Article: Human parainfluenza virus 4 outbreak and the role of diagnostic tests

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TitleHuman parainfluenza virus 4 outbreak and the role of diagnostic tests
AuthorsLau, SKP1
To, WK3
Tse, PWT3
Chan, AKH3
Woo, PCY1
Tsoi, HW1
Leung, AFY3
Li, KSM1
Chan, PKS4
Lim, WWL2
Yung, RWH2
Chan, KH1
Yuen, KY1
Issue Date2005
PublisherAmerican Society for Microbiology.
CitationJournal Of Clinical Microbiology, 2005, v. 43 n. 9, p. 4515-4521 [How to Cite?]
DOI: http://dx.doi.org/10.1128/JCM.43.9.4515-4521.2005
AbstractOwing to the difficulties in isolating the virus and the lack of routine surveillance, the clinical significance of human parainfluenza virus 4 (HPIV-4) is less well defined than that of the other human parainfluenza viruses. We describe the first outbreak of HPIV-4 infection in a developmental disabilities unit, involving 38 institutionalized children and three staff members, during a 3-week period in autumn 2004. Most subjects had upper respiratory tract infections (URTI), while lower respiratory tract infections (LRTI) occurred in three children (7%), one complicated by respiratory failure requiring ventilation support. All patients recovered. Nasopharyngeal aspirates tested for HPIV-4 were positive by reverse transcriptase PCR (RT-PCR) in all 41 cases (100%), by direct immunofluorescence in 29 of 39 tested cases (74%), and by cell cultures in 6 of 37 cases (16%), and serum was positive for antibodies against HPIV-4 in all 35 cases (100%) with serum samples available. In addition, RT-PCR detected HPIV-4 in four children (three LRTI and one URTI) out of 115 patients with community-acquired respiratory tract infection. Molecular analysis of the 1,198-bp phosphoprotein sequences showed that HPIV-4 isolates among the cases were genetically similar, whereas the community controls were more genetically distant, supporting nosocomial transmission of a single HPIV-4 genotype during the outbreak. Moreover, the HPIV-4 causing the outbreak is more closely related to HPIV-4A than HPIV-4B. HPIV-4 may be an important cause of more severe respiratory illness in children. The present RT-PCR assay is a sensitive, specific, and rapid method for the diagnosing HPIV-4 infection. To better define the epidemiology and clinical spectrum of disease of HPIV-4 infections, HPIV-4 should be included in the routine panels of respiratory virus detection on respiratory specimens. Copyright © 2005, American Society for Microbiology. All Rights Reserved.
ISSN0095-1137
2011 Impact Factor: 4.153
2011 SCImago Journal Rankings: 0.397
DOIhttp://dx.doi.org/10.1128/JCM.43.9.4515-4521.2005
ISI Accession Number IDWOS:000232020400031
PubMed Central IDPMC1234116
ReferencesReferences in Scopus
DC Field
Value
dc.contributor.authorLau, SKP
dc.contributor.authorTo, WK
dc.contributor.authorTse, PWT
dc.contributor.authorChan, AKH
dc.contributor.authorWoo, PCY
dc.contributor.authorTsoi, HW
dc.contributor.authorLeung, AFY
dc.contributor.authorLi, KSM
dc.contributor.authorChan, PKS
dc.contributor.authorLim, WWL
dc.contributor.authorYung, RWH
dc.contributor.authorChan, KH
dc.contributor.authorYuen, KY
dc.date.accessioned2008-06-12T06:36:00Z
dc.date.available2008-06-12T06:36:00Z
dc.date.issued2005
dc.description.abstractOwing to the difficulties in isolating the virus and the lack of routine surveillance, the clinical significance of human parainfluenza virus 4 (HPIV-4) is less well defined than that of the other human parainfluenza viruses. We describe the first outbreak of HPIV-4 infection in a developmental disabilities unit, involving 38 institutionalized children and three staff members, during a 3-week period in autumn 2004. Most subjects had upper respiratory tract infections (URTI), while lower respiratory tract infections (LRTI) occurred in three children (7%), one complicated by respiratory failure requiring ventilation support. All patients recovered. Nasopharyngeal aspirates tested for HPIV-4 were positive by reverse transcriptase PCR (RT-PCR) in all 41 cases (100%), by direct immunofluorescence in 29 of 39 tested cases (74%), and by cell cultures in 6 of 37 cases (16%), and serum was positive for antibodies against HPIV-4 in all 35 cases (100%) with serum samples available. In addition, RT-PCR detected HPIV-4 in four children (three LRTI and one URTI) out of 115 patients with community-acquired respiratory tract infection. Molecular analysis of the 1,198-bp phosphoprotein sequences showed that HPIV-4 isolates among the cases were genetically similar, whereas the community controls were more genetically distant, supporting nosocomial transmission of a single HPIV-4 genotype during the outbreak. Moreover, the HPIV-4 causing the outbreak is more closely related to HPIV-4A than HPIV-4B. HPIV-4 may be an important cause of more severe respiratory illness in children. The present RT-PCR assay is a sensitive, specific, and rapid method for the diagnosing HPIV-4 infection. To better define the epidemiology and clinical spectrum of disease of HPIV-4 infections, HPIV-4 should be included in the routine panels of respiratory virus detection on respiratory specimens. Copyright © 2005, American Society for Microbiology. All Rights Reserved.
dc.description.naturepublished_or_final_version
dc.format.extent388 bytes
dc.format.mimetypetext/html
dc.identifier.citationJournal Of Clinical Microbiology, 2005, v. 43 n. 9, p. 4515-4521 [How to Cite?]
DOI: http://dx.doi.org/10.1128/JCM.43.9.4515-4521.2005
dc.identifier.doihttp://dx.doi.org/10.1128/JCM.43.9.4515-4521.2005
dc.identifier.epage4521
dc.identifier.hkuros114674
dc.identifier.isiWOS:000232020400031
dc.identifier.issn0095-1137
2011 Impact Factor: 4.153
2011 SCImago Journal Rankings: 0.397
dc.identifier.issue9
dc.identifier.openurl
dc.identifier.pmcidPMC1234116
dc.identifier.pmid16145100
dc.identifier.scopuseid_2-s2.0-24744440562
dc.identifier.spage4515
dc.identifier.urihttp://hdl.handle.net/10722/49171
dc.identifier.volume43
dc.languageeng
dc.publisherAmerican Society for Microbiology.
dc.publisher.placeUnited States
dc.relation.ispartofJournal of Clinical Microbiology
dc.relation.referencesReferences in Scopus
dc.rightsJournal of Clinical Microbiology. Copyright © American Society for Microbiology.
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License
dc.rightsCopyright © American Society for Microbiology, Journal of Clinical Microbiology, 2005, v. 43 n. 9, p. 4515-4521
dc.subject.meshCross Infection - diagnosis - epidemiology - virology
dc.subject.meshDisease Outbreaks
dc.subject.meshParainfluenza Virus 4, Human - classification - genetics - isolation & purification
dc.subject.meshRubulavirus Infections - diagnosis - epidemiology - virology
dc.subject.meshAntibodies, Viral - blood
dc.titleHuman parainfluenza virus 4 outbreak and the role of diagnostic tests
dc.typeArticle
Author Affiliations
  1. The University of Hong Kong
  2. Centre for Health Protection
  3. Caritas Medical Centre Hong Kong
  4. Chinese University of Hong Kong