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Human Metapneumovirus Infection in a Children's Hospital - It Should Get More Attention
Nellie Hani1, Wendi Gornick2, Beth Huff2
1Division of Pediatric Endocrinology, Department of Pediatrics, University of Michigan, Ann Arbor, MI.
Insights
Human metapneumovirus (hMPV) caused higher hospitalization rates in children than RSV and influenza over six seasons. ICU admissions and deaths were similar, with many ICU patients having chronic lung disease.
Area of Science:
- Pediatric Infectious Diseases
- Virology
- Public Health Surveillance
Background:
- Respiratory Syncytial Virus (RSV) and influenza are leading causes of pediatric hospitalizations and ICU admissions.
- Human metapneumovirus (hMPV) is another significant respiratory virus in children.
- Comparative data on hMPV, RSV, and influenza over multiple seasons is crucial for understanding their impact.
Purpose of the Study:
- To compare hospitalization, ICU admission, hospital-acquired infection (HAI), and mortality rates for hMPV, RSV, and influenza in children.
- To assess the characteristics of hMPV-infected children requiring hospitalization and ICU care.
Main Methods:
- Retrospective analysis of data from 2014-2019 winter viral seasons.
- Tracking of hMPV, RSV, and influenza infections in children's hospitals.
- Assessment of hospitalization, ICU admission, HAI, and mortality rates for hMPV compared to RSV and influenza.
Main Results:
- hMPV admissions showed significantly higher hospitalization rates than both RSV and influenza.
- ICU admissions, deaths, and HAIs for hMPV were comparable to RSV and influenza.
- Among hMPV cases, 12.3% had chronic lung disease (CLD) and 4.9% required tracheostomies. Of ICU admissions, 82% had underlying conditions, including CLD (29%) and tracheostomies (20%).
Conclusions:
- hMPV infection in children leads to higher hospitalization rates compared to RSV and influenza, with similar ICU and HAI rates.
- Underlying medical conditions, particularly CLD, are common in hMPV-infected children requiring ICU admission.
- Further research on disease surveillance and vaccine development for high-risk children is warranted.
Background:
Respiratory syncytial virus (RSV) and influenza infections are a major cause of hospitalization and intensive care unit (ICU) admission to children's hospitals and are closely tracked. We compared data over 6 seasons of human metapneumovirus (hMPV), RSV and influenza infections.
Methods:
During the 2014-2019 winter viral seasons, hMPV, RSV and influenza infections were tracked. For hMPV admissions, rates of hospitalizations, ICU admissions, hospital-acquired infections (HAIs) and mortalities were assessed and compared with RSV and influenza admissions. Retrospective data was used to study patients infected with hMPV.
Results:
During the winter seasons of 2014-2019, the rates of hospitalization due to hMPV were significantly higher than both RSV and influenza. ICU admissions, deaths and HAIs for hMPV were similar to RSV and influenza.Of the 471 total cases with hMPV, 58 (12.3%) had chronic lung disease (CLD) and 23 (4.9%) were tracheostomy dependent. Among 104 hMPV ICU admissions from 2013 to 2019, 86 (82%) had an underlying medical diagnosis, 30 (29%) had CLD, 21 (20%) had tracheostomies and 33 (32%) required mechanical ventilation. The average age of hMPV infected children in our ICU is 3 years and 10 months.
Conclusions:
Our large descriptive study of hMPV infected children over 6 seasons showed higher rates of hospitalization compared with RSV and influenza, similar ICU and HAI rates, and deaths. ICU admitted children often had associated co-morbidities, including CLD. Further studies for focused disease surveillance and potential vaccine development for high-risk children are needed.
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