Funding outcome

Everyone has been infected by Respiratory Syncytial Virus (RSV) by the time they turn two. RSV is the greatest cause of hospitalization of infants worldwide. In North America, each year the RSV infection season begins in October and the last RSV infections are admitted to hospital in April. Despite the periodic nature of RSV seasons, the number of people infected in a season and the severity of their disease is variable. In fact, every hospital, even those in the same city, deal with the RSV season in different ways. There is one preventative measure that is called Palivizumab, but it is only reserved for the highest risk infants and we do not know how well it works. Ideally, seasonal viruses should have efficient public health monitoring to ensure hospitals are ready for the impact of changes in their ability to cause disease. RSV genomes are small and known to mutate quickly. With such rapid mutation, the severity and numbers of RSV infections can vary significantly each season depending on RSV evolution. These mutations lead to evasion of drugs such as Palivizumab. To date, there has not been wide-scale sequencing (genome identification) of viral isolates in Canada to determine where RSV in Canada originates, and whether there are signatures in RSV evolution that may help health care professionals prepare for the next season. Nor do we know how virus changes from mutation affect virus susceptibility to Palivizumab. Our project's strength is a unique collaboration with the Alberta Provincial Health Laboratories PROVlab and Nationwide Children's Hospital in Ohio that pairs powerful public health knowledge with our expertise as a virology and genome sequencing lab. Together this builds our RSV distinction of susceptibility to Palivizumab program in Alberta. From PROVLab and Nationwide, we acquire patient samples to determine the severity of the patient's RSV infection when they enter the hospital. We also determine the susceptibility of the patient's RSV to Palivizumab in the lab. By isolating the virus out of samples and then sequencing it, we can determine correlates of disease severity and drug susceptibility from infection of RSV as well as viral transmissibility of RSV throughout the community. We hypothesize that small mutations in the genome of the virus regulate its virulence and susceptibility to Palivizumab. By sequencing each virus, we can get a story about where it came from, how sick it will make high-risk infants, and how many people it will infect in that season.