title: Human metapneumovirus and exacerbations of chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  Respiratory viruses are a common trigger for exacerbations of chronic obstructive pulmonary disease (COPD). Human metapneumovirus (hMPV) is a paramyxovirus associated with respiratory tract infections and wheezing. Our aim was to determine whether hMPV was associated with exacerbations of COPD.
  
  
  METHODS
  The study was designed as an observational cohort study carried out in a 944-bed urban teaching hospital located in New Haven, Connecticut. Between December 2002 and May 2003, patients hospitalized due to an exacerbation of COPD were identified. Nasopharyngeal specimens obtained from these patients were tested for human metapneumovirus by RT-PCR and for respiratory syncytial virus, influenza A and B, parainfluenza-1, -2, and -3 and adenovirus by a cytospin-enhanced direct immunofluorescence assay and/or viral culture.
  
  
  RESULTS
  Fifty individuals met enrollment criteria and hMPV was identified in 6 (12%), respiratory syncytial virus in 4 (8%), influenza A in 2 (4%) and parainfluenza type 3 in 1 (2%) patients. Both A and B hMPV genotypes were identified in patients hospitalized due to exacerbations of COPD.
  
  
  CONCLUSIONS
  hMPV was frequently identified in patients hospitalized due to an exacerbation of COPD. Further studies are necessary to determine the epidemiology and the impact of hMPV in COPD patients.
authors.affiliation: Department of Internal Medicine, Infectious Diseases Section, Yale University School of Medicine, New Haven, CT 06520, USA. richard.martinello@yale.edu
authors.forename: Richard A
authors.initials: RA
authors.lastname: Martinello
authors.forename: Frank
authors.initials: F
authors.lastname: Esper
authors.forename: Carla
authors.initials: C
authors.lastname: Weibel
authors.forename: David
authors.initials: D
authors.lastname: Ferguson
authors.forename: Marie L
authors.initials: ML
authors.lastname: Landry
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Kahn
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003237:Connecticut; D005260:Female; D006760:Hospitalization; D006784:Hospitals, Teaching; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D029121:Metapneumovirus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D008875:Middle Aged; D018184:Paramyxoviridae Infections / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology*; D010802:Phylogeny; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology* / Q000821:virology*; D020133:Reverse Transcriptase Polymerase Chain Reaction