WU polyomavirus in children with acute lower respiratory tract infections, South Korea.In South Korea, WU polyomavirus (WUPyV) was detected in 34 (7%) of 486 children with acute lower respiratory tract infections, 3 (4.2%) of 72 asymptomatic children, and as coinfection with other respiratory viruses in 23 (67.6%) children. Although WUPyV was frequently detected, its clinical role has not been distinquished from that of coinfecting viruses.
The polyomaviruses JC virus and BK virus usually produce asymptomatic infections, but in immunocompromised immunocompromised /im·mu·no·com·pro·mised/ (-kom´pro-mizd) having the immune response attenuated by administration of immunosuppressive drugs, by irradiation, by malnutrition, or by certain disease processes (e.g., cancer). patients, they can become oncogenic oncogenic /on·co·gen·ic/ (-jen´ik) giving rise to tumors or causing tumor formation; said especially of tumor-inducing viruses.
on·co·gen·ic or on·cog·e·nous
adj. or induce disease (1-3). In 2007, new polyoma viruses such as WU polyomavirus (WUPyV) and KI polyomavirus (KIPyV) were identified in respiratory specimens from children with acute respiratory tract infections (4,5). Gaynor et al. (4) reported WUPyV prevalence of 3.0% in Australia and 0.6% in the United States. Allander et al. (5) reported 1.0% prevalence of KIPyV in nasopharyngeal nasopharyngeal
pertaining to the nasal and pharyngeal cavities.
see nasopharyngeal meatus.
see reverse sneeze. aspirates from children with mainly respiratory tract diseases. However, the clinical roles of WUPyV and KIPyV during acute respiratory tract infection needed to be clarified because of the high frequency of their codetection with other respiratory viruses (4,5). The purpose of our study was to determine prevalence of recently identified WUPyV and KIPyV in children who were asymptomatic and children who had acute lower respiratory tract infection.
At Sanggyepaik Hospital, Seoul, South Korea, from September 2006 through June 2007, nasopharyngeal aspirates were collected from 558 children <6 years of age: 486 were hospitalized with acute lower respiratory tract infection, and 72 were asymptomatic (those who visited the well-being clinic or were being admitted for elective surgery), informed consent was obtained from the children's parents, and the study was approved by the internal review board of Sanggyepaik Hospital.
Viral RNA RNA: see nucleic acid.
in full ribonucleic acid
One of the two main types of nucleic acid (the other being DNA), which functions in cellular protein synthesis in all living cells and replaces DNA as the carrier of genetic was extracted from each sample by using a QIAamp Viral RNA Mini Kit (QIAGEN GmbH, Hilden, Germany), and reverse transcription of 0.5 [micro]g of each RNA sample was performed. All nasopharyngeal aspirates from the study population were tested for common respiratory viruses such as human respiratory syncytial virus Human respiratory syncytial virus (RSV) is a negative-sense, single-stranded RNA virus of the family Paramyxoviridae, which includes common respiratory viruses such as those causing measles and mumps. (hRSV), influenza virus A and B, parainfluenza virus (PIV PIV Particle Image Velocimetry
PIV Personal Identity Verification (FIPS 201)
PIV Pentium 4
PIV Peak Inverse Voltage
PIV Personal Identification Verification
PIV Post Indicator Valve (firefighting) ), and adenovirus adenovirus
Any of a group of spheroidal viruses, made up of DNA wrapped in a protein coat, that cause sore throat and fever in humans, hepatitis in dogs, and several diseases in fowl, mice, cattle, pigs, and monkeys. by using multiplex reverse transcription--PCR (RT-PCR RT-PCR
reverse transcriptase-polymerase chain reaction. See PCR1. ) (6,7). The rest of each specimen was then frozen at -80[degrees]C until tested. RT-PCR assays were performed for rhinovirus rhinovirus
Any of a group of picornaviruses capable of causing common colds in humans. The virus is thought to be transmitted to the upper respiratory tract by airborne droplets. (RV), human metapneumovirus (hMPV), human coronavirus (hCoV)-NL63, hCoV-OC43, hCoV-229E, and hCoV HKU-1, as described (8-13). Positive and negative controls were included in each experiment.
DNA DNA: see nucleic acid.
or deoxyribonucleic acid
One of two types of nucleic acid (the other is RNA); a complex organic compound found in all living cells and many viruses. It is the chemical substance of genes. was extracted from the aspirates by using a QIAamp DNA Blood Mini Kit (QIAGEN GmbH). PCR PCR polymerase chain reaction.
polymerase chain reaction
Polymerase chain reaction (PCR) assays were performed to detect human bocavirus (hBoV) by using primers for the nonstructural-1 and nucleoprotein-1 genes, as described (14). To detect WUPyV, PCR was performed by using primers AG0044 (5'-TGT TAC 1. TAC - Translator Assembler-Compiler. For Philco 2000.
