Viral etiology, seasonality and severity of hospitalized patients with severe acute respiratory infections in the Eastern Mediterranean Region, 2007–2014

Abstract

IntroductionLittle is known about the role of viral respiratory pathogens in the etiology, seasonality or severity of severe acute respiratory infections (SARI) in the Eastern Mediterranean Region.MethodsSentinel surveillance for SARI was conducted from December 2007 through February 2014 at 20 hospitals in Egypt, Jordan, Oman, Qatar and Yemen. Nasopharyngeal and oropharyngeal swabs were collected from hospitalized patients meeting SARI case definitions and were analyzed for infection with influenza, respiratory syncytial virus (RSV), adenovirus (AdV), human metapneumovirus (hMPV) and human parainfluenza virus types 1–3 (hPIV1-3). We analyzed surveillance data to calculate positivity rates for viral respiratory pathogens, describe the seasonality of those pathogens and determine which pathogens were responsible for more severe outcomes requiring ventilation and/or intensive care and/or resulting in death.ResultsAt least one viral respiratory pathogen was detected in 8,753/28,508 (30.7%) samples tested for at least one pathogen and 3,497/9,315 (37.5%) of samples tested for all pathogens–influenza in 3,345/28,438 (11.8%), RSV in 3,942/24,503 (16.1%), AdV in 923/9,402 (9.8%), hMPV in 617/9,384 (6.6%), hPIV1 in 159/9,402 (1.7%), hPIV2 in 85/9,402 (0.9%) and hPIV3 in 365/9,402 (3.9%). Multiple pathogens were identified in 501/9,316 (5.4%) participants tested for all pathogens. Monthly variation, indicating seasonal differences in levels of infection, was observed for all pathogens. Participants with hMPV infections and participants less than five years of age were significantly less likely than participants not infected with hMPV and those older than five years of age, respectively, to experience a severe outcome, while participants with a pre-existing chronic disease were at increased risk of a severe outcome, compared to those with no reported pre-existing chronic disease.ConclusionsViral respiratory pathogens are common among SARI patients in the Eastern Mediterranean Region. Ongoing surveillance is important to monitor changes in the etiology, seasonality and severity of pathogens of interest.

Epidemiology of severe cases of influenza and other acute respiratory infections in the Eastern Mediterranean Region, July 2016 to June 2018

“…Moreover, the influenza A subtypes varied by time; influenza A(H3N2) circulated predominantly in influenza season 2016/17, whereas influenza A(H1N1)pdm09 was predominant in the influenza season 2017/18. The trends in influenza viruses observed in our study are similar to those described in a previous study in the Region [18].…”

Human metapneumovirus in paediatric intensive care unit (PICU) admissions in the United Kingdom (UK) 2006–2014

“…It is also clear that HMPV has a seasonal variation in its incidence with a 'peak season' occurring between November and May, with the maximal incidence occurring in April. Similar seasonal patterns have been shown by other studies in the northern hemisphere, with the season being noted to range from November through to May, with peaks occurring between February to April [8,[19][20][21][22]. Interestingly we found few cases in January despite there being more cases in the months either side.…”

Detection of Viruses and <i>Mycoplasma pneumoniae</i> in Hospitalized Patients with Severe Acute Respiratory Infection in Northern China, 2015–2016

“…RSV (8.68 ) was the most frequently detected virus in 2015, which was in agreement with reports from southern and eastern China (19,20) and an eastern Mediterranean region (21). However, the most commonly identified virus in 2016 was influenza, similar to another report (22), but different from a report that found HRV to be the most common respiratory virus (23).…”