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Du Y, Li W, Guo Y, Li L, Chen Q, He L, Shang S. Epidemiology and genetic characterization of human metapneumovirus in pediatric patients from Hangzhou China. J Med Virol 2022; 94:5401-5408. [PMID: 35871601 DOI: 10.1002/jmv.28024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 07/08/2022] [Accepted: 07/21/2022] [Indexed: 12/15/2022]
Abstract
Human metapneumovirus (HMPV), which is distributed worldwide, is a significant viral respiratory pathogen responsible for causing acute respiratory tract infections (ARTIs) in children. The aim of the present study was to investigate the epidemiological and genetic characteristics of HMPV in pediatric patients in Hangzhou China following the peak of onset of coronavirus disease 2019 (COVID-19). A total of 1442 throat swabs were collected from the pediatric patients with a diagnosis of ARTI from November 2020 to March 2021. The following viruses were detected by real-time polymerase chain reaction analysis: HMPV, RSV, adenovirus, hPIV1-3, influenza A, and influenza B. A two-step method was used to amplify the F genes of the HMPV-positive samples. Following sequencing, phylogenetic analyses were conducted using the MEGA version 7 software package. Among the 1442 samples, 103 (7.14%) were positive for HMPV. No significant differences were observed in the gender distribution. The highest incidence of HMPV occurred in children older than 6 years and the lowest was noted in children younger than 6 months. Lower respiratory tract infections were diagnosed at a higher rate than upper respiratory tract infections in HMPV-infected children. Only 10 HMPV-infected children (5.41%) were inpatients compared with 93 outpatients (7.39%). Co-infection was observed in 31 HMPV-positive samples including 24 samples of double infection and seven samples of triple infection. A total of 61F gene fragments of HMPV, which were approximately 727 bp in length were successfully sequenced. All the HMPVs belonged to the genotype B and were clustered into subgenotypes B1 (1.6%, 1/61) and B2 (98.4%, 60/61). A total of four specific amino acid substitutions were noted as follows: aa280, aa296, aa392, and aa396. These substitutions were present between sequences derived from the subgenotypes B1 and B2 in the fusion open reading frame from position 244 to 429. In conclusion, the present study provided significant information regarding the epidemiological and genetic characteristics of HMPV in children living in Hangzhou. Following the first peak of the COVID-19 pandemic, HMPV was considered an important viral respiratory pathogen present in children with ARTI.
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Affiliation(s)
- Yun Du
- Department of Respiratory Medicine, Jiangxi Provincial Children's Hospital, Nanchang, Jiangxi, China
| | - Wei Li
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, Zhejiang, China
| | - Yajun Guo
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, Zhejiang, China
| | - Lin Li
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, Zhejiang, China
| | - Qiang Chen
- Department of Respiratory Medicine, Jiangxi Provincial Children's Hospital, Nanchang, Jiangxi, China
| | - Lin He
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, Zhejiang, China
| | - Shiqiang Shang
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, Zhejiang, China
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Barrera-Badillo G, Olivares-Flores B, Ruiz-López A, Fierro-Valdez MÁ, Gutiérrez-Vargas RI, López-Martínez I. Human Metapneumovirus: Etiological Agent of Severe Acute Respiratory Infections in Hospitalized and Deceased Patients with a Negative Diagnosis of Influenza. Pathogens 2020; 9:pathogens9020085. [PMID: 32013048 PMCID: PMC7168596 DOI: 10.3390/pathogens9020085] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 01/25/2020] [Accepted: 01/25/2020] [Indexed: 01/19/2023] Open
Abstract
Human metapneumovirus (HMPV) is one of the four major viral pathogens associated with acute respiratory tract infections (ARI) and creates a substantial burden of disease, particularly in young children (<5 years) and older individuals (≥65 years). The objective of this study was to determine the epidemiological behavior of HMPV in Mexico. This retrospective study was conducted over a nine-year period and used 7283 influenza-negative respiratory samples from hospitalized and deceased patients who presented Severe Acute Respiratory Infection (SARI). The samples were processed with the help of qualitative multiplex RT-PCR for simultaneous detection of 14 respiratory viruses (xTAG® RVP FAST v2). 40.8% of the samples were positive for respiratory viruses, mainly rhinovirus/enterovirus (47.6%), respiratory syncytial virus (15.9%), HMPV (11.1%) and parainfluenza virus (8.9%). Other respiratory viruses and co-infections accounted for 16.5%. HMPV infects all age groups, but the most affected group was infants between 29 days and 9 years of age (65.6%) and adults who are 40 years and older (25.7%). HMPV circulates every year from November to April, and the highest circulation was observed in late winter. The results of this study aim to raise awareness among clinicians about the high epidemiological impact of HMPV in young children and older individuals in order to reduce the economic burden in terms of health care costs.
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Affiliation(s)
- Gisela Barrera-Badillo
- Institute of Epidemiological Diagnosis and Reference “Dr. Manuel Martinez Baez” (InDRE), Health Secretary. Francisco de P. Miranda No. 177. Colony Lomas de Plateros. Town Hall., Alvaro Obregon 1480, Mexico City, Mexico; (B.O.-F.); (A.R.-L.); (M.Á.F.-V.); (I.L.-M.)
- Correspondence: ; Tel.: +52-55-3893-9972
| | - Beatriz Olivares-Flores
- Institute of Epidemiological Diagnosis and Reference “Dr. Manuel Martinez Baez” (InDRE), Health Secretary. Francisco de P. Miranda No. 177. Colony Lomas de Plateros. Town Hall., Alvaro Obregon 1480, Mexico City, Mexico; (B.O.-F.); (A.R.-L.); (M.Á.F.-V.); (I.L.-M.)
| | - Adriana Ruiz-López
- Institute of Epidemiological Diagnosis and Reference “Dr. Manuel Martinez Baez” (InDRE), Health Secretary. Francisco de P. Miranda No. 177. Colony Lomas de Plateros. Town Hall., Alvaro Obregon 1480, Mexico City, Mexico; (B.O.-F.); (A.R.-L.); (M.Á.F.-V.); (I.L.-M.)
| | - Miguel Ángel Fierro-Valdez
- Institute of Epidemiological Diagnosis and Reference “Dr. Manuel Martinez Baez” (InDRE), Health Secretary. Francisco de P. Miranda No. 177. Colony Lomas de Plateros. Town Hall., Alvaro Obregon 1480, Mexico City, Mexico; (B.O.-F.); (A.R.-L.); (M.Á.F.-V.); (I.L.-M.)
| | - Rosaura Idania Gutiérrez-Vargas
- General Directorate of Epidemiology; Health Secretary. Francisco de P. Miranda No. 157. Colony Lomas de Plateros. Town Hall. Alvaro Obregon, Mexico City 01480, Mexico;
| | - Irma López-Martínez
- Institute of Epidemiological Diagnosis and Reference “Dr. Manuel Martinez Baez” (InDRE), Health Secretary. Francisco de P. Miranda No. 177. Colony Lomas de Plateros. Town Hall., Alvaro Obregon 1480, Mexico City, Mexico; (B.O.-F.); (A.R.-L.); (M.Á.F.-V.); (I.L.-M.)
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3
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Zhu R, Guo C, Zhao L, Deng J, Wang F, Sun Y, Qian Y. Epidemiological and genetic characteristics of human metapneumovirus in pediatric patients across six consecutive seasons in Beijing, China. Int J Infect Dis 2019; 91:137-142. [PMID: 31821893 DOI: 10.1016/j.ijid.2019.11.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 11/11/2019] [Accepted: 11/12/2019] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To investigate the genetic characteristics of human metapneumovirus (hMPV) circulating among children with acute respiratory tract infections (ARTIs) in Beijing, China. METHODS Clinical samples were obtained from outpatients and hospitalized children with ARTIs between August 2010 and July 2016. Reverse transcription polymerase chain reaction assays were used to screen and identify hMPV, while partial glycoprotein gene sequences were used for phylogenetic analysis. RESULTS Among the 10 918 samples, 292 (2.7%) were positive for hMPV. Overall, the virus was more prevalent among inpatients (4.3%) than outpatients (1.2%). A biennial alternating pattern of hMPV infection was observed, with infection rates fluctuating between 1.6% and 4.0%. Most cases were detected between December and April, showing clear-cut seasonality. Sub-genotypes A2b, B1, and B2 co-circulated in winter and spring in an alternating pattern, while only one A1-positive case was observed in 2012. The seasonal peak of hMPV was slightly delayed or overlapped with that of respiratory syncytial virus and influenza virus. hMPV activity increased in the 2010-2011 and 2014-2015 seasons, when influenza activity was apparently decreased compared with other epidemic seasons. CONCLUSIONS This study provides information on the epidemiological and genetic characteristics of hMPV in children in Beijing, and reinforces the significance of hMPV in children with ARTIs, especially lower respiratory tract infections.
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Affiliation(s)
- Runan Zhu
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Capital Institute of Pediatrics, 2 Yabao Road, Chaoyang District, Beijing 100020, China
| | - Chunying Guo
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Capital Institute of Pediatrics, 2 Yabao Road, Chaoyang District, Beijing 100020, China
| | - Linqing Zhao
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Capital Institute of Pediatrics, 2 Yabao Road, Chaoyang District, Beijing 100020, China
| | - Jie Deng
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Capital Institute of Pediatrics, 2 Yabao Road, Chaoyang District, Beijing 100020, China
| | - Fang Wang
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Capital Institute of Pediatrics, 2 Yabao Road, Chaoyang District, Beijing 100020, China
| | - Yu Sun
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Capital Institute of Pediatrics, 2 Yabao Road, Chaoyang District, Beijing 100020, China
| | - Yuan Qian
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Capital Institute of Pediatrics, 2 Yabao Road, Chaoyang District, Beijing 100020, China.
