BACKGROUND: Human metapneumovirus (hMPV) is a newly described paramyxovirus that is mainly associated with bronchiolitis in children. We sought to describe the epidemiological, virological, and histopathological findings associated with a large outbreak of hMPV infection in a long-term care facility. METHODS: An investigation of the outbreak was performed by public health authorities, who used standardized questionnaires to collect relevant clinical information from all residents of the facility. Nasopharyngeal samples were obtained from a subset of patients who had influenza-like illnesses for testing by viral culture and reverse-transcriptase polymerase chain reaction. Lung tissue samples from a patient whose case was fatal were available for molecular, histopathological, and immunohistochemical testing. RESULTS: A total of 96 (27%) of 364 residents of a long-term care facility presented with respiratory or constitutional symptoms between 1 January 2006 and 15 February 2006. The attack rate in the most affected ward was 72% (31 of 43 patients), which included 4 of the 6 polymerase chain reaction-confirmed cases of hMPV infection. In contrast, viral culture results were positive for hMPV in only 2 of the 5 polymerase chain reaction-positive samples tested. The most reported diagnosis was an upper respiratory tract infection or an influenza-like illness, although 21% of residents in 1 of the 3 wards that had confirmed cases of hMPV infection had lower respiratory tract infections. The fatality rate was 50% (3 of 6 patients) among confirmed cases and 9.4% (9 of 96 patients) among patients with possible cases. A patient with a fatal case had histopathological findings that confirmed the presence of hMPV RNA and proteins in the bronchiolar epithelium of affected lobes. Phylogenetic analysis revealed the presence of 2 distinct strains of hMPV circulating simultaneously on different wards. CONCLUSION: hMPV can be associated with important outbreaks of acute respiratory tract infection in elderly institutionalized persons.
BACKGROUND:Human metapneumovirus (hMPV) is a newly described paramyxovirus that is mainly associated with bronchiolitis in children. We sought to describe the epidemiological, virological, and histopathological findings associated with a large outbreak of hMPVinfection in a long-term care facility. METHODS: An investigation of the outbreak was performed by public health authorities, who used standardized questionnaires to collect relevant clinical information from all residents of the facility. Nasopharyngeal samples were obtained from a subset of patients who had influenza-like illnesses for testing by viral culture and reverse-transcriptase polymerase chain reaction. Lung tissue samples from a patient whose case was fatal were available for molecular, histopathological, and immunohistochemical testing. RESULTS: A total of 96 (27%) of 364 residents of a long-term care facility presented with respiratory or constitutional symptoms between 1 January 2006 and 15 February 2006. The attack rate in the most affected ward was 72% (31 of 43 patients), which included 4 of the 6 polymerase chain reaction-confirmed cases of hMPVinfection. In contrast, viral culture results were positive for hMPV in only 2 of the 5 polymerase chain reaction-positive samples tested. The most reported diagnosis was an upper respiratory tract infection or an influenza-like illness, although 21% of residents in 1 of the 3 wards that had confirmed cases of hMPVinfection had lower respiratory tract infections. The fatality rate was 50% (3 of 6 patients) among confirmed cases and 9.4% (9 of 96 patients) among patients with possible cases. A patient with a fatal case had histopathological findings that confirmed the presence of hMPV RNA and proteins in the bronchiolar epithelium of affected lobes. Phylogenetic analysis revealed the presence of 2 distinct strains of hMPV circulating simultaneously on different wards. CONCLUSION:hMPV can be associated with important outbreaks of acute respiratory tract infection in elderly institutionalized persons.
Authors: Chin-Fen Yang; Chiaoyin K Wang; Sharon J Tollefson; Linda D Lintao; Alexis Liem; Marla Chu; John V Williams Journal: Arch Virol Date: 2013-02-06 Impact factor: 2.574
Authors: John V Williams; Kathryn M Edwards; Geoffrey A Weinberg; Marie R Griffin; Caroline B Hall; Yuwei Zhu; Peter G Szilagyi; Chiaoyin K Wang; Chin-Fen Yang; David Silva; Dan Ye; Richard R Spaete; James E Crowe Journal: J Infect Dis Date: 2010-06-15 Impact factor: 5.226
Authors: Ann R Falsey; Gerard E Dallal; Maria A Formica; Gloria G Andolina; Davidson H Hamer; Lynette L Leka; Simin Nikbin Meydani Journal: J Am Geriatr Soc Date: 2008-06-28 Impact factor: 5.562
Authors: Ann R Falsey; Patricia A Hennessey; Maria A Formica; Mary M Criddle; Jamie M Biear; Edward E Walsh Journal: Vaccine Date: 2009-12-08 Impact factor: 3.641