Molecular characterization and clinical epidemiology of human respiratory syncytial virus (HRSV) A and B in hospitalized children, Southern Brazil

Moreira, Francielli Brusco; Rosário, Cristine Secco; Santos, Jucélia Stadinicki dos; Avanzi, Valéria Miranda; Nogueira, Meri Bordignon; Vidal, Luíne Rosele Renaud; Raboni, Sônia Mara

doi:10.1002/jmv.24795

Cited by 12 publications

(12 citation statements)

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“…Following the first reports of RSV-A ON1 in Canada [9] and Germany [14], genotype ON1 was detected in many other countries and regions [3, 13], including Asia [8, 17–28], Africa [12, 29–31], Europe [32–39] and North and South America [40–43]. In line with our results, several multi-season studies have previously reported ON1 to have rapidly replaced RSV-A non-ON1 genotypes [18, 19, 25, 28, 30–33, 35, 37–39, 42–45]. Furthermore, ON1 has recently been reported to be the currently most prevalent RSV-A genotype worldwide [43].…”

Section: Discussionsupporting

confidence: 90%

“…Some of previous inpatient studies comparing RSV-A ON1 with RSV-A non-ON1 genotypes found no difference in clinical severity [11, 38], while others showed divergent correlations between genotype ON1 and viral virulence [2]. Several authors have suggested a higher virulence of RSV-A ON1, based on the observation of higher rates of PICU admission and/or mechanical ventilation [42], earlier hospitalization and a higher rate of lower respiratory tract infections [19] or more frequent refusal to feed [44]. In contrast, three studies reported a milder course of illness associated with genotype ON1, such as a lower severity score [32], a lower rate of bronchopneumonia / lower respiratory tract disease [33, 35] and a lower hospitalization rate [33].…”

Section: Discussionmentioning

confidence: 99%

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Spread and clinical severity of respiratory syncytial virus A genotype ON1 in Germany, 2011–2017

et al. 2019

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Background The Respiratory Syncytial Virus (RSV) A genotype ON1, which was first detected in Ontario (Canada) in 2010/11, appeared in Germany in 2011/12. Preliminary observations suggested a higher clinical severity in children infected with this new genotype. We investigated spread and disease severity of RSV-A ON1 in pediatric in- and outpatient settings. Methods During 2010/11 to 2016/17, clinical characteristics and respiratory samples from children with acute respiratory tract infections (RTI) were obtained from ongoing surveillance studies in 33 pediatric practices (PP), one pediatric hospital ward (PW) and 23 pediatric intensive care units (PICU) in Germany. RSV was detected in the respiratory samples by PCR; genotypes were identified by sequencing. Within each setting, clinical severity markers were compared between RSV-A ON1 and RSV-A non-ON1 genotypes. Results A total of 603 children with RSV-RTI were included (132 children in PP, 288 in PW, and 183 in PICU). Of these children, 341 (56.6%) were infected with RSV-A, 235 (39.0%) with RSV-B, and one child (0.2%) with both RSV-A and RSV-B; in 26 (4.3%) children, the subtype could not be identified. In the 341 RSV-A positive samples, genotype ON1 was detected in 247 (72.4%), NA1 in 92 (26.9%), and GA5 in 2 children (0.6%). RSV-A ON1, rarely observed in 2011/12, was the predominant RSV-A genotype in all settings by 2012/13 and remained predominant until 2016/17. Children in PP or PW infected with RSV-A ON1 did not show a more severe clinical course of disease compared with RSV-A non-ON1 infections. In the PICU group, hospital stay was one day longer (median 8 days, inter-quartile range (IQR) 7–12 vs. 7 days, IQR 5–9; p = 0.02) and duration of oxygen treatment two days longer (median 6 days, IQR 4–9 vs. 4 days, IQR 2–6; p = 0.03) for children infected with RSV-A ON1. Conclusions In children, RSV-A ON1 largely replaced RSV-A non-ON1 genotypes within two seasons and remained the predominant RSV-A genotype in Germany during subsequent seasons. A higher clinical severity of RSV-A ON1 was observed within the group of children receiving PICU treatment, whereas in other settings clinical severity of RSV-A ON1 and non-ON1 genotypes was largely similar. Electronic supplementary material The online version of this article (10.1186/s12879-019-4266-y) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Spread and clinical severity of respiratory syncytial virus A genotype ON1 in Germany, 2011–2017

et al. 2019

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“…Yoshihara et al reported hospitalization incidence was significantly increased after the emergence of ON1, and risk of lower respiratory tract infection was 2.26 (95% CI: 1.37–3.72) times higher, and radiologically confirmed pneumonia was 1.98 (95% CI: 1.01–3.87) times greater in ON1 compared to NA1 [ 78 ]. A report from Brazil also noted an increase of intensive care unit admissions and need for mechanical ventilation associated with ON1genotype [ 79 ]. In contrast, reports from Italy, the Philippines, South Africa, Spain found no evidence of clinical differences in disease severity in correlation to genotype [ 30 , 56 , 80 , 81 ].…”

