Surveillance of Respiratory Pathogens Among Rapid Diagnostic Test-Negative Acute Respiratory Infection Patients in Myanmar in 2023, with a Focus on Rhinovirus and Enterovirus Genotyping

Figures

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  Figure 1. Data procedures. During the study period, we collected samples from 582 patients, and after RDT, 267 patients with negative RDT results participated in the study. We used multiplex PCR to examine the samples of these patients with negative RDT results, and a total of 299 pathogen infections were detected, of which 160 were single-pathogen infections and 66 were multiple-pathogen infections. We analyzed the symptoms and basic information of patients with single-pathogen infection. For patients with multiple infections, we analyzed the types of pathogens co-infected with RVs/EVs. In addition, we found that among all infected people, the number of patients infected with RVs/EVs was the largest, so we further analyzed the samples of patients infected with RVs/EVs.

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  Figure 2. Epidemic curve of acute respiratory infections (ARIs) in Myanmar by month. We plotted the epidemic curve by month, which shows that the number of detected cases increased significantly from June, peaked in August, and then gradually decreased. RV/EV, RSV, and hMPV were most detected in August. Other pathogens, such as adenovirus, parainfluenza virus (types 1–4), Mycoplasma pneumoniae, and influenza A (H1N1) virus (pdm09), were also active from July to October.

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  Figure 3. Phylogenetic analysis of the partial VP4/VP2 gene of rhinovirus. We marked RV-A in red, RV-B in blue, RV-C in yellow, CV-B in green, and EV-D in gray. A phylogenetic tree was constructed based on the 102 RV/EV sample sequences tested in this study and reference sequences containing genotype information from around the world. The tree was generated using the neighbor-joining method, and branch support was determined using 1000 bootstrap iterations using MEGA software. The generated tree nodes are annotated with bootstrap values.