Respiratory Pathogen Panel

Our Panel identifies common viral and bacterial organisms associated with infection.

Adenovirus

Adenovirus

Adenoviruses (AdV) are a diverse group of non-enveloped DNA viruses with seven species (A to G). Adenovirus species B, C, and E primarily cause acute respiratory disease while species A, D, F and G can cause a variety of illnesses, including cystitis, gastroenteritis, and conjunctivitis. All adenovirus types have been associated with human disease3 and may be found in respiratory specimens. Outbreaks often occur in institutional settings such as military training, long-term care facilities, and pediatric tertiary-care hospitals, due to high rates of transmission in closed populations. Adenoviruses are shed for long periods of time and persist on surfaces in an infective state.

Coronavirus HKU1, NL63, 229E, OC43

Coronavirus HKU1, NL63, 229E, OC43

Human coronaviruses were established as respiratory pathogens in the 1960s and six serological variants associated with human disease have been characterized to date: 229E, OC43, HKU1, NL63, Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV), and Middle East Respiratory Syndrome Coronavirus (MERS-CoV; SARSCoV and MERS-CoV are not detected by the FilmArray RP2). These viruses are most commonly associated with upper respiratory tract infections; however, they have also been detected in individuals with lower respiratory tract infections. Coronaviruses have been associated with croup and exacerbation of asthma. Coronavirus infection occurs more often in the winter and there appears to be a periodicity of epidemics for some strains. Coronavirus infections (with the exception of SARS and MERS-CoV) are generally self-limiting.

Human Metapneumovirus

Human Metapneumovirus

Human Metapneumovirus (hMPV) is in the family Paramyxoviridae. HMPV was discovered in 2001 as a respiratory pathogen in children. Further studies confirmed hMPV infections in persons of all ages. The two genotypes, A and B, can circulate at the same time and do not appear to differ in the severity of illness. HMPV is the second leading cause of bronchiolitis in young children. Additionally, infection can result in a broad range of upper and lower respiratory symptoms: cough, rhinorrhea, wheeze, dyspnea, and fever. HMPV is estimated to be responsible for 5-7% of respiratory tract infections in children and 3% among individuals of all ages. The seasonal peak of hMPV is winter and early spring and often co-occurs with the seasonal peak of Respiratory Syncytial Virus (RSV).

Human Rhinovirus/Enterovirus

Human Rhinovirus/Enterovirus

Rhinoviruses (HRV) and Enteroviruses (EV) are related RNA viruses in the Picornaviridae family.29 There are more than 100 serotypes of human rhinovirus based on the serology of the capsid protein.29 Rhinovirus is noted as causing the “common cold”, but may also be involved in precipitating asthma attacks and severe complications. Enteroviruses are divided into four species that include a total of at least 89 distinct types. Individual types can be associated with different clinical manifestations, including nonspecific respiratory illnesses in infants or adults. Both rhinoviruses and enteroviruses are prevalent year round.

Influenza A, A/H1, A/H3, A/H1-2009, B

Influenza A, A/H1, A/H3, A/H1-2009, B

Influenza A and B (Flu A/B) are RNA viruses in the Orthomyxoviridae family. During annual influenza epidemics, 5-20% of the population is affected with respiratory tract infections with rapid onset of fever. The dominant type of influenza virus varies often due to antigenic drift and shift. Influenza A can be subtyped by the hemagglutinin (H) and neuraminidase (N) genes; influenza A subtypes H1N1 and H3N2 are the strains that most commonly infect humans. More severe disease and increased mortality are associated with H3N2 subtype. During the 2009-10 influenza season, influenza A (H1N1)pdm09 (H1- 2009,also known as ‘swine flu’) became the dominant circulating influenza virus, accounting for approximately 99% of reported influenza infections and has since replaced pre-2009 H1N1 strains. Currently, at least four antiviral medications are available for influenza treatment – amantadine, rimantadine, zanamivir and oseltamivir – with type-specific efficacy and drug resistance arising with the spread of new strains of the virus. Complications with viral or bacterial pneumonia increase mortality from influenza infections.

Parainfluenza Virus 1, 2, 3, 4

Parainfluenza Virus 1, 2, 3, 4

Parainfluenza Viruses (PIVs) are RNA viruses in the Paramyxoviridae family. In the 1950s, parainfluenza viruses were determined to be respiratory pathogens different from influenza viruses. Parainfluenza viruses are divided into four types (1-4). Parainfluenza virus 1 causes biennial epidemics in the fall, with 50% of croup cases attributed to this virus. Parainfluenza virus 2 causes epidemics every one to two years, which may alternate with parainfluenza virus 1 circulation. Children less than six months old are particularly susceptible to parainfluenza virus 3 infection, with outbreaks occurring in neonatal intensive care units. PIV3 is associated with the highest mortality and morbidity of all strains and epidemics are most common in the spring and summer. Parainfluenza virus 4 infection affects all age groups but because of infrequent detection periodicity of infection has not been established.

Respiratory Syncytial Virus

Respiratory Syncytial Virus

Respiratory Syncytial Virus (RSV) is a member of the RNA viruses in the Paramyxoviridae family, related to human metapneumoviruses and parainfluenza viruses. RSV has two major subtypes (A and B), which vary annually in their prevalence.26 RSV is the most common cause of severe respiratory disease in infants, with acute bronchiolitis as the major cause of hospitalization. RSV is now also recognized as an important pathogen in adults, although adult infections are in general less severe and limited to the upper respiratory tract. Peak activity of RSV is typically in January and February.

Bordetella Parapertussis/Pertussis

Bordetella Parapertussis/Pertussis

Bordetella pertussis, a gram-negative bacterium, is the predominant causative agent of whooping cough or pertussis, a vaccine-preventable, highly infectious disease that is reportable to public health organizations. Pertussis occurs most commonly in children but also occurs in adolescents and adults and outbreaks have been documented in fully vaccinated populations due to waning immunity (immunity has been shown to decrease 5-10 years after vaccination). Early (catarrhal) pertussis disease is non-specific, and classic signs of pertussis (paroxysmal coughing, inspiratory ‘whoop’, posttussive emesis, as well as apnea or cyanosis in infants) do not arise until approximately two weeks after the initial onset of symptoms. Bordetella parapertussis is known to cause a milder pertussis-like disease. No peak season has been defined for Bordetella infections.

Chlamydia Pneumoniae

Chlamydia Pneumoniae

Chlamydia pneumoniae (previously known as Chlamydophila pneumoniae) is an obligate intracellular bacterium that causes acute respiratory infections and is a common cause of community-acquired atypical (walking) pneumonia and bronchitis. C. pneumoniae has an incubation period of approximately three weeks and can be transmitted from asymptomatic carriers. Outbreaks occur in schools, military barracks, and nursing homes.40 No peak season has been identified for C. pneumoniae infections.

Mycoplasma Pneumoniae

Mycoplasma Pneumoniae

Mycoplasma pneumoniae is another bacterial agent of community-acquired atypical pneumonia, occurring frequently in outbreak situations. Incubation time for M. pneumoniae infection is approximately 1 to 4 weeks. M. pneumoniae respiratory disease does not have a defined season of highest incidence but epidemics have a periodicity of 3-7 years.

References : Wikipedia and Cirilliant