrigues Guimarães Alves
- Clinical Virology Laboratory, Infectious Diseases Unit, Medicine Department, São Paulo Federal University, Rua Pedro de Toledo, 781 - Vila Clementino, 15° andar frente, São Paulo, SP 04039-032 Brazil
| | - Danielle Dias Conte
- Clinical Virology Laboratory, Infectious Diseases Unit, Medicine Department, São Paulo Federal University, Rua Pedro de Toledo, 781 - Vila Clementino, 15° andar frente, São Paulo, SP 04039-032 Brazil
| | | | | | | | - Nancy Bellei
- Clinical Virology Laboratory, Infectious Diseases Unit, Medicine Department, São Paulo Federal University, Rua Pedro de Toledo, 781 - Vila Clementino, 15° andar frente, São Paulo, SP 04039-032 Brazil
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Shen Z, Zhang Y, Li H, Du L. Rapid typing diagnosis and clinical analysis of subtypes A and B of human respiratory syncytial virus in children. Virol J 2022; 19:15. [PMID: 35062975 PMCID: PMC8781464 DOI: 10.1186/s12985-022-01744-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 01/12/2022] [Indexed: 12/04/2022] Open
Abstract
Background Human respiratory syncytial virus (HRSV) is the leading pathogens causing acute respiratory infections (ARI) in children under five years old. We aimed to investigate the distribution of HRSV subtypes and explore the relationship between viral subtypes and clinical symptoms and disease severity. Methods From November 2016 to April 2017, 541 children hospitalized because of ARI were included in the study. Throat swabs were collected for analysis and all samples were tested by multiplex one-step qRT-PCR for quantitative analysis and typing of HRSV. Patients’ demographics, clinical symptoms as well as laboratory and imaging results were retrieved from medical records. Results HRSV was detected in 19.6% of children hospitalized due to ARI. HRSV-positive children were younger (P < 0.001), had a higher frequency of wheezing and pulmonary rales (P < 0.001; P = 0.003), and were more likely to develop bronchopneumonia (P < 0.001). Interleukin (IL) 10、CD4/CD8 (below normal range) and C-reactive protein levels between subtypes A and B groups were significantly different (P = 0.037; P = 0.029; P = 0.007), and gender differences were evident. By age-stratified analysis between subtypes A and B, we found significant differences in fever frequency and lymphocyte ratio (P = 0.008; P = 0.03) in the 6–12 months age group, while the 12. 1–36 months age group showed significant differences in fever days and count of leukocytes, platelets, levels aspartate aminotransferase, IL-6, lactate dehydrogenase and proportion CD4 positive T cells(P = 0.013; P = 0.018; P = 0.016; P = 0.037; P = 0.049; P = 0.025; P = 0.04). We also found a positive correlation between viral load and wheezing days in subtype A (P < 0.05), and a negative correlation between age, monocyte percentage and LDH concentration in subtype B (P < 0.05). Conclusions HRSV is the main causative virus of bronchopneumonia in infants and children. The multiplex one-step qRT-PCR not only provides a rapid and effective diagnosis of HRSV infection, but also allows its typing. There were no significant differences in the severity of HRSV infection between subtypes A and B, except significant gender-specific and age-specific differences in some clinical characteristics and laboratory results. Knowing the viral load of HRSV infection can help understanding the clinical features of different subtypes of HRSV infection.
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Rios Guzman E, Hultquist JF. Clinical and biological consequences of respiratory syncytial virus genetic diversity. Ther Adv Infect Dis 2022; 9:20499361221128091. [PMID: 36225856 PMCID: PMC9549189 DOI: 10.1177/20499361221128091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 08/30/2022] [Indexed: 11/17/2022] Open
Abstract
Respiratory syncytial virus (RSV) is one of the most common etiological agents of global acute respiratory tract infections with a disproportionate burden among infants, individuals over the age of 65, and immunocompromised populations. The two major subtypes of RSV (A and B) co-circulate with a predominance of either group during different epidemic seasons, with frequently emerging genotypes due to RSV's high genetic variability. Global surveillance systems have improved our understanding of seasonality, disease burden, and genomic evolution of RSV through genotyping by sequencing of attachment (G) glycoprotein. However, the integration of these systems into international infrastructures is in its infancy, resulting in a relatively low number (~2200) of publicly available RSV genomes. These limitations in surveillance hinder our ability to contextualize RSV evolution past current canonical attachment glycoprotein (G)-oriented understanding, thus resulting in gaps in understanding of how genetic diversity can play a role in clinical outcome, therapeutic efficacy, and the host immune response. Furthermore, utilizing emerging RSV genotype information from surveillance and testing the impact of viral evolution using molecular techniques allows us to establish causation between the clinical and biological consequences of arising genotypes, which subsequently aids in informed vaccine design and future vaccination strategy. In this review, we aim to discuss the findings from current molecular surveillance efforts and the gaps in knowledge surrounding the consequence of RSV genetic diversity on disease severity, therapeutic efficacy, and RSV-host interactions.
