Molecular Detection of Respiratory Syncytial Virus in Infants and Young Children by the Conventional Reverse Transcriptase Polymerase Chain Reaction
Main Article Content
Keywords
RSV, Respiratory tract infection, Demographic, Clinical characteristics, Iraq
Abstract
Background: At the peak of the viral season, World Health Organization ranked respiratory syncytial virus (RSV) as a major cause of acute respiratory infections in more than 60% of children and more than 80% of infants younger than one year. The current study is the first in the governorate of Was it to investigate respiratory syncytial virus subtypes. The objectives of the study were to estimate the frequency of respiratory syncytial virus in children ≤5 years old and to recognize some potential risk factors that might be associated with respiratory tract infections.
Methodology: A cross sectional study with conventional reverse transcription polymerase chain reaction was performed on nasopharyngeal swabs from 158 pediatric patients. We compared the demographic and clinical characteristics of the patients aged 15 days to 60 months hospitalised with RTIs or seen at private clinics (cases, n = 158) and control children (n = 40) with non-respiratory
symptoms during the respiratory season of 2021–2022. Pearson’s chi-square (x²) model was applied, and P ≤ 0.05 was considered significant.
Results: RSV nucleic acid was detected in 15 (9.49%) of the 158 clinical specimens after amplification of the F gene. The identity of these amplified fragments was confirmed as human respiratory syncytial virus subtype B by sequencing. Except the clinical presentation there was no overall association between negative and positive cases while breast feeding and family history of the same condition when comparing the control and positive cases showed statistically significant.
Conclusions: conventional PCR was successfully detected the subtype B of h RSV while it may not the appropriate PCR type for subtype A detecting or that the RSVB was the only subtype circulated in 2021-2022 winter.
References
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Medicine 15;2018(2):87-97.
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27. Varela FH, Scotta MC, Polese-Bonatto M, Sartor ITS, Ferreira CF, Fernandes IR, et al. Absence of detection of RSV and influenza during the COVID-19 pandemic in a Brazilian cohort: Likely role of lower transmission in the community. J Glob Health. 2021;11:05007.
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31. Chernozhukov V, Kasahara H, Schrimpf P. Causal impact of masks, policies, behavior on early covid-19 pandemic in the U.S. J Econom. 2021;220(1):23-62.
32. Zheng X, Song Z, Li Y, Zhang J, Wang XL. Possible interference between seasonal epidemics of influenza and other respiratory viruses in Hong Kong, 2014-2017. BMC Infect Dis. 2017;17(1):772.
33. Poole S, Brendish NJ, Clark TW. SARS-CoV-2 has displaced other seasonal respiratory viruses: Results from a prospective cohort study. J Infect.2020;81(6):966-72.
34. Britton PN, Hu N, Saravanos G, Shrapnel J, Davis J, Snelling T, et al. COVID-19 public health measures and respiratory syncytial virus. Lancet Child Adolesc Health. 2020;4(11):e42-e3.
35. Stera G, Pierantoni L, Masetti R, Leardini D, Biagi C, Buonsenso D, et al. Impact of SARSCoV-2 Pandemic on Bronchiolitis Hospitalizations: The Experience of an Italian Tertiary Center. Children (Basel). 2021;8(7).
36. Lumley SF, Richens N, Lees E, Cregan J, Kalimeris E, Oakley S, et al. Changes in paediatric respiratory infections at a UK teaching
hospital 2016-2021; impact of the SARS-CoV-2 pandemic. J Infect. 2022;84(1):40-7.
37. Lee JT, Chang LY, Wang LC, Kao CL, Shao PL, Lu CY, et al. Epidemiology of respiratory syncytial virus infection in northern Taiwan,
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39. D'Elia C, Siqueira MM, Portes SA, Sant'Anna CC. [Respiratory syncytial virus -- associated lower respiratory tract infections in hospitalized infants]. Rev Soc Bras Med Trop. 2005;38(1):7-10.
