Prevalence of Human Respiratory Prevalence of Human Respiratory - - PDF document

Prevalence of Human Respiratory Prevalence of Human Respiratory Viruses in Children with Acute Viruses in Children with Acute Respiratory Tract Infections in Beijing, Respiratory Tract Infections in Beijing, 2007 2007 -

• 2009

2009

• R. GONZALEZ
• R. GONZALEZ

Dr.

• Dr. Christophe M

Christophe Mй йrieux rieux Laboratory, Laboratory, CAMS IPB CAMS IPB-

• Fondation

Fondation M Mй йrieux rieux

12th National Virology Conference – Ulaanbaatar, Mongolia - Sept 2009

Introduction on CML Introduction on CML

Initiated in March 2005 Joint unit between IPB CAMS and Fondation Mйrieux Located in Beijing, China Close to the Peking Union Medical College Hospital (PUMCH) 400 square-meters 2 common labs P2 facilities (4 different labs) P3 lab (located in the Institute of Laboratory Animal Sciences from CAMS) Team of 16 people: 1 director, 1 lab operation manager, 2 clinicians, 3 scientists, 1 knowledge engineer, 8 technicians. Additional 700 square-meters of labs in October 2009 (located in other area)

Main missions of CML Main missions of CML

A key player contributing to China’s emergency response against infectious diseases. Investigations on etiology and epidemiology of viral respiratory infections in Chinese population Development of technology platforms for unknown virus identification and discovery of unknown respiratory viruses in ARTI samples Development of new diagnosis and intervention technologies based on systems biology Providing training to GABRIEL network partners from low-income countries Achievements

First large comprehensive investigation on etiology of adult ARTIs in China (CMI journal, Oct 2008) First identification of group C rhinovirus in China (EID journal, Oct 2008) First report on Saffold cardiovirus in China (EID journal, May 2009) First detection of WU polyomavirus in China (EID journal, Jan 2009)

Respiratory sample screening Respiratory sample screening

Molecular tests

Real-time NASBA PCR or RT-PCR Nasopharyngeal aspirate Child patient from BCH (Beijing Children Hospital) blood

Method Virus detected 1 NASBA Respiratory syncytial virus (RSV), Influenza A&B, Human Metapneumovirus (hMPV), Enterovirus 2 Multiplex RT nested- PCR Parainfluenza virus1, 2, 3, and 4, Enterovirus, Rhinovirus 3 Multiplex RT nested- PCR Influenza A+B, RSV A & B 4 One-step RT-PCR Human coronavirus (OC43, 229E, NL63, and HKU1), hMPV 5 PCR Adenovirus, Human Bocavirus

Seasonal distribution of Seasonal distribution of respiratory viruses in children respiratory viruses in children from BCH from BCH

IFVA hMPV HCoV EV Adv IFVB HBoV HPIVs HRV RSV

Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr 2007 2008 2009

Respiratory viruses distribution Respiratory viruses distribution according to the age group according to the age group

28 (1.8) 2 (1.9) 3 (1.4) 6 (3.5) 3 (1.7) 6 (2.4) 8 (1.3) EV 42 (2.8) 2 (0.9) 7 (4.1) 9 (5.0) 13 (5.2) 11 (1.8) hMPV 56 (3.7) 1 (0.5) 3 (1.7) 18 (9.9) 23 (9.3) 11 (1.8) HBoV 59 (3.9) 1 (1.0) 3 (1.4) 6 (3.5) 14 (7.7) 15 (6.1) 20 (3.4) COV 72 (4.7) 1 (1.0) 7 (3.2) 12 (6.9) 14 (7.7) 17 (6.9) 21 (3.5) AdV 106 (7.0) 2 (1.9) 22 (10.0) 27 (15.6)* 17 (9.4) 15 (6.1) 23 (3.9) IFVA/B 191 (12.5) 3 (2.9) 7 (3.2) 23 (13.3) 37 (20.4)† 47 (19.0)† 74 (12.4) PIV 421 (27.6) 13 (12.4) 28 (12.7) 41 (23.7) 58 (32.0)† 87 (35.1)† 194 (32.5)† HRV 554 (36.4) 1 (1.0) 17 (7.7) 39 (22.5) 50 (27.6) 108 (43.4)* 339 (56.8)* RSV 371 (24.3) 1 (1.0) 11 (5.0) 36 (20.8) 54 (29.8) 98 (39.5) 171 (28.6) Co-detection cases 447 (29.3) 83 (79.1) 144 (65.5) 56 (32.4) 26 (14.4) 39 (15.7) 99 (16.6) Negative patients 1067 (70.0) 22 (21.0) 76 (34.5) 117 (67.6) 155 (85.6) 209 (84.3) 488 (81.7) Positive patients 1524 105 220 173 181 248 597 Patients tested

Total ≥10y ≥5-10y ≥2-5y ≥1-2y ≥6-12m <6m Age groups

# Percentage *p <0.01 † p<0.05

Co Co-

• detection rate of respiratory

detection rate of respiratory viruses according to the age group viruses according to the age group

371 (24.3) 1524 Total Age groups < 6m 6-<12m 1-<2y 2-<5y 5-<10y ≥10y Patients tested 597 248 181 173 220 105 Co-detected cases (%) 171 (28.6) 98 (39.5) 54 (29.8) 36 (20.8) 11 (5.0) 1 (1.0)

Multiple viruses detection Multiple viruses detection

Most frequent co-detections

RSV+HRV (especially in children under 6 months old) Followed by RSV+PIV (also more frequent in children under 6 months old)

Triple co-detections quite frequent 7 cases of 4 viruses co-detections

Most of them observed in young children (under 6 months old)

• HRV+RSV+IFVA+CoV
• HRV+RSV+PIV+CoV
• HRV+RSV+AdV+HBoV
• HRV+RSV+AdV+hMPV
• HRV+RSV+CoV+hMPV
• HRV+RSV+PIV+HBoV
• PIV+RSV+AdV+HBoV

Distribution of Distribution of HPIVs HPIVs infections infections according to the age group according to the age group

< 6m 6-<12m 1-<2y 2-<5y 5-<10y ≥10y total

2 4 6 8 10 12 14 16 Detection rate%

HPIV1 HPIV2 HPIV3 HPIV4

Seasonality of Seasonality of HPIVs HPIVs infections infections

Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr

2007 2008

5 10 15 20 25 30 35 40 45 50

Detection rate%

HPIV1 HPIV2 HPIV3 HPIV4 HPIVs

2009

Distribution of Distribution of HCoVs HCoVs infections infections according to the age group according to the age group

7 18 10 10 14 59 1524 Total 1 1 1 4 Untyped 7 8 3 NL63 1 2 2 2 HKU1 6 1 229E 1 1 2 1 4 5 OC43 1 3 6 14 15 20 HCoV positive patients 105 220 173 181 248 597 Tested patients ≥10y 5-<10y 2-<5y 1-<2y 6-<12m < 6m Age groups

Thank You ! Thank You !