Summer outbreak of severe RSV-B disease, Minnesota, 2017 associated with emergence of a genetically distinct viral lineage

Beth K Thielen, Erica Bye, Xiong Wang, Stacene Maroushek, Hannah Friedlander, Sarah Bistodeau, Jaime Christensen, Erik Reisdorf, Meghan H Shilts, Karen Martin, Kathryn Como-Sabetti, Anna K Strain, Patricia Ferrieri, Ruth Lynfield

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


BACKGROUND: Respiratory syncytial virus (RSV) typically causes winter outbreaks in temperate climates. During summer 2017, the Minnesota Department of Health (MDH) received a report of an increased cases of severe RSV-B infection.

METHODS: We compared characteristics of summer 2017 cases with those from the surrounding 4 summers (2014-2018). To understand the genetic relatedness among viruses, we performed high-throughput sequencing of RSV from patients with a spectrum of illness from multiple clinical sites in Minnesota and Wisconsin.

RESULTS: From May-Sept. 2017, 58 cases of RSV (43 RSV-B) were reported compared to 20-29 cases (3-7 RSV-B) during the same time frame in other years. The median age and frequency of co-morbidities was similar, but 55% (24/43) were admitted to the ICU in 2017 compared to 12% in preceding 3 years (OR: 4.84, p<0.01). Sequencing was performed on 137 specimens from March 2016-March 2018. Outbreak cases formed a unique clade sharing a single conserved non-synonymous change in the SH gene. We observed increased cases during the following winter season, during which time the new lineage was the predominant circulating strain.

CONCLUSIONS: We identified an outbreak of severe RSV-B disease associated with a new genetic lineage among urban Minnesota children during a time of expected low RSV circulation.

Original languageEnglish (US)
Pages (from-to)288-297
Number of pages10
JournalThe Journal of infectious diseases
Issue number2
Early online dateFeb 20 2020
StatePublished - Jun 29 2020

Bibliographical note

Funding Information:
Financial support. This work was supported by the Centers for Disease Control and Prevention (grant number CDC-RFA-CK17-170102CONT18 cooperative agreement to the Emerging Infections Program); and the National Institutes of Health (grant number T32 5T32AI055433-14 to B. K. T.).

Publisher Copyright:
© The Author(s) 2020.


  • molecular epidemiology
  • respiratory infections
  • respiratory syncytial virus
  • viral next-generation sequencing
  • viral pathogenesis

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.


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