10. Conclusions
The epidemiology and clinical manifestations associated with hMPV have been found to be reminiscent of those of the hRSV, with most severe RTI occuring in young infants, elderly subjects, and immunocompromised hosts. The seasonal distribution resembles that of hRSV and influenza virus infections, with recurrent epidemics during the winter months. hMPV is the second most important cause, after hRSV, of viral lower RTI in children. hMPV infections account for at least 4 to 8% of the RTI in hospitalized children. In the general community hMPV infections account for at least 3% of patients who visit a general practitioner for RTI. Interestingly, the rates of detection of hMPV have been generally higher in retrospective than prospective studies, an observation consistent with some selection bias. Larger prospective studies, not limited to the typical respiratory virus season, not limited to testing respiratory samples negative for the other respiratory viruses, and using appropriate controls need to be conducted. Diagnosis is made by RT-PCR assays aimed at amplifying the N, L, or P genes. Additional research to define the pathogenesis of this viral infection and the host’ specific immune response will enhance our knowledge and guide the search for preventive and therapeutic strategies.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Bastien, N., Normand, S., Taylor, T., Ward, D., Peret, T.C.T., Boivin, G., Anderson, L.J., and Li, Y. (2003a). Sequence analysis of the N, P, M and F genes of Canadian human metapneumovirus strains. Virus Res 93:51–62.
Bastien, N., Ward, D., Van Caeseele, P., Brandt, K., Lee, S.H.S., McNabb, G., Klisko, B., Chan, E., and Li, Y. (2003b). Human metapneumovirus infection in the Canadian population. J Clin Microbiol 41:4642–4646.
Biacchesi, S., Skiadopoulos, M.H., Boivin, G., Hanson, C.T., Murphy, B.R., Collins, P.L., and Buchholz, U.J. (2003). Genetic diversity between human metapneumovirus subgroups. Virology 315:1–9.
Biacchesi, S., Skiadopoulos, M.H., Tran, K.C., Murphy, B.R., Collins, P.L., and Buchholz, U.J. (2004). Recovery of human metapneumovirus from cDNA: optimization of growth in vitro and expression of additional genes. Virology 321:247–259.
Boivin, G., Abed, Y., Pelletier, G., Ruel, L., Moisan, D., Côté, S., Peret, T.C.T., Erdman, D.D., and Anderson, L.J. (2002). Virological features and clinical manifestations associated with human metapneumovirus: a new paramyxovirus responsible for acute respiratory-tract infections in all age groups. J Infect Dis 186:1330–1334.
Côté, S., Abed, Y., and Boivin, G. (2003). Comparative evaluation of real-time PCR assays for detection of the human metapneumovirus. J Clin Microbiol 41:3631–3635.
Crowe, J.E. (2004). Human metapneumovirus as major cause of human respiratory tract disease. Pediatr Infect Dis J 23:S215–S221.
Døllner, H., Risnes, K., Radtke, A., and Nordbø, S.A. (2004). Outbreak of human metapneumovirus infection in Norwegian children. Pediatr Infect Dis J 23:436–440.
Esper, F., Martinello, R.A., Boucher, D., Weibel, C., Ferguson, D., Landry, M.L., and Kahn, J.S. (2004). A 1-year experience with human metapneumovirus in children aged <5 years. J Infect Dis 189:1388–1396.
Falsey, A.R., Erdman, D., Anderson, L.J., and Walsh, E.E. (2003). Human metapneumovirus infections in young and elderly adults. J Infect Dis 187:785–790.
Freymuth, F., Vabret, A., Legrand, L., Eterradossi, N., Lafay-Delaire, F., Brouard, J., and Guillois, B. (2003). Presence of the new human metapneumovirus in french children with bronchiolitis. Pediatr Infect Dis J 22:92–94.
Hamelin, M.-E., Abed, Y., and Boivin, G. (2004). Human metapneumovirus: a new player among respiratory viruses. Clin Infect Dis 38:983–990.
van den Hoogen, B.G., de Jong, J.C., Groen, J., Kuiken, T., de Groot, R., Fouchier, R.A.M., and Osterhaus, A.D.E.M. (2001). A newly discovered human pneumovirus isolated from young children with respiratory tract disease. Nat Med 7:719–724.
van den Hoogen, B.G., Bestebroer, T.M., Osterhaus, A.D.E.M., and Fouchier, R.A.M. (2002). Analysis of the genomic sequence of a human metapneumovirus. Virology 295:119–132.
van den Hoogen, B.G., van Doornum, G.J.J., Fockens, J.C., Cornelissen, J.J., Beyer, W.E.P., de Groot, R., Osterhaus, A.D.E.M., and Fouchier, R.A.M. (2003). Prevalence and clinical symptoms of human metapneumovirus infection in hospitalised patients. J Infect Dis 188:1571–1577.
van den Hoogen, B.G., Osterhaus, A.D.E.M., and Fouchier, R.A.M. (2004a). Clinical impact and diagnosis of human metapneumovirus infection. Pediatr Infect Dis J 23:S25–S32.
van den Hoogen, B.G., Herfst, S., Sprong, L., Cane, P.A., Forleo-Neto, E., de Swart, R.L., Osterhaus, A.D.E.M., and Fouchier, R.A.M. (2004b). Antigenic and genetic variability of human metapneumoviruses. Emerg Infect Dis 10:658–666.
Jartti, T., van de Hoogen, B., Garofalo, R.P., Osterhaus, A.D.E.M., and Ruuskanen, O. (2002). Metapneumovirus and acute wheezing in children. Lancet 360:1393–1394.
Jartti, T., Lehtinen, P., Vuorinen, T., Österback, R., van de Hoogen, B., Osterhaus, A.D.E.M., and Ruuskanen, O. (2004). Respiratory picornaviruses and respiratory syncytial virus as causative agents of acute expiratory wheezing in children. Emerg Infect Dis 10:1095–1101.
Kuiken, T., van den Hoogen, B.G., van Riel, D.A.J., Laman, J.D., van Amerongen, G., Sprong, L., Fouchier, R.A.M., and Osterhaus, A.D.E.M. (2004). Experimental human metapneumovirus infection of cynomolgus macaques (Macaca fascicularis) results in virus replication in ciliated epithelial cells and pneumocytes with associated lesions throughout the respiratory tract. Am J Pathol 164:1893–1900.
König, B., König, W., Arnold, R., Werchau, H., Ihorst, G., and Forster, J. (2004). Prospective study of human metapneumovirus infection in children less than 3 years of age. J Clin Microbiol 42:4632–4635.
Laham, F.R., Israele, V., Casellas, J.M., Garcia, A.M., Lac Prugent, C.M., Hoffman, S.J., Hauer, D., Thumar, B., Name, M.I., Pascual, A., Taratutto, N., Ishida, M.T., Balduzzi, M., Maccarone, M., Jackli, S., Passarino, R., Gaivironsky, R.A., Karron, R.A., Polack, N.R., and Polack, F.P. (2004). Differential production of inflammatory cytokines in primary infection with human metapneumovirus and with other common respiratory viruses of infancy. J Infect Dis 189:47–56.
Ludewick, H.P., Abed, Y., van Niekerk, N., Boivin, G., Klugman, K.P., and Madhi, S.A. (2005). Human metapneumovirus genetic variability, South Africa. Emerg Infect Dis 11:1074–1078.
Mackay, I.M., Jacob, K.C., Woolhous, D., Waller, K., Syrmis, M.W., Whiley, D.M., Siebert, D.J., Nissen, M., and Sloots, T.P. (2003). Molecular assays for detection of human metapneumovirus. J Clin Microbiol 41:100–105.
Mackay, I.M., Bialasiewicz, S., Waliuzzaman, Z., Chidlow, G.R., Fegredo, D.C., Laingam, S., Adamson, P., Harnett, G.B., Rawlinson, W., Nissen, M., and Sloots, T.P. (2004). Use of the P genes to genotype human metapneumovirus identifies 4 viral subtypes. J Infect Dis 190:1913–1918.
Madhi, S.A., Ludewick, H., Abed, Y., Klugman, K.P., and Boivin, G. (2003). Human metapneumovirus-associated lower respiratory tract infections among hospitalized human immunodeficiency virus type 1 (HIV-1)-uninfected African infants. Clin Infect Dis 37:1705–1710.
