Comparative epidemiology of human metapneumovirus‐ and respiratory syncytial virus‐associated hospitalizations in Guatemala

Influenza and Other Respiratory Viruses

John P. McCracken⁴  Wences Arvelo³  José Ortíz¹  Lissette Reyes²  Jennifer Gray⁴  Alejandra Estevez⁴  Oscar Castañeda¹  Gayle Langley⁵ 

[1] Guatemalan Social Security Institute, Guatemala City, Guatemala;Ministry of Public Health and Social Welfare, Cuilapa, Santa Rosa, Guatemala;Division of Global Disease Detection and Emergency Response, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA;Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala;Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA

关键词: Acute respiratory infection;    human metapneumovirus;    pneumonia;    respiratory syncytial virus;    surveillance;   

DOI  :  10.1111/irv.12251

来源: Wiley

【 摘 要 】

Abstract

Background

Human metapneumovirus (HMPV) is an important cause of acute respiratory infections (ARI), but little is known about how it compares with respiratory syncytial virus (RSV) in Central America.

Objectives

In this study, we describe hospitalized cases of HMPV- and RSV-ARI in Guatemala.

Methods

We conducted surveillance at three hospitals (November 2007–December 2012) and tested nasopharyngeal and oropharyngeal swab specimens for HMPV and RSV using real-time reverse transcription-polymerase chain reaction. We calculated incidence rates, and compared the epidemiology and outcomes of HMPV-positive versus RSV-positive and RSV-HMPV-negative cases.

Results

We enrolled and tested specimens from 6288 ARI cases; 596 (9%) were HMPV-positive and 1485 (24%) were RSV-positive. We observed a seasonal pattern of RSV but not HMPV. The proportion HMPV-positive was low (3%) and RSV-positive high (41%) for age <1 month, whereas these proportions were similar (~20%) by age 2 years. The annual incidence of hospitalized HMPV-ARI was 102/100 000 children aged <5 years [95% confidence interval (CI): 75–178], 2·6/100 000 persons aged 5–17 years (95%CI: 1·2–5·0), and 2·6/100 000 persons aged ≥18 years (95%CI: 1·5–4·9). Among children aged <5 years, HMPV-positive cases were less severe than HMPV-RSV-negative cases after adjustment for confounders [odds ratio (OR) for intensive care = 0·63, 95% CI 0·47–0·84]; OR for death = 0·46, 95% CI 0·23–0·92).

Conclusions

Human metapneumovirus is a substantial contributor to ARI hospitalization in Guatemala, but HMPV hospitalizations are less frequent than RSV and, in young children, less severe than other etiologies. Preventive interventions should take into account the wide variation in incidence by age and unpredictable timing of incidence peaks.

【 授权许可】

CC BY   
© 2014 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.