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4
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Ábrego LE, Mirazo S, Delfraro A, Franco D, Castillo M, Gaitán M, Castillo J, Moreno B, Pascale JM, Arbiza J. Genotypes of human metapneumovirus circulating during 2010-2012 in children from Panama. J Med Virol 2017; 90:604-608. [DOI: 10.1002/jmv.24969] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 09/21/2017] [Indexed: 11/09/2022]
Affiliation(s)
- Leyda E. Ábrego
- Deparment of Research in Virology and Biotechnology; Gorgas Memorial Institute of Health Studies; Panama City Panama
| | - Santiago Mirazo
- Virology Section, School of Sciences; University of the Republic; Montevideo Uruguay
| | - Adriana Delfraro
- Virology Section, School of Sciences; University of the Republic; Montevideo Uruguay
| | - Danilo Franco
- Deparment of Research in Virology and Biotechnology; Gorgas Memorial Institute of Health Studies; Panama City Panama
- School of Medicine; University of Panama; Panama City Panama
| | - Marlene Castillo
- Deparment of Research in Virology and Biotechnology; Gorgas Memorial Institute of Health Studies; Panama City Panama
| | - Melissa Gaitán
- Deparment of Research in Virology and Biotechnology; Gorgas Memorial Institute of Health Studies; Panama City Panama
| | - Juan Castillo
- Department of Genomic and Proteomic; Gorgas Memorial Institute of Health Studies; Panama City Panama
| | - Brechla Moreno
- Deparment of Research in Virology and Biotechnology; Gorgas Memorial Institute of Health Studies; Panama City Panama
| | - Juan M. Pascale
- School of Medicine; University of Panama; Panama City Panama
- Department of Genomic and Proteomic; Gorgas Memorial Institute of Health Studies; Panama City Panama
| | - Juan Arbiza
- Virology Section, School of Sciences; University of the Republic; Montevideo Uruguay
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5
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Sato K, Watanabe O, Ohmiya S, Chiba F, Suzuki A, Okamoto M, Younghuang J, Hata A, Nonaka H, Kitaoka S, Nagai Y, Kawamura K, Hayashi M, Kumaki S, Suzuki T, Kawakami K, Nishimura H. Efficient isolation of human metapneumovirus using MNT-1, a human malignant melanoma cell line with early and distinct cytopathic effects. Microbiol Immunol 2017; 61:497-506. [PMID: 28940687 DOI: 10.1111/1348-0421.12542] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 08/23/2017] [Accepted: 09/16/2017] [Indexed: 01/30/2023]
Abstract
Isolation of human metapneumovirus (HMPV) from clinical specimens is currently inefficient because of the lack of a cell culture system in which a distinct cytopathic effect (CPE) occurs. The cell lines LLC-MK2, Vero and Vero E6 are used for isolation of HMPV; however, the CPE in these cell lines is subtle and usually requires a long observation period and sometimes blind passages. Thus, a cell line in which an early and distinct CPE occurs following HMPV inoculation is highly desired by clinical virology laboratories. In this study, it was demonstrated that, in the human malignant melanoma cell line MNT-1, obvious syncytium formation occurs shortly after inoculation with HMPV-positive clinical specimens. In addition, the growth and efficiency of isolation of HMPV were greater using MNT-1 than using any other conventional cell line. Addition of this cell line to our routine viral isolation system for clinical specimens markedly enhanced isolation frequency, allowing isolation-based surveillance. MNT-1 has the potential to facilitate clinical and epidemiological studies of HMPV.
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Affiliation(s)
- Ko Sato
- Virus Research Center, Clinical Research Division, Sendai Medical Center, 2-8-8 Miyagino, Miyagino-ku, Japan
- Department of Medical Microbiology, Mycology and Immunology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan
| | - Oshi Watanabe
- Virus Research Center, Clinical Research Division, Sendai Medical Center, 2-8-8 Miyagino, Miyagino-ku, Japan
| | - Suguru Ohmiya
- Virus Research Center, Clinical Research Division, Sendai Medical Center, 2-8-8 Miyagino, Miyagino-ku, Japan
| | - Fumiko Chiba
- Virus Research Center, Clinical Research Division, Sendai Medical Center, 2-8-8 Miyagino, Miyagino-ku, Japan
| | - Akira Suzuki
- Virus Research Center, Clinical Research Division, Sendai Medical Center, 2-8-8 Miyagino, Miyagino-ku, Japan
| | - Michiko Okamoto
- Virus Research Center, Clinical Research Division, Sendai Medical Center, 2-8-8 Miyagino, Miyagino-ku, Japan
| | - Jiang Younghuang
- Tauns Laboratories, 761-1 Kamishima, Izunokuni, Shizuoka 410-2325, Japan
| | - Akihiro Hata
- Tauns Laboratories, 761-1 Kamishima, Izunokuni, Shizuoka 410-2325, Japan
| | - Hiroyuki Nonaka
- Tauns Laboratories, 761-1 Kamishima, Izunokuni, Shizuoka 410-2325, Japan
| | - Setsuko Kitaoka
- Department of Pediatrics, Sendai Medical Center, 2-8-8 Miyagino, Miyagino-ku, Sendai 983-8520, Japan
| | - Yukio Nagai
- Nagai Pediatric Clinic, 1-25-10 Miyagino, Miyagino-ku, Sendai, 983-0045, Japan
| | - Kazuhisa Kawamura
- Kawamura Children's Clinic, 1-16-1 Takamatsu, Aoba-ku, Sendai 981-0907, Japan
| | - Masahiro Hayashi
- Department of Dermatology, Faculty of Medicine, Yamagata University, 2-2-2 Iida-nishi, Yamagata 990-9585, Japan
| | - Satoru Kumaki
- Department of Pediatrics, Sendai Medical Center, 2-8-8 Miyagino, Miyagino-ku, Sendai 983-8520, Japan
| | - Tamio Suzuki
- Department of Dermatology, Faculty of Medicine, Yamagata University, 2-2-2 Iida-nishi, Yamagata 990-9585, Japan
| | - Kazuyoshi Kawakami
- Department of Medical Microbiology, Mycology and Immunology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan
| | - Hidekazu Nishimura
- Virus Research Center, Clinical Research Division, Sendai Medical Center, 2-8-8 Miyagino, Miyagino-ku, Japan
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6
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Grützmacher K, Keil V, Leinert V, Leguillon F, Henlin A, Couacy-Hymann E, Köndgen S, Lang A, Deschner T, Wittig RM, Leendertz FH. Human quarantine: Toward reducing infectious pressure on chimpanzees at the Taï Chimpanzee Project, Côte d'Ivoire. Am J Primatol 2017; 80. [PMID: 28095600 PMCID: PMC7161855 DOI: 10.1002/ajp.22619] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Revised: 10/13/2016] [Accepted: 10/19/2016] [Indexed: 12/02/2022]
Abstract
Due to their genetic relatedness, great apes are highly susceptible to common human respiratory pathogens. Although most respiratory pathogens, such as human respiratory syncytial virus (HRSV) and human metapneumovirus (HMPV), rarely cause severe disease in healthy human adults, they are associated with considerable morbidity and mortality in wild great apes habituated to humans for research or tourism. To prevent pathogen transmission, most great ape projects have established a set of hygiene measures ranging from keeping a specific distance, to the use of surgical masks and establishment of quarantines. This study investigates the incidence of respiratory symptoms and human respiratory viruses in humans at a human‐great ape interface, the Taï Chimpanzee Project (TCP) in Côte d'Ivoire, and consequently, the effectiveness of a 5‐day quarantine designed to reduce the risk of potential exposure to human respiratory pathogens. To assess the impact of quarantine as a preventative measure, we monitored the quarantine process and tested 262 throat swabs for respiratory viruses, collected during quarantine over a period of 1 year. Although only 1 subject tested positive for a respiratory virus (HRSV), 17 subjects developed symptoms of infection while in quarantine and were subsequently kept from approaching the chimpanzees, preventing potential exposure in 18 cases. Our results suggest that quarantine—in combination with monitoring for symptoms—is effective in reducing the risk of potential pathogen exposure. This research contributes to our understanding of how endangered great apes can be protected from human‐borne infectious disease.
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Affiliation(s)
- Kim Grützmacher
- Project Group Epidemiology of Highly Pathogenic Microorganisms, Robert Koch-Institute, Berlin, Germany.,Department of Primatology, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Verena Keil
- Project Group Epidemiology of Highly Pathogenic Microorganisms, Robert Koch-Institute, Berlin, Germany
| | - Vera Leinert
- Department of Primatology, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Floraine Leguillon
- Project Group Epidemiology of Highly Pathogenic Microorganisms, Robert Koch-Institute, Berlin, Germany.,University Montpellier 2, Montpellier, France
| | - Arthur Henlin
- Project Group Epidemiology of Highly Pathogenic Microorganisms, Robert Koch-Institute, Berlin, Germany.,University Montpellier 2, Montpellier, France
| | - Emmanuel Couacy-Hymann
- Laboratoire National d'appui au Développement Agricole/Laboratoire Central de Pathologie Animale, Bingerville, Côte d'Ivoire
| | - Sophie Köndgen
- Project Group Epidemiology of Highly Pathogenic Microorganisms, Robert Koch-Institute, Berlin, Germany
| | - Alexander Lang
- Project Group Epidemiology of Highly Pathogenic Microorganisms, Robert Koch-Institute, Berlin, Germany
| | - Tobias Deschner
- Department of Primatology, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Roman M Wittig
- Department of Primatology, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany.,Taï Chimpanzee Project, CSRS, Abidjan, Côte d'Ivoire
| | - Fabian H Leendertz
- Project Group Epidemiology of Highly Pathogenic Microorganisms, Robert Koch-Institute, Berlin, Germany
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7
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Grützmacher KS, Köndgen S, Keil V, Todd A, Feistner A, Herbinger I, Petrzelkova K, Fuh T, Leendertz SA, Calvignac-Spencer S, Leendertz FH. Codetection of Respiratory Syncytial Virus in Habituated Wild Western Lowland Gorillas and Humans During a Respiratory Disease Outbreak. ECOHEALTH 2016; 13:499-510. [PMID: 27436109 PMCID: PMC7088376 DOI: 10.1007/s10393-016-1144-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 06/07/2016] [Accepted: 06/07/2016] [Indexed: 05/11/2023]
Abstract
Pneumoviruses have been identified as causative agents in several respiratory disease outbreaks in habituated wild great apes. Based on phylogenetic evidence, transmission from humans is likely. However, the pathogens have never been detected in the local human population prior to or at the same time as an outbreak. Here, we report the first simultaneous detection of a human respiratory syncytial virus (HRSV) infection in western lowland gorillas (Gorilla gorilla gorilla) and in the local human population at a field program in the Central African Republic. A total of 15 gorilla and 15 human fecal samples and 80 human throat swabs were tested for HRSV, human metapneumovirus, and other respiratory viruses. We were able to obtain identical sequences for HRSV A from four gorillas and four humans. In contrast, we did not detect HRSV or any other classic human respiratory virus in gorilla fecal samples in two other outbreaks in the same field program. Enterovirus sequences were detected but the implication of these viruses in the etiology of these outbreaks remains speculative. Our findings of HRSV in wild but human-habituated gorillas underline, once again, the risk of interspecies transmission from humans to endangered great apes.
