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. 2023 Apr;29(4):865–868. doi: 10.3201/eid2904.221834

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Emerging Infectious Diseases is a publication of the U.S. Government. This publication is in the public domain and is therefore without copyright. All text from this work may be reprinted freely. Use of these materials should be properly cited.

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Molecular epidemiology and genomic characterization of RSV during 2021–22 and 2022–23 outbreaks, Washington, USA. A) Number of patients positive for RSV-A and RSV-B during 2021–22 and 2022–23 outbreaks. Graph shows 5-week averages of RSV-positive cases in Washington detected by PCR; data were taken from The National Respiratory and Enteric Virus Surveillance System (https://www.cdc.gov/surveillance/nrevss/index.html) through December 7, 2022. Tick marks indicate weeks for each month beginning on November 28, 2020, and ending on December 3, 2022. Orange and green dots show collection dates for RSV genomes analyzed in this study. B, C) Maximum-likelihood phylogenetic trees of complete genomes of RSV-A (B) and RSV-B (C) collected during 2017–2022. Collection years for specimens are depicted by tree branch color. RSV genomes from the United States are highlighted with light blue circles at branch tips. Red arrow indicates the location of the major phylogenetic clade comprising most of the sequences from Washington during 2021–22 and 2022–23; black arrows indicate locations of other sequences from Washington during 2022–23. Scale bar indicates nucleotide substitutions per site. Complete phylogenetic trees are provided in the Appendix. RSV, respiratory syncytial virus; RSV-A, RSV subtype A; RSV-B, RSV subtype B.