Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN 37232-2581, USA.
N Engl J Med. 2013 Feb 14;368(7):633-43. doi: 10.1056/NEJMoa1204630.
The inpatient and outpatient burden of human metapneumovirus (HMPV) infection among young children has not been well established.
We conducted prospective, population-based surveillance for acute respiratory illness or fever among inpatient and outpatient children less than 5 years of age in three U.S. counties from 2003 through 2009. Clinical and demographic data were obtained from parents and medical records, HMPV was detected by means of a reverse-transcriptase polymerase-chain-reaction assay, and population-based rates of hospitalization and estimated rates of outpatient visits associated with HMPV infection were determined.
HMPV was detected in 200 of 3490 hospitalized children (6%), 222 of 3257 children in outpatient clinics (7%), 224 of 3001 children in the emergency department (7%), and 10 of 770 asymptomatic controls (1%). Overall annual rates of hospitalization associated with HMPV infection were 1 per 1000 children less than 5 years of age, 3 per 1000 infants less than 6 months of age, and 2 per 1000 children 6 to 11 months of age. Children hospitalized with HMPV infection, as compared with those hospitalized without HMPV infection, were older and more likely to receive a diagnosis of pneumonia or asthma, to require supplemental oxygen, and to have a longer stay in the intensive care unit. The estimated annual burden of outpatient visits associated with HMPV infection was 55 clinic visits and 13 emergency department visits per 1000 children. The majority of HMPV-positive inpatient and outpatient children had no underlying medical conditions, although premature birth and asthma were more frequent among hospitalized children with HMPV infection than among those without HMPV infection.
HMPV infection is associated with a substantial burden of hospitalizations and outpatient visits among children throughout the first 5 years of life, especially during the first year. Most children with HMPV infection were previously healthy. (Funded by the Centers for Disease Control and Prevention and the National Institutes of Health.).
人类偏肺病毒（HMPV）感染在幼儿中的住院和门诊负担尚未得到充分证实。
我们对 2003 年至 2009 年间美国三个县小于 5 岁的住院和门诊患儿的急性呼吸道疾病或发热进行了前瞻性、基于人群的监测。从家长和病历中获取临床和人口统计学数据，采用逆转录-聚合酶链反应检测 HMPV，并确定与 HMPV 感染相关的住院率和估计的门诊就诊率。
在 3490 名住院患儿中，有 200 名（6%）检测到 HMPV，在 3257 名门诊患儿中，有 222 名（7%），在 3001 名急诊患儿中，有 224 名（7%），在 770 名无症状对照者中，有 10 名（1%）检测到 HMPV。总体上，HMPV 感染导致的每年住院率为每 1000 名 5 岁以下儿童 1 例，每 1000 名 6 个月以下婴儿 3 例，每 1000 名 6-11 个月儿童 2 例。与未感染 HMPV 的住院患儿相比，感染 HMPV 的患儿年龄更大，更有可能被诊断为肺炎或哮喘，需要补充氧气，在重症监护病房的停留时间更长。估计每年与 HMPV 感染相关的门诊就诊量为每 1000 名儿童 55 次就诊和 13 次急诊就诊。大多数 HMPV 阳性的住院和门诊患儿没有潜在的医疗条件，尽管与未感染 HMPV 的住院患儿相比，早产儿和哮喘患儿更常见。
HMPV 感染与儿童前 5 年生命期间，特别是在第一年的大量住院和门诊就诊负担相关。大多数感染 HMPV 的患儿之前健康。（由疾病控制和预防中心和美国国立卫生研究院资助）。
