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Background: Human Metapneumovirus (HMPV) belongs to the Pneumoviridae family and is responsible for respiratory infections. Mild infections are well-recognized in children, while its precise impact in various categories of immunocompromised adults has not been well addressed., Research Question: We retrospectively studied HMPV infections in immunocompromised adults followed in two large French university medical centers., Study Design and Methods: We identified immunocompromised adults with positive HMPV Polymerase Chain Reaction (PCR) for 36 months and reviewed their medical charts. For lung transplant recipients (LTR), FEV1 was collected at baseline, during and after infection. Imaging was centralized and chest involvement was categorized by dominant CT patterns. We compared severe patients (requiring oxygen or ventilation) and non hypoxemic patients., Results: Seventy-two patients were included, 27 were LTR, 25 had a hematological malignancy or were hematopoietic stem cell recipients, 20 had another immunocompromised status. Twenty patients (28%) presented a hypoxemic infection, requiring hospitalization and intensive care units transfers in 50/72 (69.4%) and 9/72 (12.5%) respectively, with only one death. Hypoxemia was less pronounced in LTRs (p = 0.014). Finally, age and dyspnea remained independent factors associated with hypoxemia (p < 0.005). The most frequent radiological patterns were bronchopneumonia (34.2%) and bronchiolitis (39.5% and 64.3% in the overall population and in LTRs respectively, p = 0.045). FEV1 improved in LTRs at one month and 85% had recovered their baseline FEV1 within 6 months., Interpretations: In immunocompromised adults, HMPV infections required frequent hospitalizations and ICU transfers, while mortality is low. In LTRs, bronchiolitis pattern was predominant with short and long-term favorable outcome., Competing Interests: Declaration of competing interest V.A.-F. has received grants (to her institution) from the ANRS, ViiV Healthcare and the MSD AVENIR foundation and honoraria and travel grants from ViiV Healthcare and Gilead Sciences, for participation in educational programs and conferences; Others authors do not have conflict of interest related to the present article., (Copyright © 2024. Published by Elsevier Ltd.)

The aim of this study was to compare the effect of 2 different vaccination programs using vaccines against infection bronchitis virus (IBV) and avian metapneumovirus (aMPV) on the humoral immune response, production performance, carcass weight and composition, and the percentage of selected internal organs. During the rearing of broiler chickens, blood was collected for serum samples from randomly selected birds from each experimental group on d 1, 21, 28, and 38. Geometric mean titer (GMT) values were determined for the aforementioned diseases using serological ELISA tests, performed during routine veterinary inspections. During rearing, body weight, mortality, and feed consumption were monitored, allowing the calculation of feed consumption per kilogram of body weight gain (FCR) and the European Production Index (EPI). At the end of rearing, 20 chickens were selected for dissection, 10 birds from each group. After slaughter, the weight of the eviscerated carcass was determined, and the percentages of carcass parts and selected internal organs in the body weight were calculated. The vaccination program exerted a significant (P<0.05) effect on body weight on days 14, 21, 28, 35 and 42, the percentage of wings in the carcass and the proportion (%) of heart, liver and spleen in body weight. ELISA showed no significant effect of the vaccination program on the anti-IBV serological response, and no negative effect of covaccination against both diseases on the anti-aMPV serological response., Competing Interests: DISCLOSURES The authors declare no conflicts of interest., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Avian metapneumovirus (aMPV) causes respiratory and reproductive diseases in birds, including chickens. In the chicken industry, live vaccines against aMPV subtypes A and B, which are the major aMPV subtypes, are widely used to control disease caused by aMPV. In this study, we evaluated the cross protective efficacy of a live aMPV subtype B vaccine administered via 3 different routes (nasal, spray, and oral) against virulent aMPV subtype A in chickens. At 3 wk after vaccination of 1-wk-old specific-pathogen-free chickens, we measured the serological responses. On the same day, we challenged the birds with aMPV subtype A. Protection was evaluated by viral gene detection and histopathological examination at 3 and 5 days postchallenge. Although there were differences in the serological responses according to administration route, all vaccinated birds showed complete protection at 5 days postchallenge. Regardless of administration route, genome of challenge virus was not detected in vaccinated group, and there were significant differences between vaccinated birds and control group. Overall, our results demonstrated that a subtype B aMPV vaccine can provide cross protection against virulent subtype A aMPV in chickens., (Copyright © 2023. Published by Elsevier Inc.)