Section: Discussionmentioning

confidence: 99%

Molecular epidemiology of human respiratory syncytial virus among children in Japan during three seasons and hospitalization risk of genotype ON1

et al. 2018

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We investigated the genetic diversity, the circulation patterns, and risk for hospital admission of human respiratory syncytial virus (HRSV) strains in Japan between 2012 through 2015. During the study period, 744 HRSV-positive cases were identified by rapid diagnostic test. Of these, 572 samples were positive by real-time PCR; 400 (69.9%) were HRSV-A, and 172 (30.1%) were HRSV-B. HRSV-A and -B alternated as the dominant strain in the subsequent seasons. Phylogenetic tree analysis of the second hyper-variable region of the G protein classified the HRSV-A specimens into NA1 (n = 242) and ON1 (n = 114) genotypes and the HRSV-B specimens into BA9 (n = 60), and BA10 (n = 27). The ON1 genotype, containing a 72-nucleotide duplication in the G protein’s second hyper-variable region, was first detected in the 2012–2013 season but it predominated and replaced the older NA1 HRSV-A in the 2014–2015 season, which also coincided with a record number of HRSV cases reported to the National Infectious Disease Surveillance in Japan. The risk of hospitalization was 6.9 times higher for the ON1 genotype compared to NA1. In conclusion, our data showed that the emergence and predominance of the relatively new ON1 genotype in Japan was associated with a record high number of cases and increased risk for hospitalization.

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“…While several authors have shown that the severity of the infection follows the viral load [4,5,37,38], others have not [7,12,33]. Some studies found an association between viral load and symptom frequency, but not severity itself [39,40]. Viral load measurement methods are widely variable between studies: some authors use plaque assay [4] or semi-quantitative analyses, such as ct [5,7,32], others use quantitative methods [38][39][40][41].…”

Section: Plos Onementioning

confidence: 99%

Seasonality, molecular epidemiology, and virulence of Respiratory Syncytial Virus (RSV): A perspective into the Brazilian Influenza Surveillance Program

et al. 2021

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Background Respiratory Syncytial Virus (RSV) is the main cause of pediatric morbidity and mortality. The complex evolution of RSV creates a need for worldwide surveillance, which may assist in the understanding of multiple viral aspects. Objectives This study aimed to investigate RSV features under the Brazilian Influenza Surveillance Program, evaluating the role of viral load and genetic diversity in disease severity and the influence of climatic factors in viral seasonality. Methodology We have investigated the prevalence of RSV in children up to 3 years of age with severe acute respiratory infection (SARI) in the state of Espirito Santo (ES), Brazil, from 2016 to 2018. RT-qPCR allowed for viral detection and viral load quantification, to evaluate association with clinical features and mapping of local viral seasonality. Gene G sequencing and phylogenetic reconstruction demonstrated local genetic diversity. Results Of 632 evaluated cases, 56% were caused by RSV, with both subtypes A and B co-circulating throughout the years. A discrete inverse association between average temperature and viral circulation was observed. No correlation between viral load and disease severity was observed, but children infected with RSV-A presented a higher clinical severity score (CSS), stayed longer in the hospital, and required intensive care, and ventilatory support more frequently than those infected by RSV-B. Regarding RSV diversity, some local genetic groups were observed within the main genotypes circulation RSV-A ON1 and RSV-B BA, with strains showing modifications in the G gene amino acid chain. Conclusion Local RSV studies using the Brazilian Influenza Surveillance Program are relevant as they can bring useful information to the global RSV surveillance. Understanding seasonality, virulence, and genetic diversity can aid in the development and suitability of antiviral drugs, vaccines, and assist in the administration of prophylactic strategies.

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Molecular characterization and clinical epidemiology of human respiratory syncytial virus (HRSV) A and B in hospitalized children, Southern Brazil

Cited by 12 publications

References 20 publications

Spread and clinical severity of respiratory syncytial virus A genotype ON1 in Germany, 2011–2017

Spread and clinical severity of respiratory syncytial virus A genotype ON1 in Germany, 2011–2017

Molecular epidemiology of human respiratory syncytial virus among children in Japan during three seasons and hospitalization risk of genotype ON1

Seasonality, molecular epidemiology, and virulence of Respiratory Syncytial Virus (RSV): A perspective into the Brazilian Influenza Surveillance Program

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