Department of Medicine, Division of Infectious Diseases and International Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
Department of Pediatrics, Division of Pediatric Infectious Diseases and Immunology, University of Minnesota, Minneapolis, Minnesota, USA.
J Infect Dis. 2020 Jun 29;222(2):288-297. doi: 10.1093/infdis/jiaa075.
Respiratory syncytial virus (RSV) typically causes winter outbreaks in temperate climates. During summer 2017, the Minnesota Department of Health received a report of increased cases of severe RSV-B infection.
We compared characteristics of summer 2017 cases with those of 2014-2018 summers. To understand the genetic relatedness among viruses, we performed high-throughput sequencing of RSV from patients with a spectrum of illness from sites in Minnesota and Wisconsin.
From May to September 2017, 58 RSV cases (43 RSV-B) were reported compared to 20-29 cases (3-7 RSV-B) during these months in other years. Median age and frequency of comorbidities were similar, but 55% (24/43) were admitted to the ICU in 2017 compared to 12% in preceding 3 years (odds ratio, 4.84, P < .01). Sequencing was performed on 137 specimens from March 2016 to March 2018. Outbreak cases formed a unique clade sharing a single conserved nonsynonymous change in the SH gene. We observed increased cases during the following winter season, when the new lineage was the predominant strain.
We identified an outbreak of severe RSV-B disease associated with a new genetic lineage among urban Minnesota children during a time of expected low RSV circulation.
呼吸道合胞病毒（RSV）通常在温带气候中引发冬季疫情。2017 年夏季，明尼苏达州卫生部收到了一份关于严重 RSV-B 感染病例增加的报告。
我们比较了 2017 年夏季病例与 2014-2018 年夏季病例的特征。为了了解病毒之间的遗传关系，我们对来自明尼苏达州和威斯康星州不同地点的不同疾病严重程度的患者的 RSV 进行了高通量测序。
2017 年 5 月至 9 月期间报告了 58 例 RSV 病例（43 例 RSV-B），而在其他年份的同期报告了 20-29 例（3-7 例 RSV-B）。中位年龄和合并症的频率相似，但 2017 年 55%（24/43）的患者被收入 ICU，而前 3 年为 12%（比值比，4.84，P<.01）。对 2016 年 3 月至 2018 年 3 月的 137 个样本进行了测序。暴发病例形成了一个独特的分支，在 SH 基因中共享一个单一的保守非同义突变。我们观察到在接下来的冬季季节，即新谱系成为主要流行株时，病例数量增加。
我们在明尼苏达州城市儿童中发现了一种与新遗传谱系相关的严重 RSV-B 疾病暴发，而此时 RSV 的流行率预计较低。
