Abstract
Impact of recently discovered viruses on epidemiology of acute respiratory tract infections (ARTI) is still unclear. We studied the impact of recently discovered human metapneumovirus (hMPV), human bocavirus (HBoV), and new coronaviruses (HCoV‐NL63 and HKU1) on the global epidemiology of ARTI. From October 2006 to April 2007, 237 pediatric patients affected by ARTI were enrolled in our study. Specimens were tested for respiratory viruses by polymerase chain reaction. One hundred twenty‐four out of 237 samples (52.3%) were positive for one or more viruses. Picornaviruses were the most prevalent viruses (n = 61, 43.6%), followed by respiratory syncytial virus (n = 34, 24.3%) and Adenovirus (n = 25, 17.9%); hMPV (n = 9, 6.4%) was the fourth most common virus detected. HBoV and HCoV showed a low prevalence (respectively 2.9% and 2.1%). RSV was the prevalent agent of LRTI (38%). Viruses were identified in more than 50% of the studied ARTI, providing useful information on clinical features and epidemiology of specific agents affecting children in cold months. Although routine surveillance of respiratory viruses does not seem cost‐effective, continuous monitoring of ARTI etiology could be a useful tool for planning resources for the development of new vaccines and antiviral agents. J. Med. Virol. 81:750–756, 2009 © 2009 Wiley‐Liss, Inc.
Keywords: respiratory tract infection, metapneumovirus, bocavirus, respiratory syncytial virus, coronavirus
REFERENCES
- Allander T, Tammi MT, Eriksson M, Bjerkner A, Tiveljung‐Lindell A, Andersson B. 2005. Cloning of a human parvovirus by molecular screening of respiratory tract samples. Proc Natl Acad Sci USA 102: 12891–12896. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Armstrong GL, Conn LA, Pinner RW. 1999. Trends in infectious disease mortality in the United States during the 20th century. JAMA 281: 61–66. [DOI] [PubMed] [Google Scholar]
- Boivin G, Abed Y, Pelletier G, Ruel L, Moisan D, Côte S, Peret TC, Erdmann DD, Anderson LJ. 2002. Virological features and clinical manifestations associated with human metapneumovirus: A new paramyxovirus responsible for acute respiratory‐tract infections in all age groups. J Infect Dis 186: 1330–1334. [DOI] [PubMed] [Google Scholar]
- Boivin G, De Serres G, Hamelin ME, Côte S, Argouin M, Tremblay G, Maranda‐Aubut R, Sauvageau C, Ouakki M, Boulianne N, Couture C. 2007. An outbreak of severe respiratory tract infection due to human metapneumovirus in a long‐term care facility. Clin Infect Dis 44: 1152–1158. [DOI] [PubMed] [Google Scholar]
- Bosis S, Esposito S, Niesters HG, Crovari P, Osterhaus AD, Principi N. 2005. Impact of human metapneumovirus in childhood: Comparison with respiratory syncytial virus and influenza viruses. J Med Virol 75: 101–104. [DOI] [PubMed] [Google Scholar]
- Brownlee JW, Turner RB. 2008. New developments in the epidemiology and clinical spectrum of rhinovirus infections. Curr Opin Pediatr 20: 67–71. [DOI] [PubMed] [Google Scholar]
- Choi EH, Lee HJ, Kim SJ, Eun BW, Kim NH, Lee JA, Lee JH, Song EK, Kim SH, Park JY, Sung JY. 2006. The association of newly identified respiratory viruses with lower respiratory tract infections in Korean children, 2000–2005. Clin Infect Dis 43: 585–592. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Christensen A, Norbø SA, Krokstad S, Rognlien AG, Døllner H. 2008. Human bocavirus commonly involved in multiple viral airway infections. J Clin Virol 41: 34–37. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Debiaggi M, Canducci F, Sampaolo M, Marinozzi MC, Parea M, Terulla C, Colombo AA, Alessandrino EP, Bragotti LZ, Arghittu M, Goglio A, Migliavacca R, Romero E, Clementi M. 2006. Persistent symptomless human metapneumovirus infection in hematopoietic stem cell transplant recipients. J Infect Dis 194: 474–478. [DOI] [PubMed] [Google Scholar]