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Affiliation(s)
- Estefany Rios Guzman
- Department of Medicine, Division of Infectious
Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL,
USA
- Center for Pathogen Genomics and Microbial
Evolution, Institute for Global Health, Northwestern University Feinberg
School of Medicine, Chicago, IL, USA
| | - Judd F. Hultquist
- Robert H. Lurie Medical Research Center,
Northwestern University, 9-141, 303 E. Superior St., Chicago, IL 60611,
USA
- Department of Medicine, Division of Infectious
Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL,
USA
- Center for Pathogen Genomics and Microbial
Evolution, Institute for Global Health, Northwestern University Feinberg
School of Medicine, Chicago, IL, USA
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Bottau P, Liotti L, Laderchi E, Palpacelli A, Calamelli E, Colombo C, Serra L, Cazzato S. Something Is Changing in Viral Infant Bronchiolitis Approach. Front Pediatr 2022; 10:865977. [PMID: 35498813 PMCID: PMC9047867 DOI: 10.3389/fped.2022.865977] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 03/23/2022] [Indexed: 11/13/2022] Open
Abstract
Acute Viral Bronchiolitis is one of the leading causes of hospitalization in the first 12-24 months of life. International guidelines on the management of bronchiolitis broadly agree in recommending a minimal therapeutic approach, not recommending the use of bronchodilators. Guidelines, generally, consider bronchiolitis as a "unique disease" and this runs the risk of not administering therapy in some patients who could benefit from the use of bronchodilators, for instance, in those who will develop asthma later in their life and face first episode in the age of bronchiolitis. Today, there is growing evidence that bronchiolitis is not a single illness but can have different "endotypes" and "phenotypes," based on age, personal or family history of atopy, etiology, and pathophysiological mechanism. There is evidence that some phenotypes of bronchiolitis are more strongly associated with asthma features and are linked to higher risk for asthma development. In these populations, possible use of bronchodilators might have a better impact. Age seems to be the main feature to suggest a good response to a bronchodilator-trial, because, among children > 6 months old with bronchiolitis, the presence of a subset of patients with virus-induced wheezing or the first episode of asthma is more likely. While waiting for new research to define the relationship between therapeutic options and different phenotypes, a bronchodilator-trial (using short-acting β2 agonists with metered-dose inhalers and valved holding chambers) seems appropriate in every child with bronchiolitis and age > 6 months.
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Affiliation(s)
- Paolo Bottau
- Pediatric and Neonatology Unit, Imola Hospital, Imola, Italy
| | - Lucia Liotti
- Pediatric Unit, Department of Mother and Child Health, Salesi Children's Hospital, Ancona, Italy
| | - Eleonora Laderchi
- Postgraduate School of Pediatrics, University of Bologna, Bologna, Italy
| | - Alessandra Palpacelli
- Pediatric Unit, Department of Mother and Child Health, Salesi Children's Hospital, Ancona, Italy
| | | | - Carlotta Colombo
- Postgraduate School of Pediatrics, University of Bologna, Bologna, Italy
| | - Laura Serra
- Pediatric and Neonatology Unit, Imola Hospital, Imola, Italy
| | - Salvatore Cazzato
- Pediatric Unit, Department of Mother and Child Health, Salesi Children's Hospital, Ancona, Italy
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Chen X, Zhu Y, Wang W, Li C, An S, Lu G, Jin R, Xu B, Zhou Y, Chen A, Li L, Zhang M, Xie Z. A multi-center study on Molecular Epidemiology of Human Respiratory Syncytial Virus from Children with Acute Lower Respiratory Tract Infections in the Mainland of China between 2015 and 2019. Virol Sin 2021; 36:1475-1483. [PMID: 34398429 PMCID: PMC8365132 DOI: 10.1007/s12250-021-00430-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 05/18/2021] [Indexed: 11/25/2022] Open
Abstract
Human respiratory syncytial virus (RSV) is a major pathogen of acute lower respiratory tract infection among young children. To investigate the prevalence and genetic characteristics of RSV in China, we performed a molecular epidemiological study during 2015-2019. A total of 964 RSV-positive specimens were identified from 5529 enrolled patients during a multi-center study. RSV subgroup A (RSV-A) was the predominant subgroup during this research period except in 2016. Totally, 535 sequences of the second hypervariable region (HVR-2) of the G gene were obtained. Combined with 182 Chinese sequences from GenBank, phylogenetic trees showed that 521 RSV-A sequences fell in genotypes ON1 (512), NA1 (6) and GA5 (3), respectively; while 196 RSV-B sequences fell in BA9 (193) and SAB4 (3). ON1 and BA9 were the only genotypes after December 2015. Genotypes ON1 and BA9 can be separated into 10 and 7 lineages, respectively. The HVR-2 of genotype ON1 had six amino acid changes with a frequency more than 10%, while two substitutions H258Q and H266L were co-occurrences. The HVR-2 of genotype BA9 had nine amino acid substitutions with a frequency more than 10%, while the sequences with T290I and T312I were all from 2018 to 2019. One N-glycosylation site at 237 was identified among ON1 sequences, while two N-glycosylation sites (296 and 310) were identified in the 60-nucleotide duplication region of BA9. To conclusion, ON1 and BA9 were the predominant genotypes in China during 2015-2019. For the genotypes ON1 and BA9, the G gene exhibited relatively high diversity and evolved continuously.
