Increasing rhinovirus prevalence in paediatric intensive care patients since the SARS-CoV2 pandemic.

BACKGROUND: Rhinovirus (HRV) is a significant seasonal pathogen in children. The emergence of SARS-CoV2, and the social restrictions introduced in, disrupted viral epidemiology. Here we describe the experience of Great Ormond Street Hospital (GOSH), where HRV almost entirely disappeared from the paediatric intensive care units (PICU) during the first national lockdown and then rapidly re-emerged with a fast-increasing incidence, leading to concerns about possible nosocomial transmission in a vulnerable population. OBJECTIVES: To describe alterations in HRV infection amongst PICU patients at GOSH since the emergence of SARS-COV2 STUDY DESIGN: 10,950 nasopharyngeal aspirate viral PCR samples from GOSH PICU patients from 2019 to 2023 were included. 3083 returned a positive result for a respiratory virus, with 1530 samples positive for HRV. 66 HRV isolates from August 2020 - Jan 2021, the period of rapidly increasing HRV incidence, were sequenced. Electronic health record data was retrospectively collected for the same period. RESULTS: Following a reduction in the incidence of HRV infection during the first national lockdown, multiple genotypes of HRV emerged amongst GOSH PICU patients, with the incidence of HRV infection rapidly surging to levels higher than that seen prior to the emergence of SARS-CoV2 and continuing to circulate at increased incidence year-round. CONCLUSIONS: The incidence of HRV infection amongst GOSH PICU patients is markedly higher than prior to the emergence of SARS-CoV2, a pattern not seen in other respiratory viruses. The increased burden of HRV-infection in vulnerable PICU patients has both clinical and infection prevention and control Implications.

Favipiravir and Zanamivir Cleared Infection with Influenza B in a Severely Immunocompromised Child.

A combination of favipiravir and zanamivir successfully cleared influenza B infection in a child who had undergone bone marrow transplant for X-linked severe combined immunodeficiency, with no recovery of T lymphocytes. Deep sequencing of viral samples illuminated the within-host dynamics of infection, demonstrating the effectiveness of favipiravir in this case.

Evaluation of endocrine and immune responses of steers challenged with infectious bovine rhinotracheitis virus.

OBJECTIVE: To evaluate the endocrine and immune responses of steers challenged with infectious bovine rhinotracheitis virus (IBRV). ANIMALS: 12 crossbred beef steers. PROCEDURES: Steers were randomly assigned to IBRV- (control) or IBRV+ treatment groups. Experimentally challenged steers (IBRV+) received a dose of IBRV intranasally (8.0 50% tissue culture infective doses), IBRV- steers received a saline (0.9% NaCl) solution placebo intranasally, and each group was placed in an isolated paddock. At 72 hours after challenge, all steers were fitted with indwelling jugular catheters and placed into individual stanchions. Blood samples were collected on days 4 through 8. Serum was analyzed for concentrations of cortisol, interleukin-6, interferon-γ, tumor necrosis factor-α, growth hormone, and insulin-like growth factor I. RESULTS: From 72 to 144 hours after challenge inoculation, the IBRV+ group had significantly greater mean rectal temperature, compared with the IBRV- group; the greatest temperatures in both groups were observed at 72 hours. Serum cortisol concentrations were increased in both groups from hours 72 to 136 and serum interferon-γ concentrations were greater in the IBRV+ from 94 to 112 hours after inoculation. Growth hormone concentration was greater in the IBRV+ group at various time points, but no difference in insulin-like growth factor- I concentration was observed. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that IBVR challenge altered growth hormone concentration at some time points but was not associated with large increases in circulating proinflammatory cytokines.