Skip to content
1887

Abstract

Influenza C virus (ICV) is a lesser known member of the family, primarily causing respiratory tract infections in children. Co-infection with WU polyomavirus (WUPyV), a recently identified human polyomavirus, has been rarely reported. This study presents the first laboratory-confirmed case of ICV infection in Sri Lanka and its co-infection with WUPyV.

Nasopharyngeal and oropharyngeal swabs were collected from children aged 3 months to 14 years with respiratory tract symptoms between November 2022 and February 2023. Samples were screened using multiplex real-time PCR (RT-PCR) and Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) RT-PCR. A nasopharyngeal swab from a 14-month-old infant showing an insignificant curve in respiratory PCR was subjected to whole-genome sequencing using the Illumina platform. Data were analysed for genomic characterization, and phylogenetic analysis was performed using the haemagglutinin-esterase gene of ICV.

Full-genome sequencing identified ICV and WUPyV in the sample. Phylogenetic analysis revealed that the ICV isolate belonged to the C/Sao Paulo lineage. The patient presented with mild symptoms, including fever, cough and cold, with normal inflammatory markers, and recovered with supportive care.

This case highlights the importance of considering ICV in paediatric respiratory illnesses, despite its under-diagnosis due to limited diagnostic tools. Unlike influenza A and B, ICV lacks neuraminidase, rendering neuraminidase inhibitors ineffective. The absence of ICV in current influenza vaccines further complicates preventive strategies. Co-detection of WUPyV raises questions about its role as a co-pathogen, with its clinical significance requiring further investigation.

This report underscores the need for enhanced molecular diagnostic techniques and surveillance to better understand the epidemiology and clinical impact of ICV and its co-infections.

Funding
This study was supported by the:
  • University of Peradeniya, Sri Lanka
    • Principal Award Recipient: I.De Silva
  • Health System Enhancement Project
    • Principal Award Recipient: T.K.G.SSumathipala
  • This is an open-access article distributed under the terms of the Creative Commons Attribution License.
Loading

Article metrics loading...

/content/journal/acmi/10.1099/acmi.0.000968.v3
2025-10-29
2025-11-10

Metrics

Loading full text...

Full text loading...

/deliver/fulltext/acmi/7/10/acmi000968.v3.html?itemId=/content/journal/acmi/10.1099/acmi.0.000968.v3&mimeType=html&fmt=ahah

