Epidemiology of Respiratory Syncytial Virus Across Five Influenza Seasons Among Adults and Children One Year of Age and Older—Washington State, 2011/2012–2015/2016

2020 ◽  
Vol 223 (1) ◽  
pp. 147-156
Author(s):  
Michael L Jackson ◽  
Emily Scott ◽  
Jane Kuypers ◽  
Arun K Nalla ◽  
Pavitra Roychoudury ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Cumulative Incidence ◽  
Influenza Infection ◽  
Age Groups ◽  
Respiratory Illness ◽  
Kaiser Permanente ◽  
Subtype B ◽  
Syncytial Virus ◽  
The Impact ◽  
Virus Subtype

Abstract Background Vaccines and novel prophylactics against respiratory syncytial virus (RSV) are in development. To provide a baseline for evaluating these interventions, we characterized the incidence and molecular epidemiology of RSV in persons aged ≥1 year. Methods We identified patients with medically attended acute respiratory illness (MAARI) from the 2011/2012 through 2015/2016 influenza seasons among members of Kaiser Permanente Washington. We estimated the cumulative incidence of MAARI for laboratory-confirmed RSV or influenza infection. Results Annual cohorts ranged from 82 266 to 162 633 individuals, 14% of whom were children aged 1 to 17 years. Cumulative incidence of RSV each season ranged from 14 per 1000 population (95% confidence interval [CI], 12–16) to 22 per 1000 (95% CI, 19–25). Incidence of RSV was greater than influenza in children aged 12–23 months and 2–4 years; incidence of influenza was greater in other age groups. Respiratory syncytial virus subtype A dominated in 2011/2012, 2012/2013, and 2015/2016, with ON1 being the most common genotype. Respiratory syncytial virus subtype B dominated in 2013/2014 and 2014/2015, primarily of the BA genotype. Conclusions The burden of RSV is comparable to that of influenza across the life course. These results provide a baseline for evaluating the impact of new RSV interventions on the epidemiology of RSV.

scholarly journals Integrating epidemiological and genetic data with different sampling intensities into a dynamic model of respiratory syncytial virus transmission

2020 ◽  
Author(s):  
Ivy K. Kombe ◽  
Charles N. Agoti ◽  
Patrick K. Munywoki ◽  
D. James Nokes ◽  
Graham F. Medley
Keyword(s):  
Respiratory Syncytial Virus ◽  
Dynamic Model ◽  
Age Groups ◽  
Virus Transmission ◽  
Respiratory Illness ◽  
Whole Genome Sequencing Data ◽  
Sequencing Data ◽  
Significant Burden ◽  
Syncytial Virus ◽  
The Individual

AbstractBackgroundRespiratory syncytial virus (RSV) is responsible for a significant burden of acute respiratory illness in children under 5 years old. Prior to rolling out any vaccination program, identification of the source of infant infections could further guide vaccination strategies.MethodsWe extended a dynamic model calibrated at the individual host level initially fit to social-temporal data on shedding patterns to include whole genome sequencing data available at a lower sampling intensity.ResultsIn this study population of 493 individuals with 55 infants under the age of 1 year distributed across 47 households, we found that 52% of RSV-B and 60% of RSV-A cases arose from infection within the household. Forty-five percent of infant infections appeared to occur in the household, of which 68% were a result of transmission from a child aged between 2 and 13 years living in the same household as the infant.ConclusionThese results further highlight the importance of pre-school and school-aged children in RSV transmission, particularly the role they play in directly infecting the household infant. These age groups are a potential RSV vaccination target group.

scholarly journals The Impact of Human Immunodeficiency Virus Exposure on Respiratory Syncytial Virus–associated Severe Respiratory Illness in South African Infants, 2011–2016

