Epidemiology of Human Metapneumovirus Among Children With Severe or Very Severe Pneumonia in High Pneumonia Burden Settings: the Pneumonia Etiology Research For Child Health (PERCH) Study Experience.

Details

• Alternative Title:
  Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases, 2025, v. 31, no. 3: Epidemiology of Human Metapneumovirus Among Children With Severe or Very Severe Pneumonia in High Pneumonia Burden Settings: the Pneumonia Etiology Research For Child Health (PERCH) Study Experience.
• Journal Article:
  Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
• Personal Author:
  Miyakawa, Ryo ; Zhang, Haijun ; Brooks, W. Abdullah ; Prosperi, Christine ; Baggett, Henry C. ; Feikin, Daniel R. ; Hammitt, Laura L. ; Howie, Stephen R.C. ; Kotloff, Karen L. ; Levine, Orin S. ; Madhi, Shabir A. ; Murdoch, David R. ; O'Brien, Katherine L. ; Scott, J. Anthony G. ; Thea, Donald M. ; Antonio, Martin ; Awori, Juliet O. ; Bunthi, Charatdao ; Driscoll, Amanda J. ; Ebruke, Bernard ; Fancourt, Nicholas S. ; Higdon, Melissa M. ; Karron, Ruth A. ; Moore, David P. ; Morpeth, Susan C. ; Mulindwa, Justin M. ; Park, Daniel E. ; Rahman, Mohammed Ziaur ; Rahman, Mustafizur ; Salaudeen, Rasheed A. ; Sawatwong, Pongpun ; Seidenberg, Phil ; Sow, Samba O. ; Tapia, Milagritos D. ; Knoll, Maria Deloria
• Description:
  After respiratory syncytial virus (RSV), human metapneumovirus (hMPV) was the second-ranked pathogen attributed to severe pneumonia in the PERCH study. We sought to characterize hMPV-positive cases in high-burden settings, which have limited data, by comparing with RSV-positive and other cases.
  
  Children aged 1-59 months hospitalized with suspected severe pneumonia and age/season-matched community controls in seven African and Asian countries had nasopharyngeal/oropharyngeal swabs tested by multiplex PCR for 32 respiratory pathogens, among other clinical and lab assessments at admission. Odds ratios adjusted for age and site (adjusted OR aOR) were calculated using logistic regression. Aetiologic probability was estimated using Bayesian nested partial latent class analysis. Latent class analysis identified syndromic constellations of clinical characteristics.
  
  hMPV was detected more frequently among cases (267/3887, 6.9%) than controls (115/4976, 2.3%), among cases with pneumonia chest X-ray findings (8.5%) than without (5.5%), and among controls with respiratory tract illness (3.8%) than without (1.8%; all p ≤ 0.001). HMPV-positive cases were negatively associated with the detection of other viruses (aOR, 0.18), especially RSV (aOR, 0.11; all p < 0.0001), and positively associated with the detection of bacteria (aORs, 1.77; p 0.03). No single clinical syndrome distinguished hMPV-positive from other cases. Among hMPV-positive cases, 65.2% were aged <1 year and 27.5% had pneumonia danger signs; positive predictive value for hMPV aetiology was 74.5%; mortality was 3.9%, similar to RSV-positive (2.4%) and lower than that among other cases (9.6%).
  
  HMPV-associated severe paediatric pneumonia in high-burden settings was predominantly in young infants and clinically indistinguishable from RSV. HMPV-positives had low case fatality, similar to that in RSV-positives.
• Content Notes:
  Author manuscript
• Subjects:
  • Humans
  • Metapneumovirus
  • Paramyxoviridae Infections
  • Infant
  • Female
  • Male
  • Child, Preschool
  • Pneumonia, Viral
  • Africa
  • Pneumonia
  More +
• Keywords:
  • Africa
  • Asia
  • Human metapneumovirus (hMPV)
  • Paediatric
  • Severe pneumonia
• Source:
  Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases, 2025, v. 31, no. 3
• DOI:
  https://doi.org/10.1016/j.cmi.2024.10.023
• ISSN:
  1198-743X ; 1469-0691
• Pubmed ID:
  39489292
• Pubmed Central ID:
  PMC13076004
• Document Type:
  Text
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Genre:
  Journal Article
• Place as Subject:
  Asia
• Pages in Document:
  441-450 (22 pdf pages)
• Volume:
  31
• Issue:
  3
• Download URL:
  https://stacks.cdc.gov/view/cdc/261946/cdc_261946_DS1.pdf
• File Type:
  [PDF - 637.98 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:d6a006954366a5c8c645e5a2f8b903d070597a0a46e60d623e64b9635687bd73342be7d02676984cabbb79b8019a6ddc550f841321a3be1a6a4e5f98c04ff1b4