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Affiliation(s)
- Kim S Grützmacher
- Project group Epidemiology of Highly Pathogenic Microorganisms, Robert Koch-Institute, Seestr 10, 13353, Berlin, Germany
| | - Sophie Köndgen
- Project group Epidemiology of Highly Pathogenic Microorganisms, Robert Koch-Institute, Seestr 10, 13353, Berlin, Germany
| | - Verena Keil
- Project group Epidemiology of Highly Pathogenic Microorganisms, Robert Koch-Institute, Seestr 10, 13353, Berlin, Germany
| | - Angelique Todd
- World Wildlife Fund (WWF), Dzanga Sangha Protected Areas, Bayanga, Central African Republic
| | - Anna Feistner
- World Wildlife Fund (WWF), Dzanga Sangha Protected Areas, Bayanga, Central African Republic
| | | | - Klara Petrzelkova
- Institute of Vertebrate Biology, Academy of Sciences, Brno, 60365, Czech Republic
- Biology Centre, Institute of Parasitology, Academy of Sciences of the Czech Republic, Ceske Budejovice, Czech Republic
| | - Terrence Fuh
- World Wildlife Fund (WWF), Dzanga Sangha Protected Areas, Bayanga, Central African Republic
| | - Siv Aina Leendertz
- Project group Epidemiology of Highly Pathogenic Microorganisms, Robert Koch-Institute, Seestr 10, 13353, Berlin, Germany
| | - Sébastien Calvignac-Spencer
- Project group Epidemiology of Highly Pathogenic Microorganisms, Robert Koch-Institute, Seestr 10, 13353, Berlin, Germany
| | - Fabian H Leendertz
- Project group Epidemiology of Highly Pathogenic Microorganisms, Robert Koch-Institute, Seestr 10, 13353, Berlin, Germany.
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8
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Reiche J, Jacobsen S, Neubauer K, Hafemann S, Nitsche A, Milde J, Wolff T, Schweiger B. Human metapneumovirus: insights from a ten-year molecular and epidemiological analysis in Germany. PLoS One 2014; 9:e88342. [PMID: 24505479 PMCID: PMC3914980 DOI: 10.1371/journal.pone.0088342] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Accepted: 01/13/2014] [Indexed: 11/19/2022] Open
Abstract
Human metapneumovirus (HMPV) is a cause of respiratory tract illness at all ages. In this study the epidemiological and molecular diversity among patients of different ages was investigated. Between 2000-2001 and 2009-2010, HMPV was detected in 3% (138/4,549) of samples from outpatients with influenza-like illness with a new, sensitive real-time RT-PCR assay. Several hundred (797) clinical specimens from hospitalized children below the age of 4 years with acute respiratory illness were investigated and HMPV was detected in 11.9% of them. Investigation of outpatients revealed that HMPV infections occurred in individuals of all ages but were most prevalent in children (0-4 years) and the elderly (>60 years). The most present clinical features of HMPV infections were cough, bronchitis, fever/shivers and pneumonia. About two thirds of HMPV-positive samples were detected in February and March throughout the study period. Molecular characterization of HMPV revealed a complex cyclic pattern of group dominance where HMPV subgroup A and B viruses predominated in general for three consecutive seasons. German HMPV represented all genetic lineages including A1, A2, B1, B2, sub-clusters A2a and A2b. For Germany, not only time-dependent circulation of lineages and sub-clusters was observed but also co-circulation of two or three predominant lineages. Two newly emerging amino acid substitutions (positions 223 and 280) of lineage B2 were detected in seven German HMPV sequences. Our study gives new insights into the molecular epidemiology of HMPV in in- and outpatients over a time period of 10 years for the first time. It is one of only few long-term surveillance studies in Europe, and allows comparative molecular analyses of HMPV circulating worldwide.
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Affiliation(s)
- Janine Reiche
- Division of Influenza Viruses and Other Respiratory Viruses, National Reference Centre for Influenza, Robert Koch Institute, Berlin, Germany
| | - Sonja Jacobsen
- Division of Influenza Viruses and Other Respiratory Viruses, National Reference Centre for Influenza, Robert Koch Institute, Berlin, Germany
| | - Katrin Neubauer
- Division of Influenza Viruses and Other Respiratory Viruses, National Reference Centre for Influenza, Robert Koch Institute, Berlin, Germany
| | - Susi Hafemann
- Division of Influenza Viruses and Other Respiratory Viruses, National Reference Centre for Influenza, Robert Koch Institute, Berlin, Germany
| | - Andreas Nitsche
- Centre for Biological Threats and Special Pathogens, Highly Pathogenic Viruses, Robert Koch Institute, Berlin, Germany
| | - Jeanette Milde
- Division of Influenza Viruses and Other Respiratory Viruses, National Reference Centre for Influenza, Robert Koch Institute, Berlin, Germany
| | - Thorsten Wolff
- Division of Influenza Viruses and Other Respiratory Viruses, National Reference Centre for Influenza, Robert Koch Institute, Berlin, Germany
| | - Brunhilde Schweiger
- Division of Influenza Viruses and Other Respiratory Viruses, National Reference Centre for Influenza, Robert Koch Institute, Berlin, Germany
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9
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Xiao N, Zhang B, Xie Z, Zhou Q, Zhang R, Zhong L, Ding X, Li J, Song J, Gao H, Hou Y, Duan Z. Prevalence of human metapneumovirus in children with acute lower respiratory infection in Changsha, China. J Med Virol 2013; 85:546-53. [PMID: 23296388 PMCID: PMC7166472 DOI: 10.1002/jmv.23501] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2012] [Indexed: 11/24/2022]
Abstract
Human metapneumovirus (hMPV) causes acute respiratory infections in children. The prevalence and clinical characteristics of hMPV were determined in nasopharyngeal aspirates of children in Changsha, China. Reverse transcription-polymerase chain reaction (RT-PCR) or PCR was employed to screen for both hMPV and other common respiratory viruses in 1,165 nasopharyngeal aspirate specimens collected from children with lower respiratory tract infections from September 2007 to August 2008. All PCR products were sequenced, and demographic and clinical data were collected from all patients. Seventy-six of 1,165 (6.5%) specimens were positive for hMPV, of which 85.5% (65/76) occurred in the winter and spring seasons. The hMPV coinfection rate was 57.9% (44/76), and human bocavirus was the most common virus detected in conjunction with hMPV. Phylogenetic analysis revealed that 94.7% of the hMPV detected were of subgroup A2, 5.3% were subgroup B2, and none belonged to either the A1 or B1 subgroups. No significant differences were found in terms of the frequency of diagnosis and clinical signs between either the co- and mono-infection groups, or between patients with and without underlying diseases. It was concluded that hMPV is an important viral pathogen in pediatric patients with lower respiratory tract infections in Changsha. Only hMPV genotypes A2 and B2 were co-circulating in this locality; human bocavirus was the most common coinfecting virus, and coinfection did not affect disease severity.
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Affiliation(s)
- Ni‐guang Xiao
- The People's Hospital of Hunan Province, Hunan, China
- National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - Bing Zhang
- The People's Hospital of Hunan Province, Hunan, China
| | - Zhi‐ping Xie
- National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | | | - Rong‐fang Zhang
- National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
- The First Hospital of Lanzhou University, Lanzhou, China
| | - Li‐li Zhong
- The People's Hospital of Hunan Province, Hunan, China
| | | | - Jia Li
- The People's Hospital of Hunan Province, Hunan, China
| | - Jing‐rong Song
- National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
- The First Hospital of Lanzhou University, Lanzhou, China
| | - Han‐chun Gao
- National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - Yun‐de Hou
- National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - Zhao‐jun Duan
- National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
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Souza JS, Watanabe A, Carraro E, Granato C, Bellei N. Severe metapneumovirus infections among immunocompetent and immunocompromised patients admitted to hospital with respiratory infection. J Med Virol 2012; 85:530-6. [PMID: 23239530 DOI: 10.1002/jmv.23477] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2012] [Indexed: 11/09/2022]
Abstract
Human metapneumovirus (hMPV) is considered an important cause of acute respiratory infections. hMPV can cause morbidity in hematopoietic stem cell transplant recipients and recent research has demonstrated that it is an important virus in patients admitted to hospital with respiratory infections and suspected of having pandemic 2009 influenza A (H1N1pdm09) virus. The purpose of this study was to investigate infections caused by hMPV in two groups of patients admitted to hospital: Immunocompromized patients with a potential risk of severe outcomes and immunocompetent patients with severe acute respiratory syndrome. A total of 288 samples were tested: 165 samples were collected from patients with suspected influenza A (H1N1) pdm09 infection during the first pandemic wave in 2009; and 123 samples were collected from patients of a hematopoietic stem cell transplantation program in 2008-2009. Amplification of the hMPV genes was performed by polymerase chain reaction. This was followed by sequencing and phylogenetic analysis. hMPV was detected in 14.2% (41/288) of all samples: 17% (28/165) of immunocompetent patients with suspected H1N1 infection and 10.6% (13/123) among hematopoietic stem cell transplant recipients. hMPV accounted for 12.1% (8/66) of immunocompetent adults patients with severe respiratory infections (median age, 55.9 years). Two hMPV subtypes were identified, A2 (26.9%; 7/26) and B2 (73.1%; 19/26) but no difference was observed between the patient groups in terms of age or immunosuppression level. This study highlights the significance of hMPV in immunocompetent adult patients with severe infections and further investigations are recommended for understanding the impact of this virus.
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Affiliation(s)
- Juliana Sinohara Souza
- Medicine Department, Clinical Virology Laboratory, Infectious Diseases Unit, Sao Paulo Federal University, Sao Paulo, SP, Brazil
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11
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Detection and genetic diversity of human metapneumovirus in hospitalized children with acute respiratory infections in Southwest China. J Clin Microbiol 2012; 50:2714-9. [PMID: 22692746 DOI: 10.1128/jcm.00809-12] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Human metapneumovirus (hMPV) is the main pathogen causing respiratory tract infection in susceptible populations, particularly in children and the elderly. Specimens were collected from hospitalized children with acute lower respiratory tract infections (ALRTI), and the hMPV was detected by using real-time reverse transcription-PCR (RT-PCR). The full-length G gene of hMPV was amplified by RT-PCR. A total of 1,410 nasopharyngeal aspirates (NPAs) were collected from April 2008 to March 2011, and 114 (10.2%) were positive for hMPV. Most hMPV-positive children were <5 years of age. The hMPV infection rate peaked in the spring-summer season of 2008 to 2009 and 2009 to 2010, while hMPV circulated predominantly during the winter-spring season of 2010 to 2011. The full-length G gene of 23 hMPV strains was amplified, and group A and B viruses accounted for 95.7% (22/23) and 4.3% (1/23), respectively. Genotype A2b of hMPV appeared to be predominant during the study period. Three genotypes (A2b, A1, and B1) were prevalent in the epidemic season of 2008 to 2009, and only genotype A2b was identified in the other two seasons (2009 to 2010 and 2010 to 2011). The G gene of hMPV was predicted to encode proteins with four different lengths, in which one with 210 amino acids was first identified in China. These findings suggest that hMPV was an important pathogen of ALRTI in pediatric patients, especially those <5 years of age. Genotype A2b of hMPV likely predominates in Southwest China, where other genotypes also circulate.