2019 ◽  
Vol 69 (12) ◽  
pp. 2208-2211
Author(s):  
Meredith L McMorrow ◽  
Stefano Tempia ◽  
Sibongile Walaza ◽  
Florette K Treurnicht ◽  
Jocelyn Moyes ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Respiratory Syncytial Virus ◽  
South African ◽  
Respiratory Illness ◽  
Immunodeficiency Virus ◽  
Birth Dose ◽  
Virus Exposure ◽  
Syncytial Virus ◽  
The Impact ◽  
Severe Respiratory Illness

Abstract From 2011 through 2016, we conducted surveillance for severe respiratory illness in infants. Human immunodeficiency virus exposure significantly increased the risk of respiratory syncytial virus (RSV)–associated hospitalization in infants aged <5 months. More than 60% of RSV-associated hospitalizations occurred in the first 4 months of life and may be preventable through maternal vaccination or birth-dose monoclonal antibody.

scholarly journals The Impact of Maternal Human Immunodeficiency Virus Infection on the Burden of Respiratory Syncytial Virus Among Pregnant Women and Their Infants, Western Kenya

2020 ◽  
Author(s):  
Bryan O Nyawanda ◽  
Nancy A Otieno ◽  
Michael O Otieno ◽  
Gideon O Emukule ◽  
Godfrey Bigogo ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Respiratory Syncytial Virus ◽  
Hiv Infection ◽  
Pregnant Women ◽  
Respiratory Illness ◽  
Western Kenya ◽  
Immunodeficiency Virus ◽  
Maternal Hiv ◽  
Syncytial Virus ◽  
The Impact

Abstract Background Respiratory syncytial virus (RSV) is an important cause of respiratory illness worldwide; however, burden data on mother–infant pairs remain sparse in sub-Saharan Africa, where human immunodeficiency virus (HIV) is prevalent. We evaluated the impact of maternal HIV infection on the burden of RSV among mothers and their infants in western Kenya. Methods We enrolled pregnant women (≤20 weeks’ gestation) and followed them and their newborns weekly for up to 3–6 months postpartum, to document cases of acute respiratory illness (ARI). Nasal/oropharyngeal swabs were collected and tested for RSV using polymerase chain reaction. Analyses were stratified by maternal HIV status and incidence was computed per 1000 person-months. Results Compared to RSV-negative ARI cases, RSV-positive cases were associated with cough, apnea, and hospitalization among infants. RSV incidence per 1000 person-months among mothers was 4.0 (95% confidence interval [CI], 3.2–4.4), and was twice that among the HIV-infected mothers (8.4 [95% CI, 5.7–12.0]) compared to the HIV-uninfected mothers (3.1 [95% CI, 2.3–4.0]). Among infants, incidence per 1000 person-months was 15.4 (95% CI, 12.5–18.8); incidence did not differ by HIV exposure or prematurity. Conclusions HIV infection may increase the risk of RSV illness among pregnant women. Future maternal RSV vaccines may have added benefit in areas with high HIV prevalence.

scholarly journals Incidence of Medically Attended Respiratory Syncytial Virus and Influenza Illnesses in Children 6–59 Months Old During Four Seasons

2016 ◽  
Vol 3 (2) ◽  
Author(s):  
Melissa D. Simpson ◽  
Burney A. Kieke ◽  
Maria E. Sundaram ◽  
David L. McClure ◽  
Jennifer K. Meece ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Age Groups ◽  
Respiratory Illness ◽  
Acute Respiratory Illness ◽  
Seasonal Incidence ◽  
Four Seasons ◽  
Virus Incidence ◽  
Nasal Swabs ◽  
Polymerase Chain ◽  
Syncytial Virus

