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Preliminary Genomic Analysis of the RSV Surge 2022 in Massachusetts Reveals a Polyphyletic Epidemic Driven by the Expansion of Multiple Lineages - Virological

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  • Preliminary Genomic Analysis of the RSV Surge 2022 in Massachusetts Reveals a Polyphyletic Epidemic Driven by the Expansion of Multiple Lineages - Virological

    Dec 09 2022

    Introduction

    As reported by the United States (US) Center for Disease Prevention and Control, the US experienced an early and severe respiratory syncytial virus (RSV) surge in autumn 2022 (Figure 1). This increase in RSV cases relative to previous years, alongside coincident epidemics of SARS-CoV-2 and Influenza, has put intense pressure on hospitals and urgent care centers [1]; however, the factors promoting the surge in cases are unknown. A leading hypothesis suggests an increase in the susceptible population brought on by limited RSV circulation during COVID-19, particularly involving children ages one to three, who are among the most susceptible to severe RSV [2]. Alternatively, the emergence of a highly transmissible and/or virulent “variant” of RSV could account for the increase. These possibilities can be distinguished by genome sequencing of surge-associated samples because a highly-transmissible variant will appear as a cluster of closely-related sequences in a phylogenetic tree. To characterize the viral genomic basis of the 2022 RSV surge in Massachusetts (MA), we sequenced RSV genomes and analyzed clinical data from symptomatic patients who presented to the Massachusetts General Hospital (MGH), a large academic medical center in Boston, MA, and its affiliated outpatient practices in the Greater Boston Area.

    Results

    Metagenomic sequencing of 108 samples produced 63 partial or complete genomes for downstream analysis

    From early September to mid November 2022, MGH reported a surge in RSV cases, with a total of 950 RSV-positive samples (Table 1A). In the MGH dataset, the number of positive RSV cases peaked the week of October 29, 2022, much earlier than previous years, and subsequently fell, mirroring trends that occurred at the state and national level (Figure 1) [3]. This anomaly in timing and intensity of RSV circulation in 2022 has been noted on the global scale [4].

    To characterize the RSV population underlying the surge, we performed unbiased whole-genome sequencing of 108 residual diagnostic upper respiratory tract specimens collected in November 2022. ...

    Preliminary Genomic Analysis of the RSV Surge 2022 in Massachusetts Reveals a Polyphyletic Epidemic Driven by the Expansion of Multiple Lineages Introduction As reported by the United States (US) Center for Disease Prevention and Control, the US experienced an early and severe respiratory syncytial virus (RSV) surge in autumn 2022 (Figure 1). This increase in RSV cases relative to previous years, alongside coincident epidemics of SARS-CoV-2 and Influenza, has put intense pressure on hospitals ...
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