School of Public Health, Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA.
Sustainable Sciences Institute, Managua, Nicaragua.
Influenza Other Respir Viruses. 2022 Nov;16(6):1112-1121. doi: 10.1111/irv.13034. Epub 2022 Aug 14.
Human metapneumovirus (hMPV) is an important cause of pediatric respiratory infection. We leveraged the Nicaraguan Pediatric Influenza Cohort Study (NPICS) to assess the burden and seasonality of symptomatic hMPV infection in children.
NPICS is an ongoing prospective study of children in Managua, Nicaragua. We assessed children for hMPV infection via real-time reverse-transcription polymerase chain reaction (RT-PCR). We used classical additive decomposition analysis to assess the temporal trends, and generalized growth models (GGMs) were used to estimate effective reproduction numbers.
From 2011 to 2016, there were 564 hMPV symptomatic infections, yielding an incidence rate of 5.74 cases per 100 person-years (95% CI 5.3, 6.2). Children experienced 3509 acute lower respiratory infections (ALRIs), of which 160 (4.6%) were associated with hMPV infection. Children under the age of one had 55% of all symptomatic hMPV infections (62/112) develop into hMPV-associated ALRIs and were five times as likely as children over one to have an hMPV-associated ALRI (rate ratio 5.5 95% CI 4.1, 7.4 p < 0.001). Additionally, symptomatic reinfection with hMPV was common. In total, 87 (15%) of all observed symptomatic infections were detected reinfections. The seasonality of symptomatic hMPV outbreaks varied considerably. From 2011 to 2016, four epidemic periods were observed, following a biennial seasonal pattern. The mean ascending phase of the epidemic periods were 7.7 weeks, with an overall mean estimated reproductive number of 1.2 (95% CI 1.1, 1.4).
Symptomatic hMPV infection was associated with substantial burden among children in the first year of life. Timing and frequency of symptomatic hMPV incidence followed biennial patterns.
人偏肺病毒（hMPV）是小儿呼吸道感染的重要病因。我们利用尼加拉瓜儿科流感队列研究（NPICS）来评估小儿有症状 hMPV 感染的负担和季节性。
NPICS 是尼加拉瓜马那瓜正在进行的前瞻性儿童研究。我们通过实时逆转录聚合酶链反应（RT-PCR）评估儿童的 hMPV 感染情况。我们使用经典的附加分解分析来评估时间趋势，并使用广义增长模型（GGM）来估计有效繁殖数。
2011 年至 2016 年，共有 564 例 hMPV 有症状感染，发病率为 5.74 例/100 人年（95%CI 5.3，6.2）。儿童经历了 3509 次急性下呼吸道感染（ALRI），其中 160 例（4.6%）与 hMPV 感染有关。1 岁以下儿童有 55%的所有有症状 hMPV 感染（62/112）发展为 hMPV 相关的 ALRI，其发生 hMPV 相关 ALRI 的可能性是 1 岁以上儿童的五倍（率比 5.5，95%CI 4.1，7.4 p < 0.001）。此外，hMPV 再次感染的症状很常见。在所有观察到的有症状感染中，共有 87 例（15%）被检测为再感染。有症状 hMPV 暴发的季节性差异很大。2011 年至 2016 年，共观察到四个流行期，呈两年一次的季节性模式。流行期的平均上升阶段为 7.7 周，总体估计繁殖数为 1.2（95%CI 1.1，1.4）。
在生命的第一年，有症状的 hMPV 感染对儿童造成了相当大的负担。有症状的 hMPV 发病率的时间和频率遵循两年一次的模式。
