Human metapneumovirus in the preterm neonate: current perspectives

Abstract

Premature birth (<37 weeks gestation) occurs in ~11% of all births in the US. These infants are at risk of chronic lung disease and respiratory conditions, including bronchopulmonary dysplasia. Respiratory viruses are important causes of acute respiratory illness (ARI) in preterm infants, leading to rehospitalization, increased health care burden, and long-term morbidity. Human metapneumovirus (HMPV) is a paramyxovirus discovered in 2001 that is related to respiratory syncytial virus. Epidemiologic studies show that HMPV is a leading cause of ARI in children and adults worldwide. Prematurity is a major risk factor for severe HMPV disease, requiring hospitalization. Moreover, limited data suggest that HMPV infection during infancy is associated with asthma and recurrent wheezing, which are common long-term pulmonary complication of prematurity. HMPV causes nosocomial outbreaks of ARI in hospitals and long-term care facilities, although there are few studies of the prevalence of HMPV in neonatal intensive care unit populations. HMPV is a common and important virus in premature infants, and caregivers for preterm infants should consider this virus in patients with acute respiratory symptoms.

Role for Maternal Asthma in Severe Human Metapneumovirus Lung Disease Susceptibility in Children

“…However, the role for hMPV as a coinfecting agent is still unclear and requires further study [46][47][48]. In a changing epidemiological landscape driven by preventive interventions against RSV, hMPV may soon alter its role and overall importance as a childhood pathogen should viral replacement occur [49]. Targeting children of asthmatic mothers for prophylaxis against hMPV may be a cost-effective strategy in the era of personalized medicine.…”

Intraoperative Acute Respiratory Failure in an Immunocompromised Patient with Human Metapneumovirus

“…Treatment is largely supportive respiratory care and antivirals. Vaccines are currently being explored [ 2 , 3 , 6 , 11 , 14 – 16 ]. Interestingly, in immunocompromised patients who may have subtle symptomatology and an equivocal chest x-ray, a CT scan may be necessary to diagnosis involvement in the lower respiratory tract.…”