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41. Hardelid P, Verfuerden M, McMenamin J, Smyth RL, Gilbert R. The contribution of child, family and health service factors to respiratory syncytial virus (RSV) hospital admissions in the first 3 years of life: birth cohort study in Scotland, 2009 to 2015. Euro Surveill. 2019;24(1).
42. Arriola CS, Kim L, Langley G, Anderson EJ, Openo K, Martin AM, et al. Estimated Burden of Community-Onset Respiratory Syncytial VirusAssociated Hospitalizations Among Children Aged <2 Years in the United States, 2014-15. J Pediatric Infect Dis Soc. 2020;9(5):587-95.
43. Pickles RJ, DeVincenzo JP. Respiratory syncytial virus (RSV) and its propensity for causing bronchiolitis. J Pathol. 2015;235(2):266-76.
44. Duijts L, Jaddoe VW, Hofman A, Moll HA. Prolonged and exclusive breastfeeding reduces the risk of infectious diseases in infancy.
Pediatrics. 2010;126(1):e18-25.
45. Tromp I, Kiefte-de Jong J, Raat H, Jaddoe V, Franco O, Hofman A, et al. Breastfeeding and the risk of respiratory tract infections after infancy: The Generation R Study. PLoS One. 2017;12(2):e0172763.
46. Dixon DL. The Role of Human Milk Immunomodulators in Protecting Against Viral Bronchiolitis and Development of Chronic
Wheezing Illness. Children (Basel). 2015;2(3):289-304.
47. Lamberti LM, Zakarija-Grković I, Fischer Walker CL, Theodoratou E, Nair H, Campbell H, et al. Breastfeeding for reducing the risk of
pneumonia morbidity and mortality in children under two: a systematic literature review and meta-analysis. BMC Public Health. 2013;13
Suppl 3(Suppl 3):S18.
48. Cowling BJ, Ali ST, Ng TWY, Tsang TK, Li JCM, Fong MW, et al. Impact assessment of nonpharmaceutical interventions against coronavirus disease 2019 and influenza in Hong Kong: an observational study. Lancet Public Health. 2020;5(5):e279-e88.
49. Seale H, Dyer CEF, Abdi I, Rahman KM, Sun Y, Qureshi MO, et al. Improving the impact of nonpharmaceutical interventions during COVID-19: examining the factors that influence engagement and the impact on individuals. BMC Infect Dis. 2020;20(1):607.
50. Pandolfi E, Gesualdo F, Rizzo C, Carloni E, Villani A, Concato C, et al. Breastfeeding and Respiratory Infections in the First 6 Months of
Life: A Case Control Study. Front Pediatr. 2019;7:152.
51. Lee B, Raszka WV, Jr. COVID-19 Transmission and Children: The Child Is Not to Blame. Pediatrics. 2020;146(2).
52. Bradley JP, Bacharier LB, Bonfiglio J, Schechtman KB, Strunk R, Storch G, et al. Severity of respiratory syncytial virus bronchiolitis is affected by cigarette smoke exposure and atopy. Pediatrics. 2005;115(1):e7- 14.
53. von Linstow ML, Høgh M, Nordbø SA, EugenOlsen J, Koch A, Høgh B. A community study of clinical traits and risk factors for human
metapneumovirus and respiratory syncytial virus infection during the first year of life. Eur J Pediatr. 2008;167(10):1125-33.
54. Behrooz L, Balekian DS, Faridi MK, Espinola JA, Townley LP, Camargo CA, Jr. Prenatal and postnatal tobacco smoke exposure and risk of severe bronchiolitis during infancy. Respir Med. 2018;140:21-6.
55. DiFranza JR, Masaquel A, Barrett AM, Colosia AD, Mahadevia PJ. Systematic literature review assessing tobacco smoke exposure as a risk factor for serious respiratory syncytial virus disease among infants and young children. BMC Pediatr. 2012;12:81.