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Affiliation(s)
- Xiangpeng Chen
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, 2019RU016, Laboratory of Infection and Virology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Yun Zhu
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, 2019RU016, Laboratory of Infection and Virology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Wei Wang
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, 2019RU016, Laboratory of Infection and Virology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Changchong Li
- The 2nd Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Shuhua An
- Children's Hospital of Hebei Province, Shijiazhuang, 050031, China
| | - Gen Lu
- Guangzhou Women and Children's Medical Center, Guangzhou, 510623, China
| | - Rong Jin
- Guiyang Maternal and Child Health Hospital, Guiyang, 550003, China
| | - Baoping Xu
- Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 10045, China
| | - Yunlian Zhou
- The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Aihuan Chen
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China
| | - Lei Li
- Yinchuan Maternal and Child Health Care Hospital, Yinchuan, 750001, China
| | - Meng Zhang
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, 2019RU016, Laboratory of Infection and Virology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Zhengde Xie
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, 2019RU016, Laboratory of Infection and Virology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
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Clinical Epidemiological Characteristics and Risk Factors for Severe Bronchiolitis Caused by Respiratory Syncytial Virus in Vietnamese Children. Int J Pediatr 2021; 2021:9704666. [PMID: 34819958 PMCID: PMC8608547 DOI: 10.1155/2021/9704666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/31/2021] [Accepted: 11/01/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction Bronchiolitis is the most prevalent cause of hospitalization in infants under the age of 12 months. The disease is caused by respiratory syncytial virus (RSV) infection, which can cause breathing difficulties and respiratory failure. Therefore, it is necessary to discover the risk factors of severe bronchiolitis to diagnose and treat promptly. This study is aimed at describing the epidemiological characteristics and clinical features of acute bronchiolitis caused by RSV and assessing the related factors to severe acute bronchiolitis in studied patients. Methods A descriptive cross-sectional study was carried out in Haiphong Children's Hospital, Haiphong, Vietnam, for one year, from October 1, 2016, to September 30, 2017. All bronchiolitis admissions < 2 years were included. Results 377 children were evaluated, including 261 boys and 116 girls; children under 6 months accounted for the highest proportion (57%), and 47 (12.5%) of all patients had severe disease. Wheezing was the main reason to be taken to the hospital 261 (69.2%). Clinical symptoms of acute bronchiolitis such as cough, tachypnea, and runny nose were found in all patients. Bronchiolitis cases increased in the winter-spring season, and the highest registered number of patients was 42 in March. Image of bronchiolitis on chest X-ray was found in all patients, and air trapping lung was found in 124 (32.9%) patients. The risk factors included age (≤6 months), low birth weight, preterm birth, nonbreastfeeding for the first six months, early weaning, and exposition to cigarette smoke increased the severe disease (p < 0.05). Conclusion The number of hospitalized infants with bronchiolitis caused by RSV has an upward trend during the winter-spring season (from October to March). This study confirms that age, preterm birth, breastfeeding under 6 months, history of exposure to cigarette smoking, low birth weight, having sibling(s) under five years old going to kindergarten, history of undergoing cesarean section, history of mechanical ventilation, poor living condition, and maternal education are 10 risk factors of severe bronchiolitis caused by RSV.
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Idris OO, Kolawole OM. Seroprevalence and molecular characterization of human respiratory syncytial virus and human adenovirus among children in Ado-Ekiti, Nigeria. J Med Virol 2021; 94:2548-2557. [PMID: 34816447 DOI: 10.1002/jmv.27473] [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: 04/03/2021] [Accepted: 11/19/2021] [Indexed: 11/10/2022]
Abstract
In children, the respiratory syncytial virus and adenovirus majorly cause acute respiratory infections. The study evaluated the seroprevalence and conducted the molecular characterization of human respiratory syncytial virus (HRSV) and human adenovirus (HAdV) among children. Venous blood, nasopharyngeal, and oropharyngeal swabs were collected from children presenting with acute respiratory infections in a tertiary health facility in Ado-Ekiti, Nigeria. A serological investigation was carried out on the sera samples for the detection of anti-HRSV immunoglobulin M (IgM), anti-HRSV IgG, anti-HAdV IgM, and anti-HAdV IgG using ELISA (enzyme-linked immunosorbent assay) kits. The amplification and sequencing of HRSV and HAdV were carried out using specific primer pairs that targeted the glycoprotein (G) gene of HRSV and the hexon gene of HAdV, respectively. The seroprevalence of HRSV IgG and IgM was 73% and 7.5%, respectively, while the seroprevalence of HAdV IgG and IgM was 98.5% and 8.5%, respectively. The age of enrolled children, presence of fever, and cough were associated (p < 0.05) with the infection. HRSV subtype B (HRSV-B) (13.3%), and species of HAdV (Mastadenovirus B and C) (11.7%) were detected among the studied population. There was no viral coinfection with both HRSV and HAdV. In infancy and early childhood, HRSV-B, HAdV species B and C are common etiologic agents of respiratory infections as reported in this study. Further studies on molecular characterization of respiratory tract viruses including circulating respiratory syncytial virus and adenovirus are hereby advocated.
