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Volume 18, Number 1—January 2012
Dispatch

Molecular Evolution of Respiratory Syncytial Virus Fusion Gene, Canada, 2006–2010

Jesse Papenburg, Julie Carbonneau, Marie-Ève Hamelin, Sandra Isabel, Xavier Bouhy, Najwa Ohoumanne, Pierre Déry, Bosco A. Paes, Jacques Corbeil, Michel G. Bergeron, Gaston De Serres, and Guy BoivinComments to Author 
Author affiliations: McGill University Health Centre, Montréal, Québec, Canada (J. Papenburg); Centre de Recherche du Centre Hospitalier Universitaire de Québec, Québec City, Québec, Canada (J. Papenburg, J. Carbonneau, M.-È. Hamelin, S. Isabel, X. Bouhy, P. Déry, J. Corbeil, M.G. Bergeron, G. Boivin); Institut National de Santé Publique du Québec, Québec (N. Ohoumanne, G. De Serres); McMaster Children’s Hospital, Hamilton, Ontario, Canada (B.A. Paes)

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Table 2

Characteristics of 23 children in whom clinically significant respiratory syncytial virus respiratory tract infection developed while receiving palivizumab immunoprophylaxis, Canada, 2006–2010*

Location and patient ID Age, mo/ sex† GA at birth, wk + d Underlying
comorbidities No. doses PZB‡ Delay, d§ Clinical diagnoses H Multiplex PCR/DNA results Mutation
Québec City, Québec (2006–2010)
C0607-1023 9/F 32 + 4 Prematurity, LBW 3 21 Bronchiolitis No RSV-A;
enterovirus type A K272Q
H0607-064 24/M 38 + 3 Congenital myopathy 3 15 Pneumonia;
bronchospasm Yes RSV-B NF
H0607-132 12/M 38 + 5 Pulmonary artery stenosis 5 7 Bronchiolitis Yes RSV-A NF
H0708-199 4/M 30 + 4 Prematurity, VLBW 4 14 Bronchiolitis Yes RSV-B NF
H0809-037 11/F 27 + 5 Prematurity, ELBW 3 14 Bronchiolitis Yes RSV-A NF
C0809-1055 6/F 29 + 0 Prematurity, ELBW, triplet 4 27 Bronchiolitis No RSV-A N276S
C0809-1056 6/M 29 + 0 Prematurity, ELBW, triplet 4 27 Bronchiolitis No RSV-A N276S
C0809-1057 6/M 29 + 0 Prematurity, VLBW, triplet 4 27 Bronchiolitis No RSV-A N276S
H0910-004 4/F 39 + 5 Choanal hypoplasia 1 16 Apnea;
upper RTI Yes RSV-A N276S
H0910-140 6/M 25 + 5 Prematurity, ELBW 4 29 Bronchiolitis Yes RSV-B NF
H0910-144 13/F 26 + 5 Prematurity, VLBW 4 7 Pneumonia Yes RSV-A K272M, N276S
H0910-150 9/M 28 + 3 Prematurity, VLBW 4 12 Upper RTI;
acute otitis media Yes RSV-A;
adenovirus type C N276S
Montréal, Québec (2009–2010)
MCH0910-001 15/M 40 + 4 Total anomalous pulmonary venous return 3 26 Pneumonia Yes RSV¶ N276S
MCH0910-002 6/F 39 + 0 Pulmonary valve stenosis, right aortic arch 2 7 Bronchiolitis Yes RSV¶ N276S
MCH0910-003 5/M 39 + 6 Cystic fibrosis 3 24 Bronchiolitis No RSV¶ N276S
MCH0910-004 7/M 36 + 2 Prematurity, BPD hypotonia 4 6 Bronchiolitis Yes RSV¶ N276S
MCH0910-005 15/M 40 + 4 Neuromuscular disorder, recurrent aspirations 4 13 Upper RTI;
acute otitis media No RSV¶ N276S
MCH0910-006 2/M 34 + 6 Prematurity, LBW 1 14 Bronchiolitis Yes RSV¶ N276S
MCH0910-007 19/F 25 + 0 Prematurity, ELBW, BPD 3 19 Bronchiolitis, bronchospasm Yes RSV¶ N276S
MCH0910-008 2/F 38 + 1 Neuromuscular disorder, ventricular septal defect 2 12 Bronchiolitis Yes RSV¶ N276S
Hamilton, Ontario (2009–2010)
MAC0910-001 1/F 34 + 5 Prematurity, LBW 2 3 Bronchiolitis Yes RSV¶ N276S
MAC0910-002 6/F 34 + 3 Prematurity, LBW, twin 1 25 Bronchiolitis Yes RSV¶ N276S
MAC0910-003 6/F 34 + 3 Prematurity,
VLBW, IUGR, twin 1 27 Bronchiolitis Yes RSV¶ N276S

*Patient identification (ID) nomenclature: hospitalized (H) or clinic (C) prospective study participant, Montréal Children’s Hospital (MCH) or McMaster Children’s Hospital (MAC) patient. GA, gestational age; PZB, palivizumab; multiplex PCR/DNA, hybridization assay; mutation, mutation in respiratory syncytial virus fusion protein PZB binding site (residues 262–276); RSV, respiratory syncytial virus; LBW, low birthweight (1,500–2,500 g); NF, no mutation found in PZB binding site; VLBW, very low birthweight (1,000–1,499 g); ELBW, extremely low birthweight (<1,000 g); RTI, respiratory tract infection; BPD, bronchopulmonary dysplasia; IUGR, intrauterine growth restriction.
†Median patient age 6.0 mo (range 1–24 mo).
‡Mean ± SD no. palivizumab doses received that winter: 3.0 ± 1.2 doses.
§Median interval between last palivizumab dose and symptom onset: 15.0 d (range 3–27 d).
¶Retrospectively identified participants from Montréal Children’s Hospital or McMaster Children’s Hospital were RSV-positive by direct immunofluorescence assay (Chemicon International, Temecula, CA, USA) and were not tested by the multiplex PCR/DNA hybridization assay (14).

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