ORIGINAL ARTICLE Detection and follow-up of torque teno midi virus (‘‘small anelloviruses’’) in nasopharyngeal aspirates and three other human body fluids in children Zso ´fia Buria ´n • Hajnalka Szabo ´ • Gyo ¨ngyi Sze ´kely • Ka ´lma ´n Gyurkovits • Pe ´ter Pankovics • Tibor Farkas • Ga ´bor Reuter Received: 23 March 2011 / Accepted: 3 May 2011 / Published online: 19 May 2011 Ó Springer-Verlag 2011 Abstract Torque teno midi virus/small anellovirus (TTMDV/SAV) is a member of the family Anelloviridae. It has a single-stranded, circular, negative-sense DNA gen- ome. Its pathogenic role in human disease remains to be confirmed. In this study, viral shedding, molecular epide- miology and genetic diversity of TTMDV/SAV were studied in human body fluids. Nasopharyngeal aspirates collected from children with acute respiratory disease were tested by PCR/nested PCR for TTMDV/SAV in two sea- sons (2005/2006, 2006/2007). Two years later, additional urine, stool, and serum samples and nasopharyngeal aspi- rates were collected from eight symptomless children for follow-up investigation. Forty-three (46.7%) of the 92 nasopharyngeal aspirates collected contained TTMDV/ SAV. High genetic diversity was observed; however, identical sequences were also detected in two patients. The mean age of the infected children was 3 years (1 months- 8 years), and 58% of them were female. Co-infection with RSV was detected in 23% of the samples. In a follow-up study, nasopharyngeal aspirates and serum of six (75%), stool samples of four (50%) and urine samples of two (25%) of the eight children were anellovirus-positive. None of the anellovirus sequences were identical in the two collection periods, but identical sequences were detected in different body fluids collected at the same time from the same child. TTMDV/SAVs shedding was detected in four human body fluids. As a consequence, it is possible that generalized infection and fecal/uro-oral transmission of TTMDV/SAV occur. TTMDV/SAVs are frequently pres- ent in nasopharyngeal aspirates, although the variants may only be transient agents. Further research is needed to investigate the pathogenesis and pathogenic role of TTMDV/SAV. Introduction Anelloviruses have a single-stranded, circular, negative- sense DNA genome (*2-3.9 kb) and are classified as members of the novel family Anelloviridae. The family currently includes nine genera (from Alphatorquevirus to Zetatorquevirus) containing viruses from humans and animals. Human anelloviruses belong to the genera Alphatorquevirus (torque teno virus, TTV), Betatorquevi- rus (torque teno mini virus, TTMV) and Gammatorquevi- rus (torque teno midi virus (TTMDV)—previously also referred as ‘‘small anellovirus’’ (SAV) [2, 6, 10]. TTV was first identified in the serum of a patient with post-transfu- sion hepatitis of unknown aetiology in 1997 [11]. In 2000, torque teno mini virus (TTMV) was accidentally discov- ered in the serum of a blood donor [13]. TTMDV/SAV (including SAV1 and 2) was discovered in plasma samples of patients with acute viral infection syndrome in 2005 [3, 7]. Nucleotide sequence data reported are available in the GenBank database under accession numbers HQ677728-HQ677765. Z. Buria ´n Á P. Pankovics Á G. Reuter (&) Regional Laboratory of Virology, National Reference Laboratory of Gastroenteric Viruses, A ´ NTSZ Regional Institute of State Public Health Service, Szabadsa ´g u ´t 7., Pecs 7623, Hungary e-mail: reuter.gabor@ddr.antsz.hu H. Szabo ´ Á G. Sze ´kely Á K. Gyurkovits Department of Pulmonology, Kaposi Mo ´r Teaching Hospital, Mosdo ´s, Hungary T. Farkas Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA 123 Arch Virol (2011) 156:1537–1541 DOI 10.1007/s00705-011-1021-0