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Affiliation(s)
- Olayinka O Idris
- Department of Microbiology, Faculty of Life Sciences, Infectious Diseases and Environmental Health Research Group, University of Ilorin, Ilorin, Nigeria.,Department of Biological Sciences, College of Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Olatunji M Kolawole
- Department of Microbiology, Faculty of Life Sciences, Infectious Diseases and Environmental Health Research Group, University of Ilorin, Ilorin, Nigeria
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Respiratory Syncytial Virus: New Challenges for Molecular Epidemiology Surveillance and Vaccination Strategy in Patients with ILI/SARI. Vaccines (Basel) 2021; 9:vaccines9111334. [PMID: 34835265 PMCID: PMC8622394 DOI: 10.3390/vaccines9111334] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/10/2021] [Accepted: 11/12/2021] [Indexed: 12/14/2022] Open
Abstract
Several respiratory pathogens are responsible for influenza-like illness (ILI) and severe respiratory infections (SARI), among which human respiratory syncytial virus (hRSV) represents one of the most common aetiologies. We analysed the hRSV prevalence among subjects with ILI or SARI during the five influenza seasons before the emergence of SARS-CoV-2 epidemic in Sicily (Italy). Respiratory specimens from ILI outpatients and SARI inpatients were collected in the framework of the Italian Network for the Influenza Surveillance and molecularly tested for hRSV-A and hRSV-B. Overall, 8.1% of patients resulted positive for hRSV. Prevalence peaked in the age-groups <5 years old (range: 17.6–19.1%) and ≥50 years old (range: 4.8–5.1%). While the two subgroups co-circulated throughout the study period, hRSV-B was slightly predominant over hRSV-A, except for the season 2019–2020 when hRSV-A strongly prevailed (82.9%). In the community setting, the distribution of hRSV subgroups was balanced (47.8% vs. 49.7% for hRSV-A and hRSV-B, respectively), while most infections identified in the hospital setting were caused by hRSV-B (69.5%); also, this latter one was more represented among hRSV cases with underlying diseases, as well as among those who developed a respiratory complication. The molecular surveillance of hRSV infections may provide a valuable insight into the epidemiological features of ILI/SARI. Our findings add new evidence to the existing knowledge on viral aetiology of ILI and SARI in support of public health strategies and may help to define high-risk categories that could benefit from currently available and future vaccines.
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Lee YE, Choi OK, Bang SJ, Cho HG, Lee HK, Han BS, Lee SH, Cheng J, Cho JH, Suh JW. Molecular epidemiological study of the G protein of human respiratory syncytial virus detected in patients with acute respiratory infections in Gyeonggi Province, South Korea. J Med Virol 2021; 94:549-556. [PMID: 34730256 DOI: 10.1002/jmv.27431] [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: 07/15/2021] [Revised: 10/12/2021] [Accepted: 11/01/2021] [Indexed: 11/11/2022]
Abstract
To investigate the molecular characteristics of human respiratory syncytial virus (HRSV) detected in Gyeonggi Province from 2015/16 to 2017/18, 2331 specimens from patients with sporadic acute respiratory illness and 85 specimens from four HRSV outbreaks in the postpartum care center were analyzed by real-time reverse transcription PCR. HRSVs were detected in 97 of the 2416 (4.0%) specimens, and among the positive specimens, 38 (39.2%) were identified as HRSV-A and 59 (60.8%) as HRSV-B. During the study periods, HRSV-B predominated in all seasons, except in 2016/17 during which HRSV-A predominated. Depending on the age groups, HRSV prevalence was the highest in 0- to 2-year-old patients. Comparison of noninfected subjects with HRSV-infected subjects revealed that HRSV infection more frequently resulted in fever, nasal obstruction, and wheezing, although the frequency of sore throat was low; however, comparison of the symptoms between HRSV-A- and HRSV-B-infected patients revealed no significant differences in symptoms. Phylogenetic analysis showed that all HRSV-A patients had an ON1 genotype, and all HRSV-B patients had an BA9 genotype. These results provide a valuable reference regarding the circulating pattern and molecular characterization of HRSV. Continuous monitoring will be essential to detect newly emerging HRSV genotypes.
