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      Use of an Innovative Web-Based Laboratory Surveillance Platform to Analyze Mixed Infections Between Human Metapneumovirus (hMPV) and Other Respiratory Viruses Circulating in Alberta (AB), Canada (2009–2012)

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          Abstract

          We investigated the proportions of mono vs. mixed infections for human metapneumovirus (hMPV) as compared to adenovirus (ADV), four types of coronavirus (CRV), parainfluenza virus (PIV), RSV, and enterovirus/rhinovirus (ERV) in Alberta, Canada. Using the Data Integration for Alberta Laboratories (DIAL) platform, 26,226 respiratory specimens at ProvLab between 1 July 2009 and 30 June 2012 were selected and included in the study. Using the Respiratory Virus Panel these specimens tested positive for one or more respiratory virus and negative for influenza A and B. From our subset hMPV was the fourth most common virus (n=2,561) with 373 (15%) identified as mixed infection using DIAL. Mixed infection with hMPV was most commonly found in infants less than 6 months old and ERV was most commonly found in mixed infection with hMPV (230/373, 56%) across all age groups. The proportion of mixed-infection vs. mono-infection was highest for ADV (46%), followed by CRV 229E (32%), CRV HKU1 (31%), CRV NL63 (28%), CRV OC43 (23%), PIV (20%), RSV (17%), hMPV (15%) and ERV (13%). hMPV was significantly more likely to be identified in mono infection as compared with ADV, CRV, PIV, and RSV with the exception of ERV [p<0.05].

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          Most cited references33

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          A newly discovered human pneumovirus isolated from young children with respiratory tract disease

          From 28 young children in the Netherlands, we isolated a paramyxovirus that was identified as a tentative new member of the Metapneumovirus genus based on virological data, sequence homology and gene constellation. Previously, avian pneumovirus was the sole member of this recently assigned genus, hence the provisional name for the newly discovered virus: human metapneumovirus. The clinical symptoms of the children from whom the virus was isolated were similar to those caused by human respiratory syncytial virus infection, ranging from upper respiratory tract disease to severe bronchiolitis and pneumonia. Serological studies showed that by the age of five years, virtually all children in the Netherlands have been exposed to human metapneumovirus and that the virus has been circulating in humans for at least 50 years.
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            Human metapneumovirus infections in young and elderly adults.

            Human metapneumovirus virus (hMPV) is a newly discovered respiratory pathogen with limited epidemiological data available. Cohorts of young and older adults were prospectively evaluated for hMPV infection during 2 winter seasons. Patients hospitalized for cardiopulmonary conditions during that period were also studied. Overall, 44 (4.5%) of 984 illnesses were associated with hMPV infection, and 9 (4.1%) of 217 asymptomatic subjects were infected. There was a significant difference in rates of hMPV illnesses between years 1 and 2 (7/452 [1.5%] vs. 37/532 [7.0%]; P<.0001). In the second year, 11% of hospitalized patients had evidence of hMPV infection. Infections occurred in all age groups but were most common among young adults. Frail elderly people with hMPV infection frequently sought medical attention. In conclusion, hMPV infection occurs in adults of all ages and may account for a significant portion of persons hospitalized with respiratory infections during some years.
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              Virological features and clinical manifestations associated with human metapneumovirus: a new paramyxovirus responsible for acute respiratory-tract infections in all age groups.

              The virological features and clinical findings associated with the new human metapneumovirus (HMPV) were examined retrospectively in Canadian patients hospitalized for various respiratory conditions since 1993. Thirty-eight previously unidentified respiratory viruses isolated from rhesus monkey kindey (LLC-MK2) cells were found to be positive for HMPV by reverse-transcription polymerase chain reaction, and those strains clustered in 2 phylogenetic groups. Children aged 65 years represented 35.1% and 45.9% of the HMPV-infected cases, respectively. In hospitalized children, the most frequent diagnoses were pneumonitis (66.7%) and bronchiolitis (58.3%), whereas bronchitis and/or bronchospasm (60%) and pneumonitis (40%) were most commonly seen in elderly subjects. Of the 15 patients with pneumonitis, 4 (26.7%) had immunosuppressive conditions and 6 (40%) were infants aged <15 months. These findings suggest that HMPV can be associated with severe lower-respiratory-tract infections in very young children, the elderly, and immunocompromised patients.

                Author and article information

                Journal
                Viruses
                Viruses
                viruses
                Viruses
                MDPI
                1999-4915
                05 November 2012
                November 2012
                : 4
                : 11
                : 2754-2765
                Affiliations
                [1 ]Provincial Laboratory for Public Health (ProvLab), 3030 Hospital Dr. NW, Calgary, Alberta, T2N 4W4, Canada; Email: sumana.fathima@ 123456albertahealthservices.ca
                [2 ]University of Alberta, Room 3-588B, ECHA, 11405 – 87 Avenue, Edmonton, Alberta, Canada T6G 1C9; Email: bonita.lee@ 123456albertahealthservices.ca
                [3 ]Public Health Agency of Canada, 130 Colonnade Road A.L. 6501H Ottawa, Ontario, K1A 0K9, Canada; Email: jennifer.may-hadford@ 123456phac-aspc.gc.ca
                [4 ]Canadian Network for Public Health Intelligence, Public Health Agency of Canada, 1015 Arlington St, Winnipeg, Manitoba, R3E 3R2, Canada; Email: shamir.nizar.mukhi@ 123456phac-aspc.gc.ca
                [5 ]University of Calgary, 2500 University Drive Northwest, Calgary, Alberta, T2N 1N4, Canada; Email: steven.drews@ 123456albertahealthservices.ca
                Author notes
                [* ] Corresponding author: steven.drews@ 123456albertahealthservices.ca ; Tel.: +1 403 944-1068; Fax: +1 403 283-0142.
                Article
                viruses-04-02754
                10.3390/v4112754
                3509671
                23202503
                fdeb2a15-536f-43a6-b86d-b7a8842acfa5
                © 2012 by the authors; licensee MDPI, Basel, Switzerland.

                This article is an open-access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/3.0/).

                History
                : 30 August 2012
                : 12 October 2012
                : 26 October 2012
                Categories
                Article

                Microbiology & Virology
                testing,respiratory,epidemiology,hmpv,co-infection
                Microbiology & Virology
                testing, respiratory, epidemiology, hmpv, co-infection

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