Molecular epidemiology of two consecutive outbreaks of parainfluenza 3 in a bone marrow transplant unit.
Two consecutive nosocomial outbreaks of parainfluenza 3, in which 5 of 15 infected patients died, occurred in an adult bone marrow transplant unit. Parainfluenza 3 strain variation was assessed by reverse transcription-PCR sequencing of part of the parainfluenza 3 F gene, including the noncoding region, directly from clinical samples. Sequence data from the outbreaks were compared with those from 15 other parainfluenza 3 isolates circulating concurrently in the community; altogether, 13 strains which fell into three lineages were identified. Four immunosuppressed patients shed virus persistently for between 1 and 4 months without change in sequence. The first outbreak lasted 4 months and involved three parainfluenza 3 strains, and one persistently infected patient was implicated as the source of infection for three others. The second outbreak lasted for 1 month but involved only one strain. These data indicate that introduction of community parainfluenza 3 strains to the bone marrow transplant unit was followed by person-to-person transmission within the unit rather than reintroduction of virus from the community.
Enteric and Respiratory Virus Laboratory, Central Public Health Laboratory, London, United Kingdom. mzambon@phls.co.uk
M
M
Zambon
T
T
Bull
C J
CJ
Sadler
J M
JM
Goldman
K N
KN
Ward
D000293:Adolescent; D000328:Adult; D001483:Base Sequence; D016026:Bone Marrow Transplantation; D003428:Cross Infection / Q000453:epidemiology* / Q000821:virology; D004196:Disease Outbreaks; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D008969:Molecular Sequence Data; D010224:Parainfluenza Virus 3, Human / Q000235:genetics* / Q000302:isolation & purification; D010802:Phylogeny; D016133:Polymerase Chain Reaction / Q000379:methods; D010253:Respirovirus Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D017422:Sequence Analysis, DNA; D006113:United Kingdom / Q000453:epidemiology; D014760:Viral Fusion Proteins / Q000235:genetics*
D014760:Viral Fusion Proteins