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HMPV common cause of respiratory illness
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Human metapneumovirus infection has a population incidence rate similar to that of influenza and parainfluenza virus 3, according to a recently published report.
Researchers from the Vanderbilt University School of Medicine conducted a 2-year surveillance of 2 counties of hMPV infection among children older than 5 years who were hospitalized with an acute respiratory infection or fever. Nasal and throat specimens were obtained from 1,104 children. The specimens were tested for hMPV by real-time reverse-transcription polymerase chain reaction and genotyped.
Researchers used population-based, laboratory-confirmed active surveillance to define the burden of hMPV infection among hospitalized children. Previous reports have stated that hMPV disease in children is commonly seen in those with underlying medical conditions. One-third of the study consisted of children with high-risk conditions and two-thirds of the study cohort was otherwise healthy children with hMPV. The researchers suggested that these children are at higher risk for hospitalization with hMPV infection but did not observe an association between hMPV hospitalization and a history of asthma.
The researchers noted that 42% of the children tested positive for hMPV, and the overall annual rate of hMPV-associated hospitalizations per 1,000 children was 1.2% among children younger than 5 years. The annual rate of hospitalization for hMPV infection was less than that for respiratory syncytial virus infection but similar to that for influenza and parainfluenza virus 3 infection in all age groups. The researchers also reported that asthma, bronchiolitis and pneumonia were the most common diagnosis of children with hMPV infection and hMPV was most prominent from March to May.
Most hMPV-associated hospitalizations occurred among otherwise healthy children.
The researchers acknowledged some limitations to their study, including the study’s length, demographic and institutional differences in medical practices. They also noted hMPV’s seasonal and demographic variabilities.
The researchers said that they hope that their findings will prompt the development of preventive and therapeutic strategies for hMPV infection and highlight the need to consider hMPV infection as a cause of acute respiratory infection among hospitalized children, especially in the spring months. – by Amanda Jamieson
Williams JV. J Infect Dis.1890-1898.
I think the effect of the findings is to flesh out the epidemiology of hMPV. Since its discovery in 2001, there have been many reports on the epidemiology of hMPV. However, few were prospective and none were population-based. So, studies that identify hMPV in 10% of hospitalized children tell us that the virus is important but don’t place it in context. The strength of this CDC-sponsored study is that the design allows us to determine the incidence of hospitalization due to hMPV in the pediatric population in direct comparison to RSV, influenza and human parainfluenza virus type 3. Many pediatricians and the general public remain unaware that hMPV is as important to public health as these other common viruses; this report should increase that awareness.
– John V. Williams, MD
Vanderbilt
University Medical Center
Nashville, Tenn.