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Comparison of prevalence and clinical features of paediatric respiratory infections due to respiratory syncytial virus and human metapneumovirus

Abstract number: P2212

Beneri C., Manji R., Sood S., Ginocchio C.

Objectives: The purpose of this study was to compare the prevalence and clinical features of two paediatric respiratory pathogens, respiratory syncytial virus (RSV) and human metapneumovirus (hMPV) in children <5 yr.

Methods: Respiratory specimens (n = 657) collected 10/2004–4/2006 were tested for RSV and hMPV using NucliSENS analyte specific reagents and the NucliSENS EasyQ Basic Kit (bioMérieux, Durham, NC). Prevalence and admission rates were based on the total group. Chart review (n = 64) was conducted for 35 RSV+, 26 hMPV+, 3 RSV+/hMPV+ children evaluated in the ED or hospitalised. Case report forms were used to evaluate patient demographics, clinical findings, and clinical course.

Results: The overall infection rates were: RSV= 22.5% (<2 yr: 27.5%; 2–<5 yr: 12.7%), hMPV= 5.5% (<2 yr: 5.8%; 2–<5 yr: 4.6%). RSV and hMPV seasons overlapped although RSV peaked Nov-Jan and hMPV peaked Feb-April. The percentages of children requiring hospitalisation were 24.5% (RSV+) and 58.8% (hMPV+). Patients with chart review showed similar age distribution for RSV+ and hMPV+ (<2 yr: 65.7% vs 65.4%, 2–<5 yr: 34.3% vs 34.6%, respectively). There was no statistically significant difference in underlying co-morbidities, which included reactive airway disease, significant prematurity, muscular dystrophy, chronic lung disease, congenital heart disease, and leukaemia (p = 0.4004). Clinical findings were similar in both groups in terms of retractions, wheezing, and crackles (p = 0.2300, p = 0.9839, p = 0.3425, respectively). hMPV+ patients were more likely to present with fever (p leqslant R: less-than-or-eq, slant 0.001) and rash (p = 0.0111). RSV+ patients were more likely to present with rhinorrhoea (p = 0.0033) and diarrhoea (p = 0.0340). Although not statistically significant there was a trend towards more chest radiographs in hMPV+ patients (p = 0.0553). Upper and lower respiratory tract infections were seen in all groups but 19.2% of hMPV+ patients required mechanical ventilation versus 11.4% of RSV+ patients. This however did not affect length of stay in the intensive care unit or total hospital stay for either group. Patients co-infected with RSV and hMPV were not more likely to have severe disease.

Conclusion: RSV is the most prevalent cause of respiratory disease in children <5 yr. Seasonality and clinical symptoms of RSV and hMPV overlap, yet there are distinctions in prevalence peaks and clinical symptoms. This data suggests that hMPV infection may result in more hospital admissions and increased severity of symptoms.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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