Staff View: Viral Load and Sequence Analysis Reveal the Symptom Severity, Diversity, and Transmission Clusters of Rhinovirus Infections

Viral Load and Sequence Analysis Reveal the Symptom Severity, Diversity, and Transmission Clusters of Rhinovirus Infections

Background Rhinovirus (RV) is one of the main viral etiologic agents of acute respiratory illnesses. Despite the heightened disease burden caused by RV, the viral factors that increase the severity of RV infection, the transmission pattern, and seasonality of RV infections remain unclear. Methods An...

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Main Authors:	Ng, Kim Tien, Oong, Xiang Yong, Lim, Sin How, Chook, Jack Bee, Takebe, Yutaka, Chan, Yoke Fun, Chan, Kok Gan, Hanafi, Nik Sherina, Pang, Yong Kek, Kamarulzaman, Adeeba, Tee, Kok Keng
Format:	Article
Published:	Oxford University Press 2018
Subjects:	R Medicine
Online Access:	http://eprints.um.edu.my/21142/ https://doi.org/10.1093/cid/ciy063
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spelling	my.um.eprints.211422019-05-07T06:47:24Z http://eprints.um.edu.my/21142/ Viral Load and Sequence Analysis Reveal the Symptom Severity, Diversity, and Transmission Clusters of Rhinovirus Infections Ng, Kim Tien Oong, Xiang Yong Lim, Sin How Chook, Jack Bee Takebe, Yutaka Chan, Yoke Fun Chan, Kok Gan Hanafi, Nik Sherina Pang, Yong Kek Kamarulzaman, Adeeba Tee, Kok Keng R Medicine Background Rhinovirus (RV) is one of the main viral etiologic agents of acute respiratory illnesses. Despite the heightened disease burden caused by RV, the viral factors that increase the severity of RV infection, the transmission pattern, and seasonality of RV infections remain unclear. Methods An observational study was conducted among 3935 patients presenting with acute upper respiratory illnesses in the ambulatory settings between 2012 and 2014. Results The VP4/VP2 gene was genotyped from all 976 RV-positive specimens, where the predominance of RV-A (49%) was observed, followed by RV-C (38%) and RV-B (13%). A significant regression in median nasopharyngeal viral load (VL) (P <.001) was observed, from 883 viral copies/μL at 1-2 days after symptom onset to 312 viral copies/μL at 3-4 days and 158 viral copies/μL at 5-7 days, before declining to 35 viral copies/μL at ≥8 days. In comparison with RV-A (median VL, 217 copies/μL) and RV-B (median VL, 275 copies/μL), RV-C-infected subjects produced higher VL (505 copies/μL; P <.001). Importantly, higher RV VL (median, 348 copies/μL) was associated with more severe respiratory symptoms (Total Symptom Severity Score ≥17, P =.017). A total of 83 phylogenetic-based transmission clusters were identified in the population. It was observed that the relative humidity was the strongest environmental predictor of RV seasonality in the tropical climate. Conclusions Our findings underline the role of VL in increasing disease severity attributed to RV-C infection, and unravel the factors that fuel the population transmission dynamics of RV. Oxford University Press 2018 Article PeerReviewed Ng, Kim Tien and Oong, Xiang Yong and Lim, Sin How and Chook, Jack Bee and Takebe, Yutaka and Chan, Yoke Fun and Chan, Kok Gan and Hanafi, Nik Sherina and Pang, Yong Kek and Kamarulzaman, Adeeba and Tee, Kok Keng (2018) Viral Load and Sequence Analysis Reveal the Symptom Severity, Diversity, and Transmission Clusters of Rhinovirus Infections. Clinical Infectious Diseases, 67 (2). pp. 261-268. ISSN 1058-4838 https://doi.org/10.1093/cid/ciy063 doi:10.1093/cid/ciy063
institution	Universiti Malaya
building	UM Library
collection	Institutional Repository
continent	Asia
