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Human metapneumovirus in the preterm neonate: current perspectives
Nathalie L Maitre1, John V Williams2
1Center for Perinatal Research, Department of Pediatrics, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA.
Insights
Human metapneumovirus (HMPV) is a significant cause of acute respiratory illness in premature infants. Early identification and consideration of HMPV are crucial for managing respiratory symptoms in this vulnerable population.
Area of Science:
- Pediatrics
- Virology
- Public Health
Background:
- Premature birth (<37 weeks gestation) affects ~11% of US births, increasing risks for chronic lung disease and respiratory conditions like bronchopulmonary dysplasia.
- Respiratory viruses are primary causes of acute respiratory illness (ARI) in preterm infants, leading to rehospitalization, increased healthcare costs, and long-term health issues.
- Human metapneumovirus (HMPV), a paramyxovirus related to RSV, is a leading cause of ARI globally, with prematurity being a key risk factor for severe disease.
Purpose of the Study:
- To highlight the significance of Human metapneumovirus (HMPV) in premature infants.
- To underscore the association between HMPV infection in infancy and long-term pulmonary complications such as asthma and recurrent wheezing.
- To address the limited data on HMPV prevalence in neonatal intensive care units (NICUs) and its role in nosocomial outbreaks.
Main Methods:
- Literature review and analysis of existing epidemiologic data on HMPV.
- Examination of HMPV's impact on preterm infants and its association with ARI and long-term pulmonary outcomes.
- Assessment of HMPV's role in hospital-acquired infections within NICU settings.
Main Results:
- HMPV is a common and significant cause of ARI in preterm infants, often requiring hospitalization.
- Infant HMPV infection is linked to an increased risk of developing asthma and recurrent wheezing.
- HMPV contributes to nosocomial outbreaks of ARI in healthcare facilities, including NICUs.
Conclusions:
- Human metapneumovirus (HMPV) is an important pathogen in premature infants presenting with acute respiratory symptoms.
- Healthcare providers should consider HMPV in the differential diagnosis for preterm infants with respiratory illness.
- Further research is needed on HMPV prevalence in NICUs and its long-term effects on preterm infants.
Abstract:
Premature birth (<37 weeks gestation) occurs in ~11% of all births in the US. These infants are at risk of chronic lung disease and respiratory conditions, including bronchopulmonary dysplasia. Respiratory viruses are important causes of acute respiratory illness (ARI) in preterm infants, leading to rehospitalization, increased health care burden, and long-term morbidity. Human metapneumovirus (HMPV) is a paramyxovirus discovered in 2001 that is related to respiratory syncytial virus. Epidemiologic studies show that HMPV is a leading cause of ARI in children and adults worldwide. Prematurity is a major risk factor for severe HMPV disease, requiring hospitalization. Moreover, limited data suggest that HMPV infection during infancy is associated with asthma and recurrent wheezing, which are common long-term pulmonary complication of prematurity. HMPV causes nosocomial outbreaks of ARI in hospitals and long-term care facilities, although there are few studies of the prevalence of HMPV in neonatal intensive care unit populations. HMPV is a common and important virus in premature infants, and caregivers for preterm infants should consider this virus in patients with acute respiratory symptoms.
