Virus World

Introduction

As reported by the United States (US) Center for Disease Prevention and Control, the US experienced an early and severe respiratory syncytial virus (RSV) surge in autumn 2022. This increase in RSV cases relative to previous years, alongside coincident epidemics of SARS-CoV-2 and Influenza, has put intense pressure on hospitals and urgent care centers [1]; however, the factors promoting the surge in cases are unknown. A leading hypothesis suggests an increase in the susceptible population brought on by limited RSV circulation during COVID-19, particularly involving children ages one to three, who are among the most susceptible to severe RSV [2]. Alternatively, the emergence of a highly transmissible and/or virulent “variant” of RSV could account for the increase. These possibilities can be distinguished by genome sequencing of surge-associated samples because a highly-transmissible variant will appear as a cluster of closely-related sequences in a phylogenetic tree. To characterize the viral genomic basis of the 2022 RSV surge in Massachusetts (MA), we sequenced RSV genomes and analyzed clinical data from symptomatic patients who presented to the Massachusetts General Hospital (MGH), a large academic medical center in Boston, MA, and its affiliated outpatient practices in the Greater Boston Area.

Discussion

We show that the expansion of multiple clades has contributed to the RSV surge in MA in the autumn of 2022. In cases sampled during the peak of the surge at a major academic medical center and its affiliated outpatient practices in the greater Boston area, RSV-A predominates, and circulating clades have a MRCA more than 5 years before the present. The polyphyletic nature of viral genomes sequenced in eastern MA suggests that the emergence of a single, highly transmissible RSV lineage is unlikely to account for the 2022 surge. Additional genomic and immunological data are needed to fully understand the causes of the 2022 RSV surge, including pre-COVID-19 pandemic sequences to evaluate changes in RSV genomic diversity during the COVID-19 pandemic.

Published in Virological.org (Dec. 9 , 2022)

Health ministry says cases yet to be confirmed and come after the viral infection detected in UK and Portugal.  Health authorities in Spain have issued an alert over a possible outbreak of monkeypox after eight men showed symptoms compatible with the viral infection, which has already been detected in the UK and Portugal. In a statement, the health ministry cautioned that the eight suspected cases – all in the Madrid region – had yet to be confirmed, but said a nationwide alert had been issued “to guarantee a swift, coordinated and timely response”. A spokesperson for Madrid’s regional health department said the suspected cases were being analysed by the National Microbiology Centre to obtain a definitive diagnosis.  “Generally speaking, monkeypox is spread by respiratory transmission, but the characteristics of the eight suspected cases point towards fluid contact,” the spokesperson said. “The eight suspected cases in Madrid are among men who have sex with men. They are doing well but this illness can require hospital treatment.” Fernando Simón, an epidemiologist who heads Spain’s health emergencies centre, said while it was unlikely that monkeypox would spread significantly, “that can’t be ruled out”.

Portuguese authorities have confirmed five cases and are investigating another 15 suspected cases. In a statement on Wednesday, Portugal’s health ministry said the cases it had detected – all in the Lisbon and Tagus Valley region – had all involved men whose symptoms included ulcerative lesions. “The UK has reported similar cases of ulcerative lesions, with confirmed monkeypox virus infection,” it said. “We are monitoring the situation at national level and in conjunction with European institutions.” The first of the seven cases logged in the UK involved a person who had recently been to Nigeria, where they are believed to have contracted the infection. According to the UK Health Security Agency, all four of the most recent cases are men who identify as gay or bisexual or other men who have sex with men. The health body is asking these groups “to be alert” to possible symptoms, which include rashes or lesions on any part of their body, especially their genitalia, and to contact a sexual health service if they have concerns.  Early symptoms of monkeypox include fever, headache, muscle aches, swollen lymph nodes and chills. A rash that can look like chickenpox or syphilis can also develop and spread from the face to other parts of the body, including the genitals. Most people recover within a few weeks. A handful of cases of monkeypox, which has two forms and is typically found in central and western Africa, have been diagnosed in the UK in the past. It is thought the seven UK cases involve the west African strain, which is milder than the more severe central African, or Congo, strain.