Circulation of other respiratory viruses and viral co-infection during the 2009 pandemic influenza

Navarro-Marí, José María; Pérez-Ruiz, Mercedes; Galán Montemayor, Juan Carlos; Marcos Maeso, María Ángeles; Reina, Jordi; de Oña Navarro, María; Cilla Eguiluz, Carlos Gustavo

doi:10.1016/S0213-005X(12)70101-5

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Abstract

Coinciding with the pandemic wave of the influenza A(H1N1)pdm09 virus, other respiratory viruses have co-circulated in our area and were responsible for many acute respiratory infections and influenza-like illness (ILI). Apart from the pandemic virus that was responsible for most ILI cases, incidence rates of other viruses have varied among geographical areas. In general, human rhinovirus was the most frequent among individuals from the community, and respiratory syncytial virus among hospitalized patients. Detection rates of other respiratory viruses such as human metapneumovirus, adenovirus or parainfluenza viruses have been much lower. On the basis of an interference mechanism, human rhinovirus may contribute to modulate the pandemic wave, although available data are not conclusive to support this hypothesis. In contrast, the epidemic wave of respiratory syncytial virus during 2009–2010 was similar to previous seasons. Overall, incidence rates of respiratory viruses other than influenza did not change significantly during the pandemic season compared to other seasons. No association has been found between coinfection of pandemic influenza and other respiratory viruses with the prognosis of patients with influenza. The involvement of clinical virology laboratories in the etiological diagnosis of ILI cases has improved and has optimized diagnostic procedures.

Keywords:

Co-infection

Influenza-like illness

Pandemic influenza

Resumen

Coincidiendo con la onda pandémica 2009 por el virus de la gripe A(H1N1)pdm09, otros virus respiratorios han circulado en nuestro medio, provocando numerosos casos de infección respiratoria aguda y de síndrome gripal (ILI, influenza-like illness). Aparte del virus pandémico, que fue responsable de la mayoría de los casos de ILI, la incidencia de otros virus ha sido diferente según la zona. En general, rinovirus fue el virus más frecuente en la comunidad y virus respiratorio sincitial en pacientes hospitalizados. Las tasas de detección de otros virus como metaneumovirus humano, adenovirus o virus parainfluenza han sido mucho menores. Sobre la base de un mecanismo de interferencia, la presencia de rinovirus pudo contribuir a modular la onda pandémica de gripe, aunque los datos existentes no apoyan esta hipótesis de modo concluyente, mientras que la onda de virus respiratorio sincitial en 2009–2010 se ha presentado de forma similar a otros años. En conjunto, la incidencia de los distintos virus respiratorios de gripe no varió significativamente durante la temporada de la pandemia con respecto a otros años. Por otro lado, no se ha asociado la coinfección por virus de la gripe con otros virus respiratorios con el pronóstico de los pacientes con gripe. La implicación de los laboratorios de virología clínica en el diagnóstico de ILI ha supuesto una mejora y una mayor optimización en los procedimientos diagnósticos.

Palabras clave:

Coinfección

Síndrome gripal

Gripe pandémica

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