Human metapneumovirus is a significant cause of morbidity in children

Feb 13th – In a study published today, children hospitalized for respiratory infection illness or fever were more likely to be infected with HMPV than healthy controls.

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1. Children hospitalized for respiratory infection illness or fever were more likely to be infected with HMPV than healthy controls.

2. Children with HMPV infection were more likely to require oxygen therapy and had longer ICU stays than uninfected children.

There have been no studies characterizing the burden of disease of Human Metapneumovirus (HMPV) since its discovery in 2001.  The results of this study suggest that it is a significant cause of respiratory illness in children less than 5 years of age and a cause of outpatient clinic visits as well as inpatient hospital admissions.  According to the study, the annual rate of hospitalization for children under 5 with HMPV equals the rate of influenza: both 1 per 1000 children.  Additionally children infected with HMPV appear to have harsher hospital courses than uninfected children, with longer ICU stays and an oxygen requirement.  One limitation is that only an association has been established – many children in the study had comorbidities that could have contributed to their hospital courses and illnesses.

Click to read the study in NEJM

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1. Children hospitalized for respiratory infection illness or fever were more likely to be infected with HMPV than healthy controls.

2. Children with HMPV infection were more likely to require oxygen therapy and had longer ICU stays than uninfected children.

This [prospective population-based] study: drew from data collected by the New Vaccine Surveillance Network (NVSN) between 2003 and 2009.  Children <5 years old who had an acute respiratory illness or fever were enrolled either from hospital admissions or outpatient visits from multiple centers.  Cases were matched with healthy controls < 5 years old through well-child visits at primary care clinics.  Children were tested for Human Metapneumovirus (HMPV) via PCR of nasal and throat swabs. 6% of inpatients and 7% of outpatients were found to be HMPV positive.  Only 1% of the controls were positive.  HMPV positive children were more likely to require supplemental oxygen and had longer mean ICU stays.  There was no difference in the rate of ICU admissions or intubations between HMPV positive and HMPV negative inpatient children.

In sum: There have been no studies characterizing the burden of disease of Human Metapneumovirus (HMPV) since its discovery in 2001.  The results of this study suggest that it is a significant cause of respiratory illness in children less than 5 years of age and a cause of outpatient clinic visits as well as inpatient hospital admissions.  According to the study, the annual rate of hospitalization for children under 5 with HMPV equals the rate of influenza: both 1 per 1000 children.  Additionally children infected with HMPV appear to have harsher hospital courses than uninfected children, with longer ICU stays and an oxygen requirement.  One limitation is that only an association has been established – many children in the study had comorbidities that could have contributed to their hospital courses and illnesses.

Click to read the study in NEJM

By Akira Shishido and Mitalee Patil

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