Human Metapneumovirus Infection in Young Children Hospitalized With Respiratory Tract Disease

• Published in: The Pediatric infectious disease journal Vol. 25; no. 4; pp. 354 - 359
• Main Authors: Foulongne, Vincent, Guyon, Gaël, Rodière, Michel, Segondy, Michel
• Format: Journal Article
• Language: English
• Published: Baltimore, MD Lippincott Williams & Wilkins, Inc 01-04-2006; Philadelphia, PA Lippincott; Hagerstown, MD
• Subjects: Biological and medical sciences; Child, Preschool; Female; Hospitalization; Humans; Incidence; Infant; Infant, Newborn; Infectious diseases; Male; Medical sciences; Metapneumovirus - genetics; Metapneumovirus - isolation & purification; Paramyxoviridae Infections - complications; Paramyxoviridae Infections - epidemiology; Paramyxoviridae Infections - physiopathology; Paramyxoviridae Infections - virology; Phylogeny; Respiratory Syncytial Virus Infections - complications; Respiratory Syncytial Virus Infections - epidemiology; Respiratory Syncytial Virus Infections - physiopathology; Respiratory Syncytial Virus Infections - virology; Respiratory Syncytial Virus, Human; Respiratory Tract Infections - epidemiology; Respiratory Tract Infections - physiopathology; Respiratory Tract Infections - virology; Human; Infection; Respiratory tract; Pediatrics; Respiratory disease; children; respiratory tract disease; Hospitalization; human metapneumovirus; Child
• ISSN: 0891-3668; 1532-0987
• DOI: 10.1097/01.inf.0000207480.55201.f6

BACKGROUND:Human metapneumovirus (hMPV) is a newly recognized pathogen associated with respiratory tract disease (RTD).
OBJECTIVES:To evaluate the incidence of hMPV infection in children hospitalized with RTD and to analyze the virologic and clinical features of hMPV infection.
STUDY DESIGN:All children younger than 5 years of age hospitalized for RTD were included in this 1-year prospective study. hMPV was detected in nasopharyngeal secretions by reverse transcription polymerase chain reaction. The hMPV F gene amplification products were sequenced, and a phylogenetic tree was constructed. Samples were also tested for other respiratory viruses by both direct immunofluorescence assay and virus culture.
RESULTS:hMPV, detected in 50 of 589 (8.5%) children, represented the second leading cause of RTD after respiratory syncytial virus (RSV). Infections with hMPV occurred mainly between December and April. hMPV isolates clustered into the 4 subgroups (A1, A2, B1 and B2) currently recognized; the majority (72%) of hMPV isolates belonged to subgroup A1. Among the 35 children infected with hMPV alone, 23 (65.7%) had bronchiolitis, 5 (14.3%) had pneumonia, 2 (5.7%) had asthma exacerbation and 5 (14.3%) had a limited upper RTD. Fifteen (30%) of the hMPV-infected children were coinfected with RSV. As compared with children infected with hMPV or RSV alone, duration of hospitalization and requirement for supplemental oxygen were increased in the hMPV/RSV-coinfected children.
CONCLUSIONS:hMPV is a frequent cause of RTD in young children. hMPV/RSV coinfection is frequent and could be more severe than a single hMPV or RSV infection.