Many pathogens that cause chronic diseases in birds use the respiratory tract as a primary route of infection, and respiratory disorders are the main leading source of financial losses in the poultry business. Respiratory infections are a serious problem facing the poultry sector, causing severe economic losses. Avian influenza virus, Newcastle disease virus, infectious bronchitis virus, and avian pneumovirus are particularly serious viral respiratory pathogens. Mycoplasma gallisepticum, Staphylococcus, Bordetella avium, Pasteurella multocida, Riemerella anatipestifer, Chlamydophila psittaci, and Escherichia coli have been identified as the most serious bacterial respiratory pathogens in poultry. This review gives an updated summary, incorporating the latest data, about the evidence for the circulation of widespread, economically important poultry respiratory pathogens, with special reference to possible methods for the control and prevention of these pathogens., Competing Interests: DISCLOSURES Authors declare no conflict of interests., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: As there have been no comprehensive reports of human metapneumovirus-associated encephalopathy (hMPVE), this study examined the clinical features of hMPVE in children in Japan., Method: A nationwide survey of children with hMPVE was conducted using a structured research form. An initial survey asked pediatricians about children with hMPVE treated between 2014 and 2018. A second survey obtained patient information from hospitals that responded to the initial survey and those identified as having treated cases from a literature search. We collected demographic data, symptoms of hMPV infection, neurological symptoms, laboratory data, treatment, and outcomes. Outcomes were determined using the Pediatric Cerebral Performance Category Score., Result: Clinical information was available for 16 children. Their median age was 37 months. Six had preexisting neurological disorders. The interval between the onsets of infection and hMPVE was 4 days. Outcomes were good in 11 patients and poor in 5. There were no significant differences in demographic data, neurological symptoms, or laboratory data between the patients with good and poor outcomes. The encephalopathy subtypes were acute encephalopathy with biphasic seizures and late reduced diffusion in 3, clinically mild encephalitis/encephalopathy with a reversible splenial lesion in 3, hemorrhagic shock and encephalopathy syndrome in 2, and others in 8., Conclusion: The outcomes of children with hMPVE were not very different from those of acute encephalopathy due to other viruses. We found no factors associated with poor outcomes., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.)