References

  1. Mandell GL, Bennett JE, Dolin R. Mandell, Douglas and Bennett’s Principles and Practice of Infectious Diseases 2000
    [Google Scholar]
  2. Dykes AC, Cherry JD, Nolan CE. A clinical, epidemiologic, serologic, and virologic study of influenza c virus infection. JAMA Internal Medicine 1980; 140:1295–1298 [View Article]
    [Google Scholar]
  3. Calvo C, Garcia-Garcia ML, Centeno M, Perez-Brena P, Casas I. Influenza C virus infection in children, Spain. Emerg Infect Dis 2006; 12:1621–1622 [View Article]
    [Google Scholar]
  4. Camp JV, Redlberger-Fritz M. Increased cases of influenza C virus in children and adults in Austria, 2022. J Med Virol 2023; 95:e28201 [View Article] [PubMed]
    [Google Scholar]
  5. Lin R, Xing Z, Liu X, Chai Q, Xin Z et al. Performance of targeted next-generation sequencing in the detection of respiratory pathogens and antimicrobial resistance genes for children. J Med Microbiol 2023; 72:001771 [View Article] [PubMed]
    [Google Scholar]
  6. Sumathipala S, Bowatte A, Perera S, Rathnayaka D, De Silva I et al.Influenza c virus (c/Sri Lanka/68/2023) segment 1 polymerase PB2 (PB2) gene, complete cds GenBank 2024 http://www.ncbi.nlm.nih.gov/nuccore/PQ044620.1 accessed 6 December 2024
    [Google Scholar]
  7. Sumathipala S, Bowatte A, Perera S, Rathnayaka D, De Silva I et al.Influenza c virus (c/Sri Lanka/68/2023) segment 2 polymerase PB1 (PB1) gene, complete cds GenBank 2024 http://www.ncbi.nlm.nih.gov/nuccore/PQ044621.1 accessed 6 December 2024
    [Google Scholar]
  8. Sumathipala S, Bowatte A, Perera S, Rathnayaka D, De Silva I et al.Influenza c virus (c/Sri Lanka/68/2023) segment 3 polymerase P3 (P3) gene, complete cds GenBank 2024 http://www.ncbi.nlm.nih.gov/nuccore/PQ044622.1 accessed 6 December 2024
    [Google Scholar]
  9. Sumathipala S, Bowatte A, Perera S, Rathnayaka D, De Silva I et al.Influenza c virus (c/Sri Lanka/68/2023) segment 4 hemagglutinin-esterase (HE) gene, complete cds GenBank 2024 http://www.ncbi.nlm.nih.gov/nuccore/PQ044623.1 accessed 6 December 2024
    [Google Scholar]
  10. Sumathipala S, Bowatte A, Perera S, Rathnayaka D, De Silva I et al.Influenza c virus (c/Sri Lanka/68/2023) segment 5 nucleoprotein (NP) gene, complete cds GenBank 2024 http://www.ncbi.nlm.nih.gov/nuccore/PQ044624.1 accessed 6 December 2024
    [Google Scholar]
  11. Sumathipala S, Bowatte A, Perera S, Rathnayaka D, De Silva I et al.Influenza c virus (c/Sri Lanka/68/2023) segment 6 matrix protein 1 (M1) gene, complete cds; and CM2 protein (CM2) gene, partial cds GenBank 2024 http://www.ncbi.nlm.nih.gov/nuccore/PQ044625.1 accessed 6 December 2024
    [Google Scholar]
  12. Sumathipala S, Bowatte A, Perera S, Rathnayaka D, De Silva I et al.Influenza c virus (c/Sri Lanka/68/2023) segment 7 nonstructural protein 2 (NEP) and nonstructural protein 1 (NS1) genes, complete cds GenBank 2024 http://www.ncbi.nlm.nih.gov/nuccore/PQ044626.1 accessed 6 December 2024
    [Google Scholar]
  13. Sumathipala S, Bowatte A, Perera S, Rathnayake D, De Silva I et al.UNVERIFIED: WU polyomavirus isolate 01, complete genome GenBank 2024 http://www.ncbi.nlm.nih.gov/nuccore/PQ066767.1 accessed 7 December 2024
    [Google Scholar]
  14. Matsuzaki Y, Ikeda T, Abiko C, Aoki Y, Mizuta K et al. Detection and quantification of influenza C virus in pediatric respiratory specimens by real-time PCR and comparison with infectious viral counts. J Clin Virol 2012; 54:130–134 [View Article] [PubMed]
    [Google Scholar]
  15. Gouarin S, Vabret A, Dina J, Petitjean J, Brouard J et al. Study of influenza c virus infection in france. Journal of Medical Virology 2008; 80:1441–1446 [View Article]
    [Google Scholar]
  16. Katagiri S, Ohizumi A, Homma M. An Outbreak of Type C Influenza in a Children’s Home. Journal of Infectious Diseases 1983; 148:51–56 [View Article]
    [Google Scholar]
  17. Matsuzaki Y, Sugawara K, Furuse Y, Shimotai Y, Hongo S et al. Genetic Lineage and Reassortment of Influenza C Viruses Circulating between 1947 and 2014. J Virol 2016; 90:8251–8265 [View Article] [PubMed]
    [Google Scholar]
  18. Levinson W. Review of Medical Microbiology and Immunology McGraw-Hill Education; 2006
    [Google Scholar]
  19. Yamaoka M, Homma M, Hotta H. MDCK cell cultures supplemented with high concentrations of trypsin exhibit remarkable susceptibility to influenza C virus. Arch Virol 1995; 140:937–944 [View Article] [PubMed]
    [Google Scholar]
  20. Moriuchi H, Oshima T, Nishimura H, Nakamura K, Katsushima N et al. Human malignant melanoma cell line (HMV-II) for isolation of influenza C and parainfluenza viruses. J Clin Microbiol 1990; 28:1147–1150 [View Article] [PubMed]
    [Google Scholar]
  21. Babakir-Mina M, Ciccozzi M, Bonifacio D, Bergallo M, Costa C et al. Identification of the novel KI and WU polyomaviruses in human tonsils. J Clin Virol 2009; 46:75–79 [View Article] [PubMed]
    [Google Scholar]
  22. Kean JM, Rao S, Wang M, Garcea RL. Seroepidemiology of human polyomaviruses. PLOS Pathog 2009; 5:e1000363 [View Article] [PubMed]
    [Google Scholar]
  23. Babakir-Mina M, Ciccozzi M, Perno CF, Ciotti M. The human polyomaviruses KI and WU: virological background and clinical implications. APMIS 2013; 121:746–754 [View Article] [PubMed]
    [Google Scholar]
/content/journal/acmi/10.1099/acmi.0.000968.v3
Loading
/content/journal/acmi/10.1099/acmi.0.000968.v3
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An error occurred
Approval was partially successful, following selected items could not be processed due to error