title: Prevalence of human metapneumovirus and influenza virus infections among Japanese children during two successive winters.
abstract: BACKGROUND
  Human metapneumoviruses (hMPVs) are recognized as a leading cause of respiratory infections in young infants in many countries. The objective of this study was to identify links between hMPV and influenza virus infections among children with influenza-like illness.
  
  
  METHODS
  This study was conducted in 2 influenza seasons (2002-2003 and 2003-2004) at 2 pediatric outpatient clinics in Niigata city, Japan. Nasopharyngeal swabs or aspirates were collected from influenza-like illness patients, and hMPV and influenza were detected by reverse transcription-polymerase chain reaction (RT-PCR). A nucleotide sequence of 352 nucleotides segment of the F gene was performed.
  
  
  RESULTS
  A total of 765 influenza viruses and 84 hMPV were identified from 1498 nasopharyngeal swabs or aspirates by virus isolation and RT-PCR, respectively. hMPV-positive rates in patients with influenza-like illness were 5.7 and 5.2% in the 2002-2003 and 2003-2004 seasons, respectively. Epidemic curves of influenza and hMPV patients showed similar patterns with peaks in February in 2 influenza seasons. hMPV infections occurred frequently in infants and school children. Approximately 46% of hMPV patients were coinfected with influenza A viruses, but those coinfected cases were not clinically distinct from the others. No coinfection with influenza B viruses was found. Phylogenetic analysis of the hMPV fusion gene sequences revealed that 2 distinct hMPV cocirculated and that completely identical strains in subgroup A were observed over 2 years.
  
  
  CONCLUSIONS
  HMPV plays an important pathogenic role in patients with influenza-like illness in winter seasons, often in coinfections with influenza A viruses.
authors.affiliation: Department of Public Health, Niigata University, School of Medicine, Japan. asammy@med.niigata-u.ac.jp
authors.forename: Asami
authors.initials: A
authors.lastname: Sasaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Suzuki
authors.forename: Reiko
authors.initials: R
authors.lastname: Saito
authors.forename: Mizuho
authors.initials: M
authors.lastname: Sato
authors.forename: Isamu
authors.initials: I
authors.lastname: Sato
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Sano
authors.forename: Makoto
authors.initials: M
authors.lastname: Uchiyama
mesh_terms: D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D009980:Influenza A virus / Q000235:genetics / Q000302:isolation & purification; D009981:Influenza B virus / Q000235:genetics / Q000302:isolation & purification; D007251:Influenza, Human / Q000150:complications* / Q000453:epidemiology* / Q000821:virology; D007564:Japan / Q000453:epidemiology; D029121:Metapneumovirus / Q000235:genetics / Q000302:isolation & purification; D018184:Paramyxoviridae Infections / Q000150:complications* / Q000453:epidemiology* / Q000821:virology; D015995:Prevalence; D012621:Seasons