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Genetic diversity and molecular epidemiology of human rhinoviruses in South Africa
Authors:Marthi A Pretorius  Stefano Tempia  Florette K Treurnicht  Sibongile Walaza  Adam L Cohen  Jocelyn Moyes  Orienka Hellferscee  Ebrahim Variava  Halima Dawood  Meera Chhagan  Sumayya Haffjee  Shabir A Madhi  Cheryl Cohen  Marietjie Venter
Institution:1. Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, , Johannesburg, South Africa;2. Department of Medical Virology, University of Pretoria, , Pretoria, South Africa;3. Influenza Division, Centers for Disease Control and Prevention, , Atlanta, GA, USA;4. Influenza Division, Centers for Disease Control and Prevention, , Pretoria, South Africa;5. Influenza Programme, Centers for Disease Control and Prevention–South Africa, , Pretoria, South Africa;6. Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, , Johannesburg, South Africa;7. Department of Medicine, Klerksdorp Tshepong Hospital, , Klerksdorp, South Africa;8. Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, , Johannesburg, South Africa;9. Department of Medicine, Pietermaritzburg Metropolitan Hospital, , Pietermaritzburg, South Africa;10. Department of Medicine, University of KwaZulu Natal, , Pietermaritzburg, South Africa;11. Department of Paediatrics, University of KwaZulu Natal, , Pietermaritzburg, South Africa;12. School of Pathology, University of KwaZulu Natal, , Pietermaritzburg, South Africa;13. Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, University of the Witwatersrand, , Johannesburg, South Africa;14. Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases, University of the Witwatersrand, , Johannesburg, South Africa;15. Global Disease Detection, Centres for Disease Control and Prevention, , Pretoria, South Africa
Abstract:

Background

Rhinoviruses (RV) are a well-established cause of respiratory illness. RV-C has been associated with more severe illness. We aimed to characterize and compare the clinical presentations and disease severity of different RV type circulating in South Africa.

Method

We performed two analyses of RV-positive specimens identified through surveillance in South Africa across all age groups. First, RV-positive specimens identified through severe acute respiratory illness (SARI) surveillance in four provinces was randomly selected from 2009 to 2010 for molecular characterization. Second, RV-positive specimens identified through SARI, influenza-like illness (ILI) and control surveillance at hospitals and outpatient clinics in during 2012–2013 were used to determine the association of RV type with severe disease. Selected specimens were sequenced, and phylogenetic analysis was performed.

Results

Among the 599 sequenced specimens from 2009 to 2010 and 2012 to 2013, RV-A (285, 48%) and RV-C (247, 41%) were more commonly identified than RV-B (67, 11%), with no seasonality and a high genetic diversity. A higher prevalence of RV infection was identified in cases with SARI 515/962 (26%); aRRR = 1·6; 95% CI 1·21; 2·2] and ILI 356/962 (28%); aRRR = 1·9; 95% CI 1·37; 2·6] compared with asymptomatic controls (91/962, 22%). There was no difference in disease severity between the different type when comparing SARI, ILI and controls.

Conclusion

All three type of RV were identified in South Africa, although RV-A and RV-C were more common than RV-B. RV was associated with symptomatic respiratory illness; however, there was no association between RV type and disease severity.
Keywords:Disease association  genetic diversity  rhinovirus  South Africa
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