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Affiliation(s)
- Yea-Eun Lee
- Team of Infectious Disease Investigation, Gyeonggi-Do Institute of Health and Environment, Suwon, Republic of Korea
| | - Ok-Kyung Choi
- Team of Infectious Disease Investigation, Gyeonggi-Do Institute of Health and Environment, Suwon, Republic of Korea
| | - Seon-Jae Bang
- Team of Infectious Disease Investigation, Gyeonggi-Do Institute of Health and Environment, Suwon, Republic of Korea
| | - Han-Gil Cho
- Team of Infectious Disease Investigation, Gyeonggi-Do Institute of Health and Environment, Suwon, Republic of Korea
| | - Hyun-Kyung Lee
- Team of Infectious Disease Investigation, Gyeonggi-Do Institute of Health and Environment, Suwon, Republic of Korea
| | - Baek-Sang Han
- Team of Infectious Disease Investigation, Gyeonggi-Do Institute of Health and Environment, Suwon, Republic of Korea
| | - Sun-Hwa Lee
- Center of Laboratory Medicine, Seegene Medical Foundation, Seoul, Republic of Korea
| | - Jinhua Cheng
- Myongji Bioefficacy Research Center, Myongji University, Yongin, Republic of Korea
| | - Joo-Hyung Cho
- Myongji Bioefficacy Research Center, Myongji University, Yongin, Republic of Korea
| | - Joo-Won Suh
- Myongji Bioefficacy Research Center, Myongji University, Yongin, Republic of Korea
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Biagi C, Scarpini S, Paleari C, Fabi M, Dondi A, Gabrielli L, Gennari M, Lanari M, Pierantoni L. Impact of Guidelines Publication on Acute Bronchiolitis Management: 10-Year Experience from a Tertiary Care Center in Italy. Microorganisms 2021; 9:2221. [PMID: 34835347 PMCID: PMC8625287 DOI: 10.3390/microorganisms9112221] [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: 09/18/2021] [Revised: 10/21/2021] [Accepted: 10/23/2021] [Indexed: 11/16/2022] Open
Abstract
Bronchiolitis is the most common lower respiratory tract infection in infants. According to evidence-based guidelines, diagnosis is clinical, there is no need for routine use of laboratory or instrumental tests and therapy is primarily supportive, based on oxygen and adequate fluid supplementation. Nevertheless, unnecessary diagnostic tests and pharmacological treatments are still very common. The aim of this retrospective cohort study was to evaluate how the management of bronchiolitis has changed in the last ten years in a Tertiary Care Center in Italy, assessing adherence to national guidelines. Considering the publication of the Italian inter-society consensus document in 2014, we compared patients admitted in the prior four epidemic seasons with patients admitted in the latter six epidemic seasons. The comparison between the two groups showed a significant reduction in the prescription of systemic corticosteroids (58.9% vs. 41.8%, p < 0.001), nebulized epinephrine (73.8% vs. 38.3%, p < 0.001) and antibiotics (59.5% vs. 42.3%, p < 0.001), together with a drastic decrease in the use of chest X-ray (92.2% vs. 54.4%, p < 0.001). On the contrary, the use of inhaled salbutamol remained substantially stable over time (39.4% vs. 37.6%, p = 0.505). Despite the encouraging results, further efforts are needed to limit the prescription of ineffective therapies like antibiotics and inhaled salbutamol.
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Affiliation(s)
- Carlotta Biagi
- Pediatric Emergency Unit, Scientific Institute for Research and Healthcare (IRCCS), Sant’Orsola Hospital, 40138 Bologna, Italy; (C.B.); (M.F.); (A.D.); (M.G.); (M.L.); (L.P.)
| | - Sara Scarpini
- Specialty School of Pediatrics, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy;
| | - Camilla Paleari
- Specialty School of Pediatrics, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy;
| | - Marianna Fabi
- Pediatric Emergency Unit, Scientific Institute for Research and Healthcare (IRCCS), Sant’Orsola Hospital, 40138 Bologna, Italy; (C.B.); (M.F.); (A.D.); (M.G.); (M.L.); (L.P.)
| | - Arianna Dondi
- Pediatric Emergency Unit, Scientific Institute for Research and Healthcare (IRCCS), Sant’Orsola Hospital, 40138 Bologna, Italy; (C.B.); (M.F.); (A.D.); (M.G.); (M.L.); (L.P.)
| | - Liliana Gabrielli
- Microbiology Unit, Scientific Institute for Research and Healthcare (IRCCS), Sant’Orsola Hospital, 40138 Bologna, Italy;
| | - Monia Gennari
- Pediatric Emergency Unit, Scientific Institute for Research and Healthcare (IRCCS), Sant’Orsola Hospital, 40138 Bologna, Italy; (C.B.); (M.F.); (A.D.); (M.G.); (M.L.); (L.P.)
| | - Marcello Lanari
- Pediatric Emergency Unit, Scientific Institute for Research and Healthcare (IRCCS), Sant’Orsola Hospital, 40138 Bologna, Italy; (C.B.); (M.F.); (A.D.); (M.G.); (M.L.); (L.P.)
| | - Luca Pierantoni
- Pediatric Emergency Unit, Scientific Institute for Research and Healthcare (IRCCS), Sant’Orsola Hospital, 40138 Bologna, Italy; (C.B.); (M.F.); (A.D.); (M.G.); (M.L.); (L.P.)
