Viral aetiology of influenza-like illnesses and severe acute respiratory illnesses in Morocco, September 2014 to December 2016

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Background: There is a scarcity of information on the viral aetiology of influenza-like illness (ILI) and severe acute respiratory infection (SARI) among patients in Morocco. Methods: From September 2014 to December 2016, we prospectively enrolled inpatients and outpatients from all age groups meeting the World Health Organization (WHO) case definition for ILI and SARI from 59 sentinel sites. The specimens were tested using real-time monoplex reverse-transcription polymerase chain reaction method for detecting 16 relevant respiratory viruses. Results: At least one respiratory virus was detected in 1423 (70.8%) of 2009 specimens. Influenza viruses were the most common, detected in 612 (30.4%) of processed samples, followed by respiratory syncytial virus (RSV) in 359 (17.9%), human rhinovirus (HRV) in 263 (13.1%), adenovirus (HAdV) in 124 (6.2%), parainfluenza viruses (HPIV) in 107 (5.3%), coronaviruses (HCoV) in 94 (4.7%), human bocavirus (HBoV) in 92 (4.6%), and human metapneumovirus (HMPV) in 74 (3.7%). From 770 samples from children under 5 years old, RSV (288, 36.6%), influenza viruses (106, 13.8%), HRV (96, 12.5%) and HAdV (91, 11.8%) were most prevalent. Among 955 samples from adults, Influenza viruses (506, 53.0%), and HRV (167, 17.5%) were most often detected. Co-infections were found in 268 (18.8%) of 1423 positive specimens, and most (60.4%) were in children under 5 years of age. While influenza viruses, RSV, and HMPV had a defined period of circulation, the other viruses did not display clear seasonal patterns. Conclusions: We found that RSV was predominant among SARI cases in Morocco, particularly in children under 5 years of age. Our results are in line with reported data from other parts of the world, stating that RSV is the leading cause of lower respiratory tract infections in infants and young children.

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