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Karimata Y, Kinjo T, Parrott G, Uehara A, Nabeya D, Haranaga S, Higa F, Tateyama M, Miyagawa K, Kishaba T, Otani K, Okamoto M, Nishimura H, Fujita J. Clinical Features of Human Metapneumovirus Pneumonia in Non-Immunocompromised Patients: An Investigation of Three Long-Term Care Facility Outbreaks. J Infect Dis 2019; 218:868-875. [PMID: 29733351 PMCID: PMC7107412 DOI: 10.1093/infdis/jiy261] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 05/01/2018] [Indexed: 11/25/2022] Open
Abstract
Background Several studies have reported outbreaks due to human metapneumovirus (hMPV) in long-term care facilities (LTCF) for the elderly. However, most of these reports are epidemiological studies and do not investigate the clinical features of hMPV pneumonia. Methods Three independent outbreaks of hMPV occurred at separate LTCF for intellectually challenged and elderly residents. A retrospective evaluation of hMPV pneumonia and its clinical and radiological features was conducted using available medical records and data. Results In 105 hMPV infections, 49% of patients developed pneumonia. The median age of pneumonia cases was significantly higher than non-pneumonia cases (P < .001). Clinical manifestations of hMPV pneumonia included high fever, wheezing in 43%, and respiratory failure in 31% of patients. An elevated number of white blood cells as well as increased levels of C-reactive protein, creatine phosphokinase, and both aspartate and alanine transaminases was also observed among pneumonia cases. Evaluation of chest imaging revealed proximal bronchial wall thickenings radiating outward from the hilum in most patients. Conclusions The aforementioned characteristics should be considered as representative of hMPV pneumonia. Patients presenting with these features should have laboratory testing performed for prompt diagnosis.
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Affiliation(s)
- Yosuke Karimata
- Department of Infectious Diseases, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Takeshi Kinjo
- Department of Infectious Diseases, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Gretchen Parrott
- Department of Infectious Diseases, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Ayako Uehara
- Department of Infectious Diseases, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Daijiro Nabeya
- Department of Infectious Diseases, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Shusaku Haranaga
- Department of Infectious Diseases, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Futoshi Higa
- Department of Infectious Diseases, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Masao Tateyama
- Department of Infectious Diseases, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Keiko Miyagawa
- Personnel Health Management Center, Department of General Affairs, Okinawa Prefectural Government, Japan
| | - Tomoo Kishaba
- Department of Respiratory Medicine, Okinawa Chubu Hospital, Japan
| | - Kanako Otani
- Virus Research Center, Sendai Medical Center, National Hospital Organization, Miyagi, Japan.,Department of Virology, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Michiko Okamoto
- Department of Virology, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Hidekazu Nishimura
- Virus Research Center, Sendai Medical Center, National Hospital Organization, Miyagi, Japan
| | - Jiro Fujita
- Department of Infectious Diseases, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
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Seynaeve D, Augusseau-Rivière B, Couturier P, Morel-Baccard C, Landelle C, Bosson JL, Gavazzi G, Mallaret MR. Outbreak of Human Metapneumovirus in a Nursing Home: A Clinical Perspective. J Am Med Dir Assoc 2019; 21:104-109.e1. [PMID: 31101588 PMCID: PMC7105973 DOI: 10.1016/j.jamda.2019.03.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 03/12/2019] [Accepted: 03/15/2019] [Indexed: 01/26/2023]
Abstract
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.
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Affiliation(s)
- Damien Seynaeve
- Service d'Hygiène Hospitalière et de Gestion des Risques, CHU Grenoble Alpes, Grenoble Cedex, France.
