Skip to main content

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

  • Natalie Neu (a1) (a2), Theresa Plaskett (a2), Gordon Hutcheon (a2) (a3), Meghan Murray (a1), Karen L. Southwick (a4) and Lisa Saiman (a1) (a5)...

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.


Retrospective study of influenza-like illness (ILI).


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


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


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).


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.

Corresponding author
630 West 168th Street, PH4–468, New York, NY 10032 (
Hide All
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;7:719724.
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;350:443450.
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: 10241026.
4. Heikkinen, T, Osterback, R, Peltola, V, Jartti, T, Vainionpaa, R. Human metapneumovirus infections in children. Emerg Infect Dis 2008;14:101106.
5. Dollner, H, Risnes, K, Radtke, A, Nordbo, SA. Outbreak of human metapneumovirus infection in Norwegian children. Pediatr Infect Dis J 2004;23:436440.
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;188:18651867.
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;27:406412.
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;137:6672.
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;47:12211224.
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;44:11521158.
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;196:705708.
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):948952.
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;51:481482.
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; 45:191195.
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; 164:2430.
16. Centers for Disease Control and Prevention. Influenza: Reports and Surveillance Methods in the United States, Accessed January 2010.
17. McPherson, M, Arango, P, Fox, H, et al. A new definition of children with special health care needs. Pediatrics 1998;102: 137140.
18. Honda, H, Iwahashi, J, Kashiwagi, T, et al. Outbreak of human metapneumovirus infection in elderly inpatients in Japan. J Am Geriatr Soc 2006;54:177180.
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; 43:55205525.
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;25:320324.
21. Harris, JA. Infection control in pediatric extended care facilities. Infect Control Hosp Epidemiol 2006;27:598603.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed