Myeong Sun Jang; Meeyong Shin

doi:10.4168/aard.2017.5.5.269

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Jang and Shin: The epidemiology and clinical manifestation of human metapneumovirus infection in children during 2011–2014

Original Article

Allergy Asthma Respir Dis 2017;5(5):269-273.

Published online: 5 September 2017

DOI: https://doi.org/10.4168/aard.2017.5.5.269

The epidemiology and clinical manifestation of human metapneumovirus infection in children during 2011–2014

Myeong Sun Jang, Meeyong Shin

Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea

Correspondence to: Meeyong Shin https://orcid.org/0000-0003-3699-8741 Department of Internal Medicine, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Korea Tel: +82-62-220-6571, Fax: +82-62-225-8578, E-mail: ischoi@chonnam.ac.kr

Received 26 March 201715 August 2017 Accepted 16 August 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study was performed to investigate the epidemiologic and clinical features of human metapneumovirus (hMPV).

Methods

We performed realtime reverse transcription polymerase chain reaction with nasopharyngeal samples from 2,403 children who were hospitalized with acute respiratory infection. Then medical records of 120 children, who were diagnosed with hMPV respiratory infection between 2011 and 2014, were retrospectively analyzed retrospectively and compared to epidemiologic data on respiratory virus infection reported by Korea Centers for Disease Control and Prevention.

Results

We detected 120 hMPV-positive cases out of 1,723 virus-positive specimens (7.0%), which prevailed mostly in spring between March and May. Respiratory infection with hMPV was more common in female patients (55.0%) and hPMV infection was prevalent among children aged <5 years (80.8%). Coinfections with other respiratory viruses were observed in 34 patients of 120 hMPV-positive cases (28.3%), mostly with rhinovirus (52.9%). In addition, hPMV infection mostly presented with pneumonia (71.7%). Among 120 hMPV-positive patients during the recent 4 years, most (68.3%) were diagnosed in 2014. During 2011–2014, influenza virus infection was prevalent mainly from January to March, and hMPV infection started to appear just after the end of influenza virus outbreak.

Conclusion

In Korean children, hMPV was a common causative organism of viral pneumonia during the spring season. The hMPV infection pandemic was observed in 2014 and the clinical importance of hMPV has recently been increasing. Therefore, additional studies are required to define the epidemiology, disease characteristics caused by hMPV, and the cause of recent outbreak.

Keywords: Metapneumovirus, Respiratory tract infections, Korea, Child

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Fig. 1.

Monthly incidence of human metapneumovirus infection.

Fig. 2.

Relation of influenza virus (IFV) and human metapneumovirus (hMPV) in Korea.

Fig. 3.

Age distribution of the patients with human metapneumovirus infection.

Table 1.

Detection rate of hMPV by multiplex realtime polymerase chain reaction in nasopharyngeal aspirate

Characteristic	2011–2014	2011–2013	2014
Total
Virus positive	1,723	799	924
hMPV positive	120 (7.0)	38 (4.8)	82 (9.0)
March–May
Virus positive	354	128	226
hMPV positive	96 (27.1)	29 (22.7)	67 (30.0)

Values are presented as number or number (%). hMPV, human metapneumovirus.

Table 2.

Demographic and clinical manifestations of human metapneumovirus infection

Characteristic	Total (n=120)	2011-2013 (n=38)	2014 (n=82)	P-value
Sex
Male	54 (45.0)	21 (55.3)	33 (40.2)	0.18
Female	66 (55.0)	17 (44.7)	49 (59.8)
Age (yr), mean±SD	2.59±1.82	3.78±2.57	2.04±0.94	<0.001
Age distribution				<0.001
<12 mo	9 (7.5)	0 (0.0)	9 (11.0)
1, <2 yr	28 (23.3)	5 (13.2)	23 (28.0)
2, <3 yr	32 (26.7)	8 (21.1)	24 (29.3)
3, <4 yr	24 (20.0)	7 (18.4)	17 (20.7)
4, <5 yr	13 (10.8)	9 (23.7)	4 (4.9)
≥5 yr	14 (11.7)	9 (23.7)	5 (6.1)
Hospital stay (day), median (range)	4.92 (2–29)	4.91 (2–29)	4.66 (2–16)	0.003
Clinical diagnosis				0.007
Pneumonia	86 (71.7)	20 (52.6)	66 (80.5)
Acute bronchiolitis	20 (16.7)	11 (28.9)	9 (11.0)
Acute bronchitis	4 (3.3)	1 (2.6)	3 (3.7)
Asthma	3 (2.5)	3 (7.9)	0 (0.0)
Croup	3 (2.5)	2 (5.3)	1 (1.2)
Miscellaneous	4 (3.3)	1 (2.6)	3 (3.7)

Values are presented as number (%) unless otherwise indicated. SD, standard deviation.

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