title: Association of human metapneumovirus with acute otitis media.
abstract: OBJECTIVE
  Human metapneumovirus (hMPV) is a recently described paramyxovirus that has been associated with acute upper and lower respiratory infection (LRI) in infants and children worldwide. We previously observed that one-third of the children with hMPV-associated LRI had been diagnosed with a concomitant acute otitis media (AOM). In the current study, we sought to investigate an association between hMPV and children presenting with AOM as a primary diagnosis.
  
  
  METHODS
  We used realtime RT-PCR for hMPV to retrospectively test 144 paired nasal wash (NW) and middle ear fluid (MEF) specimens that had been prospectively collected from children with AOM during a 3-year period from 1990-1992. RNA was extracted from archived, frozen samples and realtime RT-PCR for hMPV was performed.
  
  
  RESULTS
  We detected hMPV in 8/144 (6%) NW and 1/144 MEF. Several of the children still tested positive for hMPV in NW 3 days later, showing persistent virus shedding. All were detected from November-May and six had bacterial co-pathogens. Two of the eight (25%) hMPV-infected children had no bacterial pathogen isolated, suggesting that hMPV may be associated with AOM as a sole pathogen.
  
  
  CONCLUSIONS
  These data show that hMPV is associated with a proportion of AOM and thus has additional morbidity and healthcare impact related to these illnesses.
authors.affiliation: Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, USA. john.williams@vanderbilt.edu
authors.forename: John V
authors.initials: JV
authors.lastname: Williams
authors.forename: Sharon J
authors.initials: SJ
authors.lastname: Tollefson
authors.forename: Sangeeta
authors.initials: S
authors.lastname: Nair
authors.forename: Tasnee
authors.initials: T
authors.lastname: Chonmaitree
mesh_terms: D000208:Acute Disease; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D029121:Metapneumovirus / Q000235:genetics / Q000302:isolation & purification*; D009017:Morbidity; D017817:Nasal Lavage Fluid / Q000821:virology; D010033:Otitis Media / Q000453:epidemiology / Q000821:virology*; D018184:Paramyxoviridae Infections / Q000150:complications* / Q000453:epidemiology; D012367:RNA, Viral / Q000032:analysis; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction
chemical_list: D012367:RNA, Viral