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Burden of human metapneumovirus infection in young children
Kathryn M Edwards1, Yuwei Zhu, Marie R Griffin
1Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN 37232-2581, USA.
Insights
Human metapneumovirus (HMPV) causes significant hospitalizations and outpatient visits in young children, particularly infants. Most affected children were previously healthy, highlighting HMPV as a key pediatric respiratory pathogen.
Area of Science:
- Pediatric infectious diseases
- Virology
- Public health surveillance
Background:
- The clinical and economic impact of human metapneumovirus (HMPV) in young children remains largely unquantified.
- Establishing the burden of HMPV is crucial for understanding its role in pediatric respiratory illnesses.
Purpose of the Study:
- To determine the population-based burden of HMPV infections in young children.
- To characterize clinical features and healthcare utilization associated with HMPV in pediatric populations.
Main Methods:
- Prospective, population-based surveillance of acute respiratory illness in children under 5 years old across three U.S. counties (2003-2009).
- HMPV detection using reverse-transcriptase polymerase-chain-reaction (RT-PCR) assays.
- Calculation of hospitalization and outpatient visit rates, with analysis of clinical data.
Main Results:
- HMPV was detected in 6-7% of children with acute respiratory illness across inpatient, outpatient, and emergency settings.
- Annual hospitalization rates were 1/1000 for children <5 years, peaking in infants (3/1000 for <6 months).
- HMPV-associated outpatient visits were estimated at 55 clinic and 13 ED visits per 1000 children annually.
Conclusions:
- HMPV infection represents a significant cause of pediatric hospitalizations and outpatient visits, especially in infants.
- The majority of children with HMPV infections were previously healthy, indicating widespread susceptibility.
- Findings underscore the importance of HMPV in the differential diagnosis of pediatric respiratory infections.
Background:
The inpatient and outpatient burden of human metapneumovirus (HMPV) infection among young children has not been well established.
Methods:
We conducted prospective, population-based surveillance for acute respiratory illness or fever among inpatient and outpatient children less than 5 years of age in three U.S. counties from 2003 through 2009. Clinical and demographic data were obtained from parents and medical records, HMPV was detected by means of a reverse-transcriptase polymerase-chain-reaction assay, and population-based rates of hospitalization and estimated rates of outpatient visits associated with HMPV infection were determined.
Results:
HMPV was detected in 200 of 3490 hospitalized children (6%), 222 of 3257 children in outpatient clinics (7%), 224 of 3001 children in the emergency department (7%), and 10 of 770 asymptomatic controls (1%). Overall annual rates of hospitalization associated with HMPV infection were 1 per 1000 children less than 5 years of age, 3 per 1000 infants less than 6 months of age, and 2 per 1000 children 6 to 11 months of age. Children hospitalized with HMPV infection, as compared with those hospitalized without HMPV infection, were older and more likely to receive a diagnosis of pneumonia or asthma, to require supplemental oxygen, and to have a longer stay in the intensive care unit. The estimated annual burden of outpatient visits associated with HMPV infection was 55 clinic visits and 13 emergency department visits per 1000 children. The majority of HMPV-positive inpatient and outpatient children had no underlying medical conditions, although premature birth and asthma were more frequent among hospitalized children with HMPV infection than among those without HMPV infection.
Conclusions:
HMPV infection is associated with a substantial burden of hospitalizations and outpatient visits among children throughout the first 5 years of life, especially during the first year. Most children with HMPV infection were previously healthy. (Funded by the Centers for Disease Control and Prevention and the National Institutes of Health.).
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