528. Characterization of human metapneumovirus (hMPV) infection among adults with influenza-like illness
Session: Poster Abstract Session: Respiratory Infections: Viral (non Influenza)
Thursday, October 8, 2015
Room: Poster Hall
Background: Human metapneumovirus (hMPV) is a known cause of influenza-like illness (ILI). Much of what is known regarding the epidemiology and clinical characteristics of hMPV stems from studies of children and individuals with underlying medical conditions. Evaluations of the burden and characteristics of hMPV infection among otherwise healthy adults are warranted.

Methods: We conducted an observational, longitudinal study of ILI among otherwise healthy children and adults from 2009-2015. Information on demographics, potential risk factors and symptom severity were collected at baseline. Participants reported symptom severity for an additional 7 days via diary. Nasopharyngeal swabs were collected at baseline and tested on a multiplex viral respiratory panel (Diatherix Laboratories, Inc.; Huntsville, AL).

Results: Of 898 patients with ILI, 58 (7%) were positive for hMPV. hMPV was detected between December and May, and peaked in February. Twenty-eight (48.2%) cases were ≥18y; these accounted for 4.4% of adults. Of the 28 adult cases, 7 (25%) had co-detected viral pathogens, 1 (3.5%) had pneumococcus co-detection. Adults with hMPV were white (68%), male (68%), and non-smokers (50%), with a median (range) age of 33 (21-58)y. We did not identify significant risk factors for detection of hMPV in adults including exposure to young children. Over 75% reported classic flu symptoms (e.g., sore throat, cough, muscle aches). hMPV symptom severity did not differ between men and women, nor between adults and children. When compared to those with influenza, adults with hMPV reported less severe systemic and gastrointestinal symptoms (p=0.03 and p<0.01, respectively) in the first 3 days of illness. By contrast, upper respiratory symptoms were more severe for hMPV than influenza, particularly at days 5 and 6 of illness. 

Conclusion: Although hMPV appears to be a relatively minor contributor to the burden of ILI among otherwise healthy adults, its spectrum of symptom severity and clinical presentation is comparable to that of influenza. Infected adults did not have increased exposure to young children who are at risk for hMPV. hMPV was a less common cause of ILI in adults, but the severity of illness and co-detection of other pathogens was similar to that seen in children.

Michelande Ridore, MS1, Wei-Ju Chen, PhD2, Mary Fairchok, MD3, Christina Schofield, MD FACP, FIDSA4, Tahaniyat Lalani, MBBS, MHS5, Patrick Danaher, MD, FIDSA6, Michael Rajnik, MD7, Erin Mcdonough, BS8, Leslie Malone, MS, MB(ASCP)CM9, Elena Grigorenko, PhD10, Donald Stalons, PhD, D(ABMM), MPH9, Deepika Mor, MS2, Timothy Burgess, MD, MPH7, John Arnold, MD11, Eugene Millar, PhD12 and Henry M. Jackson Foundation for the Advancement of Military Medicine, (1)Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Rockville, MD, (2)Infectious Disease Clinical Research Program, Uniformed Services University, Bethesda, MD, (3)Infectious Disease Clinical Research Program, Tacoma, WA, (4)Madigan Army Medical Center, Tacoma, WA, (5)Naval Medical Center Portsmouth, Portsmouth, VA, (6)San Antonio Military Health System, Fort Sam Houston, TX, (7)Walter Reed National Military Medical Center, Bethesda, MD, (8)Naval Health Research Center, San Diego, CA, (9)Diatherix Laboratories, Inc., Huntsville, AL, (10)Diatherix Laboratories, Inc, Huntsville, AL, (11)Naval Medical Center San Diego, San Diego, CA, (12)Infectious Disease Clinical Research Program, Rockville, MD

Disclosures:

M. Ridore, None

W. J. Chen, None

M. Fairchok, None

C. Schofield, None

T. Lalani, None

P. Danaher, None

M. Rajnik, None

E. Mcdonough, None

L. Malone, Diatherix Lab: Investigator , Salary

E. Grigorenko, Diatherix lab: Investigator , Salary

D. Stalons, Diatherix Lab: Investigator , Salary

D. Mor, None

T. Burgess, None

J. Arnold, None

E. Millar, None

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