New genetic lineage of RSV-B discovered in Minnesota children
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An outbreak of severe respiratory syncytial virus disease was associated with a new genetic lineage of the virus among a group of Minnesota children, according to a study published in The Journal of Infectious Diseases.
“RSV has been known for decades to be one of the most common causes of hospitalization in young children, but, like many other viruses, it has the ability to change over time and potentially cause new diseases manifestations,” Beth K. Thielen, MD, PhD, fellow in adult and pediatric infectious diseases and adjunct assistant professor of pediatrics in the University of Minnesota’s departments of medicine and pediatrics, told Healio. “We do not yet have a vaccine against RSV, but there are multiple candidates in the pipeline. Genetic diversity has important implications for vaccine development.”
Thielen and colleagues compared clinical characteristics of a severe RSV-B outbreak in Minnesota during summer 2017 with similar outbreaks during the summers of 2014, 2015, 2016 and 2018. They used high-throughput sequencing of RSV from patients with a variety of illness to assess the genetic relatedness among the viruses. Sequencing was performed on 137 specimens between March 2016 and March 2018.
From May to September of 2017, 58 cases of RSV, including 43 RSV-B cases, were reported compared with 20 to 29 cases, including three to seven RSV-B cases, during the same time periods in the other years analyzed. Although median age and frequency of comorbidities were comparable, 55% of patients (including 24 of 43 patients with RSV-B) were admitted to the ICU in 2017 compared with just 12% in the preceding 3 years (OR = 4.84; P < .01). Outbreak cases formed a distinct clade sharing a single conserved nonsynonymous change in their SH gene.
Thielen noted that the new RSV lineage may have the ability to spread locally and globally.
“The new viral lineage we found was closely related to other viruses found in Australia and South America, suggesting it can spread globally,” Thielen said. “I would expect it will be found in other areas of the Unites States. Strong public health surveillance systems are critical to understanding this epidemiology.”
Thielen also emphasized that researchers still do not fully understand the mechanism behind the new RSV lineage’s association with greater disease severity and that further studies are warranted.
“Clinicians are vital in recognizing new patterns of disease when they emerge,” Thielen said. “By working closely with public health departments, it is possible to identify these new diseases quickly.” – by Eamon Dreisbach
Disclosure: Thielen reports no relevant financial disclosures.
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