Human respiratory syncytial virus subgroups A and B outbreak in a kindergarten in Zhejiang Province, China, 2023

Front Public Health. 2024 Feb 16:12:1368744. doi: 10.3389/fpubh.2024.1368744. eCollection 2024.

Abstract

Background: In May-June 2023, an unprecedented outbreak of human respiratory syncytial virus (HRSV) infections occurred in a kindergarten, Zhejiang Province, China. National, provincial, and local public health officials investigated the cause of the outbreak and instituted actions to control its spread.

Methods: We interviewed patients with the respiratory symptoms by questionnaire. Respiratory samples were screened for six respiratory pathogens by real-time quantitative polymerase chain reaction (RT-PCR). The confirmed cases were further sequenced of G gene to confirm the HRSV genotype. A phylogenetic tree was reconstructed by maximum likelihood method.

Results: Of the 103 children in the kindergarten, 45 were classified as suspected cases, and 25 cases were confirmed by RT-PCR. All confirmed cases were identified from half of classes. 36% (9/25) were admitted to hospital, none died. The attack rate was 53.19%. The median ages of suspected and confirmed cases were 32.7 months and 35.8 months, respectively. Nine of 27 confirmed cases lived in one community. Only two-family clusters among 88 household contacts were HRSV positive. A total of 18 of the G gene were obtained from the confirmed cases. Phylogenetic analyses revealed that 16 of the sequences belonged to the HRSV B/BA9 genotype, and the other 2 sequences belonged to the HRSV A/ON1 genotype. The school were closed on June 9 and the outbreak ended on June 15.

Conclusion: These findings suggest the need for an increased awareness of HRSV coinfections outbreak in the kindergarten, when HRSV resurges in the community after COVID-19 pandemic.

Keywords: HRSV genotype B; attack rate; family cluster; human respiratory syncytial virus (HRSV) genotype A; kindergarten; outbreak.

MeSH terms

  • Child
  • Child, Preschool
  • China / epidemiology
  • Disease Outbreaks
  • Humans
  • Pandemics
  • Phylogeny
  • Respiratory Syncytial Virus, Human* / genetics
  • Schools

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by Public Health Talent Training Program Sponsored by the National Bureau of Disease Control and Prevention, the Zhejiang Provincial Program for the Cultivation of High-Level Innovative Health Talents, which had no role in the study design, data collection, data analysis, data interpretation, writing of the report, or the decision to submit.