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Sansone F, Attanasi M, Di Filippo P, Sferrazza Papa GF, Di Pillo S, Chiarelli F. Usefulness of Lung Ultrasound in Paediatric Respiratory Diseases. Diagnostics (Basel) 2021; 11:1783. [PMID: 34679481 PMCID: PMC8534634 DOI: 10.3390/diagnostics11101783] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 01/02/2023] Open
Abstract
Respiratory infection diseases are among the major causes of morbidity and mortality in children. Diagnosis is focused on clinical presentation, yet signs and symptoms are not specific and there is a need for new non-radiating diagnostic tools. Among these, lung ultrasound (LUS) has recently been included in point-of-care protocols showing interesting results. In comparison to other imaging techniques, such as chest X-ray and computed tomography, ultrasonography does not use ionizing radiations. Therefore, it is particularly suitable for clinical follow-up of paediatric patients. LUS requires only 5-10 min and allows physicians to make quick decisions about the patient's management. Nowadays, LUS has become an early diagnostic tool to detect pneumonia during the COVID-19 pandemic. In this narrative review, we show the most recent scientific literature about advantages and limits of LUS performance in children. Furthermore, we discuss the major paediatric indications separately, with a paragraph fully dedicated to COVID-19. Finally, we mention potential future perspectives about LUS application in paediatric respiratory diseases.
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Affiliation(s)
- Francesco Sansone
- Paediatric Allergy and Pulmonology Unit, Department of Paediatrics, University of Chieti-Pescara, 66100 Chieti, Italy; (F.S.); (M.A.); (P.D.F.); (S.D.P.)
| | - Marina Attanasi
- Paediatric Allergy and Pulmonology Unit, Department of Paediatrics, University of Chieti-Pescara, 66100 Chieti, Italy; (F.S.); (M.A.); (P.D.F.); (S.D.P.)
| | - Paola Di Filippo
- Paediatric Allergy and Pulmonology Unit, Department of Paediatrics, University of Chieti-Pescara, 66100 Chieti, Italy; (F.S.); (M.A.); (P.D.F.); (S.D.P.)
| | - Giuseppe Francesco Sferrazza Papa
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, 20146 Milan, Italy;
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, 20144 Milan, Italy
| | - Sabrina Di Pillo
- Paediatric Allergy and Pulmonology Unit, Department of Paediatrics, University of Chieti-Pescara, 66100 Chieti, Italy; (F.S.); (M.A.); (P.D.F.); (S.D.P.)
| | - Francesco Chiarelli
- Paediatric Allergy and Pulmonology Unit, Department of Paediatrics, University of Chieti-Pescara, 66100 Chieti, Italy; (F.S.); (M.A.); (P.D.F.); (S.D.P.)
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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.
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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
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46
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Saravanos GL, Ramos I, Britton PN, Wood NJ. Respiratory syncytial virus subtype circulation and associated disease severity at an Australian paediatric referral hospital, 2014-2018. J Paediatr Child Health 2021; 57:1190-1195. [PMID: 33638925 DOI: 10.1111/jpc.15419] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/13/2021] [Accepted: 02/04/2021] [Indexed: 11/28/2022]
Abstract
AIM Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory tract infections in children and the development of vaccines to protect at-risk groups is a global priority. The aim of this study was to describe RSV subtype circulation patterns and associated disease severity to inform on potential impact of an RSV-specific prevention strategy. METHODS Single-centre retrospective observational study of children aged <16 years with laboratory-confirmed RSV infection from 2014 to 2018 inclusive. We described the features and frequency of all RSV subtype detections. We selected a random sample of RSV-A and RSV-B cases from each year (n = 200), described demographic and clinical features of these cases, and compared indicators of disease severity between subtypes. RESULTS We identified 3591 RSV detections over a 5-year period and found consistent co-circulation of subtypes with alternating predominance. Demographic and clinical characteristics were similar between children presenting with RSV-A and RSV-B infections. There was no difference in indicators of severity between the subtypes except for paediatric intensive care unit length of stay which was longer in the RSV-B group (3 vs. 5 days, P = 0.006). Respiratory co-infections were more frequent in the RSV-B group (41.8% vs. 27.4%, P = 0.035). When these were excluded there was no longer a detectable difference in paediatric intensive care unit length of stay. CONCLUSIONS We found co-circulation of RSV subtypes and no convincing evidence of a difference in disease severity between subtypes. RSV-specific interventions will need to be equally effective against both RSV-A and RSV-B to have the greatest impact on reducing severe RSV disease in this population.