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Cabeça TK, Bellei N. Human coronavirus NL-63 infection in a Brazilian patient suspected of H1N1 2009 influenza infection: description of a fatal case. J Clin Virol 2012; 53:82-4. [PMID: 21978613 PMCID: PMC7108457 DOI: 10.1016/j.jcv.2011.09.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2011] [Revised: 09/09/2011] [Accepted: 09/12/2011] [Indexed: 01/18/2023]
Abstract
Human coronaviruses (HCoVs) cause upper respiratory tract and occasionally lower respiratory tract diseases. The recently described human coronavirus NL63 has not been well investigated among Brazilian patients. We reported the clinical course of an HCoV-NL63 infection in a hospitalised patient suspected of H1N1 2009 infection during the second pandemic wave of influenza activity. A 46-year-old female, health care worker with diabetes and presenting with influenza-like illness (ILI) was admitted to the hospital. During 9 days of influenza-like symptoms, the patient had diabetes decompensation, haemorrhagic pneumonia, rhabdomyolysis, respiratory and renal failure, pericarditis, and brain edema and died. HCoV-NL63 may be a causative agent of previously unexplained respiratory illnesses.
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Affiliation(s)
- Tatiane K Cabeça
- Clinical Virology Laboratory of the Universidade Federal de São Paulo, Discipline of Infectology, Department of Medicine, Universidade Federal de São Paulo-SP, Brazil.
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13
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Human metapneumovirus strains circulating in Latin America. Arch Virol 2011; 157:563-8. [PMID: 22200894 DOI: 10.1007/s00705-011-1204-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2011] [Accepted: 11/21/2011] [Indexed: 10/14/2022]
Abstract
The human metapneumovirus (HMPV) is responsible for acute respiratory tract infections in young children, elderly patients, and immunocompromised hosts. In this study, we genetically analyzed the circulating HMPV in Central and South America from July 2008 to June 2009 and characterized the strains present in this region. Samples were collected during an international collaborative influenza like illness surveillance study and then sequenced with specific primers for the HMPV G gene. Our results show that two distinct clusters of HMPV circulated in Central and South America, subtypes A2 and B2 being the predominant strains.
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Legrand L, Vabret A, Dina J, Petitjean-Lecherbonnier J, Stéphanie G, Cuvillon D, Tripey V, Brouard J, Freymuth F. Epidemiological and phylogenic study of human metapneumovirus infections during three consecutive outbreaks in Normandy, France. J Med Virol 2011; 83:517-24. [PMID: 21264874 PMCID: PMC7166733 DOI: 10.1002/jmv.22002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Human metapneumovirus (hMPV) is responsible for respiratory tract disease, particularly in the young and elderly population. An epidemiological and phylogenic study was performed on children admitted to hospital with an acute lower respiratory tract infection (LRI). Data were obtained and analyzed over three consecutive winters, from 2002–2003 to 2004–2005. Each year during the winter period, from November to March, 2,415 nasal swabs were tested by a direct immunofluorescence assay (DFA) for influenza viruses A and B, respiratory syncytial virus, parainfluenza viruses, and adenoviruses. Rhinoviruses, enteroviruses, and coronaviruses OC43 and 229E were detected by RT‐PCR. A RT‐PCR designed for the M gene was performed on negative samples for hMPV detection and phylogenic analyses. For the three consecutive winters, hMPV represented 10%, 22.6%, and 8.8% of virus‐negative samples, respectively. In most cases, clinical symptoms indicated a LRI with a final diagnosis of bronchiolitis. During the winter of 2003–2004, all viral clusters (A1, A2, B1, and B2) that circulated in France shifted progressively from the A group to the B group. This study determined the prevalence of hMPV in Normandy, its clinical impact and permitted the analysis of the molecular evolution during the successive outbreaks. J. Med. Virol. 83:517–524, 2011. © 2011 Wiley‐Liss, Inc.
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Affiliation(s)
- Loïc Legrand
- Laboratory of Human and Molecular Virology, University Hospital, Caen, France.
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15
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Li J, Wang Z, Gonzalez R, Xiao Y, Zhou H, Zhang J, Paranhos-Baccala G, Vernet G, Jin Q, Wang J, Hung T. Prevalence of human metapneumovirus in adults with acute respiratory tract infection in Beijing, China. J Infect 2011; 64:96-103. [PMID: 22085814 PMCID: PMC7112659 DOI: 10.1016/j.jinf.2011.10.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Revised: 10/22/2011] [Accepted: 10/31/2011] [Indexed: 11/29/2022]
Abstract
Objective To evaluate the prevalence and clinical manifestations of human metapneumovirus (hMPV) in immunocompetent Chinese adults with acute respiratory tract infections (ARTIs). Methods A reverse transcription PCR (RT-PCR) assay targeting the P gene was developed in this study and used to detect hMPV in nasal and throat swabs collected from 2936 immunocompetent adult patients with ARTIs in Beijing, China between July 2008 and June 2010. Results Among the 2936 patients studied, 49 (1.7%) were positive for hMPV, of whom 14 (28.6%) were positive for hMPV_A2b, 19 (38.8%) for hMPV_B1, and 16 (32.6%) for hMPV_B2. hMPV_A1 was not detected. An average detection rate of 6.6% was observed in the peak months of the two epidemic seasons studied. The hMPV prevalence was higher in the sampled elderly (>65 years, 3.2%) than in middle aged adults (25–65 years; 2.0%) and teenagers (14–25 years; 0.9%). During the study period, hMPV infections showed a biennial rhythm of seasonality, peaking from November to March in 2008/09 and from March to June in 2010. Conclusion hMPV infection plays an important role in immunocompetent adults in its epidemic season. The demographic and clinical data presented in this study improves our understanding of the pathogenesis and clinical burden of hMPV infection in adults.
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Affiliation(s)
- Jianguo Li
- State Key Laboratory of Molecular Virology and Genetic Engineering, Institute of Pathogen Biology (IPB), Peking Union Medical College (PUMC) & Chinese Academy of Medical Sciences (CAMS), 9# Dong Dan San Tiao, Dongcheng District, Beijing 100730, PR China
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Guido M, Quattrocchi M, Campa A, Zizza A, Grima P, Romano A, De Donno A. Human metapneumovirus and human bocavirus associated with respiratory infection in Apulian population. Virology 2011; 417:64-70. [PMID: 21636105 PMCID: PMC7173056 DOI: 10.1016/j.virol.2011.04.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Revised: 04/04/2011] [Accepted: 04/25/2011] [Indexed: 01/11/2023]
Abstract
We have studied the occurrence of hBoV, hMPV and InfA-B in an Apulian population with respiratory tract infections. During influenza season 2008-2009, 116 oropharingeal swabs were collected from patients affected by Influenza-Like Illness (ILI). The PCR products of hMPV M and HBoV NP-1 genes were sequenced. 78 out of 116 samples were positive for at least one respiratory virus; hBoV was detected in 53, hMPV in 22 and InfA-B in 41 out of 116 swabs. A high rate of hBoV infection in adult (18.9%) and elderly (26.4%) subjects was found. The co-infection rate was higher for hMPV (18/22 cases, 81.8%) compared to hBoV (26/53 cases, 49.1%), and InfA-B (25/41 cases, 61.0%). Co-infections were common in children. hBoV positive samples shared a high level of genetic similarity with the hBoV1 genotype, and hMPV positive samples clustered with A2 subgroup. Our results suggest that hBoV and hMPV play a role in ILI.
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Affiliation(s)
- M. Guido
- Laboratory of Hygiene, Department of Biological and Environmental Sciences and Technologies, Faculty of Sciences, University of Salento, Lecce, Italy,Corresponding author. Fax: + 39 832 298626
| | - M. Quattrocchi
- Laboratory of Hygiene, Department of Biological and Environmental Sciences and Technologies, Faculty of Sciences, University of Salento, Lecce, Italy
| | - A. Campa
- Laboratory of Hygiene, Department of Biological and Environmental Sciences and Technologies, Faculty of Sciences, University of Salento, Lecce, Italy
| | - A. Zizza
- Institute of Clinical Physiology, National Research Council, Lecce, Italy
| | - P. Grima
- Division of Infectious Diseases, HIV Center, S. Caterina Novella Hospital, Galatina, Lecce, Italy
| | - A. Romano
- Laboratory of General Physiology, Department of Biological and Environmental Sciences and Technologies, Faculty of Sciences, University of Salento, Lecce, Italy
| | - A. De Donno
- Laboratory of Hygiene, Department of Biological and Environmental Sciences and Technologies, Faculty of Sciences, University of Salento, Lecce, Italy
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Abstract
BACKGROUND Human metapneumovirus (HMPV) is a major cause of respiratory tract illness in young children and causes annual outbreaks in winter and spring seasons. We evaluated the subgroups of HMPV that caused annual outbreaks and its seasonal occurrence during a 21-year period. METHODS Real-time PCR was used for detection of HMPV in 3576 nasopharyngeal aspirates that had been continuously collected year-round for the years 1987 to 2008 from infants hospitalized with acute respiratory tract illness. Phylogenetic analysis was used to assess HMPV subgroups. RESULTS Of the 3576 samples obtained, 202 (5.6%) tested positive for HMPV. All known HMPV subgroups (A1, A2a, A2b, B1, B2) could be identified as important respiratory tract pathogens in infants. We found that one HMPV subgroup predominated each year, and it was displaced by another subgroup every 1 to 3 years. Besides the frequent change in predominant HMPV subgroups, we observed a yearly shift in the seasonal occurrence, with a strong peak of HMPV activity in late spring-summer months every second year. CONCLUSION HMPV activity is characterized by a periodic change in the predominant subgroup and it shows a stable seasonal rhythm of alternating winter and spring activity.
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Papenburg J, Boivin G. The distinguishing features of human metapneumovirus and respiratory syncytial virus. Rev Med Virol 2010; 20:245-60. [PMID: 20586081 DOI: 10.1002/rmv.651] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Acute respiratory tract infections (RTIs) are a leading cause of morbidity and mortality worldwide. Human Metapneumovirus (hMPV) is a member of the Metapneumovirus genus within the Pneumovirinae subfamily of the Paramyxoviridae family. Though hMPV was only discovered in 2001, a large body of work has already shown that it is the aetiologic agent of a substantial proportion of upper and lower RTIs across all age groups in both healthy and immunocompromised hosts throughout the world. RSV, also a pneumovirus, is the human pathogen most closely related to hMPV. RSV is the leading cause of pneumonia and bronchiolitis in infants and young children, but can also cause respiratory tract disease in all age groups. In this paper, we will review the salient features of the virology, epidemiology, pathogenesis, host immune responses, clinical manifestations and diagnostic modalities of hMPV, using RSV as a comparison. In addition, we will show how immunoprophylactic and therapeutic strategies studied and used in clinical practice for RSV-some with great success, and others tragic failure-have led to promising areas of research for the prevention and treatment of the significant burden of disease caused by hMPV.
