HUMAN METAPNEUMOVIRUS INFECTION IN HOSPITALIZED CHILDREN

Introduction Human metapneumovirus hMPV is a newly recognized pathogen associated with respiratory tract disease. Objective Characterize hMPV infection in a pediatric department in Lisbon. Methods Retrospective study from November2007February2008. Nasal wash specimens were analysed for hMPV using an enzyme immunoassay Biotrin. Results Fortyone cases were observed, median age 7months 17days3years 12months 67, 61 male, 39 had a smoking parent, 59 older siblings, 28 were not breastfed and 31 attended daycare. Twentyfour percent were born prematurely, 8 had chronic pulmonary disease, 24 a previous wheezing episode and 3 gastroesophageal reflux. At presentation median duration of illness was 4days 18days, main complaints coriza 89, cough 78, respiratory distress 67, fever 54 39C 26, feeding difficulties 39 and gastrointestinal symptoms 11. Median WBC count was 13900L 380036400L, and 19 patients had CRP 5mgdL 14 had bacterial coinfections. Chest roentgenograms revealed interstitial infiltrates 38, atelectasis 22, hyperinsufflation 28, consolidationlobar pneumonia 9, and were normal in 28. Complications occurred in 23 children 64 hypoxemia 47, atelectasis 19, bacterial superinfection 14 and hypercapnia 11. There were no fatalities. Treatment consisted of bronchodilators 72, antibiotics 3117 bacterial coinfections, oral corticosteroids 17 and respiratory rehabilitation 67. Four patients 11 needed intensive care and three were ventilated. Median duration of hospitalization was 6days 222days. Daycare attendance was associated with occurrence of complications p0.04. Conclusions There was an elevated complication rate in our patients. The hMPV disease is still underrecognized and underreported in our country. The spectrum of disease is similar to other respiratory virus.