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Affiliation(s)
- Gemma L Saravanos
- Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia.,National Centre for Immunisation Research and Surveillance, Sydney, New South Wales, Australia
| | - Isabelle Ramos
- National Centre for Immunisation Research and Surveillance, Sydney, New South Wales, Australia.,School of Medicine, University of Notre Dame Fremantle, Perth, Western Australia, Australia
| | - Philip N Britton
- Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia.,Department of Infectious Diseases and Microbiology, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Nicholas J Wood
- Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia.,National Centre for Immunisation Research and Surveillance, Sydney, New South Wales, Australia.,Department of General Medicine, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
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47
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Yuan F, Wang L. Genotyping atypical porcine pestivirus using NS5a. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2021; 92:104866. [PMID: 33872785 DOI: 10.1016/j.meegid.2021.104866] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 04/06/2021] [Accepted: 04/13/2021] [Indexed: 02/07/2023]
Abstract
Atypical porcine pestivirus (APPV) is an emerging virus discovered in 2014 and it can cause congenital tremors in pigs. Molecular epidemiology serves as an essential tool in monitoring and controlling the disease. Virus epidemiology mainly relies on genome sequencing and phylogenetic characterization. Previous molecular epidemiology studies have been using different genes/regions for phylogeny, namely whole genome, Npro, and E2 coding sequences. However, with increasing number of APPV sequences available in GenBank, no systemic studies have been performed for detailed classification of APPV strains around the globe. The goal of this study is to propose a classification strategy or taxonomy of APPV strains at genotype, subgenotype, and isolate levels. A total of 76 whole genomes and 16 partial polyprotein coding sequences were analyzed for genetic variability and suitability of all individual genes for viral phylogenies. Our results revealed that, among all the viral genes, NS5a coding sequences were proved to be the most suitable alternative for tracing APPV strains supported by its capability of reproducing the same phylogenetic and evolutionary information as the whole viral genome did. Also, a reliable cutoff to accurately classify APPV at different levels is established. We propose a genotyping scheme with three well-defined genotypes (1-3) and 7 subgenotypes for genotype 1 (1.1-1.7). For whole genome analysis, a threshold value of 84%-91% pairwise identity allows separation of all APPV subgenotypes, whereas 80% identity clearly segregate the three major APPV genotypes. For NS5a gene analysis, 82%-91% identity allows subgenotype separation and 76% identity segregate APPV genotypes. Additionally, genetic distance of whole genome exhibits ≤8% in isolate level, 9%-14% in subgenotype level, and 17%-22% in genotype level, while for NS5a encoding sequences the genetic distance displays ≤9% in isolate level, 9.9%-19.1% in subgenotype level, and 21.6%-29.7% in genotype level. These allow a clear segregation among APPV genotypes, subgenotypes, and isolates. Therefore, the proposed strategy in this study provides a solid and improved basis for molecular phylogenetics to understand APPV genetic diversity, trace the origins and control the spread of new disease outbreaks.
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Affiliation(s)
- Fangfeng Yuan
- Department of Pathobiology, College of Veterinary Medicine, University of Illinois at Urbana Champaign, Urbana, IL, USA
| | - Leyi Wang
- Veterinary Diagnostic Laboratory and Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA.
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Salimi V, Viegas M, Trento A, Agoti CN, Anderson LJ, Avadhanula V, Bahl J, Bont L, Brister JR, Cane PA, Galiano M, Graham BS, Hatcher EL, Hellferscee O, Henke DM, Hirve S, Jackson S, Keyaerts E, Kragten-Tabatabaie L, Lindstrom S, Nauwelaers I, Nokes DJ, Openshaw PJ, Peret TC, Piedra PA, Ramaekers K, Rector A, Trovão NS, von Gottberg A, Zambon M, Zhang W, Williams TC, Barr IG, Buchholz UJ. Proposal for Human Respiratory Syncytial Virus Nomenclature below the Species Level. Emerg Infect Dis 2021; 27:1-9. [PMID: 34013862 PMCID: PMC8153853 DOI: 10.3201/eid2706.204608] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Human respiratory syncytial virus (HRSV) is the leading viral cause of serious pediatric respiratory disease, and lifelong reinfections are common. Its 2 major subgroups, A and B, exhibit some antigenic variability, enabling HRSV to circulate annually. Globally, research has increased the number of HRSV genomic sequences available. To ensure accurate molecular epidemiology analyses, we propose a uniform nomenclature for HRSV-positive samples and isolates, and HRSV sequences, namely: HRSV/subgroup identifier/geographic identifier/unique sequence identifier/year of sampling. We also propose a template for submitting associated metadata. Universal nomenclature would help researchers retrieve and analyze sequence data to better understand the evolution of this virus.