country	Malaysia
content_provider	Universiti Malaya
content_source	UM Research Repository
url_provider	http://eprints.um.edu.my/
topic	R Medicine
spellingShingle	R Medicine Ng, Kim Tien Oong, Xiang Yong Lim, Sin How Chook, Jack Bee Takebe, Yutaka Chan, Yoke Fun Chan, Kok Gan Hanafi, Nik Sherina Pang, Yong Kek Kamarulzaman, Adeeba Tee, Kok Keng Viral Load and Sequence Analysis Reveal the Symptom Severity, Diversity, and Transmission Clusters of Rhinovirus Infections
description	Background Rhinovirus (RV) is one of the main viral etiologic agents of acute respiratory illnesses. Despite the heightened disease burden caused by RV, the viral factors that increase the severity of RV infection, the transmission pattern, and seasonality of RV infections remain unclear. Methods An observational study was conducted among 3935 patients presenting with acute upper respiratory illnesses in the ambulatory settings between 2012 and 2014. Results The VP4/VP2 gene was genotyped from all 976 RV-positive specimens, where the predominance of RV-A (49%) was observed, followed by RV-C (38%) and RV-B (13%). A significant regression in median nasopharyngeal viral load (VL) (P <.001) was observed, from 883 viral copies/μL at 1-2 days after symptom onset to 312 viral copies/μL at 3-4 days and 158 viral copies/μL at 5-7 days, before declining to 35 viral copies/μL at ≥8 days. In comparison with RV-A (median VL, 217 copies/μL) and RV-B (median VL, 275 copies/μL), RV-C-infected subjects produced higher VL (505 copies/μL; P <.001). Importantly, higher RV VL (median, 348 copies/μL) was associated with more severe respiratory symptoms (Total Symptom Severity Score ≥17, P =.017). A total of 83 phylogenetic-based transmission clusters were identified in the population. It was observed that the relative humidity was the strongest environmental predictor of RV seasonality in the tropical climate. Conclusions Our findings underline the role of VL in increasing disease severity attributed to RV-C infection, and unravel the factors that fuel the population transmission dynamics of RV.
format	Article
author	Ng, Kim Tien Oong, Xiang Yong Lim, Sin How Chook, Jack Bee Takebe, Yutaka Chan, Yoke Fun Chan, Kok Gan Hanafi, Nik Sherina Pang, Yong Kek Kamarulzaman, Adeeba Tee, Kok Keng
author_facet	Ng, Kim Tien Oong, Xiang Yong Lim, Sin How Chook, Jack Bee Takebe, Yutaka Chan, Yoke Fun Chan, Kok Gan Hanafi, Nik Sherina Pang, Yong Kek Kamarulzaman, Adeeba Tee, Kok Keng
author_sort	Ng, Kim Tien
title	Viral Load and Sequence Analysis Reveal the Symptom Severity, Diversity, and Transmission Clusters of Rhinovirus Infections
title_short	Viral Load and Sequence Analysis Reveal the Symptom Severity, Diversity, and Transmission Clusters of Rhinovirus Infections
title_full	Viral Load and Sequence Analysis Reveal the Symptom Severity, Diversity, and Transmission Clusters of Rhinovirus Infections
title_fullStr	Viral Load and Sequence Analysis Reveal the Symptom Severity, Diversity, and Transmission Clusters of Rhinovirus Infections
title_full_unstemmed	Viral Load and Sequence Analysis Reveal the Symptom Severity, Diversity, and Transmission Clusters of Rhinovirus Infections
title_sort	viral load and sequence analysis reveal the symptom severity, diversity, and transmission clusters of rhinovirus infections
publisher	Oxford University Press
publishDate	2018
url	http://eprints.um.edu.my/21142/ https://doi.org/10.1093/cid/ciy063
_version_	1643691478092873728
score	13.211869

Viral Load and Sequence Analysis Reveal the Symptom Severity, Diversity, and Transmission Clusters of Rhinovirus Infections

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