56. Cunningham S. Bronchiolitis. Kendig's Disorders of the Respiratory Tract in Children. 2019:420-6.e3.
57. Goto-Sugai K, Tsukagoshi H, Mizuta K, Matsuda S, Noda M, Sugai T, et al. Genotyping and phylogenetic analysis of the major genes in respiratory syncytial virus isolated from infants with bronchiolitis. Jpn J Infect Dis. 2010;63(6):393-400.
58. Tabatabai J, Ihling CM, Rehbein RM, Schnee SV, Hoos J, Pfeil J, et al. Molecular epidemiology of respiratory syncytial virus in hospitalised children in Heidelberg, Southern Germany, 2014- 2017. Infect Genet Evol. 2022;98:105209.
2021;21(1):1203.
2. Tazinya AA, Halle-Ekane GE, Mbuagbaw LT, Abanda M, Atashili J, Obama MT. Risk factors for acute respiratory infections in children under five years attending the Bamenda Regional Hospital in Cameroon. BMC Pulmonary Medicine. 2018;18(1):7.
3. Meissner HC. Viral Bronchiolitis in Children. N Engl J Med. 2016;374(1):62-72.
4. Kim S, Williams TC, Viboud C, Campbell H, Chen J, Spiro DJ. RSV genomic diversity and the development of a globally effective RSV
intervention. Vaccine. 2021;39(21):2811-20.
5. Nagasawa K, Ishiwada N. Disease burden of respiratory syncytial virus infection in the pediatric population in Japan. Journal of Infectionand Chemotherapy. 2022;28(2):146-57.
6. Hodges EN, White M, Nelson CB. All Infants Are at Risk of Developing Medically Attended Respiratory Syncytial Virus Lower Respiratory Tract Infection and Deserve Protection. The Journal of Infectious Diseases. 2022;226(Supplement_2):S148-S53.
7. Domachowske J, Halczyn J, Bonville CA. Preventing Pediatric Respiratory Syncytial Virus Infection. Pediatr Ann. 2018;47(9):e371-e6.
8. Wu P, Hartert TV. Evidence for a causal relationship between respiratory syncytial virus infection and asthma. Expert review of antiinfective therapy. 2011;9(9):731-45.
9. Michael JL. Variability of Respiratory Syncytial Virus Seasonality and Mortality. In: Mostafa G, editor. Respiratory Diseases. Rijeka: IntechOpen;2012. p. Ch. 9.
10. Sricharoenchai S, Palla E, Pasini FL, Sanicas M.Epidemiology of Respiratory Syncytial Virus Lower Respiratory Tract Infection (Rsv-Lrti) In Children in Developing Countries. Journal of Tropical Diseases & Public Health. 2016;4:1-8.
11. Viegas M, Mistchenko AS. Molecular epidemiology of human respiratory syncytial virus subgroup A over a six-year period (1999–2004) in Argentina. Journal of Medical Virology.2005;77(2):302-10.
12. Rodriguez-Martinez CE, Barbosa-Ramirez J, Acuña-Cordero R. Predictors of poor outcomes of respiratory syncytial virus acute lower respiratory infections in children under 5 years of age in a middle-income tropical country based on the National Public Health Surveillance System. Pediatr Pulmonol. 2022;57(5):1188-95.
13. Ahmed A, Parveen S, Al-Hassinah SM, AlAmery SF. An overview of respiratory syncytial virus infections in Saudi Arabia. J Infect Dev Ctries. 2018;12(11):929-36.
14. Pangesti KNA, Abd El Ghany M, Walsh MG, Kesson AM, Hill-Cawthorne GA. Molecular epidemiology of respiratory syncytial virus. Rev Med Virol. 2018;28(2).
15. Vandini S, Biagi C, Lanari M. Respiratory Syncytial Virus: The Influence of Serotype and Genotype Variability on Clinical Course of Infection. Int J Mol Sci. 2017;18(8).
16. Yu J, Liu C, Xiao Y, Xiang Z, Zhou H, Chen L, et al. Respiratory Syncytial Virus Seasonality, Beijing, China, 2007-2015. Emerg Infect Dis.
