Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-28T09:54:16.605Z Has data issue: false hasContentIssue false
  • English
  • Français

Epidemiology of Human Metapneumovirus in a Pediatric Long-Term Care Facility

Published online by Cambridge University Press:  02 January 2015

Natalie Neu ,
Theresa Plaskett ,
Gordon Hutcheon ,
Meghan Murray ,
Karen L. Southwick  and
Lisa Saiman
Natalie Neu*
Affiliation:
Department of Pediatrics, Columbia University, New York, New York Elizabeth Seton Pediatric Center, New York, New York
Theresa Plaskett
Affiliation:
Elizabeth Seton Pediatric Center, New York, New York
Gordon Hutcheon
Affiliation:
Elizabeth Seton Pediatric Center, New York, New York Department of Pediatrics, New York Medical College, Valhalla, New York
Meghan Murray
Affiliation:
Department of Pediatrics, Columbia University, New York, New York
Karen L. Southwick
Affiliation:
New York State Department of Health, New Rochelle, New York
Lisa Saiman
Affiliation:
Department of Pediatrics, Columbia University, New York, New York Department of Infection Control and Prevention, NewYork-Presbyterian Hospital, New York, New York
*
630 West 168th Street, PH4–468, New York, NY 10032 (nn45@columbia.edu)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background.

Viral respiratory pathogens cause outbreaks in pediatric long-term care facilities (LTCFs), but few studies have used viral diagnostic testing to identify the causative pathogens. We describe the use of such testing during a prolonged period of respiratory illness and elucidate the epidemiology of human metapneumovirus (hMPV) at our LTCF.

Design.

Retrospective study of influenza-like illness (ILI).

Setting.

A 136-bed pediatric LTCF from January 1 through April 30, 2010.

Methods.

The ILI case definition included fever, cough, change in oropharyngeal secretions, increase in oxygen requirement, and/or wheezing.

Results.

During the study period, 69 episodes of ILI occurred in 61 (41%) of 150 residents. A viral pathogen was detected in 27 (39%) of the episodes, including respiratory syncytial virus (RSV) (n = 3), influenza A virus (not typed; n = 2), parainfluenza virus (n = 2), adenovirus (n = 1), and hMPV (n = 19). Twenty-seven of the residents with ILI (44%) required transfer to acute care hospitals (mean length of hospitalization, 12 days; range, 3–47 days). Residents with tracheostomies were more likely to have ILI (adjusted odds ratio [OR], 3.99 [95% confidence interval {CI}, 1.87–8.53]; P = .0004). The mortality rate for residents with ILI was 1.6%. Residents with hMPV were younger (P = .03), more likely to be transferred to an acute care facility (OR, 3.73 [95% CI, 1.17–11.95]; P = .02), and less likely to have a tracheostomy (adjusted OR, 0.19 [95% CI, 0.047–0.757]; P = .02).

Discussion.

