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Human metapneumovirus infections

Author
James E Crowe, Jr, MD
Section Editors
Martin S Hirsch, MD
Sheldon L Kaplan, MD
Deputy Editor
Anna R Thorner, MD

INTRODUCTION

Respiratory tract infections commonly are caused by viral pathogens, especially in young children. Respiratory syncytial virus (RSV) is the most common pathogen identified in these infections, followed historically by parainfluenza virus (PIV); both of these viruses are in the Paramyxoviridae family. Other important viruses that cause respiratory tract infection include influenza and adenoviruses. However, despite improved methods for identifying viral pathogens in these infections, the etiology remains undetermined in a significant number of patients.

In 2001, investigators from the Netherlands discovered a new member of the Paramyxoviridae family in the genus Metapneumovirus [1]. The first representative of this genus to cause infection in humans has been called the human metapneumovirus (hMPV). Data suggest this virus has been responsible for respiratory tract infections for at least 60 years with a worldwide distribution [1-4].

The virology, pathogenesis, epidemiology, clinical manifestations, diagnosis, and treatment of hMPV will be discussed here. Other common respiratory viruses are reviewed separately. (See "Respiratory syncytial virus infection: Clinical features and diagnosis" and "Seasonal influenza in children: Clinical features and diagnosis" and "Clinical manifestations of seasonal influenza in adults" and "Parainfluenza viruses in children" and "Parainfluenza viruses in adults" and "Epidemiology and clinical manifestations of adenovirus infection".)

VIROLOGY

Within the Paramyxoviridae family, there are two subfamilies, Pneumovirinae and Paramyxovirinae. Genetic analysis determined that human metapneumovirus (hMPV) is most similar to the Pneumovirinae family, of which respiratory syncytial virus is a prominent member.

HMPV is an enveloped virus with a nonsegmented negative-sense RNA genome. HMPV is most closely related phylogenetically to avian metapneumovirus (APV) [1]. The complete genome sequence reveals a high level of homology with APV [5]. Phylogenetic analysis has identified two subgroups of hMPV, subgroups A and B, and two clades within each of these subgroups (designated A1, A2, B1, and B2), which often circulate concurrently [6,7]. A study of 727 Australian hMPV isolates was undertaken from 2001 to 2004 to determine the epidemiologic profile of genetic subtypes associated with acute respiratory tract infections [7]. Concurrent annual circulation of all four hMPV subtypes was common, although a single, and usually different, hMPV subtype predominated each year.

                      

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Literature review current through: Nov 2016. | This topic last updated: Mon Nov 30 00:00:00 GMT+00:00 2015.
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