- Esposito S, Bosis S, Niesters HG, Tremolati E, Begliatti E, Rognoni A, Tagliabue C, Principi N, Osterhaus AD. 2006. Impact of human coronavirus infections in otherwise healthy children who attended an emergency department. J Med Virol 78: 1609–1615. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Foulongne V, Olejnik Y, Perez V, Elaerts S, Rodière M, Segondy M. 2006. Human bocavirus in French children. Emerg Infect Dis 12: 1251–1253. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gerna G, Campanini G, Rovida F, Sarasini A, Lilleri D, Paolucci S, Marchi A, Baldanti F, Revello MG. 2005. Changing circulation rate of human metapneumovirus strains and types among hospitalized pediatric patients during three consecutive winter‐spring seasons. Arch Virol 150: 2365–2375. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gerna G, Piralla A, Campanini G, Marchi A, Stronati M, Rovida F. 2007. The human bocavirus role in acute respiratory tract infections of pediatric patients as defined by viral load quantification. New Microbiol 30: 383–392. [PubMed] [Google Scholar]
- Henrickson KJ, Hoover S, Kehl KS, Hua W. 2004. National disease burden of respiratory viruses detected in children by polymerase chain reaction. Pediatr Infect Dis J 23: S11–S18. [DOI] [PubMed] [Google Scholar]
- Jacques J, Bouscambert‐Duchamp M, Moret H, Carquin J, Brodard V, Lina B, Motte J, Andrèoletti L. 2006. Association of respiratory picornaviruses with acute bronchiolitis in French infants. J Clin Virol 35: 463–466. [DOI] [PubMed] [Google Scholar]
- Jartti T, Lehtinen P, Vourinen T, Osterback R, van den Hoogen B, Osterhaus AD, Ruuskanen O. 2004. Respiratory picornaviruses and respiratory syncytial virus as causative agents of acute expiratory wheezing in children. Emerg Infect Dis 10: 1095–1101. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kahn JS. 2006. Epidemiology of human metapneumovirus. Clin Microbiol Rev 19: 46–57. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kahn JS. 2007. Newly discovered respiratory viruses: Significance and implications. Curr Opin Pharmacol 7: 1–6. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kaida A, Kubo H, Goto K, Shiomi M, Kohndera U, Iritani N. 2007. Co‐infection of human metapneumovirus with adenovirus or respiratory syncytial virus among children in Japan. Microbiol Immunol 51: 679–683. [DOI] [PubMed] [Google Scholar]
- Kesebir D, Vazquez M, Weibel C, Shapiro ED, Ferguson D, Landry ML, Kahn JS. 2006. Human bocavirus infection in young children in the United States: Molecular epidemiological profile and clinical characteristics of a newly emerging respiratory virus. J Infect Dis 194: 1197–1199. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Maggi F, Pifferi M, Vatteroni M, Fornai C, Tempestini E, Anzilotti S, Lanini L, Andreoli E, Ragazzo V, Pistello M, Specter S, Bendinelli M. 2003. Human metapneumovirus associated with respiratory tract infections in a 3‐year study of nasal swabs from infants in Italy. J Clin Microbiol 41: 2987–2991. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Maggi F, Andreoli E, Pifferi M, Meschi S, Rocchi J, Bendinelli M. 2007. Human bocavirus in Italian patients with respiratory diseases. J Clin Virol 38: 321–325. [DOI] [PubMed] [Google Scholar]
- Monto AS. 1994. Studies of the community and family: Acute respiratory illness and infection. Epidemiol Rev 16: 351–373. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Papadopoulos NG, Moustaki M, Tsolia M, Bossios A, Astra E, Prezerakou A, Gourgiotis D, Kafetzis D. 2002. Association of rhinovirus infection with increased disease severity in acute bronchiolitis. Am J Respir Crit Care Med 165: 1285–1289. [DOI] [PubMed] [Google Scholar]
