Human Metapneumovirus in a Children’s Hospital – Should We Pay More Attention?
Viral respiratory infections are a major cause of hospitalization and Intensive Care Unit (ICU) admission. At childrens' hospitals, Infection Prevention closely tracks Respiratory Syncytial Virus (RSV) and Influenza, including rates of healthcare associated infections (HAI). There is conflicting data on the contribution of human Metapneumovirus (hMPV) infections to respiratory morbidity in hospitalized children.
hMPV testing was added in the 2013-14 winter viral season (D3 Ultra DFA Respiratory Virus Screening & ID Kit; Diagnostic Hybrids). Hospitalization rates, ICU admission and HAI rates were prospectively monitored and compared to current and past seasons of RSV and Influenza. Clinical information was extracted retrospectively on those patients with hMPV and RSV requiring ICU admission.
For children who underwent viral respiratory testing at our facility, rates of hospitalization, ICU admission and HAIs for hMPV were comparable to or exceeded those of RSV and Influenza for the current and past 4 winter seasons (Figures 1,2 & 3). Of 19 patients with hMPV requiring ICU admission, the average age was 6 years (y) 5 months (m) (range 8 m – 21 y 7 m), compared with an average age of 1 y 8 m (range 0 m – 15 y 4 m) for 35 ICU admitted RSV patients (p<0.05). Of hMPV infected patients, 16/19 (84%) had underlying medical diagnoses, including chronic lung disease in 10 (53%), and tracheostomy in 8 (42%). Six (32%) required mechanical ventilation. Only 12/35 (34%) RSV ICU admitted patients had underlying medical diagnoses; none had tracheostomies, 5 (14%) had chronic lung disease, 13 (37%) required mechanical ventilation. Length of hospitalization averaged 9.9 days (range 2-34 days) for hMPV and 7.7 days (range 1 – 25 days) for RSV ICU admits. Total contact isolation days were not significantly higher this season, likely due to a milder RSV season.
Among children tested for winter viral pathogens in 2013-14, hMPV rates of hospital admission, ICU admission and HAIs met or exceeded those for RSV and Influenza. ICU admitted patients with hMPV were older than those with RSV. There were more ICU admissions in hMPV patients with tracheostomy and chronic lung disease. Future efforts at surveillance and vaccine development should target this population.
H. Avila, None
C. Khong, None
N. Ashouri, None
See more of: Poster Abstract Session