Abstract Background.  Respiratory syncytial virus (RSV) and influenza are significant causes of seasonal respiratory illness in children. The incidence of influenza and RSV hospitalization is well documented, but the incidence of medically attended, laboratory-confirmed illness has not been assessed in a well defined community cohort. Methods.  Children aged 6–59 months with medically attended acute respiratory illness were prospectively enrolled during the 2006–2007 through 2009–2010 influenza seasons in a Wisconsin community cohort. Nasal swabs were tested for RSV and influenza by multiplex reverse-transcription polymerase chain reaction. The population incidence of medically attended RSV and influenza was estimated separately and standardized to weeks 40 through 18 of each season. Results.  The cohort included 2800–3073 children each season. There were 2384 children enrolled with acute respiratory illness; 627 (26%) were positive for RSV and 314 (13%) for influenza. The mean age was 28 months (standard deviation [SD] = 15) for RSV-positive and 38 months (SD = 16) for influenza-positive children. Seasonal incidence (cases per 10 000) was 1718 (95% confidence interval [CI], 1602–1843) for RSV and 768 (95% CI, 696–848) for influenza. Respiratory syncytial virus incidence was highest among children 6–11 (2927) and 12–23 months old (2377). Influenza incidence was highest (850) in children 24–59 months old. The incidence of RSV was higher than influenza across all seasons and age groups. Conclusions.  The incidence of medically attended RSV was highest in children 6–23 months old, and it was consistently higher than influenza. The burden of RSV remains high throughout the first 2 years of life.

scholarly journals In Vitro Enhancement of Respiratory Syncytial Virus Infection by Maternal Antibodies Does Not Explain Disease Severity in Infants

2017 ◽  
Vol 91 (21) ◽  
Author(s):  
Elisabeth A. van Erp ◽  
Puck B. van Kasteren ◽  
Teun Guichelaar ◽  
Inge M. L. Ahout ◽  
Cornelis A. M. de Haan ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Disease Severity ◽  
Respiratory Illness ◽  
Maternal Antibodies ◽  
Severe Illness ◽  
Antibody Dependent Enhancement ◽  
Cotton Rats ◽  
Syncytial Virus ◽  
The Impact

ABSTRACT Respiratory syncytial virus (RSV) is the leading cause of severe respiratory illness in infants. At this young age, infants typically depend on maternally transferred antibodies (matAbs) and their innate immune system for protection against infections. RSV-specific matAbs are thought to protect from severe illness, yet severe RSV disease occurs mainly below 6 months of age, when neutralizing matAb levels are present. To investigate this discrepancy, we asked if disease severity is related to antibody properties other than neutralization. Some antibody effector functions are mediated via their Fc binding region. However, it has been shown that this binding may lead to antibody-dependent enhancement (ADE) of infection or reduction of neutralization, both possibly leading to more disease. In this study, we first showed that high levels of ADE of RSV infection occur in monocytic THP-1 cells in the presence of RSV antibodies and that neutralization by these antibodies was reduced in Vero cells when they were transduced with Fc gamma receptors. We then demonstrated that antibodies from cotton rats with formalin-inactivated (FI)-RSV-induced pulmonary pathology were capable of causing ADE. Human matAbs also caused ADE and were less neutralizing in vitro in cells that carry Fc receptors. However, these effects were unrelated to disease severity because they were seen both in uninfected controls and in infants hospitalized with different levels of RSV disease severity. We conclude that ADE and reduction of neutralization are unlikely to be involved in RSV disease in infants with neutralizing matAbs. IMPORTANCE It is unclear why severity of RSV disease peaks at the age when infants have neutralizing levels of maternal antibodies. Additionally, the exact reason for FI-RSV-induced enhanced disease, as seen in the 1960s vaccine trials, is still unclear. We hypothesized that antibodies present under either of these conditions could contribute to disease severity. Antibodies can have effects that may lead to more disease instead of protection. We investigated two of those effects: antibody-dependent enhancement of infection (ADE) and neutralization reduction. We show that ADE occurs in vitro with antibodies from FI-RSV-immunized RSV-infected cotton rats. Moreover, passively acquired maternal antibodies from infants had the capacity to induce ADE and reduction of neutralization. However, no clear association with disease severity was seen, ruling out that these properties explain disease in the presence of maternal antibodies. Our data contribute to a better understanding of the impact of antibodies on RSV disease in infants.

