title: Detection of a divergent Parainfluenza 4 virus in an adult patient with influenza like illness using next-generation sequencing.
abstract: BACKGROUND
  Human Parainfluenza viruses are a common cause of both upper and lower respiratory tract infections, particularly in children. Of the four Parainfluenza virus serotypes, Parainfluenza 4 is least well characterised from both the clinical, epidemiological and genetic perspectives.
  
  
  METHODS
  Flocked nose or throat swabs from a previous study investigating viral prevalence in community-based adults suffering from influenza like illness were used as the basis for this study. Samples in which no virus was detected using a 16 viral respiratory pathogen real-time PCR panel were barcoded and pyrosequenced using the Roche 454 GS FLX Titanium chemistry. The sequences were analysed using the VirusHunter bioinformatic pipeline. Sanger sequencing was used to complete the detected Parainfluenza 4 coding region.
  
  
  RESULTS
  A variant Parainfluenza 4 subtype b strain (QLD-01) was discovered in an otherwise healthy adult who presented with influenza like illness. Strain QLD-01 shared genomic similarities with both a and b subtypes. The extent of divergence of this genome from the 5 available whole Parainfluenza 4 genomes impacted the predicted binding efficiencies of the majority of published Parainfluenza 4 PCR assays.
  
  
  CONCLUSIONS
  These findings further support a possible role for Parainfluenza 4 in the aetiology of adult respiratory disease within the community setting, and highlight the caution needed to be used in designing PCR assays from limited sequence information or in using proprietary commercial PCR assays.
authors.affiliation: Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Qld, Australia. seweryn@uq.edu.au.
authors.forename: Seweryn
authors.initials: S
authors.lastname: Bialasiewicz
authors.forename: Jodie
authors.initials: J
authors.lastname: McVernon
authors.forename: Terry
authors.initials: T
authors.lastname: Nolan
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Lambert
authors.forename: Guoyan
authors.initials: G
authors.lastname: Zhao
authors.forename: David
authors.initials: D
authors.lastname: Wang
authors.forename: Michael D
authors.initials: MD
authors.lastname: Nissen
authors.forename: Theo P
authors.initials: TP
authors.lastname: Sloots
mesh_terms: D016679:Genome, Viral; D059014:High-Throughput Nucleotide Sequencing; D006801:Humans; D008297:Male; D008875:Middle Aged; D016366:Open Reading Frames; D029482:Parainfluenza Virus 4, Human / Q000235:genetics*; D012141:Respiratory Tract Infections / Q000821:virology*; D019351:Rubulavirus Infections / Q000821:virology*