Maggi, F., Pifferi, M., Vatteroni, M., Fornai, C., Tempestini, E., Anzilotti, S., Lanini, L., Andreoli, E., Ragazzo, V., Pistello, M., Specter, S., and Bendinelli, M. (2003). Human metapneumovirus associ ated with respiratory tract infections in a 3-year study of nasal swabs from infants in Italy. J Clin Microbiol 41:2987–2991.
McAdam, A.J., Hasenbein, M.E., Feldman, H.A., Cole, S.E., Offermann, J.T., Riley, A.M., and Lieu, T.A. (2004). Human metapneumovirus in children tested at a tertiary-care hospital. J Infect Dis 190:20–26.
Mullins, J.A., Erdman, D.D., Weinberg, G.A., Edwards, K., Hall, C.B., Walker, F.J., Iwane, M., and Anderson, J.J. (2004). Human metapneumovirus infection among children hospitalized with acute respiratory illness. Emerg Infect Dis 10:700–705.
Peiris, J.S.M., Tang, W.-H., Chan, K.-H., Khong, P.-L., Guan, Y., Lau, Y.-L., and Chiu, S.S. (2003). Children with respiratory disease associated with metapneumovirus in Hong Kong. Emerg Infect Dis 9:628–633.
Principi, N., Esposito, S., and Bosis, S. (2004). Human metapneumovirus and lower respiratory tract disease in children. Correspondence. New Engl J Med 350:1788.
Rawlinson, W.D., Waliuzzaman, Z., Carter, I.W., Belessis, Y.C., Gilbert, K.M., and Morton, J.R. (2003). Asthma exacerbations in children associated with rhinovirus but not human metapneumovirus infection. J Infect Dis 187:1314–1318.
Semple, M.G., Cowell, A., Dove, W., Greensill, J., McNamara, P.S., Halfhide, C., Shears, P., Smyth, R.L., and Hart, C.A. (2005). Dual infections of infants by human metapneumovirus and human respiratory syncytial virus is strongly associated with severe bronchiolitis. J Infect Dis 191:382–386.
Thanasugarn, W., Samransamruajkit, R., Vanapongtipagorn, P., Prapphal, N., van den Hoogen, B., Osterhaus, A.D.E.M., and Poovorawan, Y. (2003). Human metapneumovirus infection in Thai children. Scand J Infect Dis 35:754–756.
Viazov, S., Ratjen, F., Scheidhauer, R., Fiedler, M., and Roggendorf, M. (2003). High prevalence of human metapneumovirus infection in young children and genetic heterogeneity of the viral isolates. J Clin Microbiol 41:3043–3045.
Williams, J.V., Harris, P.A., Tollefson, S.J., Halburnt-Rush, L.L., Pingsterhaus, J.M., Edwards, K.M., Wright, P.F., and Crowe, J.E. (2004) Human metapneumovirus and lower respiratory tract disease in otherwise healthy infants and children. N Eng J Med 350:443–450.
Wyde, P.R., Chetty, S.N., Jewell, A.M., Boivin, G., and Piedra, P.A. (2003). Comparison of the inhibition of human metapneumovirus and respiratory syncytial virus by ribavirin and immune serum globulin in vitro. Antiviral Res 60:51–59.
Wyde, P.R., Chetty, S.N., Jewell, A.M., Schoonover, S.L., and Piedra, P.A. (2005). Development of a cotton rat-human metapneumovirus (hMPV) model for identifying and evaluating potential hMPV antivirals and vaccines. Antiviral Res 66:57–66.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2006 Springer Science+Business Media, LLC
About this paper
Cite this paper
Warris, A., de Groot, R. (2006). Human Metapneumovirus: An Important Cause of Acute Respiratory Illness. In: Pollard, A.J., Finn, A. (eds) Hot Topics in Infection and Immunity in Children III. Advances in Experimental Medicine and Biology, vol 582. Springer, Boston, MA . https://doi.org/10.1007/0-387-33026-7_21
Download citation
DOI: https://doi.org/10.1007/0-387-33026-7_21
Publisher Name: Springer, Boston, MA
Print ISBN: 978-0-387-31783-0
Online ISBN: 978-0-387-33026-6
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)