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Köndgen S, Schenk S, Pauli G, Boesch C, Leendertz FH. Noninvasive monitoring of respiratory viruses in wild chimpanzees. ECOHEALTH 2010; 7:332-41. [PMID: 20865440 DOI: 10.1007/s10393-010-0340-z] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2010] [Accepted: 07/06/2010] [Indexed: 05/05/2023]
Abstract
To diagnose respiratory disease among wild great apes, there is a need for noninvasive diagnostic methods. Therefore, we analyzed fecal samples from habituated chimpanzees from Taï National Park, Côte d'Ivoire. Samples had been collected during four distinct outbreaks: two with known aetiology (March 2004 and February 2006) and two with unknown aetiology (October 2004 and August 2005). Fecal samples were screened by polymerase chain reaction (PCR) for the presence of human metapneumovirus (HMPV) and human respiratory syncytial virus (HRSV), two paramyxoviruses previously found in lung tissue of chimpanzees that died due to respiratory disease. In the March 2004 outbreak, 72% of the tested individuals were positive for HMPV, and during the 2006 epidemic, 25% tested HRSV-positive. In the outbreaks where no causative pathogen was previously known, fecal samples tested positive for either HRSV or HMPV, showing that reinfection occurred. Virus sequences were generated and compared with sequences previously found in tissue; nearly identical virus sequences in both tissue and fecal samples were found. These results demonstrate that fecal samples collected during outbreak times can be used for the diagnostic and phylogenetic analysis of HMPV and HRSV. Using such diagnostic tools, systematic noninvasive disease investigation of respiratory outbreaks in wild great apes becomes possible. The methods presented here may also be applied for the investigation of further acute diseases in great apes and other species.
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High seroprevalence of neutralizing capacity against human metapneumovirus in all age groups studied in Bonn, Germany. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2009; 17:481-4. [PMID: 20042516 DOI: 10.1128/cvi.00398-09] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Human metapneumovirus (hMPV) infections occur frequently despite high rates of perpetual seroprevalence for all age groups. Analyses of approximately 2,000 archived, randomly selected serum samples demonstrated that neutralizing capacities remain high, with a minor decrease for individuals over 69 years of age, leading to the hypothesis that reinfections occur because humoral immune responses play minor roles in the clearance of hMPV infections.
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Abstract
Numerous viruses are able to cause respiratory tract infections. With the availability of new molecular techniques, the number of pathogens detected in specimens from the human respiratory tract has increased. Some of these viral infections have the potential to lead to severe systemic disease. Other viruses are limited to playing a role in the pathogenesis of the common cold syndrome. This chapter focuses on the viral pathogens that are linked to common cold. It is not the intention to comprehensively review all the viruses that are able to cause respiratory tract infections—this would go beyond the scope of this book. The list of viruses that are briefly reviewed here includes rhinoviruses, respiratory syncytial virus, parainfluenza virus, adenovirus, metapneumovirus and coronavirus. Bocavirus is discussed as one example of a newly identified pathogen with a less established role in the etiology and pathogenesis of common cold. Influenza virus does not cause what is defined as common cold. However, influenza viruses are associated with respiratory disease and the clinical picture of mild influenza and common cold frequently overlaps. Therefore, influenza virus has been included in this chapter. It is important to note that a number of viruses are frequently co-detected with other viruses in humans with respiratory diseases. Therefore, the viral etiology and the role of viruses in the pathogenesis of common cold is complex, and numberous questions remain to be answered.
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Virtue ER, Marsh GA, Wang LF. Paramyxoviruses infecting humans: the old, the new and the unknown. Future Microbiol 2009; 4:537-54. [DOI: 10.2217/fmb.09.26] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Prior to the emergence of Hendra virus in Australia in 1994, paramyxoviruses were considered to be a taxonomic group of ubiquitous pathogens, consisting primarily of Biosafety Level 2 agents, which possessed narrow host ranges and often caused only mild or preventable diseases in humans and animals. In recent years, a number of Paramyxoviridae members have emerged, including previously unrecognized human pathogens and highly pathogenic zoonoses. The recent emergence of paramyxoviruses in humans suggests that there is an increased incidence of zoonotic transmission between wildlife, livestock and human hosts. This article explores the current body of scientific knowledge, disease burden and knowledge of reservoirs of these emerging paramyxoviruses and provides a comparative review of both older and emerging viruses that have been shown to infect humans.
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Affiliation(s)
- Elena R Virtue
- CSIRO Livestock Industries, Australian Animal Health Laboratory (AAHL), Geelong, VIC, Australia and, Australian Biosecurity Cooperative Research Centre for Emerging Infectious Disease and, Department of Microbiology and Immunology, The University of Melbourne, Parkville, VIC, Australia
| | - Glenn A Marsh
- CSIRO Livestock Industries, Australian Animal Health Laboratory (AAHL), Geelong, VIC, Australia
| | - Lin-Fa Wang
- CSIRO Livestock Industries, Australian Animal Health Laboratory, PO Bag 24, Geelong, VIC 3220, Australia, and, Australian Biosecurity Cooperative Research Centre for Emerging Infectious Disease and, Department of Microbiology and Immunology, The University of Melbourne, Parkville, VIC, Australia
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Abstract
Human metapneumovirus is a recently recognized pathogen of acute respiratory tract infection (ARI) in children as well as elderly and immunocompromised adults.The virus belongs to the family Paramyxoviridae, sub family Pneumovirinae and genus Metapneumovirus. Through genetic analysis it has been characterized into two groups A and B which are further divided into four sub-lineages. The virus is difficult to grow in tissue culture and hence reverse transcriptase-polymerase chain reaction (RT-PCR) for N and L gene is the method of choice for diagnosis. The virus has been seen in all countries with seasonal distribution in winter months for temperate and spring/summer for tropical countries. F gene is the most conserved among different lineages and efforts are underway to design recombination vaccine using F gene.
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Affiliation(s)
- S Broor
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi 110 029, India.
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Szentiks CA, Köndgen S, Silinski S, Speck S, Leendertz FH. Lethal pneumonia in a captive juvenile chimpanzee (Pan troglodytes) due to human-transmitted human respiratory syncytial virus (HRSV) and infection with Streptococcus pneumoniae. J Med Primatol 2009; 38:236-40. [PMID: 19239572 DOI: 10.1111/j.1600-0684.2009.00346.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND During an outbreak of respiratory disease in captive chimpanzees (Pan troglodytes), gorillas (Gorilla gorilla), Bornean orangutans (Pongo pygmaeus), and red-capped mangabeys (Cercocebus torquatus) also staff members showed non-specific upper respiratory signs. One infant female chimpanzee with severe respiratory symptoms died despite immediate medical treatment and was submitted for necropsy. METHODS Routine post mortem, histological and bacteriological examinations were conducted. Additionally lung tissue samples form the chimpanzee and swab samples from the staff members and the other primates were examined by PCR. RESULTS A severe catarrhal to purulent bronchopneumonia and an interstitial pneumonia were found and human respiratory syncytial virus (HRSV) as well as Streptococcus pneumoniae was detected in lung samples by PCR. Swab samples from one animal keeper revealed the same HRSV sequence as of the chimpanzee. CONCLUSIONS Therefore, it is suggested that the outbreak of respiratory disease within a zoological institution was due to transmission of HRSV between both human and primates.
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Mackay IM, Arden KE, Lambert SB. Epidemiology. COMMOND COLD 2009. [PMCID: PMC7123965 DOI: 10.1007/978-3-7643-9912-2_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The common cold is the result of an upper respiratory tract infection causing an acute syndrome characterised by a combination of non-specific symptoms, including sore throat, cough, fever, rhinorrhoea, malaise, headache, and myalgia. Respiratory viruses, alone or in combination, are the most common cause. The course f illness can be complicated by bacterial agents, causing pharyngitis or sinusitis, but the are a rare cause of cold and flu-like illnesses (CFLIs). Our understanding of CFLI epidemiology has been enhanced by molecular detection methods, particularly polymerase chain reaction (PCR) testing. PCR has not only improved detection of previously known viruses, but within the last decade has resulted in the detection of many divergent novel respiratory virus species. Human rhinovirus (HRV) infections cause nearly all CFLIs and they can be responsible for asthma and chronic obstructive pulmonary disease exacerbations. HRVs are co-detected with other respiratory viruses in statistically significant patterns, with HRVs occurring in the lowest proportion of co-detections, compared to most other respiratory viruses. Some recently identified rhinoviruses may populate an entirely new putative HRV species; HRV C. Further work is required to confirm a causal role for these newly identified viruses in CFLIs. The burden of illness associated with CFLIs is poorly documented, but where data are available, the impact of CFLIs is considerable. Individual infections, although they do not commonly result in more severe respiratory tract illness, are associated with substantial direct and indirect resource use. The product of frequency and burden for CFLIs is likely to be greater in magnitude than for any other respiratory syndrome, but further work is required to document this. Our understanding of the viral causes of CLFIs, although incomplete, has improved in recent years. Documenting burden is also an important step in progress towards improved control and management of these illnesses.
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Abstract
SUMMARY Clinical laboratories historically diagnose seven or eight respiratory virus infections using a combination of techniques including enzyme immunoassay, direct fluorescent antibody staining, cell culture, and nucleic acid amplification tests. With the discovery of six new respiratory viruses since 2000, laboratories are faced with the challenge of detecting up to 19 different viruses that cause acute respiratory disease of both the upper and lower respiratory tracts. The application of nucleic acid amplification technology, particularly multiplex PCR coupled with fluidic or fixed microarrays, provides an important new approach for the detection of multiple respiratory viruses in a single test. These multiplex amplification tests provide a sensitive and comprehensive approach for the diagnosis of respiratory tract infections in individual hospitalized patients and the identification of the etiological agent in outbreaks of respiratory tract infection in the community. This review describes the molecular methods used to detect respiratory viruses and discusses the contribution that molecular testing, especially multiplex PCR, has made to our ability to detect respiratory viruses and to increase our understanding of the roles of various viral agents in acute respiratory disease.
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Rafiefard F, Yun Z, Orvell C. Epidemiologic characteristics and seasonal distribution of human metapneumovirus infections in five epidemic seasons in Stockholm, Sweden, 2002-2006. J Med Virol 2008; 80:1631-8. [PMID: 18649344 DOI: 10.1002/jmv.21242] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The presence of human metapneumovirus (hMPV) was analyzed retrospectively by reverse transcriptase-polymerase chain reaction (RT-PCR) in five epidemic seasons, in Stockholm, 2002-2006. The occurrence of hMPV was compared with five common respiratory viruses; respiratory syncytial virus, influenza A virus, influenza B virus, parainfluenza virus and adenovirus. With a detection rate of 2.9% (n = 143/4,989) in nasopharyngeal samples over the whole period, hMPV was the fourth most common respiratory virus after RSV, influenza A and parainfluenza virus. hMPV genotype A dominated over genotype B, out of 91 genotyped virus samples 87 belonged to genotype A and four belonged to genotype B. Approximately 50.3% (n = 72/143) of the hMPV positive patients were <3 years, 49.7% (71/143) were > or =3 years and 38,5% (n = 55/143) were <1 year. The relative frequencies of hMPV infections in the three age groups were 2.8% (72/2,579), 2.9% (71/2,410) and 2.6% (55/2,122), respectively. This age distribution differed from RSV, influenza A, B and parainfluenza virus. hMPV epidemics peaked in March, not coincident with RSV or parainfluenza virus. In successive epidemic seasons, large outbreaks of hMPV alternated with small outbreaks in a regular, biannual pattern. Large hMPV virus epidemics were anticyclical to large RSV epidemics. It is concluded that the epidemiology of hMPV differs markedly from other common respiratory viruses.