scholarly journals 716. Molecular Epidemiology of Respiratory Syncytial Virus in Children and Adults in Seattle, WA

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S257-S257
Author(s):  
Emily Scott ◽  
Jane Kuypers ◽  
Michael L Jackson ◽  
Helen Chu
Keyword(s):  
Respiratory Syncytial Virus ◽  
Severe Disease ◽  
Respiratory Illness ◽  
Kaiser Permanente ◽  
Emergency Department Care ◽  
Radiographic Findings ◽  
Ct Value ◽  
Polymerase Chain ◽  
Syncytial Virus ◽  
Next Generation Sequencing Ngs

Abstract Background Respiratory syncytial virus (RSV) is the most important cause of pneumonia in children &lt;5 years worldwide and may cause severe disease in elderly and high-risk adults. Multiple RSV strains co-circulate and evolve over seasons. We seek to describe the evolution of RSV over five seasons in Seattle, WA, USA with two seasons reported here. Methods From 2014 to 2016, subjects 6 months and older seeking outpatient care for acute respiratory illness at Kaiser Permanente Washington were enrolled in the Influenza Vaccine Efficacy Network (Flu VE Network) and a respiratory swab was collected. Real-time polymerase chain reaction (RT-PCR) was performed to test and quantify RSV and subtype positive samples. A subset of RSV samples with cycle threshold (CT) value &lt;30 will be sequenced using a metagenomic next-generation sequencing (NGS) approach. Specific RSV genotypes will be associated with severe disease, defined as requiring emergency department care or hospitalization, or chest radiographic findings. Results A total of 8,730 patients were enrolled in the Flu VE Network and PCR testing of seasons 2014/2015 and 2015/2016 resulted in 562 of 4,137 (13.6%) RSV-positive specimens. Of patients with RSV-positive specimens, 204 (36.5%) were adults 18–64 years and 112 (20.0%) were 65+ years. RSV-B predominated in the 2014/2015 season (n = 298; 83.7%), whereas RSV-A was more common in the 2015/2016 season (n = 154; 79.8%) (Figure 1). The median (IQR) CT value for RSV-A specimens was 26.7 (23.3–29.9) compared with 27.9 (25.2–31.3) for RSV-B. Conclusion One RSV subtype predominated within each season. Similar RSV subtype distributions were seen across age categories. With multiple RSV vaccine candidates in development, understanding the genetic diversity and circulation of RSV various viruses within a population is important for analyzing the effects of a vaccine on the evolution of RSV. Figure 1, Total counts (A) and proportions (B) of RSV-A and RSV-B specimens collected from study patients in Seattle, WA during 2014/2015 and 2015/2016 seasons, by age category. Disclosures M. L. Jackson, sanofi pasteur: Grant Investigator, Research support. H. Chu, Sanofi-Pasteur: Grant Investigator, Grant recipient.

Increase in Detection of Respiratory Syncytial Virus Among Older Adults in Arizona

2021 ◽  
pp. 003335492097635
Author(s):  
Rebecca Bridge ◽  
Laura M. Erhart ◽  
Shane Brady ◽  
Kenneth Komatsu
Keyword(s):  
Respiratory Syncytial Virus ◽  
Hospital Discharge ◽  
Age Distribution ◽  
Age Groups ◽  
Respiratory Illness ◽  
Hospital Discharge Data ◽  
Crude Odds Ratio ◽  
Discharge Data ◽  
Testing Practices ◽  
Syncytial Virus