2019;25(6):1127-35.
17. Ren KY, Ren L, Deng Y, Xie XH, Zang N, Xie J, et al. [Epidemiological characteristics of respiratory syncytial virus in hospitalized children with acute lower respiratory tract infection in Chongqing, China, from 2013 to 2018: an analysis of 2 066 cases]. Zhongguo Dang Dai Er Ke Za Zhi. 2021;23(1):67-73.
18. Popow-Kraupp T, Aberle JH. Diagnosis of respiratory syncytial virus infection. Open Microbiol J. 2011;5:128-34.
19. Song J, Wang H, Ng TI, Cui A, Zhu S, Huang Y, et al. Sequence Analysis of the Fusion Protein Gene of Human Respiratory Syncytial Virus Circulating in China from 2003 to 2014. Sci Rep. 2018;8(1):17618.
20. AL-Shaeli, S. J., Ethaeb, A. M., & Gharban, H. A. (2022, November). Determine the glucose regulatory role of decaffeinated Green Tea extract in reduces the metastasis and cell viability of MCF7 cell line. In AIP Conference Proceedings, 2394 (1), 0200031-0200038
21. Qasim Sharhan Al-Mayah ,اIman MA, Areej Atiyah Hussein, Hala Luay Abduljabbar. Detection of Respiratory Syncytial Virus and
Human Metapneumovirus in Children with Respiratory Tract Infection by Use Real Time Polymerase Chain Reaction. Diyala Journal of
Medicine 15;2018(2):87-97.
22. Alaa H. Al-Charrakh GAA-MJATA-A. Detection of human Metapneumovirus and respiratory Syncytial Virus associated with asthmatic
patients using direct fluorescent assay and Real time – PCR. Journal Of Wassit For Science مجلة واسط للعلوم والطب. & Medicine 65-52:)1(9;2016.
23. Hassan DA, Rachid SK, Ziebuhr J. A SingleCenter Study of Viral Respiratory Tract Infections in Hospitalized Children From the
Kurdistan Region of Iraq. Glob Pediatr Health. 2018;5:2333794x18784996.
24. Yadav K, Ramachandran V, Das S, Shah D. Respiratory syncytial virus–detection, prevalence and usefulness in clinical management: a hospital based study. Int J Curr Microbiol App Sci. 2016;5(2):86-91.
25. Atyah N, Fadhil H, Al-Hamadani F, Auffi I, AlAzzawi M. Molecular detection of Subfamily Pneumovirinae among Children with Flu-like
illness by using RT-PCR. Current Research in Microbiology and Biotechnology. 2017;5:1239-44.
26. Huang QS, Wood T, Jelley L, Jennings T, Jefferies S, Daniells K, et al. Impact of the COVID-19 nonpharmaceutical interventions on
influenza and other respiratory viral infections in New Zealand. Nat Commun. 2021;12(1):1001.
27. Varela FH, Scotta MC, Polese-Bonatto M, Sartor ITS, Ferreira CF, Fernandes IR, et al. Absence of detection of RSV and influenza during the COVID-19 pandemic in a Brazilian cohort: Likely role of lower transmission in the community. J Glob Health. 2021;11:05007.
28. Williams TC, Lyttle MD, Cunningham S, Sinha I, Swann OV, Maxwell-Hodkinson A, et al. Study Pre-protocol for "BronchStart - The Impact of the COVID-19 Pandemic on the Timing, Age and Severity of Respiratory Syncytial Virus (RSV) Emergency Presentations; a Multi-Centre Prospective Observational Cohort Study".Wellcome Open Res. 2021;6:120.
29. Yeoh DK, Foley DA, Minney-Smith CA, Martin AC, Mace AO, Sikazwe CT, et al. Impact of Coronavirus Disease 2019 Public Health Measures on Detections of Influenza and Respiratory Syncytial Virus in Children During the 2020 Australian Winter. Clin Infect Dis. 2021;72(12):2199-202.