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Affiliation(s)
- Farideh Rafiefard
- Division of Clinical Microbiology, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden
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Endo R, Ebihara T, Ishiguro N, Teramoto S, Ariga T, Sakata C, Hayashi A, Ishiko H, Kikuta H. Detection of four genetic subgroup-specific antibodies to human metapneumovirus attachment (G) protein in human serum. J Gen Virol 2008; 89:1970-1977. [PMID: 18632969 DOI: 10.1099/vir.0.83679-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Human metapneumovirus (hMPV) strains are classified into two genetic groups, A and B, each of which is further divided in two genetic subgroups, A1, A2, B1 and B2. hMPV encodes two major surface glycoproteins, the fusion (F) and attachment (G) proteins, which may be immunogenic and protective antigens. Although the amino acid sequences of hMPV F protein are highly conserved, those of the G protein are highly variable with low amino acid identity between the two groups. To address the antigenic variation between the genetic subgroups, we developed an immunofluorescence assay (IFA) method using Trichoplusia ni (Tn5) insect cells infected with each recombinant baculovirus-expressed hMPV G (Bac-G) protein of the four genetic subgroups. The titre of each antibody to the four Bac-G proteins was measured by the IFA in 12 paired serum samples obtained from children infected with hMPV of each genetic subgroup. Although 11 of the 12 acute-phase serum samples in paired samples were negative for the antibody to any Bac-G proteins, all of the convalescent-phase serum samples in those paired samples were positive for the antibody to only one of the four Bac-G proteins of the infecting genotype of hMPV. Since the antibody response to hMPV G protein was transient and genetic subgroup-specific without cross-reactivity, four genetic subgroups on the basis of hMPV G protein could be identified as different serotypes. This assay may be useful for the study of immune responses of humans to different hMPV strains, especially for clarifying the risk of reinfection with hMPV.
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Affiliation(s)
- Rika Endo
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Takashi Ebihara
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Nobuhisa Ishiguro
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Shinobu Teramoto
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Tadashi Ariga
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | | | - Akio Hayashi
- Mitsubishi Chemical Medience Corporation, Tokyo, Japan
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Deffrasnes C, Cavanagh MH, Goyette N, Cui K, Ge Q, Seth S, Templin MV, Quay SC, Johnson PH, Boivin G. Inhibition of Human Metapneumovirus Replication by Small Interfering RNA. Antivir Ther 2008. [DOI: 10.1177/135965350801300603] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Human metapneumovirus (hMPV) is a major respiratory viral pathogen in young children, elderly individuals and immunocompromised patients. Despite its major effects related to bronchiolitis, pneumonia and its potential role in recurrent wheezing episodes, there is still no commercial treatment or vaccine available against this paramyxovirus. Methods We tested a therapeutic strategy for hMPV that was based on RNA interference. Results An hMPV genome-wide search for small interfering RNAs (siRNAs) by computational analysis revealed 200 potentially effective 21-mer siRNAs. Initial screening with a luciferase assay identified 57 siRNAs of interest. Further evaluation of their inhibitory potential against the four hMPV subgroups by quantitative real-time reverse transcriptase PCR and plaque immunoassay identified two highly potent siRNAs with 50% inhibitory concentration (IC50) values in the subnanomolar range. siRNA45 targets the nucleoprotein messenger RNA (mRNA) and had IC50 values <0.078 nM against representative strains from the four hMPV subgroups, whereas siRNA60, which targets the phosphoprotein mRNA, had IC50 values between 0.090– <0.078 nM against the same panel of hMPV strains. Longer 25/27-mer siRNAs known as Dicer substrates designed from the top two siRNA candidates were also evaluated and were at least as effective as their corresponding 21-mer siRNAs. Interestingly, the presence of one or two nucleotide mismatches in the target mRNA sequence of some hMPV subgroups did not always affect hMPV inhibition in vitro. Conclusions We successfully identified two highly efficient siRNAs against hMPV targeting essential components of the hMPV replication complex.
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Affiliation(s)
- Céline Deffrasnes
- Infectious Disease Research Centre of the Centre Hospitalier Universitaire de Québec and Laval University, Quebec City, QC, Canada
| | - Marie-Hélène Cavanagh
- Infectious Disease Research Centre of the Centre Hospitalier Universitaire de Québec and Laval University, Quebec City, QC, Canada
| | - Nathalie Goyette
- Infectious Disease Research Centre of the Centre Hospitalier Universitaire de Québec and Laval University, Quebec City, QC, Canada
| | | | - Qing Ge
- MDRNA Inc., Bothell, WA, USA
- Somagenics Inc., Santa Cruz, CA, USA
| | | | | | | | - Paul H Johnson
- MDRNA Inc., Bothell, WA, USA
- PhaseRx Pharmaceuticals, Seattle, WA, USA
| | - Guy Boivin
- Infectious Disease Research Centre of the Centre Hospitalier Universitaire de Québec and Laval University, Quebec City, QC, Canada
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da Silva LHA, Spilki FR, Riccetto AGL, de Almeida RS, Baracat ECE, Arns CW. Variant isolates of human metapneumovirus subgroup B genotype 1 in Campinas, Brazil. J Clin Virol 2008; 42:78-81. [DOI: 10.1016/j.jcv.2007.11.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2007] [Revised: 10/11/2007] [Accepted: 11/06/2007] [Indexed: 11/26/2022]
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Sloots TP, Whiley DM, Lambert SB, Nissen MD. Emerging respiratory agents: new viruses for old diseases? J Clin Virol 2008; 42:233-43. [PMID: 18406664 PMCID: PMC7108325 DOI: 10.1016/j.jcv.2008.03.002] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2008] [Accepted: 03/03/2008] [Indexed: 01/28/2023]
Abstract
The recent advances in molecular technology have enabled the detection of several new viral agents in specimens collected from the human respiratory tract. Human metapneumovirus was first described in 2001, and is a significant respiratory pathogen, particularly of children. Following the identification of severe acute respiratory syndrome (SARS) associated coronavirus, two other newly detected coronaviruses, NL63 and HKU1, have been linked to respiratory disease in humans. However, identifying a new virus as the causative agent of a specific disease is difficult, and ideally would involve satisfying Koch's postulates. The recently described human bocavirus and polyomaviruses KI and WU have been detected in samples collected from humans with acute respiratory infection, but as yet, have not been conclusively proven to be agents of human disease. We review the new viral agents that have been detected in respiratory samples since 2001, and examine their contribution as agents of human disease.
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Affiliation(s)
- T P Sloots
- Queensland Paediatric Infectious Diseases Laboratory, Sir Albert Sakzewski Virus Research Centre, Royal Children's Hospital and Health Service District, Queensland, Australia.
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32
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Loo LH, Tan BH, Ng LM, Tee NWS, Lin RTP, Sugrue RJ. Human metapneumovirus in children, Singapore. Emerg Infect Dis 2008; 13:1396-8. [PMID: 18252120 PMCID: PMC2857288 DOI: 10.3201/eid1309.070220] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Four hundred specimens were collected from pediatric patients hospitalized in Singapore; 21 of these specimens tested positive for human metapneumovirus (HMPV), with the A2 genotype predominating. A 5% infection rate was estimated, suggesting that HMPV is a significant cause of morbidity among the pediatric population of Singapore.
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Affiliation(s)
- Liat Hui Loo
- Nanyang Technological University, Kandang Kerbau Women's and Children's Hospital, Singapore, Singapore
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33
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Köndgen S, Kühl H, N'Goran PK, Walsh PD, Schenk S, Ernst N, Biek R, Formenty P, Mätz-Rensing K, Schweiger B, Junglen S, Ellerbrok H, Nitsche A, Briese T, Lipkin WI, Pauli G, Boesch C, Leendertz FH. Pandemic human viruses cause decline of endangered great apes. Curr Biol 2008; 18:260-4. [PMID: 18222690 DOI: 10.1016/j.cub.2008.01.012] [Citation(s) in RCA: 282] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2007] [Revised: 01/08/2008] [Accepted: 01/09/2008] [Indexed: 11/26/2022]
Abstract
Commercial hunting and habitat loss are major drivers of the rapid decline of great apes [1]. Ecotourism and research have been widely promoted as a means of providing alternative value for apes and their habitats [2]. However, close contact between humans and habituated apes during ape tourism and research has raised concerns that disease transmission risks might outweigh benefits [3-7]. To date only bacterial and parasitic infections of typically low virulence have been shown to move from humans to wild apes [8, 9]. Here, we present the first direct evidence of virus transmission from humans to wild apes. Tissue samples from habituated chimpanzees that died during three respiratory-disease outbreaks at our research site, Côte d'Ivoire, contained two common human paramyxoviruses. Viral strains sampled from chimpanzees were closely related to strains circulating in contemporaneous, worldwide human epidemics. Twenty-four years of mortality data from observed chimpanzees reveal that such respiratory outbreaks could have a long history. In contrast, survey data show that research presence has had a strong positive effect in suppressing poaching around the research site. These observations illustrate the challenge of maximizing the benefit of research and tourism to great apes while minimizing the negative side effects.
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Affiliation(s)
- Sophie Köndgen
- Robert Koch-Institut, Nordufer 20, D-13353 Berlin, Germany
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Montes M, Vicente D, Esnal O, Cilla G, Pérez-Trallero E. A PCR-restriction fragment length polymorphism assay to genotype human metapneumovirus. Clin Microbiol Infect 2007; 14:91-3. [PMID: 17986211 DOI: 10.1111/j.1469-0691.2007.01875.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Human metapneumovirus (hMPV) genotypes A and B show epidemiological and probably clinical differences. This report describes a fast and simple PCR-restriction fragment length polymorphism (PCR-RFLP) assay, involving digestion of the fusion protein gene with Tsp509I, that allows lineages A1, A2, B1 and B2 to be distinguished. The assay should help in elucidating the epidemiology of hMPV, and possibly in predicting the severity of clinical infection.
