Luchs Adriana, Adiwardana Natanael Sutikno, Rocha Leonardo Cecilio da, Viana Ellen, Guadagnucci Simone, Parise Adriana, Silva Vanessa Cristina Martins, Azevedo Lais Sampaio de, Guiducci Raquel, França Yasmin, Frank Natacha Luana Pezzuol, Silva Ana Lucia Nascimento da, Oliveira Andre Luiz Vianna de, Azevedo André Henrique Souza, Carreteiro Bárbara Segatelli, Nogueira Maurício Lacerda
Virology Center, Adolfo Lutz Institute, Sao Paulo 01246-902, Brazil.
São José do Rio Preto School of Medicine (FAMERP), São José do Rio Preto 15090-000, Brazil.
Viruses. 2025 Mar 29;17(4):497. doi: 10.3390/v17040497.
Pneumonia and diarrhea are the leading causes of death in children under 5 globally, worsened by viral infections. This study investigates viral agents in children ≤ 3 years with respiratory illness and diarrhea in Metropolitan Region of São Paulo, Brazil, during spring 2021. Twenty paired samples (oropharyngeal swab and feces) were tested using in-house qPCR for HBoV and HAdV, RT-qPCR for RVA, EV, PeV-A, and NoV, and a commercial RT-qPCR kit for SARS-CoV-2, Flu A/B, and RSV. HAstV was detected with conventional nested (RT)-PCR. Positive samples were sequenced for molecular characterization and phylogenetic analysis. Seven viruses were identified: HBoV, NoV, HAdV, PeV-A, EV, RSV, and Flu A. HBoV and NoV were detected in 75% of cases, with co-infection in 65% of patients, indicating their involvement in the gastro-respiratory illness. Genotyping of HBoV (HBoV-1), NoV (GII.4_Sydney[P16], GII.2[P16], and GII.4_Sydney[P31]), EV (Coxsackievirus A6), HAdV (species C, type 6), and PeV-A (genotype 1) showed local virus diversity. Phylogenetic analysis indicated no ongoing community outbreak, with distinct clusters observed. The findings highlight the overlap of respiratory and enteric diseases, revealing local viral diversity and high exposure to enteric viruses. This underscores the challenges in differential diagnosis and the need for syndromic surveillance.
肺炎和腹泻是全球5岁以下儿童的主要死因，病毒感染会使情况恶化。本研究调查了2021年春季巴西圣保罗大都市区3岁及以下患有呼吸道疾病和腹泻的儿童中的病毒病原体。使用针对人博卡病毒（HBoV）和人腺病毒（HAdV）的内部定量聚合酶链反应（qPCR）、针对轮状病毒A（RVA）、肠道病毒（EV）、戊型肝炎病毒A（PeV-A）和诺如病毒（NoV）的逆转录定量聚合酶链反应（RT-qPCR）以及针对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）、甲型/乙型流感病毒和呼吸道合胞病毒（RSV）的商业RT-qPCR试剂盒对20对样本（口咽拭子和粪便）进行检测。用传统巢式（逆转录）-聚合酶链反应检测星状病毒（HAstV）。对阳性样本进行测序以进行分子特征分析和系统发育分析。鉴定出七种病毒：HBoV、NoV、HAdV、PeV-A、EV、RSV和甲型流感病毒。75%的病例中检测到HBoV和NoV，65%的患者存在共同感染，表明它们与胃肠呼吸道疾病有关。HBoV（HBoV-1）、NoV（GII.4_悉尼株[P16]、GII.2[P16]和GII.4_悉尼株[P31]）、EV（柯萨奇病毒A6）、HAdV（C种，6型）和PeV-A（基因型1）的基因分型显示出当地病毒的多样性。系统发育分析表明没有正在进行的社区疫情爆发，观察到不同的聚类。研究结果突出了呼吸道疾病和肠道疾病的重叠，揭示了当地病毒的多样性以及肠道病毒的高暴露率。这凸显了鉴别诊断的挑战以及综合征监测的必要性。
