Epidemiological Survey of Human Metapneumovirus Infection in a Large Pediatric Tertiary Care Center

Abstract

The human metapneumovirus (hMPV) was recently identified and linked to acute respiratory tract infections (ARTI). To assess the clinical importance of this virus in infants and children, we developed a rapid and efficient reverse transcription-PCR-based screening method for a large volume of samples and tested retrospectively a collection of 1,132 respiratory specimens submitted over a full year period to the virology laboratory of a large tertiary care pediatric center in Montreal, Canada. A total of 41 samples from 37 patients were positive by this method. During the winter months of 2001, up to 8% of specimens submitted for respiratory virus testing were hMPV positive. Sequencing data of the hMPV M gene revealed that two genogroups of the virus, each of which can be divided into two subgroups, cocirculated during this time period. A case-controlled study was conducted to compare the symptoms associated with hMPV infection with those involving other etiologic agents causing ARTI. Symptoms most frequently observed in hMPV-positive patients were cough, wheezing, and dyspnea, although the symptomatology could differ substantially from patient to patient. No distinct symptom profile could be associated with hMPV. Three nosocomial cases of hMPV infection were identified. Together, our data suggest that hMPV is a significant cause of symptomatic respiratory tract infections in infants and children. The incidence of the disease and the morbidity associated with the infection justify adding hMPV to the list of common respiratory viruses routinely screened for by clinical laboratories.Infection with respiratory viruses is a common cause of morbidity and mortality in childhood. Despite the use of moresensitive diagnostic tools by clinical laboratories, an important proportion of respiratory infections still cannot be associated to any known pathogen.Since the first report of acute respiratory tract infections (ARTI) caused by the human metapneumovirus (hMPV) in 2001 (23), the virus has been detected in a number of countries, suggesting a world-wide distribution (6, 8-10, 13-15, 18-21, 25). hMPV is an enveloped, negative-stranded RNA virus possessing a nonsegmented genome, which has been tentatively classified within the Paramyxoviridae family. The two hMPV genogroups (A and B) that have been characterized to date share an approximate overall identity of 85% at the nucleotide level (20,23,24).In 2002, Peret et al. (20) documented hMPV infection cases in the Canadian province of Quebec and linked the virus to potentially severe illnesses in children. The finding prompted us to investigate the prevalence and the clinical importance of the newly discovered pathogen as a cause of ARTI in the pediatric population. We developed rapid and sensitive reverse transcription-PCR (RT-PCR) assays to detect the virus directly in samples submitted for respiratory virus testing to the virology laboratory of Sainte-Justine Hospital (SJH), a reference pediatric tertiary care center in the city of Montreal, Canada. A total of 41 samples we...

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“…The high rates of co-infection with hMPV-RSV reported in some studies may be due to the overlapping of virus seasons (Al-Sonboli et al 2006, Cuevas et al 2003, Principi et al 2006. No cases of hMPV-influenza A or other viruses analyzed were observed in this study, although co-infections of hMPV with other respiratory viruses had been reported in several studies (Heikkinen et al 2008, Sarasini et al 2006, Chano et al 2005, Manoha et al 2007, Sasaki et al 2005). …”

Human Metapneumovirus Circulation in the United States, 2008 to 2014

“…However, as in other studies, we determined that a smaller proportion of diagnostic tests were positive for HMPV compared with other respiratory pathogens. [18][19][20][21] The data analyzed were not robust enough to assess regional trends in HMPV circulation.…”

Molecular Epidemiological Investigation of a Nosocomial Outbreak of Human Metapneumovirus Infection in a Pediatric Hemato-Oncology Patient Population

“…The first confirmed nosocomial case seen with pediatric patients was that of an infant who never left the hospital after birth and was among 19 patients diagnosed in a single winter season at a tertiary referral hospital (6). Another previous report described 3 HAhMPV cases among a total of 37 hMPV-infected patients during a 1-year period at a large tertiary-care pediatric center (2). However, all were separate cases without evidence of proven transmission.…”