30. Sullivan SG, Carlson S, Cheng AC, Chilver MB, Dwyer DE, Irwin M, et al. Where has all the influenza gone? The impact of COVID-19 on the circulation of influenza and other respiratory viruses, Australia, March to September 2020. Euro Surveill. 2020;25(47).
31. Chernozhukov V, Kasahara H, Schrimpf P. Causal impact of masks, policies, behavior on early covid-19 pandemic in the U.S. J Econom. 2021;220(1):23-62.
32. Zheng X, Song Z, Li Y, Zhang J, Wang XL. Possible interference between seasonal epidemics of influenza and other respiratory viruses in Hong Kong, 2014-2017. BMC Infect Dis. 2017;17(1):772.
33. Poole S, Brendish NJ, Clark TW. SARS-CoV-2 has displaced other seasonal respiratory viruses: Results from a prospective cohort study. J Infect.2020;81(6):966-72.
34. Britton PN, Hu N, Saravanos G, Shrapnel J, Davis J, Snelling T, et al. COVID-19 public health measures and respiratory syncytial virus. Lancet Child Adolesc Health. 2020;4(11):e42-e3.
35. Stera G, Pierantoni L, Masetti R, Leardini D, Biagi C, Buonsenso D, et al. Impact of SARSCoV-2 Pandemic on Bronchiolitis Hospitalizations: The Experience of an Italian Tertiary Center. Children (Basel). 2021;8(7).
36. Lumley SF, Richens N, Lees E, Cregan J, Kalimeris E, Oakley S, et al. Changes in paediatric respiratory infections at a UK teaching
hospital 2016-2021; impact of the SARS-CoV-2 pandemic. J Infect. 2022;84(1):40-7.
37. Lee JT, Chang LY, Wang LC, Kao CL, Shao PL, Lu CY, et al. Epidemiology of respiratory syncytial virus infection in northern Taiwan,
2001-2005 -- seasonality, clinical characteristics, and disease burden. J Microbiol Immunol Infect. 2007;40(4):293-301.
38. Reis AD, Fink MC, Machado CM, Paz Jde P, Jr., Oliveira RR, Tateno AF, et al. Comparison of direct immunofluorescence, conventional cell culture and polymerase chain reaction techniques for detecting respiratory syncytial virus in nasopharyngeal aspirates from infants. Rev Inst Med Trop Sao Paulo. 2008;50(1):37-40.
39. D'Elia C, Siqueira MM, Portes SA, Sant'Anna CC. [Respiratory syncytial virus -- associated lower respiratory tract infections in hospitalized infants]. Rev Soc Bras Med Trop. 2005;38(1):7-10.
40. Svensson C, Berg K, Sigurs N, Trollfors B. Incidence, risk factors and hospital burden in children under five years of age hospitalised with respiratory syncytial virus infections. Acta Paediatr. 2015;104(9):922-6.
41. Hardelid P, Verfuerden M, McMenamin J, Smyth RL, Gilbert R. The contribution of child, family and health service factors to respiratory syncytial virus (RSV) hospital admissions in the first 3 years of life: birth cohort study in Scotland, 2009 to 2015. Euro Surveill. 2019;24(1).
42. Arriola CS, Kim L, Langley G, Anderson EJ, Openo K, Martin AM, et al. Estimated Burden of Community-Onset Respiratory Syncytial VirusAssociated Hospitalizations Among Children Aged <2 Years in the United States, 2014-15. J Pediatric Infect Dis Soc. 2020;9(5):587-95.
43. Pickles RJ, DeVincenzo JP. Respiratory syncytial virus (RSV) and its propensity for causing bronchiolitis. J Pathol. 2015;235(2):266-76.
44. Duijts L, Jaddoe VW, Hofman A, Moll HA. Prolonged and exclusive breastfeeding reduces the risk of infectious diseases in infancy.
Pediatrics. 2010;126(1):e18-25.
