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Journal of Clinical Microbiology, October 2004, p. 4632-4635, Vol. 42, No. 10
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.10.4632-4635.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Prospective Study of Human Metapneumovirus Infection in Children Less Than 3 Years of Age

Institute of Medical Microbiology, Otto-von-Guericke-University Magdeburg, Magdeburg,¹ Institute of Medical Biometry and Medical Informatics and Center for Clinical Trials, Albert-Ludwigs-University,² St. Josefs-Hospital, Freiburg, Germany³

Received 6 February 2004/ Returned for modification 9 June 2004/ Accepted 29 June 2004

Most lower respiratory tract infections (LRTIs) in children under the age of 3 years are due to respiratory syncytial virus (RSV). Epidemiological, host, and viral factors eventually account for the severity of LRTIs, but they do not completely explain it. Human metapneumovirus (hMPV) was recently identified in children with LRTIs. In a population-based prospective multicenter study (the PRI.DE study, conducted in Germany over 2 years), we tested 3,369 nasopharyngeal secretions from children younger than 3 years of age with LRTIs for RSV A and B, influenza viruses (IVs) A and B, and parainfluenza viruses (PIVs) 1 to 3. Of the children requiring intensive care (n = 85), 18% had hMPV infections, and 60% of these children were infected with hMPV in combination with RSV. We did not detect hMPV in a randomly selected subset of RSV-positive nasopharyngeal secretions (n = 120) from children not requiring intensive care support. hMPV was detected in <1% of virus-negative samples from patients without intensive care support (n = 620). Our data support the hypothesis that coinfections with RSV and hMPV are more severe than infections with either RSV or hMPV alone, at least in children younger than 3 years of age.

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