Human metapneumovirus (hMPV) epidemics vary in time and severity. We report findings for PCR for hMPV and respiratory syncytial virus (RSV) performed on nasopharyngeal aspirates (NPA) of hospitalized and outpatient children with respiratory tract infections between October 2004 and April 2008. A total of 3,934 NPAs were tested for hMPV and 3,859 for RSV. Of these, 198 (5%) were hMPV positive and 869 (23%) were RSV-positive. Median age was 17 months and 9 months for hMPV and RSV, respectively. Fifty-nine percent of hMPV and 58% of RSV patients were hospitalized. Proportions of hMPV positive samples for the four winter seasons were 0.4%, 11%, 0.2%, and 14%. For RSV, they were 28%, 15%, 28%, and 28%. HMPV epidemics follow a biannual variation in our area. Major epidemics were observed in winter seasons starting in odd years (2005/06 and 2007/08), minor epidemics in those starting in even years (2004/05 and 2006/07). RSV epidemics usually follow a reciprocal biannual pattern, leading to annually alternating major RSV and hMPV epidemics.

We report the history of a religion teacher who was hospitalized in December 2009 during the H1N1 outbreak at our hospital. The 62-year-old man presented in the emergency room with malaise, high fevers and dyspnea. Relevant findings included rales over both lungs, an elevated CRP and a chest x-ray with bilateral interstitial infiltrates suggesting a H1N1 pneumonia. His comorbidities included coronary and hypertensive heart disease, diabetes mellitus Type 2 and chronic renal insufficiency. Although H1N1 virus was not detected by PCR in the nasopharyngeal swabs, Oseltamivir 2 × 75 mg/die was begun and continued for 4 days. His breathing and general condition improved markedly. However, a delirium with psychotic and paranoid symptoms developed which persisted after discharge at home. There, they almost led to a catastrophic event. Although the infection could have been the cause of the delirious state, we propose that it was caused by Oseltamivir. Neuropsychiatric symptoms have been reported in case reports with Oseltamivir, however, this side effect was not specifically investigated when the drug was evaluated.

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