OBJETIVO: Detecção de oito vírus respiratórios mais comuns: vírus respiratório sincicial humano (VRSH), vírus influenza tipo A e B (IA e IB), vírus da parainfluenza 1, 2 e 3 (VPIH1, 2 e 3), adenovírus (Ad) e metapneumovírus humano (MPVH), a fim de estabelecer a etiologia das infecções respiratórias agudas (IRA) e a epidemiologia desses vírus em crianças pequenas atendidas no Hospital Universitário da Universidade de São Paulo, em São Paulo, Brasil, durante o ano de 2003. MÉTODOS: A vigilância epidemiológica foi realizada em todas as crianças menores de 5 anos hospitalizadas por causa de doenças do trato respiratório inferior (DTRI) entre 1º de janeiro de 2003 e 20 de dezembro de 2003, no hospital universitário. Amostras coletadas de nasofaringe foram analisadas quanto à presença de vírus respiratórios através da reação em cadeia da polimerase e detectadas pelo programa GeneScan. RESULTADOS: Das 336 amostras coletadas, 187 (55,6%) foram positivas para pelo menos um dos vírus respiratórios estudados. De todas as crianças, o VRSH foi identificado em 24,1%, o MPVH em 17,8%, o VPIH3 em 8,3%, o Ad em 6,8%, o IA em 5%, o VPIH1 em 0,6%, sendo que nenhum vírus foi detectado em 44,1%. Infecções virais duplas foram detectadas em 7,1% de todas as amostras (12,8% das amostras positivas). O VPIH2 e o IB não foram detectados no presente estudo. CONCLUSÕES: Este estudo confirma que as crianças menores de 5 anos, e especialmente aquelas menores de 1 ano, apresentam uma alta taxa de hospitalização devido aos seguintes vírus: VRSH, MPVH, VPIH, influenza e adenovírus. Foi possível determinar a etiologia e epidemiologia da maioria das IRAs e traçar o perfil de sazonalidade dos vírus respiratórios mais comuns entre as crianças pequenas.OBJECTIVE: Detection of the eight most common respiratory viruses: Human respiratory syncytial virus (HRSV), influenza virus A and B (IA and IB), parainfluenza viruses 1, 2 and 3 (HPIV1, 2 and 3), adenovirus (Ad) and human metapneumovirus (HMPV), in order to establish the etiology of acute respiratory infections (ARIs) and the epidemiology of these viruses in young children seen at Hospital Universitário, Universidade de São Paulo, in São Paulo, Brazil, during 2003. METHODS: The epidemiological surveillance was conducted in all children younger than 5 years hospitalized at the Hospital for lower respiratory tract infections (LRTI) from January 1, 2003 to December 30, 2003. Nasal and throat samples were scanned for respiratory viruses by polymerase chain reaction and detected by the GeneScan assay. RESULTS: Of 336 samples collected from 336 patients, 187 (55.6%) were positive for at least one of the respiratory viruses studied. Of all the children, HRSV was identified in 24.1%, HMPV in 17.8%, HPIV3 in 8.3%, Ad in 6.8%, IA in 5%, HPIV1 in 0.6%, but no virus could be detected in 44.1%. Dual virus infections were detected in 7.1% of all samples (12.8% of positive samples). HPIV2 and IB were not detected in the present study. CONCLUSIONS: This study confirms that children younger than 5 years and particularly younger than 1 year have a high hospitalization rate due to HRSV, HMPV, HPIV, influenza and adenovirus. We were able to determine the etiology and epidemiology of most ARIs and trace the seasonal profile of the commonest respiratory viruses among young children.

Human metapneumovirus (hMPV) is a newly discovered respiratory pathogen. This prospective hospital-based study investigated the clinical role and features of hMPV in Taiwan. Methods: Respiratory specimens collected from hospitalized children with acute respiratory tract infection between September 1, 2003 and April 10, 2005 were screened for metapneumovirus using real-time reverse transcription-polymerase chain reaction (RT-PCR). Results: During the study period, 930 specimens were obtained from 926 hospitalized children. After exclusion of 200 cases due to lack of clinical evidence of airway infection or diseases with known etiology, 726 were included in the analysis. Among these, 33 children had a positive result for hMPV infection. The majority of these patients were admitted during spring and early summer. Twenty-one (63.6%) were younger than 2 years of age. hMPV accounted for 13.3% of respiratory infections occurring between the ages of 18 and 24 months and was as common a respiratory pathogen as respiratory syncytial virus (RSV) in that age group. The 11 patients (33.3%) with underlying diseases had a similar disease course to those without underlying diseases. A co-pathogen was found in 11 patients (33.3%). Infected children between 2 and 5 years of age had significantly higher titers of hMPV in their respiratory specimens (103.88 copies/mL) than children younger than 2 years (102.26 copies/mL) (p = 0.013) and children older than 5 years (102.25 copies/mL) (p = 0.005). hMPV positive cases were significantly older than those with RSV infection (p = 0.002) and had a shorter duration of hospitalization (p = 0.001), fewer days of oxygen use (p = 0.001) and higher levels of C-reactive protein (p = 0.004). Conclusion: Metapneumovirus circulates in children in northern Taiwan during spring and early summer. hMPV was the most common respiratory pathogen in children aged between 18 and 24 months hospitalized with acute respiratory tract infection. Real-time RT-PCR is a sensitive method for investigating the epidemiology and diseases associated with hMPV. [J Formos Med Assoc 2007;106(1):16-24]

