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. 2017 May 3;12(5):e0176298.
doi: 10.1371/journal.pone.0176298. eCollection 2017.

Prevalence of non-influenza respiratory viruses in acute respiratory infection cases in Mexico

Larissa Fernandes-Matano  1 , Irma Eloísa Monroy-Muñoz  2 , Javier Angeles-Martínez  3 , Brenda Sarquiz-Martinez  4 , Iliana Donají Palomec-Nava  4 , Hector Daniel Pardavé-Alejandre  4 , Andrea Santos Coy-Arechavaleta  4 , Clara Esperanza Santacruz-Tinoco  4 , Joaquín González-Ibarra  5 , Cesar Raúl González-Bonilla  5 , José Esteban Muñoz-Medina  4
Affiliations

Prevalence of non-influenza respiratory viruses in acute respiratory infection cases in Mexico

Larissa Fernandes-Matano et al. PLoS One. .

Abstract

Background: Acute respiratory infections are the leading cause of morbidity and mortality worldwide. Although a viral aetiological agent is estimated to be involved in up to 80% of cases, the majority of these agents have never been specifically identified. Since 2009, diagnostic and surveillance efforts for influenza virus have been applied worldwide. However, insufficient epidemiological information is available for the many other respiratory viruses that can cause Acute respiratory infections.

Methods: This study evaluated the presence of 14 non-influenza respiratory viruses in 872 pharyngeal exudate samples using RT-qPCR. All samples met the operational definition of a probable case of an influenza-like illness or severe acute respiratory infection and had a previous negative result for influenza by RT-qPCR.

Results: The presence of at least one non-influenza virus was observed in 312 samples (35.8%). The most frequent viruses were rhinovirus (RV; 33.0%), human respiratory syncytial virus (HRSV; 30.8%) and human metapneumovirus (HMPV; 10.6%). A total of 56 cases of co-infection (17.9%) caused by 2, 3, or 4 viruses were identified. Approximately 62.5% of all positive cases were in children under 9 years of age.

Conclusion: In this study, we identified 13 non-influenza respiratory viruses that could occur in any season of the year. This study provides evidence for the prevalence and seasonality of a wide range of respiratory viruses that circulate in Mexico and constitute a risk for the population. Additionally, our data suggest that including these tests more widely in the diagnostic algorithm for influenza may reduce the use of unnecessary antibiotics, reduce the hospitalisation time, and enrich national epidemiological data with respect to the infections caused by these viruses.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Demographic distribution of the analysed samples.
In this figure, the distribution of the analysed samples is shown as follows: in green the north zone, in red the middle zone, and in blue the south zone.
Fig 2
Fig 2. Virus co-infections in ARI cases.
The figure shows the distribution of the co-infections, the circle represents the universe of positive samples (N = 312), whereas the number of viruses involved in the co-infections is broken down in the rectangle (N = 56).
Fig 3
Fig 3. Proportion of positive cases by age group.
The figure shows the detection percentage of each of the 13 non-influenza respiratory viruses identified in this study by age group.
Fig 4
Fig 4. Seasonality of the non-influenza respiratory viruses.
Seasonality of the non-influenza respiratory viruses. (A). Analysis of means (ANOM) where it was determined that the month of November, highlighted with an asterisk, had a ratio of viral detection significantly higher than other months, falling outside the decision limits (UDL = 0.51; CL = 0.36; LDL = 0.20). (B) Seasonality of RV, HRSV, and HMPV are shown; (C) Seasonality of HMdV, HPIV3, and βCoV1 are shown; (D) Seasonality of EV, PBpV, and HPIV4 are shown; (E) HCoV 229E, HPIV1, and HCoV NL63 are shown. In B, C, D and E, the percentages represent the distribution of the monthly prevalence of each virus. HPIV2 and HCoV HKU1 were not graphed due to the insufficient numbers of positive samples.
See this image and copyright information in PMC

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