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Affiliation(s)
- M Montes
- Servicio de Microbiología, Hospital Donostia, Basque Country University, San Sebastián, Spain
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35
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Identification and evaluation of a highly effective fusion inhibitor for human metapneumovirus. Antimicrob Agents Chemother 2007; 52:279-87. [PMID: 17967906 DOI: 10.1128/aac.00793-07] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Human metapneumovirus (hMPV) can cause acute upper and lower respiratory tract infections that are particularly severe in young children, elderly subjects, and immunocompromised patients. To date, no treatments or vaccines are available for hMPV infections. Our objective was to assess the inhibitory potential of several peptides derived from the heptad repeat A and B (HRA and HRB) domains of the hMPV fusion protein. Nine candidate peptides were expressed in Escherichia coli or obtained synthetically and tested in vitro and in an animal model. Excellent in vitro inhibition of an hMPV strain of the A1 subgroup was obtained with five peptides, with 50% inhibitory concentrations ranging from 1.4 nM to 3.3 microM. One peptide, HRA2, displayed very potent activity against all four hMPV subgroups. It was also moderately active against human respiratory syncytial virus (strain A2) but displayed no activity against human parainfluenza virus type 3. BALB/c mice that received the HRA2 peptide and a lethal hMPV intranasal challenge simultaneously were completely protected from clinical symptoms and mortality. On day 5 postinfection, HRA2-treated mice had undetectable lung viral loads which were significantly less than those of untreated mice (3 x 10(4) 50% tissue culture infective doses/lung). Pulmonary inflammation, levels of proinflammatory cytokines/chemokines (RANTES, gamma interferon, and monocyte chemoattractant protein 1) and airway obstruction were also significantly decreased in HRA2-treated mice. The results of this study demonstrate that potent antivirals can be derived from the hMPV fusion protein HR domains. Moreover, hMPV, compared to other paramyxoviruses and to the human immunodeficiency virus, seems to be more susceptible to HRA- than HRB-derived peptides.
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36
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Williams JV, Chen Z, Cseke G, Wright DW, Keefer CJ, Tollefson SJ, Hessell A, Podsiad A, Shepherd BE, Sanna PP, Burton DR, Crowe JE, Williamson RA. A recombinant human monoclonal antibody to human metapneumovirus fusion protein that neutralizes virus in vitro and is effective therapeutically in vivo. J Virol 2007; 81:8315-24. [PMID: 17522220 PMCID: PMC1951312 DOI: 10.1128/jvi.00106-07] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Human metapneumovirus (hMPV) is a recently discovered paramyxovirus that is a major cause of lower-respiratory-tract disease. hMPV is associated with more severe disease in infants and persons with underlying medical conditions. Animal studies have shown that the hMPV fusion (F) protein alone is capable of inducing protective immunity. Here, we report the use of phage display technology to generate a fully human monoclonal antibody fragment (Fab) with biological activity against hMPV. Phage antibody libraries prepared from human donor tissues were selected against recombinant hMPV F protein with multiple rounds of panning. Recombinant Fabs then were expressed in bacteria, and supernatants were screened by enzyme-linked immunosorbent assay and immunofluorescent assays. A number of Fabs that bound to hMPV F were isolated, and several of these exhibited neutralizing activity in vitro. Fab DS7 neutralized the parent strain of hMPV with a 60% plaque reduction activity of 1.1 mug/ml and bound to hMPV F with an affinity of 9.8 x10(-10) M, as measured by surface plasmon resonance. To test the in vivo activity of Fab DS7, groups of cotton rats were infected with hMPV and given Fab intranasally 3 days after infection. Nasal turbinates and lungs were harvested on day 4 postinfection and virus titers determined. Animals treated with Fab DS7 exhibited a >1,500-fold reduction in viral titer in the lungs, with a modest 4-fold reduction in the nasal tissues. There was a dose-response relationship between the dose of DS7 and virus titer. Human Fab DS7 may have prophylactic or therapeutic potential against severe hMPV infection.
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Affiliation(s)
- John V Williams
- Pediatric Infectious Diseases, Vanderbilt University Medical Center, D-7235 Medical Center North, 1161 21st Avenue South, Nashville, TN 37232.
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Buchholz UJ, Nagashima K, Murphy BR, Collins PL. Live vaccines for human metapneumovirus designed by reverse genetics. Expert Rev Vaccines 2007; 5:695-706. [PMID: 17181442 DOI: 10.1586/14760584.5.5.695] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Human metapneumovirus (HMPV) was first described in 2001 and has quickly become recognized as an important cause of respiratory tract disease worldwide, especially in the pediatric population. A vaccine against HMPV is required to prevent severe disease associated with infection in infancy. The primary strategy is to develop a live-attenuated virus for intranasal immunization, which is particularly well suited against a respiratory virus. Reverse genetics provides a means of developing highly characterized 'designer' attenuated vaccine candidates. To date, several promising vaccine candidates have been developed, each using a different mode of attenuation. One candidate involves deletion of the G glycoprotein, providing attenuation that is probably based on reduced efficiency of attachment. A second candidate involves deletion of the M2-2 protein, which participates in regulating RNA synthesis and whose deletion has the advantageous property of upregulating transcription and increasing antigen synthesis. A third candidate involves replacing the P protein gene of HMPV with its counterpart from the related avian metapneumovirus, thereby introducing attenuation owing to its chimeric nature and host range restriction. Another live vaccine strategy involves using an attenuated parainfluenza virus as a vector to express HMPV protective antigens, providing a bivalent pediatric vaccine. Additional modifications to provide improved vaccines will also be discussed.
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Affiliation(s)
- Ursula J Buchholz
- Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Building 50, Room 6505, 50 South Dr. MSC 8007, Bethesda, MD 20892-8007, USA.
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Manoha C, Espinosa S, Aho SL, Huet F, Pothier P. Epidemiological and clinical features of hMPV, RSV and RVs infections in young children. J Clin Virol 2007; 38:221-6. [PMID: 17241812 DOI: 10.1016/j.jcv.2006.12.005] [Citation(s) in RCA: 93] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2006] [Revised: 11/09/2006] [Accepted: 12/06/2006] [Indexed: 11/21/2022]
Abstract
BACKGROUND Human metapneumovirus (hMPV) has recently been isolated from children with acute respiratory tract infections (RTIs). The epidemiological and clinical characteristics of hMPV infection need further investigation. OBJECTIVES The purpose of this study was to compare the clinical features of hMPV, respiratory syncytial virus (RSV) and rhinoviruses (RV) infections in children less than 3 years of age presenting to an emergency department with acute respiratory illness. STUDY DESIGN From December 2002 to April 2004, all children under age three (n=931) admitted for acute respiratory illness to Dijon Hospital, France, were investigated for respiratory viruses in nasal washes. RESULTS hMPV was detected in 6% of children (in 10.1% (n=38) the first winter and in 3.3% (n=17) the second winter); RSV was detected in 28.5% of the children, while rhinoviruses were found in 18.3%. Five hMPV-infected children had evidence of dual infection, two with RSV and three others with RV. The median age of the patients with hMPV infection was 6 months, and the main clinical symptoms were rhinorrhea (74.5%) and cough (67%). A lower tract disease occurred in 66% of hMPV-positive patients. Gene sequencing of hMPV isolates revealed co-circulation of the two major groups of hMPV during the study period; no difference in pathogenicity was found. There was no difference in the prevalence of bronchiolitis where hMPV, RSV or rhinoviruses were present. Asthma was found more often in hospitalized children with hMPV and rhinoviruses than among those with RSV (p<0.001). CONCLUSIONS These results provide further evidence of the importance of hMPV as a pathogen associated with respiratory tract infection in children.
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Bermingham A, Henrickson K, Hayden F, Zambon M. VII International Symposium on Respiratory Viral Infections. Antivir Ther 2007. [DOI: 10.1177/135965350701200s09.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The VII International Symposium on Respiratory Viral Infections was a multidisciplinary forum for the presentation of recent advances in respiratory virus research with special emphasis on antiviral therapies and vaccine strategies. Topics covered in invited lectures included detection of novel respiratory viral pathogens and viral evolution, characterization of the 1918 pandemic virus, human metapneumovirus infections, human respiratory epithelial cultures for studying viral pathogenesis, the role of respiratory viruses in the pathogenesis of asthma, influenza-bacterial interactions, advances in generating vaccine candidates against global respiratory threats like avian influenza and SARS, antiviral resistance surveillance in influenza viruses, and a mini-symposium on advances in viral diagnostics. Other talks covered the live, attenuated intranasal influenza vaccine, monoclonals for respiratory syncytial virus (RSV), mechanisms of antiviral resistance in influenza B, and novel inhibitors for influenza, RSV and rhinovirus infections.
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Affiliation(s)
| | | | - Frederick Hayden
- University of Virginia School of Medicine, Charlottesville, VA, USA and Global Influenza Program, World Health Organization, Geneva, Switzerland
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Warris A, de Groot R. Human metapneumovirus infection. PEDIATRIC INFECTIOUS DISEASES REVISITED 2007. [PMCID: PMC7123282 DOI: 10.1007/978-3-7643-8099-1_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Initially, human metapneumovirus (hMPV) was isolated from children with clinical symptoms of respiratory syncytial virus (RSV) infection in whom RSV could not be detected. Since then, numerous reports have described the detection of hMPV in clinical specimens from children, adults and the elderly (both immunocompetent and immunocompromised patients), diagnosed with an acute respiratory illness all over the world. hMPV is associated with a substantial number of respiratory tract infections in otherwise healthy children, with clinical illnesses similar to those associated with other common respiratory viruses. Serological surveys have shown that hMPV is a ubiquitous virus that infects all children by the age of 5–10 years and has been circulating in humans for at least 50 years. hMPV is a member of the Metapneumovirus genus of the Paramyxoviridae family, a group of negative-stranded RNA viruses. Genetic studies on hMPV have demonstrated the presence of two distinct hMPV serotypes each divided in two subgroups. Diagnosis is made by RT-PCR assays on respiratory secretions. Rapid antigen detection tests are not yet available and its growth in cell cultures is fastidious. No vaccines, antibodies (monoclonal or polyclonal), or chemotherapeutic agents are currently licensed for use to prevent or treat hMPV infections. The contribution of hMPV to pediatric respiratory tract infections suggests that it will be important to develop a vaccine against this virus in combination with those being developed for RSV and parainfluenza viruses. Reverse genetics technology is currently used to develop multivalent vaccines against hMPV and a variety of other important respiratory viruses such as RSV. Additional research to define the pathogenesis of this viral infection and the host’ specific immune response will enhance our knowledge to guide the search for preventive and therapeutical strategies.
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Sloots TP, Mackay IM, Bialasiewicz S, Jacob KC, McQueen E, Harnett GB, Siebert DJ, Masters BI, Young PR, Nissen MD. Human metapneumovirus, Australia, 2001-2004. Emerg Infect Dis 2006; 12:1263-6. [PMID: 16965711 PMCID: PMC3291208 DOI: 10.3201/eid1708.051239] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We examined 10,025 respiratory samples collected for 4 years (2001-2004) and found a 7.1% average annual incidence of human metapneumovirus. The epidemic peak of infection was late winter to spring, and genotyping showed a change in predominant viral genotype in 3 of the 4 years.
