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Human metapneumovirus associated with central nervous system infection in children

John C Arnold1, Kumud K Singh, Edmund Milder

  • 1Division of Infectious Diseases, Department of Pediatrics, Naval Medical Center, San Diego, CA, USA. jcarnold@ucsd.edu

The Pediatric Infectious Disease Journal
|September 17, 2009
PubMed
Abstract

Insights

Human metapneumovirus (hMPV) is linked to central nervous system (CNS) illness in children. Children with hMPV infections were more likely to experience seizures compared to those with RSV infections.

Area of Science:

  • Virology
  • Neurology
  • Pediatrics

Background:

  • Human metapneumovirus (hMPV) is a known respiratory pathogen.
  • Paramyxoviruses, including hMPV, are associated with central nervous system (CNS) diseases like encephalitis.
  • Emerging evidence suggests a potential link between hMPV and CNS manifestations.

Purpose of the Study:

  • To investigate the association between hMPV infection and CNS illness in children.
  • To compare the incidence of seizures in children infected with hMPV versus respiratory syncytial virus (RSV).
  • To explore hMPV's role in pediatric neurological disorders.

Main Methods:

  • Two patient groups were studied: children with respiratory samples and pediatric encephalitis cases.
  • hMPV RNA was detected using PCR in nasal scrapings and nasopharyngeal swabs.
  • Clinical and demographic data, including seizures and hospitalization, were reviewed. Cerebrospinal fluid (CSF) was tested for hMPV RNA and IgM in encephalitis cases.

Main Results:

  • hMPV RNA was detected in 63 children; 6.3% experienced seizures, significantly higher than RSV cases (0.7%, P=0.031).
  • Children with hMPV and seizures required hospitalization, with 3 cases of status epilepticus needing intubation.
  • In encephalitis cases, hMPV was detected in nasopharyngeal swabs, but not in CSF, suggesting limited direct CNS invasion.

Conclusions:

  • Nine cases of CNS illness temporally linked to upper airway hMPV detection were identified.
  • hMPV-infected children showed a significantly higher likelihood of seizures compared to RSV-infected children.
  • Data suggest hMPV may contribute to a range of CNS diseases, from febrile seizures to severe encephalitis.

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