Jain Bhawana, Singh Ajay Kr, Dangi Tanushree, Agarwal Anjali, Verma Anil Kumar, Dwivedi Mukesh, Singh Kaleshwar P, Jain Amita
Department of Microbiology, King George Medical University, Lucknow, India.
Clin Respir J. 2014 Apr;8(2):225-33. doi: 10.1111/crj.12064. Epub 2014 Jan 17.
A comparatively newly discovered human metapneumovirus (HMPV) has emerged as an important cause of severe acute respiratory illness (SARI), second only to respiratory syncytial virus (RSV). RSV and HMPV taxonomically belong to same family and subfamily, and their clinical presentation and seasonal distribution are also seemed to be indistinguishable. Present study was planned to know the epidemiology and prevalence of HMPV and RSV in patients presented as SARI in a tertiary care hospital.
Nasopharyngeal aspirate of 440 patients fulfilling World Health Organization criteria of SARI, enrolled during a 2-year study period, were collected and tested for the presence of RSV, HMPV and their subtypes A and B by real time polymerase chain reaction along with other respiratory viruses, viz influenza A, B, parainfluenza 1, 2, 3, 4, adenovirus, measles virus and bocavirus. The demographic details, clinical profile, underlying diseases, clinical diagnosis at the time of admission and seasonal distribution were studied and analyzed statistically.
Overall positivity of RSV was 14.3% (24.68% in <5 years) and of HMPV was 3.63% (5.1% in <5 years and 5.08% in 6-12 years). Among RSV, subtype A (89%), and among HMPV, genotype B (68.8%) were predominating. Adults having underlying chronic obstructive pulmonary disease were more prone to acquire RSV and HMPV infections. RSV and HMPV positivity was restricted to winter season. We are reporting replacement of RSV with HMPV in this population.
HMPV has emerged as an important cause of SARI in children <12 years of age. Alternative predominance of RSV and HMPV is an important observation.
一种相对较新发现的人偏肺病毒（HMPV）已成为严重急性呼吸道疾病（SARI）的重要病因，仅次于呼吸道合胞病毒（RSV）。RSV和HMPV在分类学上属于同一科和亚科，它们的临床表现和季节分布似乎也难以区分。本研究旨在了解一家三级医院中以SARI就诊患者的HMPV和RSV的流行病学及流行情况。
在为期2年的研究期间，收集了440例符合世界卫生组织SARI标准的患者的鼻咽抽吸物，并通过实时聚合酶链反应检测RSV、HMPV及其A、B亚型以及其他呼吸道病毒，即甲型、乙型流感病毒、副流感病毒1、2、3、4型、腺病毒、麻疹病毒和博卡病毒的存在情况。研究并统计分析了人口统计学细节、临床特征、基础疾病、入院时的临床诊断和季节分布情况。
RSV的总体阳性率为14.3%（<5岁儿童中为24.68%），HMPV的总体阳性率为3.63%（<5岁儿童中为5.1%，6 - 12岁儿童中为5.08%）。在RSV中，A亚型占主导（89%），在HMPV中，B基因型占主导（68.8%）。患有基础慢性阻塞性肺疾病的成年人更容易感染RSV和HMPV。RSV和HMPV的阳性情况仅限于冬季。我们报告了该人群中HMPV取代RSV的情况。
HMPV已成为12岁以下儿童SARI的重要病因。RSV和HMPV的交替占主导是一项重要发现。
