Korean J Pediatr Infect Dis.  2013 Dec;20(3):168-177.

Clinical and Epidemiological Characteristics of Human Metapneumovirus Infections, in Comparison with Respiratory Syncytial Virus A and B

• Kang SY
• Hong CR
• Kang HM
• Cho EY
• Lee HJ
• Choi EH
• Lee HJ

Abstract

PURPOSE
To identify the clinical and epidemiological characteristics of human metapneumovirus infections (hMPV) in children compared to respiratory syncytial virus A (RSV A) and B (RSV B). METHOD: A retrospective review of medical records was performed in 36 patients with hMPV infection, 106 with RSV A infection, and 51 with RSV B infection, from September 2007 to July 2012.
RESULTS
The peak incidence of hMPV infection was observed in May, whereas for RSV infections in November and December. hMPV infection occurred in older patients compared to RSV A and B infection (29.9+/-32.5 months vs. 13.6+/-15.4 months, P<0.001; 29.9+/-32.5 months vs. 12.1+/-13.5 months, P<0.001, respectively). hMPV infection was more often associated with fever compared to RSV A (97.2% vs. 67.9%, P<0.001), while wheezing was less frequent compared to RSV A and B infection (16.7% vs. 47.2%, P=0.001; 16.7% vs. 37.3%, P=0.037, respectively). hMPV infection was more often diagnosed as pneumonia compared to RSV A infection (72.2% vs. 50.0%, P=0.047) while bronchiolitis was less frequent than in RSV A (5.6% vs. 34.9%, P=0.001) or RSV B infection (5.6% vs. 29.4%, P=0.006). In addition, intravenous antibiotic was more often prescribed for patients with hMPV infection than those with RSV A and B (69.4% vs. 39.6%, P=0.002; 69.4% vs. 43.1, P=0.015, respectively).
CONCLUSION
This study identified characteristics of hMPV infection compared to RSV A and B infection. Seasonality in spring, higher age group, and higher proportion of pneumonia in hMPV infections may be a useful guide for management of respiratory viral infections in children.

Keyword

Human metapneumovirus; Respiratory syncytial virus

MeSH Terms

Bronchiolitis
Child
Fever
Humans*
Incidence
Medical Records
Metapneumovirus*
Pneumonia
Respiratory Sounds
Respiratory Syncytial Viruses*
Retrospective Studies
Seasons

Figure

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  Fig. 1 Study enrollment eliminating patients in exclusion criteria.

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  Fig. 2 Epidemic pattern of hMPV, RSV A, and RSV B infections, 2007-2012. Abbreviations: hMPV, human metapneumovirus; RSV, respiratory syncytial virus.

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  Fig. 3 Age distribution of hMPV, RSV A, and B infections. Patients with underlying disease and combined infection were excluded. Proportions were calculated from each virus. No.of cases- hMPV:36, RSV A:106, RSV B:51, <3 mo: 67, 3-12 mo: 41, 13-24 mo: 39, 25 mo-4 yr: 37, ≥5 yr: 9. Abbreviations: hMPV, human metapneumovirus; RSV, respiratory syncytial virus.

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