Human metapneumoviruses have emerged in the past decades as an important global pathogen that causes severe upper and lower respiratory tract infections. Children under the age of 2, the elderly and immunocompromised individuals are more susceptible to HMPV infection than the general population due to their suboptimal immune system. Despite the recent discovery of HMPV as a novel important respiratory virus, reports have rapidly described its epidemiology, biology, and pathogenesis. However, progress is still to be made in the development of vaccines and drugs against HMPV infection as none are currently available. Herein, we discuss the importance of HMPV and review the reported strategies for anti-HMPV drug candidates. We also present the fusion protein as a promising antiviral drug target due to its multiple roles in the HMPV lifecycle. This key viral protein has previously been targeted by a range of inhibitors, which will be discussed as they represent opportunities for future drug design., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

In Ethiopia, most chicken disease outbreaks and mortalities are attributed to a respiratory syndrome known as "fengil" with variable clinical signs and undefined etiology. The main goal of this study was to determine whether key respiratory pathogens that could contribute to the fengil syndrome circulate in Ethiopia. Specifically, we aimed to determine the seroprevalence of infectious laryngotracheitis virus (ILTV), infectious bronchitis virus (IBV), Newcastle disease virus (NDV), Mycoplasma gallisepticum (Mg), and avian metapneumovirus (aMPV). A cross-sectional survey was conducted in 158 scavenging and 42 small and medium-scale intensive chicken holdings in the East, West and North Shewa Zones of central Ethiopia. Blood from 495 chickens was collected and serological tests were used to determine exposure to these pathogens. Vaccination against NDV was the only immunization practiced with a significantly higher vaccination rate in the intensive than the scavenging system. Serological evidence of a high level of exposure to all pathogens was detected, including the first report on the seroprevalence of aMPV, ILTV, and IBV in the East Shewa Zone. The chicken and holding seroprevalence rates were respectively 91% and 94% for IBV, 34% and 57% for aMPV, 47% and 66% for Mg, 27% and 51% for ILTV and in unvaccinated flocks, 39% and 53% for NDV. These pathogens could contribute to the fengil syndrome, commonly ascribed to NDV. The seroprevalence of aMPV and ILTV was higher in chickens under the scavenging system. Exposure to multiple pathogens was common, with more than 50% of chickens positive for three or more pathogens in the scavenging system. This was reflected in significant positive associations between seropositivity to ILTV, Mg, ILTV, and IBV. The role of these pathogens in the causation of respiratory disease in the field requires further investigation., Competing Interests: DISCLOSURES The authors declare that they have no conflict of interest., (Copyright © 2022. Published by Elsevier Inc.)

