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Journal of Clinical Microbiology, August 1998, p. 2289-2293, Vol. 36, No. 8
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Molecular Epidemiology of Two Consecutive Outbreaks of Parainfluenza 3 in a Bone Marrow Transplant Unit

Maria Zambon,1,* Tim Bull,2,dagger Carol J. Sadler,1 John M. Goldman,3 and Katherine N. Ward2

Enteric and Respiratory Virus Laboratory, Central Public Health Laboratory, London NW9 5HT,1 and Departments of Infectious Diseases2 and Haematology,3 Imperial College School of Medicine, London W12 0NN, United Kingdom

Received 18 February 1998/Returned for modification 17 April 1998/Accepted 20 May 1998

Two consecutive nosocomial outbreaks of parainfluenza 3, in which 5 of 15 infected patients died, occurred in an adult bone marrow transplant unit. Parainfluenza 3 strain variation was assessed by reverse transcription-PCR sequencing of part of the parainfluenza 3 F gene, including the noncoding region, directly from clinical samples. Sequence data from the outbreaks were compared with those from 15 other parainfluenza 3 isolates circulating concurrently in the community; altogether, 13 strains which fell into three lineages were identified. Four immunosuppressed patients shed virus persistently for between 1 and 4 months without change in sequence. The first outbreak lasted 4 months and involved three parainfluenza 3 strains, and one persistently infected patient was implicated as the source of infection for three others. The second outbreak lasted for 1 month but involved only one strain. These data indicate that introduction of community parainfluenza 3 strains to the bone marrow transplant unit was followed by person-to-person transmission within the unit rather than reintroduction of virus from the community.

* Corresponding author. Mailing address: Enteric and Respiratory Virus Laboratory, Central Public Health Laboratory, 61 Colindale Ave., London NW9 5HT, United Kingdom. Phone: 44 (0)181 200 4400, ext. 3239. Fax: 44 (0)181 200 1569. E-mail: mzambon{at}phls.co.uk.

dagger Present address: Department of Surgery, St. George's Hospital, London SW17, United Kingdom.

Journal of Clinical Microbiology, August 1998, p. 2289-2293, Vol. 36, No. 8
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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Antimicrob. Agents Chemother. Clin. Microbiol. Rev.
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Copyright © 1998 by the American Society for Microbiology. All rights reserved.