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Affiliation(s)
- Theo P Sloots
- Queensland Paediatric Infectious Diseases Laboratory, Royal Children's Hospital and Health Service District, Herston Road, Herston, Queensland 4029, Australia.
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42
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Gray GC, Capuano AW, Setterquist SF, Erdman DD, Nobbs ND, Abed Y, Doern GV, Starks SE, Boivin G. Multi-year study of human metapneumovirus infection at a large US Midwestern Medical Referral Center. J Clin Virol 2006; 37:269-76. [PMID: 17008122 PMCID: PMC1808498 DOI: 10.1016/j.jcv.2006.08.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2006] [Revised: 08/18/2006] [Accepted: 08/19/2006] [Indexed: 10/24/2022]
Abstract
BACKGROUND Because of its recent identification, few multi-year epidemiologic studies of hMPV infection have been reported. OBJECTIVE We sought to retrospectively describe hMPV infections among patients evaluated by a large US Midwestern referral laboratory. STUDY DESIGN Clinical specimens were submitted to a large US Midwest referral hospital from 1 October 2001 to 18 May 2004. RT-PCR was used to retrospectively screen the clinical specimens for human metapneumovirus. Demographic and clinical data were retrieved. RESULTS 34 (2.6%) of 1294 specimens were hMPV positive. Among these, 21 (62%) were culture positive and available for genetic typing. A previously considered rare genotype of hMPV, B1, was the most common single genotype identified, comprising 9 (43%) of the 21 isolates. Multivariate logistic regression modeling identified patients aged 0.4-9 years (OR=8.9; 95% CI=2.0-38.5) and those under intensive care (OR=3.2; 95% CI=1.1-8.7) as more likely to have hMPV infection than their peers. CONCLUSION In this large referral hospital viral assays more often had evidence of hMPV when they were collected from children receiving intensive care.
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Affiliation(s)
- Gregory C Gray
- Center for Emerging Infectious Diseases, Department of Epidemiology, University of Iowa College of Public Health, Iowa City, 200 Hawkins Dr., C21-K GH, Iowa City, IA 52242, USA.
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Ingram RE, Fenwick F, McGuckin R, Tefari A, Taylor C, Toms GL. Detection of human metapneumovirus in respiratory secretions by reverse-transcriptase polymerase chain reaction, indirect immunofluorescence, and virus isolation in human bronchial epithelial cells. J Med Virol 2006; 78:1223-31. [PMID: 16847967 DOI: 10.1002/jmv.20685] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Over two winters in Newcastle upon Tyne, respiratory secretions, negative by immunofluorescence staining for other respiratory viruses, were tested for the presence of human metapneumovirus (HMPV) by RT-PCR. In the second winter, specimens were also tested by immunofluorescence staining with an anti-HMPV polyclonal rabbit antiserum and immunofluorescence positive specimens were inoculated into a line of human bronchiolar cells, 16HBE140. Overall, 55 of 549 (10%) specimens tested were positive for HMPV by RT-PCR. Of 162 specimens tested by both RT/PCR and immunofluorescence staining, 23 were positive by both techniques. Of five specimens positive by RT-PCR alone, only one was confirmed with a second set of primers. Of three specimens positive by immunofluorescence alone, only one was confirmed by virus culture. All four previously recognized sub-genotypes of the virus were identified by both RT-PCR and immunofluorescence staining. Sub-genotype A1 was prevalent in the first winter and B1 prevalent in the second. HMPV replication and virus isolation rates were higher in 16HBE140 cells than in monkey kidney cells and did not require exogenous trypsin. Low passage isolates of both sub-genotypes A2 and B1 replicated slowly reaching peak titers only 12 days after inoculation. In summary, single round RT/PCR and immunofluorescence staining with a polyclonal rabbit antiserum proved of equal sensitivity in the diagnosis of HMPV infection in respiratory secretions both detecting 96% of confirmed positive specimens. 16HBE40 cells provided a significant improvement on monkey kidney cells for the isolation and propagation of the virus.
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Affiliation(s)
- R E Ingram
- The School of Clinical Medical Sciences, The University of Newcastle upon Tyne, Newcastle upon Tyne, United Kingdom
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44
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Abstract
Since the discovery of human metapneumovirus (hMPV) in 2001, the virus has been identified worldwide. hMPV is a common respiratory pathogen, particularly in infants and young children. The virus is associated with both upper and lower respiratory tract infections and may be a trigger for asthma. At least two major genotypes of hMPV circulate during community outbreaks. Whether these genotypes represent distinct serotypes remains controversial. The major challenges faced by the medical and scientific communities are the understanding of the pathogenesis of hMPV disease and the development of a safe and effective vaccine to protect against infection and disease caused by this newly recognized respiratory virus.
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Affiliation(s)
- Jeffrey S Kahn
- Department of Pediatrics, Division of Infectious Diseases, Yale University School of Medicine, P.O. Box 208064, New Haven, CT 06520-8064, USA.
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45
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Abstract
Acute respiratory tract infections (ARTIs) are a leading cause of morbidity and mortality in children worldwide, but the aetiology of many ARTIs is still unknown. In 2001, researchers in The Netherlands reported the discovery of a previously unidentified pathogen called human metapneumovirus (hMPV). Since its initial description, hMPV has been associated with ARTI in Europe (Italy, France, Spain, the UK, Germany, Denmark, Finland and Norway), America (the USA, Canada, Argentina and Brazil), Asia (India, Japan, China and Singapore), Australia and South Africa in individuals of all ages. The incidence of infection varies from 1.5% to 25%, indicating that hMPV is a ubiquitous virus with a worldwide distribution. hMPV seems to play an important role as a cause of paediatric upper and lower respiratory tract infection, with similar, but not identical, epidemiological and clinical features to those of respiratory syncytial virus and influenza virus. Moreover, the socio‐economic impact of hMPV‐infected children on their families seems to be considerable, which suggests that, like influenza virus, hMPV infection may be a substantial public health problem for the community. It may be associated with significant morbidity and mortality in pre‐term infants and children with underlying clinical conditions, although more adequately controlled studies are needed to confirm its importance in such patients. Many fundamental questions concerning the pathogenesis of hMPV disease and the host's specific immune response remain to be answered. Further studies are also required to properly define hMPV diagnosis, treatment and prevention strategies.
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Affiliation(s)
- N Principi
- Institute of Pediatrics, University of Milan, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy.
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46
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Gray GC, Capuano AW, Setterquist SF, Sanchez JL, Neville JS, Olson J, Lebeck MGA, McCarthy T, Abed Y, Boivin G. Human metapneumovirus, Peru. Emerg Infect Dis 2006; 12:347-50. [PMID: 16494771 PMCID: PMC1673211 DOI: 10.3201/eid1202.051133] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
We retrospectively studied 420 pharyngeal swab specimens collected from Peruvian and Argentinean patients with influenzalike illness in 2002 and 2003 for evidence of human metapneumovirus (HMPV). Twelve specimens (2.3%) were positive by multiple assays. Six specimens yielded HMPV isolates. Four of the 6 isolates were of the uncommon B1 genotype.
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Affiliation(s)
- Gregory C Gray
- University of Iowa College of Public Health, Iowa City, Iowa 52242, USA.
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47
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Herd KA, Mahalingam S, Mackay IM, Nissen M, Sloots TP, Tindle RW. Cytotoxic T-lymphocyte epitope vaccination protects against human metapneumovirus infection and disease in mice. J Virol 2006; 80:2034-44. [PMID: 16439559 PMCID: PMC1367143 DOI: 10.1128/jvi.80.4.2034-2044.2006] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Human metapneumovirus (hMPV) has emerged as an important human respiratory pathogen causing upper and lower respiratory tract infections in young children and older adults. In addition, hMPV infection is associated with asthma exacerbation in young children. Recent epidemiological evidence indicates that hMPV may cocirculate with human respiratory syncytial virus (hRSV) and mediate clinical disease similar to that seen with hRSV. Therefore, a vaccine for hMPV is highly desirable. In the present study, we used predictive bioinformatics, peptide immunization, and functional T-cell assays to define hMPV cytotoxic T-lymphocyte (CTL) epitopes recognized by mouse T cells restricted through several major histocompatibility complex class I alleles, including HLA-A*0201. We demonstrate that peptide immunization with hMPV CTL epitopes reduces viral load and immunopathology in the lungs of hMPV-challenged mice and enhances the expression of Th1-type cytokines (gamma interferon and interleukin-12 [IL-12]) in lungs and regional lymph nodes. In addition, we show that levels of Th2-type cytokines (IL-10 and IL-4) are significantly lower in hMPV CTL epitope-vaccinated mice challenged with hMPV. These results demonstrate for the first time the efficacy of an hMPV CTL epitope vaccine in the control of hMPV infection in a murine model.
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Affiliation(s)
- Karen A Herd
- Sir Albert Sakzewski Virus Research Centre, Royal Children's Hospital, Herston Road, Herston QLD 4029, Australia
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48
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The human metapneumovirus: biology, epidemiological features, and clinical characteristics of infection. ACTA ACUST UNITED AC 2006. [DOI: 10.1097/01.revmedmi.0000237165.94641.c1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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49
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Warris A, de Groot R. Human Metapneumovirus: An Important Cause of Acute Respiratory Illness. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2006; 582:251-64. [PMID: 16802634 DOI: 10.1007/0-387-33026-7_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Affiliation(s)
- Adilia Warris
- Radboud University Medical Center, Nijmegen, The Netherlands
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50
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Abstract
BACKGROUND Human metapneumovirus (hMPV) is a recently described human pathogen first identified in respiratory specimens of young children suffering from respiratory syndromes ranging from mild to severe. METHODS AND RESULTS Virological studies have reported the presence of hMPV infections in many countries from all continents. Seroprevalence studies have indicated that the virus has been circulating in humans for more than 50 years and that it infects virtually all children by the ages of 5-10 years. In young children, hMPV has been mainly associated with bronchiolitis but also with pneumonitis, otitis media and acute exacerbation of asthma. The contribution of hMPV in respiratory syndromes of adults has been studied considerably less; initial studies have indicated a role for this pathogen in flu-like syndromes and in significant percentages of chronic obstructive pulmonary disease exacerbations and cases of community-acquired pneumonia during the winter-spring period. Both primate and rodent experimental models have been used to characterize the pathogenesis of this respiratory virus. In some of these models, intranasal hMPV inoculation has elicited not only important viral replication but also significant pulmonary inflammation and clinical disease. Recently a few groups have developed reverse genetic systems for hMPV, allowing a better understanding of viral pathogenesis and generation of attenuated viral strains for immunization. CONCLUSIONS Recent studies on hMPV have provided a better understanding of the epidemiology and pathogenesis associated with this viral infection, and have enhanced the prospect of developing efficient therapeutic agents and vaccine candidates.
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Affiliation(s)
- Marie-Eve Hamelin
- Research Center in Infectious Diseases of the Centre Hospitalier Universitaire de Québec and Laval University, Québec City, Canada
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