Avian metapneumovirus (aMPV) is a viral pathogen that causes respiratory signs and drops in egg production most notably in turkeys but also affects chickens, ducks and other species. Four subgroups (aMPV-A, -B, -C and -D) have been characterized to date, which differ genetically, antigenically and in terms of geographic distribution and host range. Despite the rising awareness towards aMPV, many aspects of its epidemiology are still poorly understood. In this pilot study, a serological survey was carried out to assess the possible circulation of subgroups A, B, and C in intensively raised ducks in Northern Italy. A total of 220 sera from 10 Pekin duck flocks and one mallard flock were collected at slaughter and tested by subgroup-specific aMPV-A, B, and C indirect ELISA assays. None of the tested birds had been vaccinated against aMPV and no symptoms had been reported. No aMPV-A, B or C antibodies were detected in any bird of the Pekin duck flocks, whereas the entire mallard flock tested positive for aMPV-C antibodies. This is the first report of aMPV-C antibodies in ducks in Italy, where only aMPV-B has been reported to circulate in recent years. Further research efforts will be targeted towards the screening of a larger panel of samples, in the hope of obtaining positive samples from which full length genome sequences and infectious viruses can be isolated for virus characterization. Finally, the demonstration of aMPV-C specific antibodies in the serum of all sampled mallards indirectly suggests that this species is readily infected by aMPV-C and supports a possible role of wild anatids as a transmission vector of the virus., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Avian metapneumoviruses (aMPV) are a causative agent of turkey rhinotracheitis (TRT). Despite vaccination, cases of TRT outbreaks are frequently reported. Considering that there are aMPV-free areas, a part of turkey poults possess (MDA+) or do not possess (MDA-) maternally derived antibodies (MDA) in the first weeks of life, which is the time of TRT vaccination. Study was undertaken to establish the level of protection against homologue aMPV/A infection, in MDA+ and MDA- turkeys, vaccinated against TRT at the 0 or 14th d of life and infected 14 d later. With the use of ELISA test and qPCR techniques, we have established the level of immune system stimulation after the vaccination and how does it correlate with the level of protection against the aMPV infection. Vaccination of MDA+ turkeys (especially at 0 d of life) resulted in weaker IgA production in upper respiratory tract. In addition, we have demonstrated differences in both humoral and cell-mediated immunity stimulation after infection of vaccinated turkeys. Despite these differences, we have shown that all vaccinated birds were protected against the disease which was determined based on the clinical and histopathological scoring, as well as the level of aMPV/A replication and shedding. Nonvaccinated groups of turkeys displayed typical signs of TRT after infection which indicates that MDA alone are incapable of preventing the disease. Differences in TRT course were recorded between different age groups of nonvaccinated birds. Birds infected at the 28th d of life (especially MDA- birds) developed more severe signs, and the level of aMPV replication was higher than that in birds infected on the 14th d of life. Despite the minor role in alleviating TRT course, MDA seems not to interfere with the vaccination efficacy. It is hard to predict whether the observed immune system stimulation differences between MDA+ and MDA- birds after vaccination can influence the outcome of vaccination efficacy under the field conditions., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Respiratory tract infection with pneumoviruses (PVs) and paramyxoviruses (PMVs) are increasingly associated with chronic lung allograft dysfunction (CLAD) in lung transplant recipients (LTRs). Ribavirin may be a treatment option but its effectiveness is unclear, especially with respect to infection severity. We retrospectively analyzed 10 years of PV/PMV infections in LTRs. The main end points were forced expiratory volume in 1 second (FEV 1 ) at 3 and 6 months postinfection, expressed as a percentage of pre-infection FEV 1 and incidence of new or progressed CLAD 6 months postinfection. A total of 139 infections were included: 88 severe infections (63%) (defined as >10% FEV 1 loss at infection) and 51 mild infections (37%) (≤10% FEV 1 loss). Overall postinfection CLAD incidence was 20%. Associations were estimated on postinfection FEV 1 for ribavirin vs no ribavirin (+13.2% [95% CI: 7.79; 18.67]) and severe vs mild infection (-11.1% [95% CI: -14.76; -7.37]). Factors associated with CLAD incidence at 6 months were ribavirin treatment (odds ratio (OR [95% CI]) 0.24 [0.10; 0.59]), severe infection (OR [95% CI] 4.63 [1.66; 12.88]), and mycophenolate mofetil use (OR [95% CI] 0.38 [0.14; 0.97]). These data provide valuable information about the outcomes of lung transplant recipients with these infections and suggests possible associations of ribavirin use and infection severity with long-term outcomes. Well-designed prospective trials are needed to confirm these findings., (© 2020 The Authors. American Journal of Transplantation published by Wiley Periodicals LLC on behalf of The American Society of Transplantation and the American Society of Transplant Surgeons.)

