title: Respiratory syncytial virus genotypes and disease severity among children in hospital.
abstract: OBJECTIVE
  To determine the spectrum of N and G genotypes of respiratory syncytial virus (RSV) causing respiratory tract infection and whether particular genotypes are associated with severity of infection.
  
  
  METHODS
  Nasopharyngeal aspirates (NPAs) were obtained from 114 infants with acute respiratory tract infection due to RSV over two seasons. Viral mRNA was extracted from NPAs or cultured virus, reverse transcribed, and the cDNA amplified by the polymerase chain reaction using primers directed to parts of the N and G gene respectively. Amplicons were separately digested with four different restriction endonucleases for each gene. The fragments were separated by agarose gel, electrophoresis, and the electrophoretic patterns used to assign the various genotypes. Disease severity was assessed as very mild (upper respiratory tract signs only), mild (coryza and signs of lower respiratory tract infection), moderate (requiring nasogastric or intravenous fluids), and severe (requiring oxygen or ventilation).
  
  
  RESULTS
  Five of the six known N genotypes were detected, but NP4 and NP2 were found most frequently. There was no association between N genotype and disease severity. Six G (SHL) genotypes were detected. Significantly (p = 0.04) more of the infants infected with the SHL2 genotype had severe or moderate disease.
  
  
  CONCLUSIONS
  During the seasonal peaks of RSV respiratory tract infection at least 10 different RSV genotypes cocirculated. While there is no association between N genotypes and disease severity, infection with the SHL2 G genotype appears to result in moderate to severe disease.
authors.affiliation: Department of Medical Microbiology and Genito-Urinary Medicine, University of Liverpool.
authors.forename: J N
authors.initials: JN
authors.lastname: Fletcher
authors.forename: R L
authors.initials: RL
authors.lastname: Smyth
authors.forename: H M
authors.initials: HM
authors.lastname: Thomas
authors.forename: D
authors.initials: D
authors.lastname: Ashby
authors.forename: C A
authors.initials: CA
authors.lastname: Hart
mesh_terms: D000208:Acute Disease; D004587:Electrophoresis, Agar Gel; D005838:Genotype; D006760:Hospitalization; D006801:Humans; D007223:Infant; D009305:Nasopharynx / Q000821:virology; D016133:Polymerase Chain Reaction; D012333:RNA, Messenger / Q000032:analysis*; D012367:RNA, Viral / Q000032:analysis*; D018357:Respiratory Syncytial Virus Infections / Q000821:virology*; D018113:Respiratory Syncytial Virus, Human / Q000235:genetics*
chemical_list: D012333:RNA, Messenger; D012367:RNA, Viral