45. Tromp I, Kiefte-de Jong J, Raat H, Jaddoe V, Franco O, Hofman A, et al. Breastfeeding and the risk of respiratory tract infections after infancy: The Generation R Study. PLoS One. 2017;12(2):e0172763.
46. Dixon DL. The Role of Human Milk Immunomodulators in Protecting Against Viral Bronchiolitis and Development of Chronic
Wheezing Illness. Children (Basel). 2015;2(3):289-304.
47. Lamberti LM, Zakarija-Grković I, Fischer Walker CL, Theodoratou E, Nair H, Campbell H, et al. Breastfeeding for reducing the risk of
pneumonia morbidity and mortality in children under two: a systematic literature review and meta-analysis. BMC Public Health. 2013;13
Suppl 3(Suppl 3):S18.
48. Cowling BJ, Ali ST, Ng TWY, Tsang TK, Li JCM, Fong MW, et al. Impact assessment of nonpharmaceutical interventions against coronavirus disease 2019 and influenza in Hong Kong: an observational study. Lancet Public Health. 2020;5(5):e279-e88.
49. Seale H, Dyer CEF, Abdi I, Rahman KM, Sun Y, Qureshi MO, et al. Improving the impact of nonpharmaceutical interventions during COVID-19: examining the factors that influence engagement and the impact on individuals. BMC Infect Dis. 2020;20(1):607.
50. Pandolfi E, Gesualdo F, Rizzo C, Carloni E, Villani A, Concato C, et al. Breastfeeding and Respiratory Infections in the First 6 Months of
Life: A Case Control Study. Front Pediatr. 2019;7:152.
51. Lee B, Raszka WV, Jr. COVID-19 Transmission and Children: The Child Is Not to Blame. Pediatrics. 2020;146(2).
52. Bradley JP, Bacharier LB, Bonfiglio J, Schechtman KB, Strunk R, Storch G, et al. Severity of respiratory syncytial virus bronchiolitis is affected by cigarette smoke exposure and atopy. Pediatrics. 2005;115(1):e7- 14.
53. von Linstow ML, Høgh M, Nordbø SA, EugenOlsen J, Koch A, Høgh B. A community study of clinical traits and risk factors for human
metapneumovirus and respiratory syncytial virus infection during the first year of life. Eur J Pediatr. 2008;167(10):1125-33.
54. Behrooz L, Balekian DS, Faridi MK, Espinola JA, Townley LP, Camargo CA, Jr. Prenatal and postnatal tobacco smoke exposure and risk of severe bronchiolitis during infancy. Respir Med. 2018;140:21-6.
55. DiFranza JR, Masaquel A, Barrett AM, Colosia AD, Mahadevia PJ. Systematic literature review assessing tobacco smoke exposure as a risk factor for serious respiratory syncytial virus disease among infants and young children. BMC Pediatr. 2012;12:81.
56. Cunningham S. Bronchiolitis. Kendig's Disorders of the Respiratory Tract in Children. 2019:420-6.e3.
57. Goto-Sugai K, Tsukagoshi H, Mizuta K, Matsuda S, Noda M, Sugai T, et al. Genotyping and phylogenetic analysis of the major genes in respiratory syncytial virus isolated from infants with bronchiolitis. Jpn J Infect Dis. 2010;63(6):393-400.
58. Tabatabai J, Ihling CM, Rehbein RM, Schnee SV, Hoos J, Pfeil J, et al. Molecular epidemiology of respiratory syncytial virus in hospitalised children in Heidelberg, Southern Germany, 2014- 2017. Infect Genet Evol. 2022;98:105209.
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Feb 27, 2023
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Ruaa Naeem, Hussein Albayati, & Ahmed Insaaf. (2023). Molecular Detection of Respiratory Syncytial Virus in Infants and Young Children by the Conventional Reverse Transcriptase Polymerase Chain Reaction. Journal of Population Therapeutics and Clinical Pharmacology, 30(3), 1–10. https://doi.org/10.47750/jptcp.2023.30.03.001
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