| | | | - Pascal Couturier
- Clinique Universitaire de Médecine Gériatrique, CHU Grenoble Alpes, Grenoble Cedex, France
| | | | - Caroline Landelle
- Service d'Hygiène Hospitalière et de Gestion des Risques, CHU Grenoble Alpes, Grenoble Cedex, France; Université Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, Grenoble Cedex, France
| | - Jean-Luc Bosson
- Pôle de Santé Publique, CHU Grenoble Alpes, Grenoble Cedex, France; Université Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, Grenoble Cedex, France
| | - Gaëtan Gavazzi
- Clinique Universitaire de Médecine Gériatrique, CHU Grenoble Alpes, Grenoble Cedex, France; Université Grenoble Alpes, GREPI EA 7408, Grenoble Cedex, France
| | - Marie-Reine Mallaret
- Service d'Hygiène Hospitalière et de Gestion des Risques, CHU Grenoble Alpes, Grenoble Cedex, France; Université Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, Grenoble Cedex, France
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Kodama F, Nace DA, Jump RLP. Respiratory Syncytial Virus and Other Noninfluenza Respiratory Viruses in Older Adults. Infect Dis Clin North Am 2018; 31:767-790. [PMID: 29079159 PMCID: PMC5846091 DOI: 10.1016/j.idc.2017.07.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Fumihiro Kodama
- Department of Infectious Diseases, Sapporo City General Hospital, 13 Chome 1-1, Kita 11 Jonishi, Chuo-ku, Sapporo, Hokkaido 060-8604, Japan
| | - David A Nace
- Division of Geriatric Medicine, Department of Medicine, University of Pittsburgh, 3471 Fifth Avenue, Kaufmann Building Suite 500, Pittsburgh, PA 15213, USA
| | - Robin L P Jump
- Division of Infectious Diseases and HIV Medicine, Department of Medicine, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44195-5029, USA; Geriatric Research, Education, and Clinical Center (GRECC), Specialty Care Center of Innovation, Louis Stokes Cleveland Veterans Affairs Medical Center, 111C(W), 10701 East Boulevard, Cleveland, OH 44106, USA.
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Yang Z, Suzuki A, Watanabe O, Okamoto M, Ohmi A, Huang W, Nishimura H. Outbreak of human metapneumovirus infection in a severe motor-and-intellectual disabilities ward in Japan. Jpn J Infect Dis 2015; 67:318-21. [PMID: 25056083 DOI: 10.7883/yoken.67.318] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Zifeng Yang
- Clinical Virology Division, State Key Laboratory of Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University
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Seki M, Yoshida H, Gotoh K, Hamada N, Motooka D, Nakamura S, Yamamoto N, Hamaguchi S, Akeda Y, Watanabe H, Iida T, Tomono K. Severe respiratory failure due to co-infection with human metapneumovirus and Streptococcus pneumoniae. Respir Med Case Rep 2014; 12:13-5. [PMID: 26029528 PMCID: PMC4061431 DOI: 10.1016/j.rmcr.2013.12.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
A 64-year-old male patient was admitted with respiratory failure, although chest X-rays revealed only mild bronchiolitis. Streptococcus pneumoniae, which usually presents as massive lobular pneumonia, was isolated from sputum, however, pan-pathogen screening using a next-generation sequencer also detected human metapneumovirus genome fragments.
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Affiliation(s)
- Masafumi Seki
- Division of Infection Control and Prevention, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
| | - Hisao Yoshida
- Division of Infection Control and Prevention, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
| | - Kazuyoshi Gotoh
- Department of Infection Metagenomics, Genome Information Research Center, Research Institute for Microbial Diseases, Osaka University, Suita City, Osaka, Japan
| | - Nobuyuki Hamada
- Division of Infectious Diseases, Department of Infectious Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Daisuke Motooka
- Department of Infection Metagenomics, Genome Information Research Center, Research Institute for Microbial Diseases, Osaka University, Suita City, Osaka, Japan
| | - Shota Nakamura
- Department of Infection Metagenomics, Genome Information Research Center, Research Institute for Microbial Diseases, Osaka University, Suita City, Osaka, Japan
| | - Norihisa Yamamoto
- Division of Infection Control and Prevention, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
| | - Shigeto Hamaguchi
- Division of Infection Control and Prevention, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
| | - Yukihiro Akeda
- Laboratory for Clinical of Clinical Research on Infectious Diseases, Research Institute for Microbial Diseases, Osaka University, Suita City, Osaka, Japan
| | - Hiroshi Watanabe
- Division of Infectious Diseases, Department of Infectious Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Tetsuya Iida
- Department of Infection Metagenomics, Genome Information Research Center, Research Institute for Microbial Diseases, Osaka University, Suita City, Osaka, Japan
| | - Kazunori Tomono
- Division of Infection Control and Prevention, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
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