2. TAC - Terminal Access Controller. AAA AAA: see American Automobile Association.
(Triple A) A common single-cell battery used in a myriad of electronic devices of all variety. Like its double A (AA) cousin, it provides 1.5 volts of DC power. When used in series, the voltage is multiplied. TAG CTG CTG Cartridge
CTG Center for Technology in Government (SUNY, Albany, New York)
CTG Center for Technology in Government
CTG Computer Task Group (IT consulting company; Buffalo, NY, USA) CAG CAG 1 Chronic atrophic gastritis 2 Coronary angiography, see there GTC GTC
See: Good 'til cancelled order
See good-till-canceled order (GTC). AA-3') and AG0045 (5'-GCT GCA GCA, ground-controlled approach: see instrument-landing system. TAA TAA - Track Average Amplitude TGG GGA GTA CC-3'); confirmation was performed by using primers AG0048 (5'-TGT TTT TCA TCA
1. trichloroacetic acid.
2. tricarboxylic acid cycle (Krebs cycle).
TCA Tricyclic antidepressant, see there AGT AGT antiglobulin test. ATG ATG antithymocyte globulin.
lymphocyte immune globulin (antithymocyte globulin equine, ATG, ATG equine, LIG)
Pharmacologic class: Immunoglobulin
Therapeutic class: Immunosuppressant TTG CAT CC-3') and AG0049 (5'-CAC CCA AAA GAC ACT TAA AAG AAA-3'), as described (4). KIPyV was detected by nested PCR assays that used primers POLV P1-39F, POLVP1-363R, POLVP1-118F, and POLVP1-324R, as described (5). The plasmids containing major capsid capsid /cap·sid/ (kap´sid) the shell of protein that protects the nucleic acid of a virus; it is composed of structural units, or capsomers.
n. protein (VP)-I region of KIPyV and VP-2 region of WUPyV as positive control were donated by Tobias Allander and David Wang. All PCR products for WUPyV and KIPyV were sequenced to confirm the specificity for each virus. PCR product was examined after electrophoresis on a 1% agarose gel. Amplicon was purified and sequenced in both directions. Nucleotide sequences were aligned by using BioEdit version 7.0 (www. mbio.ncsu.edu/bioedit/bioedit.html) and presented in a topology tree, prepared in MEGA 3.1 (15). Using SAS (1) (SAS Institute Inc., Cary, NC, www.sas.com) A software company that specializes in data warehousing and decision support software based on the SAS System. Founded in 1976, SAS is one of the world's largest privately held software companies. See SAS System. software version 8.02 (SAS Institute, Inc., Cary, NC, USA), we performed the Fisher exact test to compare the proportion of symptomatic WUPyV patients with those who were in the control groups.
Of the 486 children who were hospitalized with acute respiratory tract infections, median age was 9 months (range 1-69 months); of the 72 asymptomatic children, median age was 14 months (range 1-77 months). The age distribution of patients with respiratory tract infections was 220 (45.3%) <12 months, 196 (40.3%) 12-23 months, and 70 (14.4%) 24-69 months. The male:female ratios of the symptomatic children (1.9:1) and asymptomatic children (1.7:1) did not differ significantly. The clinical diagnoses for the 486 symptomatic children were bronchiolitis Bronchiolitis Definition
Bronchiolitis is an acute viral infection of the small air passages of the lungs called the bronchioles.
Bronchiolitis is extremely common. for 250 children, pneumonia for 201, and croup croup (krp), acute obstructive laryngitis in young children, usually between the ages of three and six. for 35. Most children in both groups had no additional underlying medical conditions at the time of admission.
Viruses were detected in 407 (83.7%) of the 486 symptomatic children. The most frequently detected agents were hRSV in 101 (20.8%), RV in 91 (18.7%), hBoV in 51 (10.5%), PIV in 48 (9.8%), and hMPV in 34 (7.0%) (Table). WUPyV was found in 34 (7%) and KIPyV in 5 (1%) children in this group. A single virus infection with WUPyV was confirmed for 11 patients (2.2%) and KIPyV for 1 (0.2%). WUPyV was detected along with other viruses in 23 (67.6%) children.
