Prospective Monitoring of RSV Helps Identify Mutations, Study Finds

Prospective monitoring of RSV can “identify the emergence of important mutations and clades,” according to a new study of Minnesota’s viral genomic surveillance program.

The Minnesota Department of Health (MDH) conducted “whole-genome sequencing of 575 respiratory specimens collected from hospitalized and nonhospitalized RSV patients at 11 state healthcare facilities from July 2023 to February 2024.” This sequencing “classified 287 (49.9%) genomes as subgroup A and 288 (50.1%) as subgroup B.”

Comparisons of “diagrams representing evolutionary relationships showed greater diversity among all RSV-A genomes than among RSV-B genomes.” They also showed that “32.3% of genomes were identical to at least one other genome, while 53% had one SNP. Twenty-three clusters of three or more genomes were identical, including 19.5% of all genomes.”

One clade of “eight RSV-B genomes had a mutation tied to resistance to the RSV monoclonal antibody nirsevimab (Beyfortus). The most recent common ancestor of this clade likely circulated in fall 2023.”

The authors explain that these findings show “the potential use of WGS for detection and investigation of RSV outbreaks at state or local levels. Our study also provided novel cross-referencing of viral genomic data against sentinel clinical surveillance of severe RSV infections.”