Human metapneumovirus in Singapore : epidemiology, fusion-attachment protein interaction and virus-like particle assembly

Human metapneumovirus was discovered in 2001. At the same time, it was also revealed that this virus had been circulating in the human population for at least 50 years. In the years that followed, an increasing number of research groups began to publish work on various aspects of HMPV. One of the main concerns was that this virus was detected in a significant proportion of children below the age of 3 years and caused respiratory symptoms very similar to its nearest related human pathogen: human respiratory syncytial virus. Before this study, there had been no large scale study on the prevalence of HMPV in Singapore. There was also no existing data on the presence of HBoV, HCoV and HRV in hospitalized children in Singapore. We screened five hundred clincial nasopharyngeal samples and found that these four respiratory viruses are present in significant proportions. This discovery will hopefully lead to more research interest in the area of respiratory pathogens in children.DOCTOR OF PHILOSOPHY (SBS

Air quality, meteorological variability and pediatric respiratory syncytial virus infections in Singapore

Abstract Respiratory syncytial virus (RSV) is an important cause of respiratory illness among children. While studies have focused on the air-quality and climate dependence of RSV infections, few have been undertaken in South-East Asia where the burden of respiratory illness is among the highest across the globe. This study aimed to determine the relationships between climatic factors and air quality with RSV infections among children in Singapore. We obtained all laboratory-confirmed reports of RSV infections in children below 5 years old from the largest public hospital specializing in pediatric healthcare in Singapore. We assessed the independent cumulative effects of air quality and meteorological factors on RSV infection risk using the Distributed Lag Non-Linear Model (DLNM) framework in negative binomial models adjusted for long-term trend, seasonality and changes in the diagnostic systems. We included 15,715 laboratory-confirmed RSV reports from 2009 to 2019. Daily maximum temperature exhibited a complex, non-linear association with RSV infections. Absolute humidity (Relative Risk, 90th percentile [RR90th percentile]: 1.170, 95% CI: [1.102, 1.242]) was positively associated with RSV risk. Higher levels of particulate matter of aerodynamic diameter of less than (i) 2.5 µm (PM2.5), (ii) 10 µm (PM10), carbon monoxide (CO) and sulfur dioxide (SO2) were associated with lower RSV infection risk. RSV infections exhibited both annual and within-year seasonality. Our findings suggest that falls in ambient temperature and rises in absolute humidity exacerbated pediatric RSV infection risk while increases in air pollutant concentrations were associated with lowered infection risk. These meteorological factors, together with the predictable seasonality of RSV infections, can inform the timing of mitigation measures aimed at reducing transmission

Human Metapneumovirus in Children, Singapore

Four hundred specimens were collected from pediatric patients hospitalized in Singapore; 21 of these specimens tested positive for human metapneumovirus (HMPV), with the A2 genotype predominating. A 5% infection rate was estimated, suggesting that HMPV is a significant cause of morbidity among the pediatric population of Singapore

Trends in respiratory virus infections during the COVID-19 pandemic in Singapore, 2020

The COVID-19 pandemic brought unprecedented challenges to the world. Many jurisdictions implemented control measures, such as border closures, lockdowns, school and business closures, travel restrictions, mask wearing, and social distancing. This was associated with changes in the prevalence of other respiratory viruses, predominantly influenza viruses1,2 but others as well.3 Singapore represents a unique setting that is credited with having a successful COVID-19 response. It went through different response phases, from prelockdown (pandemic level 3) to a full lockdown (known as circuit breaker), followed by a phased reopening, during which schools and businesses reopened but social distancing measures and universal mask wearing remained in place (eTable in the Supplement). Our aim in this study was to assess the associated changes in respiratory virus prevalence in 2020 compared with the prepandemic year 2019.Published versio