Objectives: To describe a human metapneumovirus (hMPV) outbreak occurring in a nursing home for older adults and to identify the risk factors associated with the clinical infection., Design: A retrospective, case-controlled study., Setting and Participants: A French nursing home for older adults between December 27, 2014 and January 20, 2015. Probable cases were residents presenting at least 1 respiratory symptom or 1 constitutional symptom. Confirmed cases identified in the same way as probable cases but with a positive RT-PCR test for hMPV. Controls were residents with no symptoms of respiratory infection., Measures: Identification of hMPV was realized on nasal swab samples by RT-PCR., Results: Seventy-eight older people were resident at the time of the outbreak. Three of the 4 tested were positive for hMPV by RT-PCR and negative for 13 other viruses or bacteria. All probable infected residents presented cough; other symptoms were scarcer. An inflammatory response was present, with median C-reactive protein at 50 mg/L. The median duration of the illness was 7 days. The rate of infection among residents was high (51%), with 5 hospitalizations (12.5%) and 1 death (2.5%). In multivariate analysis, vaccination against influenza virus appeared to emerge as associated with a probable hMPV infection, but this might be an artifact, as the proportion of unvaccinated residents was low (15%). A clear infected population profile was hard to define, although limited autonomy and low ADL score may play a role. Basic hygiene precautions were reinforced, but droplet precautions seemed difficult to apply rigorously to this population., Conclusions/implications: Clinical and biological presentations were nonspecific. The rate of infection was high, highlighting the need for the rapid introduction of strict precautions to contain the infection., (Copyright © 2019 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)

We report the sudden death of a 33-month-old child owing to acute respiratory distress syndrome due to human metapneumovirus (hMPV) infection. Of 30 children attending the same day care centre, 26% and 59% had hMPV and multiple infections, respectively; three of six children with pneumonia had a diagnosis of hMPV. hMPV infection is common in childhood viral co-infections but it can cause sudden death., (Copyright © 2019 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved.)

The aim of this study was to determine if there was a correlation between respiratory syncytial virus (RSV) and metapneumovirus (MPV) genotypes and clinical data of Brazilian infants hospitalized for acute lower respiratory infection. The viruses in the patients' nasopharyngeal secretions were studied using the polymerase chain reaction and phylogenetic analysis. The study assessed 144 infants; 31.9% were RSV positive and 5.6% were MPV positive. Statistical analysis was performed using the chi-squared test, Fisher's test, Odds ratio, univariate logistic regression, non-conditional multivariate logistic regression and the forward - stepwise method. Multivariate analysis confirmed a significant relationship between a positive PCR test for RSV and hospitalization during the month of May and with pulse oximetry less than 90%. The phylogenetic analysis indicated the genotypes GA2, GA5, SAA1 (Group A), SAB1, SAB3 and BA (Group B) for RSV and Group B, subgroup B1, for MPV.

Objectives: The aim of this review is to provide updated information on the clinical spectrum, treatment options, and infection prevention strategies for respiratory viral infections (RVIs) in both solid organ (SOT) and hematopoietic stem cell transplant (HSCT) patients., Methods: The MEDLINE and PubMed databases were searched for literature regarding the aforementioned aspects of RVIs, with focus on respiratory syncytial virus, adenovirus, influenza virus, parainfluenza virus, human metapneumovirus, and rhinovirus., Results: Compared to immunocompetent hosts, SOT and HSCT patients are much more likely to experience a prolonged duration of illness, prolonged shedding, and progression of upper respiratory tract disease to pneumonia when infected with respiratory viruses. Adenovirus and respiratory syncytial virus tend to have the highest mortality and risk for disseminated disease, but all the RVIs are associated with higher morbidity and mortality in these patients than in the general population. These viruses are spread via direct contact and aerosolized droplets, and nosocomial spread has been reported., Conclusions: RVIs are associated with high morbidity and mortality among SOT and HSCT recipients. Management options are currently limited or lack strong clinical evidence. As community and nosocomial spread has been reported for all reviewed RVIs, strict adherence to infection control measures is key to preventing outbreaks., (Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: The etiological profile of viruses among adult patients with community-acquired pneumonia (CAP) has not been characterized yet. The aim of this study was twofold: first, investigate the pathogen profiles and the molecular epidemiology of respiratory viruses among Japanese CAP patients; and second, explore the clinical significance of viral infections., Methods: A cross-sectional observational study was conducted at Kyorin University Hospital. To identify respiratory pathogens, hospitalized CAP patients were enrolled, and reverse transcriptase-polymerase chain reaction technology was applied alongside conventional microbiological methods. Phylogenetic and pairwise distance analyses of 10 viruses were performed. CAP patients were divided into four etiological groups (virus alone, bacteria alone, co-detection of virus and bacteria, and not detected) and the clinical findings were compared., Results: Seventy-six patients were enrolled. Bacteria alone were detected in 39.5% (n=30) of CAP patients. Virus alone or co-detection were found in 10.5% (n=8) and 11.8% (n=9) of cases, respectively. Streptococcus pneumoniae and human metapneumovirus were the most frequently detected bacterium and virus, respectively. Phylogenetic analyses of human metapneumovirus, human rhinovirus, and human respiratory syncytial virus showed that different subgroups and genotypes might be associated with CAP. Respiratory failure was more common when a virus was detected (both virus alone and co-detection groups; n=17, 100%, p<0.05) than when a bacteria alone was detected (n=17, 56.7%)., Conclusion: Prevalence of respiratory virus infection in CAP inpatients was 22.3%. The detected viruses display high genetic divergence and correlate with increased respiratory failure., (Copyright © 2016. Published by Elsevier B.V.)

