Allergy Asthma Respir Dis.  2013 Jun;1(2):157-163. 10.4168/aard.2013.1.2.157.

Comparison of respiratory disease by human metapneumovirus and respiratory syncytial virus in children

• Chung WJ
• Kang SS
• Bang KW
• Chun YH
• Yoon JS
• Kim HH
• Kim JT
• Lee JS

• KMID: 2261864
• DOI: http://doi.org/10.4168/aard.2013.1.2.157

Abstract

PURPOSE
Human metapneumovirus (hMPV) is known to result in clinical manifestation similar to respiratory syncytial virus (RSV) in children. But some recent studies showed different features. This study compared the clinical manifestation of respiratory disease between hMPV and RSV.
METHODS
A total of 801 children who admitted to Seoul St. Mary's Hospital for respiratory infection from January to June, 2012 were enrolled. Respiratory viral polymerase chain reaction (PCR) using nasopharyngeal swab was performed in all children. We grouped hMPV positive children and RSV positive children and compared clinical features between them by retrospective chart review.
RESULTS
Among 801 children, 365 showed one virus PCR positive with 44 showing hMPV and 41 showing RSV. Respiratory diseases were upper respiratory infection, acute bronchitis, acute bronchiolitis and pneumonia. The peak season was March and April for hMPV and February and March for RSV. Fever incidence, fever duration and neutrophil percent of complete blood cell count were higher in hMPV group than RSV group (P<0.05). The mean age of hMPV group was higher than RSV group (P<0.05). But in acute bronchiolitis children, there was no mean age difference between two group. Acute bronchiolitis incidence declined with increased age for both group (P<0.05). The hMPV group showed relatively lower bronchiolitis and higher pneumonia incidence than RSV group, suggesting relation with age.
CONCLUSION
Respiratory infection by hMPV developed at late winter and spring, slightly later than RSV and at older age. The lower incidence of acute bronchiolitis for hMPV infection than RSV is maybe due to older age than RSV.

Keyword

Human metapneumovirus; Respiratory syncytial virus; Respiratory disease; Child

MeSH Terms

Blood Cell Count
Bronchiolitis
Bronchitis
Child
Fever
Humans
Incidence
Metapneumovirus
Neutrophils
Pneumonia
Polymerase Chain Reaction
Respiratory Syncytial Viruses
Retrospective Studies
Seasons
Viruses

Figure

• 

  Fig. 1 Outline of participants of our study. The 801 patients who admitted for the respiratory sign and symptom with their initial respiratory viral polymerase chain reaction (PCR) using nasopharyngeal swab were enrolled (except immune compromised patients). Of 365 patients having one respiratory viral PCR positive, 44 patients with human metapneumovirus (hMPV) and 41 patients with respiratory syncytial virus (RSV) were enrolled, excluding 280 patients with other respiratory viruses.

• 

  Fig. 2 Prevalence of human metapneumovirus (hMPV), respiratory syncytial virus (RSV), and other virus (influenza virus A, B, parainfluenza virus 1, 2, 3, rhinovirus, adenovirus, coronavirus, bocavirus) isolates from January to June, 2012. This shows that incidence of RSV infection was relatively higher at February and March and that of hMPV was slightly later at March and April.

• 

  Fig. 3 Distribution of clinical diagnosis. This shows that there was no significant difference of respiratory diagnosis between human metapneumovirus (hMPV) and respiratory syncytial virus (RSV) and they induced lower respiratory tract infection mainly. This also shows priority of RSV bronchiolitis at less than 6 months and hMPV pneumonia at more than 25 months. URI, upper respiratory infection.

• 

  Fig. 4 Comparison of mean age between patients infected with human metapneumovirus (hMPV) and respiratory syncytial virus (RSV) at peak season (hMPV, March and April; RSV, February and March) and that between patients infected with hMPV and RSV having bronchiolitis. This suggests that if there were difference of bronchiolitis incidence between two group, it could be explained not by properties of virus infection itself but by commonly involved age.

• 

  Fig. 5 Comparison of bronchiolitis incidence in patients infected with human metapneumovirus (hMPV) and respiratory syncytial virus (RSV) at each age subgroup. This shows no significant difference of bronchiolitis incidence between hMPV and RSV at each age subgroup. Test for trend statistics shows bronchiolitis incidence decreased with increased age in both hMPV and RSV group (P<0.05).

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