1887

Abstract

Influenza viruses cause significant morbidity and mortality in adults each winter. At the same time, other respiratory viruses circulate and cause respiratory illness with influenza-like symptoms. Human respiratory syncytial virus (HRSV), human parainfluenza viruses (HPIV) and human metapneumovirus have all been associated with morbidity and mortality in adults, including nosocomial infections. This study evaluated 154 respiratory specimens collected from adults with influenza-like/acute respiratory illness (ILI) seen at the Edward Hines Jr VA Hospital, Hines, IL, USA, during two successive winters, 1998–1999 and 1999–2000. The samples were tested for ten viruses in two nested multiplex RT-PCRs. One to three respiratory viruses were detected in 68 % of the samples. As expected, influenza A virus (FLU-A) infections were most common (50 % of the samples), followed by HRSV-A (16 %). Surprisingly, HPIV-4 infections (5.8 %) were the third most prevalent. Mixed infections were also relatively common (11 %). When present, HPIV infections were approximately three times more likely to be included in a mixed infection than FLU-A or HRSV. Mixed infections and HPIV-4 are likely to be missed using rapid diagnostic tests. This study confirms that ILI in adults and the elderly can be caused by HRSV and HPIVs, including HPIV-4, which co-circulate with FLU-A.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.006098-0
2009-04-01
2024-04-18
Loading full text...

Full text loading...

/deliver/fulltext/jmm/58/4/408.html?itemId=/content/journal/jmm/10.1099/jmm.0.006098-0&mimeType=html&fmt=ahah