Background: Human metapneumovirus (HMPV) is a recently discovered respiratory pathogen of the family Paramyxoviridae, the same family as that of respiratory syncytial virus (RSV). Premature children are at high risk of severe RSV infections, however, it is unclear whether HMPV infection is more severe in hospitalized children with a history of severe prematurity., Methods: We conducted a retrospective analysis of the clinical respiratory presentation of all polymerase chain reaction-confirmed HMPV infections in preschool-age children (≤5 years) with and without history of severe prematurity (<32 weeks gestation). Respiratory distress scores were developed to examine the clinical severity of HMPV infections. Demographic and clinical variables were obtained from reviewing electronic medical records., Results: A total of 571 preschool children were identified using polymerase chain reaction-confirmed viral respiratory tract infection during the study period. HMPV was identified as a causative organism in 63 cases (11%). Fifty-eight (n = 58) preschool-age children with HMPV infection were included in this study after excluding those with significant comorbidities. Our data demonstrated that 32.7% of children admitted with HMPV had a history of severe prematurity. Preschool children with a history of prematurity had more severe HMPV disease as illustrated by longer hospitalizations, new or increased need for supplemental O2, and higher severity scores independently of age, ethnicity, and history of asthma., Conclusion: Our study suggests that HMPV infection causes significant disease burden among preschool children with a history of prematurity leading to severe respiratory infections and increasing health care resource utilization due to prolonged hospitalizations., (Copyright © 2016. Published by Elsevier B.V.)

Background: Human metapneumovirus (hMPV), a recently identified respiratory virus, is a leading cause of acute respiratory tract infection in children during winter. The aims of this study were to outline epidemiological and clinical presentations of hMPV infectious diseases in young children., Patients and Methods: A prospective study was conducted from November 2007 to April2008 in children under 2 years of age admitted to the University Children's Hospital of Tours, France, for acute respiratory infection. Nasopharyngeal aspirates were systematically tested for several respiratory viruses. Epidemiological and clinical characteristics of hMPV-infected children were compared to those of patients with respiratory syncytial virus (RSV) and other viral (OTH) infections., Results: A total of 374 children were enrolled in this study. Viral investigations detected 22 (6 %) hMPV infections, 177 (47 %) RSV infections, and 175 (47 %) presumed or demonstrated other viruses. The hMPV infection had a seasonal peak in December, similar to RSV, and was uncommon after January. Most of the patients infected with hMPV were under 1 year of age and bronchiolitis was the predominant diagnosis in 90 % of these patients with clinical symptoms of a lower respiratory tract infection. The severity of the disease, estimated from the requirement of respiratory or nutritional assistance, was similar to those of RSV patients, but was higher than those in the OTH group. hMPV was more frequently detected in patients with chronic pathology, such as bronchopulmonary dysplasia, congenital heart defect, or neuromuscular disorders, and in patients who had been previously admitted for bronchiolitis., Conclusion: These results highlight that hMPV plays an important role in seasonal acute respiratory tract infections in children during winter, with a severity similar to RSV infections., (Copyright 2009 Elsevier Masson SAS. All rights reserved.)