Diverse pathogens, most notably hMPV, caused ILI in our pediatric LTCF during a prolonged period of time. Viral testing was helpful in characterizing the epidemiology of ILI in this population.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 33 , Issue 6 , June 2012 , pp. 545 - 550
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. van den Hoogen, BG, de Jong, JC, Groen, J, et al. A newly discovered human pneumovirus isolated from young children with respiratory tract disease. Nat Med 2001;7:719–724.Google Scholar
2. Williams, JV, Harris, PA, Tollefson, SJ, et al. Human metapneumovirus and lowet respiratory tract disease in otherwise healthy infants and children. N Engl J Med 2004;350:443–450.Google Scholar
3. Montejano-Elias, L, Alpuche-Solis, AG, Zarate-Chavez, V, Sanchez-Alvarado, J, Hernandez-Salinas, AE, Noyola, DE. Human metapneumovirus and other respiratory viral infections in children attending a day care center. Pediatr Infect Dis J 2009;28: 1024–1026.Google Scholar
4. Heikkinen, T, Osterback, R, Peltola, V, Jartti, T, Vainionpaa, R. Human metapneumovirus infections in children. Emerg Infect Dis 2008;14:101–106.Google Scholar
5. Dollner, H, Risnes, K, Radtke, A, Nordbo, SA. Outbreak of human metapneumovirus infection in Norwegian children. Pediatr Infect Dis J 2004;23:436–440.Google Scholar
6. Wolf, DG, Zakay-Rones, Z, Fadeela, A, Greenberg, D, Dagan, R. High seroprevalence of human metapneumovirus among young children in Israel. J Infect Dis 2003;188:1865–1867.Google Scholar
7. Caracciolo, S, Minini, C, Colombrita, D, et al. Human metapneumovirus infection in young children hospitalized with acute respiratory tract disease: virologie and clinical features. Pediatr Infect Dis 1 2008;27:406–412.Google Scholar
8. Cilla, G, Onate, E, Perez-Yarza, EG, Montes, M, Vicente, D, Perez-Trallero, E. Hospitalization rates for human metapneumovirus infection among 0- to 3-year-olds in Gipuzkoa (Basque Country), Spain. Epidemiol Infect 2009;137:66–72.Google Scholar
9. Kim, S, Sung, H, Im, HJ, Hong, SJ, Kim, MN. Molecular epidemiological investigation of a nosocomial outbreak of human metapneumovirus infection in a pediatric hemato-oncology patient population. J Clin Microbiol 2009;47:1221–1224.Google Scholar
10. Boivin, G, De Serres, G, Hamelin, ME, et al. An outbreak of severe respiratory tract infection due to human metapneumovirus in a long-term care facility. Clin Infect Dis 2007;44:1152–1158.Google Scholar
11. Louie, JK, Schnurr, DP, Pan, CY, et al. A summer outbreak of human metapneumovirus infection in a long-term-care facility. J Infect Dis 2007;196:705–708.Google Scholar
12. Ghanaiem, H, Averbuch, D, Kopiewitz, BZ, et al. An outbreak of adenovirus type 7 in a residential facility for severely disabled children. Pediatr Infect Dis J 2011;30(11):948–952.Google Scholar
13. Kopel, E, Amitai, Z, Grotto, I, Avramovich, E, Kaliner, E, Volovik, I. Recurrent outbreak of pandemic (H1N1) 2009 virus infection in a pediatric long-term care facility and the adjacent school. Clin Infect Dis 2010;51:481–482.Google Scholar
14. Ginocchio, CC, Zhang, F, Manji, R, et al. Evaluation of multiple test methods for the detection of the novel 2009 influenza A (H1N1) during the New York City outbreak. J Clin Virol 2009; 45:191–195.Google Scholar
15. Miroballi, Y, Baird, JS, Zackai, S, et al. Novel influenza A(H1N1) in a pediatric health care facility in New York City during the first wave of the 2009 pandemic. Arch Pediatr Adolesc Med 2010; 164:24–30.Google Scholar
16. Centers for Disease Control and Prevention. Influenza: Reports and Surveillance Methods in the United States, http://www.cdc.gov/flu/weekly/fluactivity.htm. Accessed January 2010.Google Scholar
17. McPherson, M, Arango, P, Fox, H, et al. A new definition of children with special health care needs. Pediatrics 1998;102: 137–140.Google Scholar
18. Honda, H, Iwahashi, J, Kashiwagi, T, et al. Outbreak of human metapneumovirus infection in elderly inpatients in Japan. J Am Geriatr Soc 2006;54:177–180.Google Scholar
19. Chano, F, Rousseau, C, Laferriere, C, Couillard, M, Charest, H. Epidemiological survey of human metapneumovirus infection in a large pediatric tertiary care center. J Clin Microbiol 2005; 43:5520–5525.Google Scholar
20. Wolf, DG, Greenberg, D, Kalkstein, D, et al. Comparison of human metapneumovirus, respiratory syncytial virus and influenza A virus lower respiratory tract infections in hospitalized young children. Pediatr Infect Dis J 2006;25:320–324.Google Scholar
21. Harris, JA. Infection control in pediatric extended care facilities. Infect Control Hosp Epidemiol 2006;27:598–603.Google Scholar