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Anderson LJ, Jadhao SJ, Paden CR, Tong S. Functional Features of the Respiratory Syncytial Virus G Protein. Viruses 2021; 13:1214. [PMID: 34372490 PMCID: PMC8310105 DOI: 10.3390/v13071214] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 05/28/2021] [Accepted: 06/18/2021] [Indexed: 12/20/2022] Open
Abstract
Respiratory syncytial virus (RSV) is a major cause of serious lower respiratory tract infections in children <5 years of age worldwide and repeated infections throughout life leading to serious disease in the elderly and persons with compromised immune, cardiac, and pulmonary systems. The disease burden has made it a high priority for vaccine and antiviral drug development but without success except for immune prophylaxis for certain young infants. Two RSV proteins are associated with protection, F and G, and F is most often pursued for vaccine and antiviral drug development. Several features of the G protein suggest it could also be an important to vaccine or antiviral drug target design. We review features of G that effect biology of infection, the host immune response, and disease associated with infection. Though it is not clear how to fit these together into an integrated picture, it is clear that G mediates cell surface binding and facilitates cellular infection, modulates host responses that affect both immunity and disease, and its CX3C aa motif contributes to many of these effects. These features of G and the ability to block the effects with antibody, suggest G has substantial potential in vaccine and antiviral drug design.
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Affiliation(s)
- Larry J. Anderson
- Department of Pediatrics, Emory University School of Medicine and Children’s Healthcare of Atlanta, Atlanta, GA 30322, USA;
| | - Samadhan J. Jadhao
- Department of Pediatrics, Emory University School of Medicine and Children’s Healthcare of Atlanta, Atlanta, GA 30322, USA;
| | - Clinton R. Paden
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30322, USA; (C.R.P.); (S.T.)
| | - Suxiang Tong
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30322, USA; (C.R.P.); (S.T.)
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50
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Liang YY, Li KW, Niu FJ, Li Y, Wei HC, Dai YL, Wang YY, Zhou CZ, Wan XH. Salvia plebeia R. Br. polysaccharides (SPP) against RSV (respiratory syncytial virus) infection: Antiviral effect and mechanisms of action. Biomed Pharmacother 2021; 141:111843. [PMID: 34175821 DOI: 10.1016/j.biopha.2021.111843] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To investigate the antiviral effect of Salvia plebeia R. Br. polysaccharides (SPP) against RSV and underlying mechanisms. METHODS SPP was extracted via alcohol-precipitation method and extract was separated into various fractions using ultrafiltration method. The polysaccharide content was determined using UV-Vis. Antiviral effect of SPP and fractions was measured using MTT method and Reed-Muench method. Sixty Balb/c mice were randomly divided into 6 groups, and received either Ribavirin or SPP. Their body weight and food intake were recorded every day throughout the experiment period. The lung index inhibition ratio and pulmonary virus titer were determined followed by the histological analysis of lungs. Furthermore, time-of-addition and effective stage analysis were carried out to determine the mechanism of action. The TLR-3 and TLR-4 levels in the lungs were determined using qRT-PCR. The levels of IFN-γ, IL-2 and TNF-α in serum were determined using ELISA. RESULTS The SPP content is 4.396%. SPP has shown a good anti-RSV effect both in vitro (TI = 123.041) and in vivo models. The antiviral activity of fractions with molecular weight ≥ 10,000 is found to possess more potent antiviral activity than other fractions. SPP inhibits the RSV proliferation and reduces the lung lesions induced by RSV. The mechanism of action involves the inhibition of TLR-3 and TLR-4 in lungs, up-regulation of IFN-γ and IL-2, and down-regulation of TNF-α in serum. It is also shown to improve the body's immune function. CONCLUSION SPP has a potential to treat diseases caused by RSV.
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Affiliation(s)
- Yi-Yu Liang
- Shandong University of Traditional Chinese Medicine, Ji'nan 250355, China
| | - Kun-Wei Li
- Shandong University of Traditional Chinese Medicine, Ji'nan 250355, China
| | - Feng-Jv Niu
- Shandong Institute of Traditional Chinese Medicine, Ji'nan 250014, China
| | - Ying Li
- Shandong University of Traditional Chinese Medicine, Ji'nan 250355, China
| | - Hao-Cheng Wei
- Shandong University of Traditional Chinese Medicine, Ji'nan 250355, China
| | - Yun-Lei Dai
- Shandong University of Traditional Chinese Medicine, Ji'nan 250355, China
| | - Yun-Yu Wang
- Shandong University of Traditional Chinese Medicine, Ji'nan 250355, China
| | - Chang-Zheng Zhou
- Shandong University of Traditional Chinese Medicine, Ji'nan 250355, China.
| | - Xin-Huan Wan
- Shandong University of Traditional Chinese Medicine, Ji'nan 250355, China.
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