- Peret TC, Boivin G, Li Y, Couillard M, Humphrey C, Osterhaus AD, Erdman DD, Anderson LJ. 2002. Characterization of human metapneumovirus isolated from patients in North America. J Infect Dis 185: 1660–1663. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pierangeli A, Gentile M, Di Marco P, Pagnotti P, Scagnolari C, Trombetti S, Lo Russo L, Tromba V, Moretti C, Midulla F, Antonelli G. 2007. Detection and typing by molecular techniques of respiratory viruses in children hospitalized for acute respiratory infection in Rome, Italy. J Med Virol 79: 463–468. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pyrc K, Berkhout B, Van Der Hoek L. 2007. The novel human coronaviruses NL63 and HKU1. J Virol 81: 3051–3057. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Renwick N, Scweiger B, Kapoor V, Liu Z, Villari J, Bullmann R, Miething R, Briese T, Lipkin WI. 2007. A recently identified rhinovirus genotype is associated with severe respiratory‐tract infection in children in Germany. J Infect Dis 196: 1754–1760. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sarasini A, Percivalle E, Rovida F, Campanini G, Genini E, Torsellini M, Paolucci S, Baldanti F, Marchi A, Revello MG, Gerna G. 2006. Detection and pathogenicity of human metapneumovirus respiratory infection in pediatric Italian patients during winter‐spring season. J Clin Virol 35: 59–68. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stockton J, Stephenson I, Fleming D, Zambon M. 2002. Human metapneumovirus as a cause of community‐acquired respiratory illness. Emerg Infect Dis 8: 897–901. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Terrosi C, Fabbiani M, Cellesi C, Cusi MG. 2007. Human bocavirus detection in an atopic child affected by pneumonia associated with wheezing. J Clin Virol 40: 43–45. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Van den Hoogen BG, De Jong JC, Groen J, Kuiken T, de Groot R, Fouchier RA, Osterhaus AD. 2001. A newly discovered human pneumovirus isolated from young children with respiratory tract disease. Nat Med 7: 719–724. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Van den Hoogen BG, Osterhaus DM, Fouchier RA. 2004. Clinical impact and diagnosis of human metapneumovirus infections. Pediatr Infect Dis J 23: S25–S32. [DOI] [PubMed] [Google Scholar]
- Van Der Hoek L, Pyrc K, Jebbink MF, Vermeulen‐Oost W, Berkhout RJ, Wolthers KC, Wertheim‐van Dillen PM, Kaandorp J, Spaargaren J, Berkhout B. 2004. Identification of a new human coronavirus. Nat Med 10: 368–373. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wilkesmann A, Schildgen O, Eis‐Hubinger AM, Geikowski T, Glatzel T, Lentze MJ, Bode U, Simon A. 2006. Human metapneumovirus infections cause similar symptoms and clinical severity as respiratory syncytial virus infections. Eur J Pediatr 165: 467–475. [DOI] [PubMed] [Google Scholar]
- Williams JV, Harris PA, Tollefson SJ, Halburnt‐Rush LL, Pingsterhaus JM, Edwards KM, Wright PF, Crowe JE. 2004. Human metapneumovirus and lower respiratory tract disease in otherwise healthy infants and children. N Engl J Med 350: 443–450. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Williams JV, Wang CK, Yang CF, Tollefson SJ, House FS, Heck JM, Chu M, Brown JB, Lintao LD, Quinto JD, Chu D, Spaete RR, Edwards KM, Wright PF, Crowe JE. 2006. The role of human metapneumovirus in upper respiratory tract infections in children: A 20‐year experience. J Infect Dis 193: 387–395. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wolf DG, Greenberg D, Kalkstein D, Shemer‐Avni Y, Givon‐Lavi N, Saleh N, Goldberg MD, Dagan R. 2006. Comparison of human metapneumovirus, respiratory syncytial virus and influenza A virus lower respiratory tract infections in hospitalized young children. Pediatr Infect Dis J 25: 320–324. [DOI] [PubMed] [Google Scholar]
- Woo PC, Lau SK, Chu CM, Chan KH, Tsoi HW, Huang Y, Wong BH, Poon RW, Cai JJ, Luk WK, Poon LL, Wong SS, Guan Y, Peiris JS, Yuen KY. 2005. Characterization and complete genome sequence of a novel coronavirus, coronavirus HKU1, from patients with pneumonia. J Virol 79: 884–895. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Woo PC, Lau SK, Tsoi HW, Huang Y, Wong BH, Poon RW, Cai JJ, Luk WK, Poon LL, Wong SS, Guan Y, Peiris JS, Yuen KY. 2005. Clinical and molecular epidemiological features of coronavirus HKU1‐associated community‐acquired pneumonia. J Infect Dis 192: 1898–1907. [DOI] [PMC free article] [PubMed] [Google Scholar]