Prevalence of Respiratory Syncytial Virus, Adenovirus and Rhinovirus in Patients with flu-like symptoms Admitted to Mazandaran Province Health Centers in north of Iran – a cross–sectional study

Background: The main viral causes of acute respiratory diseases (ARDs) include influenza viruses A and B, respiratory syncytial virus (RSV), adenovirus (ADV), rhinovirus, and parainfluenza viruses (PIV). This study aimed to investigate the prevalence of respiratory RSV, ADV and rhinovirus in patients with flu-like symptoms admitted to Mazandaran province health centers in north of Iran. Methods: This study was conducted in Mazandaran province from 21 December 2018 to 21 March 2019. The nasopharyngeal samples were collected from the patients with flu-like symptoms admitted to the health centers. ADV, RSV, influenza virus, and Human Rhinovirus (HRV) were detected by PCR and reverse-transcriptase PCR. Then, the products were visualized by gel electrophoresis on 1.5% agarose under UV light. Results: In the present study, 26 samples (26%) contained the ADV, while 9% and 5% of the samples were positive for RSV and HRV, respectively. Also, co-infection with influenza virus was identified in 12 patients, while 8 (66.66%) patients had a co-infection of influenza virus and ADV, simultaneously. Also, 2 (16.66%) co-infected patients infected by RSV and influenza virus, as well as the rate of HRV co-infection with influenza virus. There were no triple or more co-infections in this study. Moreover, one death was reported among the patients with co-infection of influenza virus and adenovirus, while other co-infected patients were cured. Conclusion: The findings will help public health officials and physicians to improve respiratory virus infection control strategies. Further molecular monitoring of respiratory viruses should be performed to investigate their epidemiological and clinical features.