Aims This study aimed to characterise seasonal variation, co-infection rates, susceptible groups (by gender, age and co-morbidities) and selected clinical features of childhood human metapneumovirus (HMPV) infection.
Methods The study was a retrospective analysis of 656 HMPV-positive respiratory samples collected from paediatric patients aged 0–15 years processed from January 2010 to December 2013 using real time PCR assays. In addition, 200 HMPV-positive samples from January 2012 to January 2013 were cross-referenced with electronic discharge summaries and descriptive statistical analyses of selected clinical features were performed.
Results 377 of 656 (57%) HMPV-positive samples were from male patients. HMPV was most frequently detected in children aged 6–9 months and the median age of patients studied was 15 months. Seasonal patterns of HMPV infection varied from year to year. The peak in HMPV-positive isolates occurred between February and May. 117 of 656 (17.5%) samples were positive for other respiratory viruses in addition to HMPV. The most common co-infections were due to rhinovirus (58/656, 8.84%) and adenovirus (36/656, 5.49%).
81 (40%) of the 200 fully-characterised patients were hospitalised, 7 (3.5%) of whom required intensive care (ICU) or high dependency (HDU) admission. Rashes were reported in 14 (7%) and febrile seizures in 9 (4.5%) of 200 patients. These clinical features were more common in children with co-infections [6/40 (15%) and 4/40 (10%) respectively].
Conclusions Male gender is suggested as a predisposing factor for HMPV infection, along with younger age. Seasonal variation of HMPV infection in Scottish children appears different to the reported winter peaks of other studies, with peak incidence occurring between February and May in our dataset. Co-infection is common, and most frequently associated with rhinovirus or adenovirus. Rashes and febrile seizures are relatively common in HMPV-positive patients, especially those co-infected with other respiratory pathogens. Human metapneumovirus is a significant cause of morbidity in children. Further, larger-scale epidemiological research appears warranted, along with work to develop new therapies aimed at targeting HMPV.
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