Association of human metapneumovirus with radiologically diagnosed community-acquired alveolar pneumonia in young children

J Pediatr. 2010 Jan;156(1):115-20. doi: 10.1016/j.jpeds.2009.07.014.

Abstract

Objectives: To determine the involvement of human metapneumovirus (HMPV) in childhood community-acquired alveolar pneumonia (CAAP) and compare the demographic, clinical, and laboratory features of HMPV-associated CAAP and CAAP associated with other respiratory viruses.

Study design: Nasopharyngeal wash specimens obtained prospectively over a 4-year period from children age < 5 years evaluated in the emergency department with radiologically diagnosed CAAP and from healthy controls were tested for HMPV by reverse-transcriptase polymerase chain reaction and for respiratory syncytial virus (RSV), adenovirus, influenza and parainfluenza viruses by direct immunofluorescence and culture.

Results: HMPV was detected in 108 of 1296 patients (8.3%) versus RSV in 23.1%, adenovirus in 3.4%, influenza A virus in 2.9%, and parainfluenza viruse in 2.9%. During the period of peak activity (November to May), HMPV was detected in 95 of 1017 patients (9.3%) and in 3 of 136 controls (2.2%) (P = .005). The patients with HMPV were older than those with RSV (P < .001) with a more common history of acute otitis media requiring tympanocentesis (P = .032), wheezing (P = .001) and gastrointestinal symptoms (P < .001) and a lower hospitalization rate (P = .005).

Conclusions: The high detection rate suggests an important role for HMPV in childhood CAAP. Our findings identify demographic and clinical features of HMPV-positive CAAP and its age-related impact on hospital admissions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child, Preschool
  • Community-Acquired Infections / epidemiology
  • Community-Acquired Infections / virology
  • Comorbidity
  • Female
  • Humans
  • Infant
  • Male
  • Metapneumovirus*
  • Numismatics
  • Paramyxoviridae Infections / epidemiology*
  • Pneumonia, Viral / virology*
  • Polymerase Chain Reaction
  • Prospective Studies
  • Pulmonary Alveoli / virology