The Impact of Infection with Human Metapneumovirus and Other Respiratory Viruses in Young Infants and Children at High Risk for Severe Pulmonary Disease

Abstract

We conducted a prospective, observational study to characterize the clinical manifestations of respiratory infections caused by human metapneumovirus (hMPV) and other viruses in 194 premature infants and young children with chronic lung disease or congenital heart disease in Buenos Aires. Children had 567 episodes of respiratory illness and were monitored until they were 2 years old or until the completion of the study. hMPV elicited 12 infections (2%) year-round; 30% were of moderate or greater severity. Human parainfluenza virus type 3 caused 24 infections (4%), and 5 (25%) of 20 lung infections led to hospitalization. Respiratory syncytial virus (RSV) caused 33 episodes--17% of infections and 32% of hospitalizations during the respiratory season. None of the 10 children infected with influenza virus had severe disease. The present study of at-risk children suggests that hMPV and influenza virus are infrequent agents of severe disease and highlights the need for preventive interventions against RSV in developing countries.

Residues of the Human Metapneumovirus Fusion (F) Protein Critical for Its Strain-Related Fusion Phenotype: Implications for the Virus Replication Cycle

“…Clinical signs and symptoms associated with hMPV infection are similar to those caused by the human respiratory syncytial virus (hRSV), the prototype of the genus Pneumovirus within the Pneumovirinae subfamily. Both viruses cause illnesses ranging from mild respiratory distress to bronchiolitis and pneumonia, although incidence and severity are normally higher with hRSV (10,18,42). hMPV isolates have been classified into two main genetic lineages (A and B), each divided into two sublineages (A1, A2, B1, and B2) (41).…”

Respiratory Syncytial Virus-Associated Hospitalizations in Pre-Mature Infants in Lima, Peru

“…As a comparison at a regional level, in a prospective cohort study of 207 very low-birth weight (birth weight 1,500 g) pre-mature infants followed until 1 year of age in Buenos Aires, Argentina, the incidence of RSV-associated hospitalizations was approximately 90 per 1,000 child-years of follow-up. 6,7 Children with underlying conditions, such as pre-maturity, chronic lung disease, congenital heart disease, and immunosuppression, are at high risk for severe RSV disease. 8 Prematurity, a major risk factor for RSV hospitalization, goes along with small, immature, and vulnerable airways, an immature immune system, an incomplete transfer of maternal antibodies, and an inadequate cellular immunity.…”

“…8,14 In South America, especially in the southern part of the continent (i.e., Chile and Argentina), some studies have shown a clear seasonality, with a peak around the fall and winter months (May to August). 5,7 However, in equatorial regions that lack dramatic seasonal temperature variations (i.e., Fortaleza, Brazil), RSV infection may have a peak in the rainy season (January to August). 15 In this study, we were not able to define a clear-cut RSV seasonality.…”

“…1,2 In Latin America, there are several studies on the epidemiology of RSV infections in children [2][3][4][5] ; however, there are limited data on the disease burden of these infections in high-risk groups, such as pre-term infants. 6,7 Prevention of RSV disease relies on infection control and hygiene measures as well as provision of immunoprophylaxis in select infants. However, the prophylaxis is expensive, and therefore, targeting the recipient population and timing of administration are important for optimal effectiveness and judicious use of limited healthcare resources.…”

Human Rhinoviruses in Severe Respiratory Disease in Very Low Birth Weight Infants

“…[1][2][3][4][5] For decades, the agent most frequently linked to these severe episodes has been respiratory syncytial virus (RSV). RSV is responsible for 2% to 18% of severe LRTI cases in VLBW infants year-round.…”