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Human Metapneumovirus Infection in Young Children Hospitalized With Respiratory Tract Disease

Foulongne, Vincent PhD*; Guyon, Gaël MD; Rodière, Michel MD; Segondy, Michel PhD*

The Pediatric Infectious Disease Journal: April 2006 - Volume 25 - Issue 4 - p 354-359
doi: 10.1097/01.inf.0000207480.55201.f6
Original Studies

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.

From the Departments of *Virology and †Pediatrics, Montpellier University Hospital, Montpellier, France

Accepted for publication November 22, 2005.

Supported by grant AOI 2003 from the Programme Hospitalier de Recherche Clinique of the Montpellier University Hospital.

E-mail Reprints not available.

© 2006 Lippincott Williams & Wilkins, Inc.