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. 2022 Mar;16(2):222-235.
doi: 10.1111/irv.12905. Epub 2021 Sep 16.

Human respiratory syncytial virus diversity and epidemiology among patients hospitalized with severe respiratory illness in South Africa, 2012-2015

Ziyaad Valley-Omar  1   2 , Stefano Tempia  3   4   5   6 , Orienka Hellferscee  1 , Sibongile Walaza  1   6 , Ebrahim Variava  6 , Halima Dawood  7   8 , Kathleen Kahn  1 , Meredith McMorrow  3   4 , Marthi Pretorius  1   9 , Senzo Mtshali  1 , Ernest Mamorobela  1 , Nicole Wolter  1   6 , Marietjie Venter  1   10 , Anne von Gottberg  1   6 , Cheryl Cohen  1   6 , Florette K Treurnicht  6   11
Affiliations

Human respiratory syncytial virus diversity and epidemiology among patients hospitalized with severe respiratory illness in South Africa, 2012-2015

Ziyaad Valley-Omar et al. Influenza Other Respir Viruses. 2022 Mar.

Abstract

Background: We aimed to describe the prevalence of human respiratory syncytial virus (HRSV) and evaluate associations between HRSV subgroups and/or genotypes and epidemiologic characteristics and clinical outcomes in patients hospitalized with severe respiratory illness (SRI).

Methods: Between January 2012 and December 2015, we enrolled patients of all ages admitted to two South African hospitals with SRI in prospective hospital-based syndromic surveillance. We collected respiratory specimens and clinical and epidemiological data. Unconditional random effect multivariable logistic regression was used to assess factors associated with HRSV infection.

Results: HRSV was detected in 11.2% (772/6908) of enrolled patients of which 47.0% (363/772) were under the age of 6 months. There were no differences in clinical outcomes of HRSV subgroup A-infected patients compared with HRSV subgroup B-infected patients but among patients aged <5 years, children with HRSV subgroup A were more likely be coinfected with Streptococcus pneumoniae (23/208, 11.0% vs. 2/90, 2.0%; adjusted odds ratio 5.7). No significant associations of HRSV A genotypes NA1 and ON1 with specific clinical outcomes were observed.

Conclusions: While HRSV subgroup and genotype dominance shifted between seasons, we showed similar genotype diversity as noted worldwide. We found no association between clinical outcomes and HRSV subgroups or genotypes.

Keywords: South Africa; human respiratory syncytial virus; severe respiratory illness.

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Conflict of interest statement

Cheryl Cohen has received funding to her institution from Sanofi Pasteur, US Centers for Disease Control and Prevention, World Health Organization, and has received funding to attend a meeting from Parexel. Dr. Dawood reports personal fees from Pfizer‐South Africa and conference attendance sponsorship from MSD‐South Africa, Pfizer‐South Africa, and Biomiereux‐South Africa.

Figures

FIGURE 1
FIGURE 1
Monthly number of human respiratory syncytial virus (HRSV)‐positive patients hospitalized with severe respiratory illness, Edendale and Klerksdorp‐Tshepong hospitals, South Africa, 2012–2015. The proportion of positives belonging to subgroup A, B and not typed is also indicated in the bar graph
FIGURE 2
FIGURE 2
Human respiratory syncytial virus (HRSV) genotypes detected among patients of any age, hospitalized with severe respiratory illness, Edendale and Klerksdorp‐Tshepong hospitals, South Africa, 2012–2015
FIGURE 3
FIGURE 3
Inferred phylogeny of human respiratory syncytial virus (HRSV) A G‐gene second variable domain of south African HRSV A isolates (red triangles) based on maximum likelihood model (Mega 5.0 under GTR GAMMA model of nucleotide evolution). Selected publicly available sequences global HRSV A sequences are represented by GenBank accession numbers (blue circles). Brackets indicate HRSV NA1 and ON1 (1.1, 1.2, and 1.3) lineages. Sample dates indicated by last 4 digits of sample names
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