References

  1. Aguilar J. C., Pérez-Breña M. P., García M. L., Cruz N., Erdman D. D., Echevarría J. E. 2000; Detection and identification of human parainfluenza viruses 1, 2, 3, and 4 in clinical samples of pediatric patients by multiplex reverse transcription-PCR. J Clin Microbiol 38:1191–1195
    [Google Scholar]
  2. Atmar R. L., Baxter B. D., Dominguez E. A., Taber L. H. 1996; Comparison of reverse transcription-PCR with tissue culture and other rapid diagnostic assays for detection of type A influenza virus. J Clin Microbiol 34:2604–2606
    [Google Scholar]
  3. Bellau-Pujol S., Vabret A., Legrand L., Dina J., Gouarin S., Petitjean-Lecherbonnier J., Pozzetto B., Ginevra C., Freymuth F. 2005; Development of three multiplex RT-PCR assays for the detection of 12 respiratory RNA viruses. J Virol Methods 126:53–63 [CrossRef]
    [Google Scholar]
  4. Boivin G., Abed Y., Pelletier G., Ruel L., Moisan D., Côté S., Peret T. C., Erdman D. D., Anderson L. J. 2002; Virological features and clinical manifestations associated with human metapneumovirus: a new paramyxovirus responsible for acute respiratory-tract infections in all age groups. J Infect Dis 186:1330–1334 [CrossRef]
    [Google Scholar]
  5. Boivin G., De Serres G., Côté S., Gilca R., Abed Y., Rochette L., Bergeron M. G., Déry P. 2003; Human metapneumovirus infections in hospitalized children. Emerg Infect Dis 9:634–640 [CrossRef]
    [Google Scholar]
  6. Casiano-Colón A. E., Hulbert B. B., Mayer T. K., Walsh E. E., Falsey A. R. 2003; Lack of sensitivity of rapid antigen tests for the diagnosis of respiratory syncytial virus infection in adults. J Clin Virol 28:169–174 [CrossRef]
    [Google Scholar]
  7. Chanock R. M., Murphy B. R., Collins P. L. 2001; Parainfluenza viruses. In Fields Virology , 4th edn. pp 1341–1379 Edited by Knipe D. M., Howley P. M. Philadelphia: Lippincott Williams & Wilkins;
    [Google Scholar]
  8. Claas E. C., van Milaan A. J., Sprenger M. J., Ruiten-Stuiver M., Arron G. I., Rothbarth P. H., Masurel N. 1993; Prospective application of reverse transcriptase polymerase chain reaction for diagnosing influenza infections in respiratory samples from a children's hospital. J Clin Microbiol 31:2218–2221
    [Google Scholar]
  9. Coiras M. T., Pérez-Breña P., García M. L., Casas I. 2003; Simultaneous detection of influenza A, B, and C viruses, respiratory syncytial virus, and adenoviruses in clinical samples by multiplex reverse transcription nested-PCR assay. J Med Virol 69:132–144 [CrossRef]
    [Google Scholar]
  10. Echevarría J. E., Erdman D. D., Swierkosz E. M., Holloway B. P., Anderson L. J. 1998; Simultaneous detection and identification of human parainfluenza viruses 1, 2, and 3 from clinical samples by multiplex PCR. J Clin Microbiol 36:1388–1391
    [Google Scholar]
  11. Glasgow K. W., Tamblyn S. E., Blair G. 1995; A respiratory outbreak due to parainfluenza virus type 3 in a home for the aged – Ontario. Can Commun Dis Rep 21:57–61
    [Google Scholar]
  12. Gonzalez I. M., Karron R. A., Eichelberger M., Walsh E. E., Delagarza V. W., Bennett R., Chanock R. M., Murphy B. R., Clements-Mann M. L., Falsey A. R. 2000; Evaluation of the live attenuated cpts 248/404 RSV vaccine in combination with a subunit RSV vaccine (PFP-2) in healthy young and older adults. Vaccine 18:1763–1772 [CrossRef]
    [Google Scholar]
  13. Henderson F. W. 1987; Pulmonary infections with respiratory syncytial virus and the parainfluenza viruses. Semin Respir Infect 2:112–121
    [Google Scholar]
  14. Henrickson K. J. 2003; Parainfluenza viruses. Clin Microbiol Rev 16:242–264 [CrossRef]
    [Google Scholar]
  15. Lau S. K., To W. K., Tse P. W., Chan A. K., Woo P. C., Tsoi H. W., Leung A. F., Li K. S., Chan P. K. other authors 2005; Human parainfluenza virus 4 outbreak and the role of diagnostic tests. J Clin Microbiol 43:4515–4521 [CrossRef]
    [Google Scholar]
  16. Lee F. E., Walsh E. E., Falsey A. R., Liu N., Liu D., Divekar A., Snyder-Cappione J. E., Mosmann T. R. 2005; The balance between influenza- and RSV-specific CD4 T cells secreting IL-10 or IFN γ in young and healthy-elderly subjects. Mech Ageing Dev 126:1223–1229 [CrossRef]
    [Google Scholar]
  17. Lindquist S. W., Darnule A., Istas A., Demmler G. J. 1997; Parainfluenza virus type 4 infections in pediatric patients. Pediatr Infect Dis J 16:34–38 [CrossRef]
    [Google Scholar]
  18. Osiowy C. 1998; Direct detection of respiratory syncytial virus, parainfluenza virus, and adenovirus in clinical respiratory specimens by a multiplex reverse transcription-PCR assay. J Clin Microbiol 36:3149–3154
    [Google Scholar]
  19. Pachucki C. T., Khurshid M. A., Nawrocki J. 2004; Utility of reverse transcriptase PCR for rapid diagnosis of influenza A virus infection and detection of amantadine-resistant influenza A virus isolates. J Clin Microbiol 42:2796–2798 [CrossRef]
    [Google Scholar]
  20. Rubin E. E., Quennec P., McDonald J. C. 1993; Infections due to parainfluenza virus type 4 in children. Clin Infect Dis 17:998–1002 [CrossRef]
    [Google Scholar]
  21. Sharova N. K., Kubinova I., Vorkunova G. K., Tumova B., Bukrinskaia A. G. 1989; Conservativism of the matrix protein of paramyxoviruses. Vopr Virusol 34:573–575 (in Russian
    [Google Scholar]
  22. Slavin K. A., Passaro D. J., Hacker J. K., Hendry R. M., Kohl S. 2000; Parainfluenza virus type 4: case report and review of the literature. Pediatr Infect Dis J 19:893–896 [CrossRef]
    [Google Scholar]
  23. Templeton K. E., Bredius R. G., Scheltinga S. A., Claas E. C., Vossen J. M., Kroes A. C. 2004; Parainfluenza virus 3 infection pre- and post-haematopoietic stem cell transplantation: re-infection or persistence?. J Clin Virol 29:320–322 [CrossRef]
    [Google Scholar]
  24. Templeton K. E., Bredius R. G., Claas E. C., Kroes A. C., Walther F. J. 2005; Parainfluenza virus 4 detection in infants. Eur J Pediatr 164:528–529 [CrossRef]
    [Google Scholar]
  25. Walsh E. E., Peterson D. R., Falsey A. R. 2007; Is clinical recognition of respiratory syncytial virus infection in hospitalized elderly and high-risk adults possible?. J Infect Dis 195:1046–1051 [CrossRef]
    [Google Scholar]
  26. Whimbey E., Champlin R. E., Couch R. B., Englund J. A., Goodrich J. M., Raad I., Przepiorka D., Lewis V. A., Mirza N. other authors 1996; Community respiratory virus infections among hospitalized adult bone marrow transplant recipients. Clin Infect Dis 22:778–782 [CrossRef]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.006098-0
Loading
/content/journal/jmm/10.1099/jmm.0.006098-0
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error