Williams John V, Harris Paul A, Tollefson Sharon J, Halburnt-Rush Lisa L, Pingsterhaus Joyce M, Edwards Kathryn M, Wright Peter F, Crowe James E
Division of Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232-2581, USA.
N Engl J Med. 2004 Jan 29;350(5):443-50. doi: 10.1056/NEJMoa025472.
We sought to determine the role of human metapneumovirus in lower respiratory tract illness in previously healthy infants and children.
We tested nasal-wash specimens, obtained over a 25-year period from otherwise healthy children presenting with acute respiratory tract illness, for human metapneumovirus.
A viral cause other than human metapneumovirus was determined for 279 of 687 visits for acute lower respiratory tract illness (41 percent) by 463 children in a population of 2009 infants and children prospectively seen from 1976 to 2001. There were 408 visits for lower respiratory tract illness by 321 children for which no cause was identified. Of these 321 children, specimens from 248 were available. Forty-nine of these 248 specimens (20 percent) contained human metapneumovirus RNA or viable virus. Thus, 20 percent of all previously virus-negative lower respiratory tract illnesses were attributable to human metapneumovirus, which means that 12 percent of all lower respiratory tract illnesses in this cohort were most likely due to this virus. The mean age of human metapneumovirus-infected children was 11.6 months, the male:female ratio was 1.8:1, 78 percent of illnesses occurred between December and April, and the hospitalization rate was 2 percent. The virus was associated with bronchiolitis in 59 percent of cases, pneumonia in 8 percent, croup in 18 percent, and an exacerbation of asthma in 14 percent. We also detected human metapneumovirus in 15 percent of samples from 261 patients with upper respiratory tract infection but in only 1 of 86 samples from asymptomatic children.
Human metapneumovirus infection is a leading cause of respiratory tract infection in the first years of life, with a spectrum of disease similar to that of respiratory syncytial virus.
我们试图确定人偏肺病毒在既往健康的婴幼儿下呼吸道疾病中的作用。
我们检测了在25年期间从患有急性呼吸道疾病的健康儿童中采集的鼻洗液标本，以检测人偏肺病毒。
在1976年至2001年前瞻性观察的2009名婴幼儿群体中，463名儿童因急性下呼吸道疾病就诊687次，其中279次（41%）确定了除人偏肺病毒以外的病毒病因。有321名儿童因下呼吸道疾病就诊408次，病因未明确。在这321名儿童中，248名儿童的标本可用。这248份标本中有49份（20%）含有人类偏肺病毒RNA或活病毒。因此，所有既往病毒检测阴性的下呼吸道疾病中有20%可归因于人偏肺病毒，这意味着该队列中所有下呼吸道疾病中有12%很可能是由该病毒引起的。感染人偏肺病毒的儿童的平均年龄为11.6个月，男女比例为1.8:1，78%的疾病发生在12月至4月之间，住院率为2%。该病毒在59%的病例中与细支气管炎有关，8%与肺炎有关，18%与喉炎有关，14%与哮喘加重有关。我们还在261例上呼吸道感染患者的15%的样本中检测到人偏肺病毒，但在86例无症状儿童的样本中仅在1份样本中检测到。
人偏肺病毒感染是生命最初几年呼吸道感染的主要原因，其疾病谱与呼吸道合胞病毒相似。