A dose titration and reduced duration medication study were performed to evaluate the current enrofloxacin treatment schedule in growing turkeys experimentally infected with avian metapneumovirus and Ornithobacterium rhinotracheale. Experimental groups of 17 four-week-old turkeys were first infected with avian metapneumovirus and 3 d later with O. rhinotracheale. Enrofloxacin treatment in the drinking water was started 24 h after O. rhinotracheale inoculation. In the dose titration study, enrofloxacin doses of 5, 10, and 20 mg/kg of BW were administered for 5 successive days. In the reduced duration medication study, the following enrofloxacin regimens were compared: 25 mg/kg of BW per day on d 0 and 2; 15 mg/kg of BW per day on d 0, 2, and 4; and 10 mg/kg of BW for 5 successive days. In both studies, all enrofloxacin treatments were equally efficacious (i.e., equally capable of shortening the course of clinical disease), eliminating O. rhinotracheale from the respiratory tract and reducing gross lesions. Ornithobacterium rhinotracheale bacteria were not recovered from any of the birds on enrofloxacin-supplemented media, indicating that none of the used treatment regimens promoted the selection of bacterial clones with reduced susceptibility or resistance to this antimicrobial agent. In conclusion, none of the alternative enrofloxacin treatment regimens yielded better results than the current prescribed treatment (i.e., 10 mg/kg of BW for 5 successive days) of O. rhinotracheale infections in turkeys. However, the reduced duration of application would offer a less time-consuming and equally effective alternative.

This is the first reported case of respiratory failure associated with human metapneumovirus (hMPV) infection in a liver transplant recipient or in a pediatric solid transplant recipient. A 9-month-old female developed respiratory distress 8 days following a liver transplant. hMPV was detected and she required intubation followed by extracorporeal membrane oxygenation for 26 days. Immunosuppressive medications were stopped during the acute infection except for methylprednisolone as treatment for acute respiratory distress. Serial Doppler ultrasounds were used to monitor for hepatic vessel thromboses and serum liver function tests to assess for hepatic dysfunction and there was no evidence of allograft rejection. The patient recovered from the nosocomial hMPV infection with satisfactory pulmonary function and possible mild developmental delay.

Severe acute respiratory syndrome (SARS) is a condition associated with substantial morbidity and mortality. Coronavirus has been associated with this severe emerging disease, with a pattern suggesting droplet or contact transmission. From April to June 2003, Institute Adolfo Lutz received 16 respiratory secretions from hospitalized patients with recent history of travel to an area with local transmission of SARS. Rapid antigen detection for influenza A and B, parainfluenza types 1, 2 and 3, respiratory syncytial virus and adenovirus; electron microscopy, polymerase chain reaction (PCR), reverse transcription PCR (RT-PCR) and serologic assay were performed. Virus isolation attempts were performed in Hep-2, Vero, MDCK, NCI-H292, MRC-5, LLC-MK2 and FRhK-4. Influenza virus of type A/Panama/2007/99 (H3N2) and A/New Caledonia/20/99 (H1N2) were identified., (Copyright © 2004 Published by Elsevier B.V.)

Background: A new paramyxovirus, the human metapneumovirus was recently isolated. We report the first French cases collected between 2000 and 2002., Material and Methods: Samples were obtained from nasopharyngeal aspirates from children hospitalised for acute respiratory tract infection in hospitals of Caen and Flers in Basse-Normandie. Human metapneumovirus was studied by polymerase chain reaction on negative samples for respiratory syncytial virus, influenza A and B virus, parainfluenza (1, 2 and 3) virus, adenovirus, coronavirus and rhinovirus. Comparison between metapneumovirus virus and respiratory syncytial virus infections was done after matching sex, age and infection month., Results: Twenty-six human metapneumovirus infections were identified. A comparative study of a matched group of children infected by respiratory syncytial virus found no significative difference for hospitalisation motive, clinical criteria and treatment., Conclusion: The human metapneumovirus is responsible for typical acute bronchiolitis in children.