In the asymptomatic group, KIPyV was not detected, but WUPyV was found in 3 (4.2%) children. Significant difference of prevalence between symptomatic and asymptomatic patients was not noted with WUPyV infection (p = 0.6) but was found with hBoV infection (p = 0.001). Most of the WUPyV infections were detected in May and June (Figure). The clinical symptoms of WUPyV infection in children were similar to those of other viral respiratory tract infections such as hRSV and hBoV. Gastrointestinal symptoms were found in 23.5% (8/34) of WUPyV-positive children. The 31 WUPyV strains detected in symptomatic children and 3 WUPyV strains in asymptomatic children, which were directly sequenced, clustered into 1 VP2 lineage (GenBank accession nos. EF639268-EF639288, EF655818-655825, and EU041602-041606). Our isolates showed 98%-100% nucleotide identity with the VP-2 region of the WUPyV reference strain (S1). Analysis of the KIPyV strains showed the same sequence with the VP1 region of the KIPyV strain (GenBank accession nos. EF639289, EF655826-655827, and EU041609-041610).
This prospective study shows that recently identified WUPyVs are prevalent in South Korean children with acute lower respiratory tract infections. Our detection of WUPyV in 34 (7.0%) of 486 children with acute lower respiratory tract infection suggests that the virus is prevalent in South Korea. Our finding of 27 (6.5%) WUPyV-positive samples among 416 patients <24 months of age compared with 7 (10%) positive samples from 70 patients >24 months of age suggests that WUPyV infection may occur more frequently in older children than in younger children; however, studies for latent infection of the virus are needed to confirm. Clinical diagnoses for patients with WUPyV-positive results only included bronchiolitis, tracheobronchitis, pneumonia, and croup. Coinfection of WUPyV with other respiratory viruses, especially hRSV, did not seem to influence the severity of disease, although we did not perform statistical analysis. Although our study tested for more viruses than previous studies and included a control group, whether detection of WUPyV in nasopharyngeal specimens means infection or just transmission in the respiratory tract remains unclear. We performed PCR assays for WUPyV in stool samples from 72 children who had acute gastroenteritis during the same study period, but it was not detected (data not shown).
Our study's limitations include small population size, short study period, lack of testing for bacterial pathogens, and limitation to hospitalized patients. Our finding of KPyV in 5 (1.0%) of 486 children who had respiratory symptoms and were mostly coinfected with other respiratory viruses is similar to that of a previous study (5). In conclusion, WUPyV was frequently found in South Korean children with acute lower respiratory tract infections, but further studies are needed to distinguish the clinical role of this virus from that of other coinfecting respiratory viruses.
This study was supported by the grant of Inje University, 2006.
Dr Hart is a researcher at the Inje University College of Medicine in Korea. His research interest is emerging infectious agents.
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Address for correspondence: Ju-Young Chung, Department of Pediatrics, Sanggyepaik Hospital, Inje University College of Medicine, 761-1 Nowon-Gu, Seoul, South Korea; email: email@example.com
Tae Hee Han, * Ju-Young Chung, * Ja Wook Koo, * Sang Woo Kim, * and Eung-Soo Hwang ([dagger])
* Inje University College of Medicine, Seoul, South Korea; and ([dagger]) Seoul National College of Medicine, Seoul, South Korea
Table. Detection of viruses among 486 children with acute lower respiratory tract infection, Seoul, South Korea * Virus No. positive (%) Single virus infection 407 (83.7) HRSV 101 (20.8) RV 91 (18.7) HBoV 51 (10.5) PIV ([dagger]) 48 (9.9) hMPV 34 (7.0) WUPyV 34 (7.0) AdV 22 (4.5) HCoV ([double dagger]) 15 (3.0) Influenza virus 6 (1.2) KIPyV 5 (1.0) Coinfection with polyomaviruses and 27 (5.5) other viruses WUPyV + hRSV 6 WuPyV + RV 5 WUPyV + PIV 5 WUPyV + hMPV 2 KIPyV + PIV 2 KIPyV + hCoV-NL63 1 KIPyV + RV 1 WUPyV + RV + PIV 2 WUPyV + hBoV + PIV 1 WUPyV + hRSV + hBoV 1 WUPyV + hCoV-NL63 + PIV 1 * HRSV, human respiratory syncytial virus; RV, rhinovirus; hBoV, human bocavirus; PIV, parainfluenzavirus; hMPV, human metapneumovirus; WUPyV, WU polyomavirus; AdV, adenovirus, HCoV, human coronavirus, KIPyV, KI polyomavirus. ([dagger]) PIV type 1 in 23 patients, PIV type 2 in 7, PIV type 3 in 10, and PIV type 4 in 8. ([double dagger]) hCoV-NL63 in 3 patients, hCoV-OC43 in 1, and hCoV-229E in 1.