Clinical course of hospitalised children infected with human metapneumovirus and respiratory syncytial virus.
OBJECTIVE
To describe the clinical presentation and outcomes of hospitalised patients infected with human metapneumovirus (hMPV) and human respiratory syncytial virus (hRSV) in a tertiary hospital in Cape Town, South Africa.


METHODS
hMPV was identified in 17 respiratory specimens submitted for viral studies during the period 2001-2003. These patients' medical folders were retrospectively reviewed for clinical, radiological and laboratory data, together with a convenience sample of 20 hRSV-infected patients.


RESULTS
hMPV-infected patients were older than those infected with hRSV (P = 0.04) and required a longer hospital stay (P = 0.02). Presenting clinical signs and symptoms were similar between groups. Fourteen (87.5%) hMPV- and 16 (80%) hRSV-infected patients presented with co-morbid and/or immunosuppressive conditions (P > or = 0.5). The most common abnormalities on chest radiographs in both groups were bronchial wall thickening, focal consolidation and atelectasis. Six (37.5%) hMPV- and 11 (55%) hRSV-infected patients required admission to the paediatric intensive care unit (P > 0.1) with five (31.3%) hMPV- and eight (40%) hRSV-infected patients requiring intubation and ventilation (P > 0.5). Three (18.7%) hMPV-patients and three (15%) hRSV-infected patients died during this admission (P > 0.5). All hMPV-infected patients who died had significant co-morbid conditions.


CONCLUSIONS
These data confirm that hMPV is a significant respiratory pathogen in this setting, with similar presentation and outcome to hRSV infection. This is the largest report of hMPV infection causing significant morbidity, prolonged hospital stay and death, associated with underlying risk factors.
Morrow
Brenda M
BM
Red Cross War Memorial Children's Hospital (RCWMCH), Physiotherapy Department and Division of Associated Paediatric Disciplines, School of Child and Adolescent Health, University of Cape Town, South Africa. bmorrow@ich.uct.ac.za
Hatherill
Mark
M
Smuts
Heidi E M
HE
Yeats
Jane
J
Pitcher
Richard
R
Argent
Andrew C
AC
D017677:Age Distribution; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data; D008297:Male; D029121:Metapneumovirus / Q000302:isolation & purification*; D009297:Nasal Mucosa / Q000821:virology; D017063:Outcome Assessment, Health Care; D018184:Paramyxoviridae Infections / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D018357:Respiratory Syncytial Virus Infections / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D012136:Respiratory Syncytial Viruses / Q000302:isolation & purification*; D013019:South Africa