527. Human metapneumovirus infection in pregnant and postpartum women
Session: Poster Abstract Session: Respiratory Infections: Viral (non Influenza)
Thursday, October 8, 2015
Room: Poster Hall
Background: Human metapneumovirus (hMPV) is a respiratory virus associated with pneumonia and mortality in primarily pediatric and immunocompromised populations. To our knowledge, the clinical manifestations of hMPV have not been described in pregnant and postpartum women. 

Methods: As part of a community-based randomized controlled trial of seasonal influenza vaccination in rural southern Nepal, pregnant women were enrolled and visited weekly through six months postpartum. If an episode of respiratory illness with fever occurred in the prior week, a mid-nasal swab was collected. To assess severity, a 1-point score was assigned to each symptom (fever, cough, sore throat, rhinorrhea, myalgia). A Wilcoxon rank-sum test was used to compare the severity scores and days of symptoms between groups.

Results: During the 3-year study period (04/2011-05/2014), 56 of 3683 women enrolled (1.5%) had hMPV detected. HMPV incidence peaked between September 2011 and January 2012.  Mean age at enrollment was similar among women with and without hMPV (23.6 vs. 23.4 years); women with hMPV had less education (3.3 vs. 5.0 years) and greater household density (4.8 vs. 4.1 people/room) compared to women without hMPV. Three (5.4%) hMPV+ women smoked, compared to 105 (3.0%) of women without hMPV. Incidence rates of hMPV were 1.3% during pregnancy and 1.8% postpartum. Overall, the most frequent symptom was cough (64.2%), followed by myalgia (60.7%). While severity score did not differ significantly between groups, pregnant women experienced longer duration of symptoms (6.5 days vs 4.5 days; p = 0.02; Table 1). 

Table 1. Severity and duration of hMPV infection among pregnant and postpartum women

Measure

Pregnant

 N=26

Postpartum

N=30

p-value

 

Severity score

3.5 (2.0, 5.0)

3.0 (2.0, 4.0)

0.40

 

Fever duration (days)

3.0 (2.0, 4.0)

3.0 (2.0, 4.0)

0.33

 

Symptom duration (days)

6.5 (4.0, 23.0)

4.5 (3.0, 10.0)

0.02

 

Data presented as median (IQR) 

 

Conclusion: HMPV is a significant cause of respiratory illness in pregnant and postpartum women in rural Nepal. Pregnant women experienced significantly increased symptom duration compared to postpartum women.

Jennifer L. Lenahan, MPHc1,2, Janet Englund, MD, FIDSA2,3, James Tielsch, PhD4, Joanne Katz, ScD5, Subarna Khatry, MBBS, DOMS6, Steven C Leclerq, MPH5,7, Jane Kuypers, PhD8, Mark C. Steinhoff, MD, FIDSA9 and Helen Y. Chu, MD MPH10, (1)Epidemiology, University of Washington School of Public Health, Seattle, WA, (2)Infectious Disease/Cctr, Seattle Children's Hospital, Seattle, WA, (3)Pediatrics, University of Washington, Seattle, WA, (4)Global Health, George Washington University, Washington, DC, (5)Johns Hopkins University, Baltimore, MD, (6)NNIPS, Kathmandu, Nepal, (7)NNIPS, Baltimore, MD, (8)University of Washington, Seattle, WA, (9)Division of Infectious Diseases, Global Health Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, (10)Allergy & Infectious Diseases, University of Washington, Seattle, WA

Disclosures:

J. L. Lenahan, None

J. Englund, None

J. Tielsch, None

J. Katz, None

S. Khatry, None

S. C. Leclerq, None

J. Kuypers, None

M. C. Steinhoff, None

H. Y. Chu, None

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