Prevalence and Characteristics of Human Metapneumovirus Infection Among Hospitalized Children at High Risk for Severe Lower Respiratory Tract Infection

Evan J Anderson; Eric A F Simões; Jim P Buttery; Penelope H Dennehy; Joseph B Domachowske; Kathryn Jensen; Jay M Lieberman; Genevieve A Losonsky; Ram Yogev

doi:10.1093/jpids/pis069

Prevalence and Characteristics of Human Metapneumovirus Infection Among Hospitalized Children at High Risk for Severe Lower Respiratory Tract Infection

J Pediatric Infect Dis Soc. 2012 Sep;1(3):212-22. doi: 10.1093/jpids/pis069. Epub 2012 Jul 3.

Authors

Evan J Anderson¹, Eric A F Simões², Jim P Buttery³, Penelope H Dennehy⁴, Joseph B Domachowske⁵, Kathryn Jensen⁶, Jay M Lieberman⁷, Genevieve A Losonsky⁶, Ram Yogev¹

Affiliations

¹ Children's Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Ilinois.
² The University of Colorado School of Medicine, Children's Hospital Colorado, Aurora.
³ Royal Children's and Monash Children's Hospitals, Murdoch Children's Research Institute, Department of Paediatrics, Monash University, Melbourne, Australia.
⁴ Hasbro Children's Hospital and The Alpert Medical School of Brown University, Providence, Rhode Island.
⁵ SUNY Upstate Medical University, Department of Pediatrics, Syracuse, New York.
⁶ Clinical Development, MedImmune, LLC, Gaithersburg, Maryland.
⁷ Miller Children's Hospital, Long Beach, California.

PMID: 26619409
DOI: 10.1093/jpids/pis069

Abstract

Background: Human metapneumovirus (HMPV) is a significant cause of respiratory tract infections. Little is known about HMPV in children who are at high risk for lower respiratory tract infection (LRTI).

Methods: To determine the prevalence of HMPV in high-risk children and to identify HMPV risk factors, children ≤24 months with prematurity, chronic lung disease, and/or congenital cardiac disease who were hospitalized with LRTI were prospectively enrolled. Nasopharyngeal aspirates were tested for HMPV, respiratory syncytial virus (RSV), influenza A and B, and parainfluenza types 1-3. Demographics, medical history, and outcomes for those with HMPV and RSV were compared. A multivariate analysis was performed to determine HMPV risk factors.

Results: Over 4 years, 1126 eligible children were enrolled. Pathogens were identified in 61% of subjects. HMPV was identified in 9.0%, second to RSV (45%). Coinfection with HMPV and RSV occurred in <1% of subjects. Subjects infected with HMPV were older (8.2 vs 4.0 months, P < .001), were born more prematurely (27 vs 33 weeks, P < .001), and more commonly had chronic lung disease (59.3% vs 21.8%, P < .001) compared with subjects infected with RSV. In a multivariate analysis that compared children infected with HMPV to all others, increasing age and household exposure to children ages 6-12 were associated with an increased risk, whereas birth at older gestational age and exposure to children age >12 were associated with a decreased risk.

Conclusions: HMPV was detected in 9% of high-risk children who were hospitalized with lower respiratory tract disease, representing the second most common virus in this population. Compared with all other subjects (including RSV-infected), subjects infected with HMPV were older but were born more prematurely.