Objectives Respiratory syncytial virus (RSV) is a common cause of respiratory illness, health care visits, and hospitalizations. Arizona, which began conducting laboratory surveillance in 2004, has noted an increase in RSV cases (defined as a laboratory-positive result) among adults aged ≥65, concurrent with increasing reports from polymerase chain reaction (PCR) testing. We assessed whether the shift in the age distribution of reported RSV cases resulted from a change in RSV testing practices. Methods We used data on laboratory-confirmed RSV cases reported during 2013-2017 from the statewide surveillance system to assess the frequency of test types (rapid antigen, immunofluorescence assay, PCR, and viral culture) by age groups across RSV seasons, and we used logistic regression to estimate changes in odds of receiving a PCR test. We used statewide emergency department hospital discharge data for the same period to assess testing practices regardless of test result. Results The overall proportion of PCR tests among RSV cases increased significantly, from 22% in 2013 to 55% in 2017 ( P < .001). The percentage of RSV cases among adults aged ≥65 also increased significantly, from 4% in 2013 to 11% in 2017 ( P < .001) of RSV cases. Adults aged ≥65 had more than 8 times the odds of positive PCR results than children aged <5, both in crude (odds ratio [OR] = 8.8; 95% CI, 7.6-10.2) and season-adjusted (adjusted OR = 8.1; 95% CI, 7.0-9.5) models. Hospital discharge data corroborated increased RSV PCR usage from 2013 to 2017. Conclusion Increasing RSV rates among adults aged ≥65 are likely a result of changes in testing practices. This age group may need more targeted intervention and future vaccination.

scholarly journals 715. Increase in Reported Respiratory Syncytial Virus Cases Among Adults in the Minneapolis-St. Paul Metropolitan Area, 2014–2018

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S257-S257
Author(s):  
Kathryn Como-Sabetti ◽  
Erica Bye ◽  
Anna Strain ◽  
Melissa McMahon ◽  
Ruth Lynfield
Keyword(s):  
Respiratory Syncytial Virus ◽  
Metropolitan Area ◽  
Catchment Area ◽  
Severe Disease ◽  
Age Groups ◽  
Respiratory Illness ◽  
Emerging Infections ◽  
Surveillance Period ◽  
Syncytial Virus ◽  
Over Time

Abstract Background Respiratory syncytial virus (RSV) is a common cause of respiratory infection, typically causing severe disease in young children. We were interested in evaluating trends of severe RSV infections in adults. Methods The Minnesota Department of Health conducts active surveillance for laboratory-confirmed RSV in hospitalized patients in the Minneapolis-St. Paul metropolitan area as part of the CDC Emerging Infections Program. Adults (≥18 years) cases identified during the RSV season (10/1–4/30) from 2014 through 2018 were analyzed and surveys of catchment-area hospital laboratories were conducted regarding respiratory virus panel (RVP) testing. Results Twenty-three catchment area hospitals serve adults. Four hospitals offered RVP during the 2014–2015 and 2015–2016 seasons; eight offered RVP during the 2016–2017 and 2017–2018 seasons. Three hundred and fifty-five cases were identified. Three hundred and nine (87%) were reported from four hospitals where RVP was offered throughout the study period. Case increases were observed at three hospitals; all of these hospitals offered RVP throughout the surveillance period; increases were not observed at hospitals where RVP was added for the 2016–2017 and 2017–2018 seasons. Cases increased from 42 in 2014–2015 to 198 in 2017–2018 (χ2 = 125.51, P &lt; 0.01), the proportion of cases reported by year was 12%, 15%, 17% and 56% during consecutive seasons. Cases by age groups over time generally did not differ; however, cases ≥85 years increased from 7% of total cases in 2014–2015 to 19% in 2017–2018 (χ2 = 6.14, P = 0.01). Overall, 23% of cases were admitted to the ICU and 7% died during hospitalization. The proportion of ICU admissions and deaths did not change over time. Conclusion We found an increase in adult RSV hospitalizations from 2014 to 2018, especially among the oldest age group. This increase was observed only at hospitals where RVP testing was offered throughout the surveillance period. It is unclear if this represents a true increase in RSV or a change in testing practices. However, it does illustrate that RSV should be considered as a cause of severe respiratory illness (SARI) in adults, particularly among the elderly. A more systematic approach in identifying the causes of SARI in adults would be informative, particularly as RSV vaccines and antivirals approach licensure. Disclosures All authors: No reported disclosures.

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