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].
Highlights
Respiratory tract infections are a global public health concern and in Canada is the eighth leading cause of death in 2009 [1]
This virus can affect any age group but several studies have shown that human metapneumovirus (hMPV) is a leading cause in lower respiratory tract infections in children [4,5,6] but it affects the elderly [7]
Clinical manifestations are similar to Respiratory Syncytial Virus (RSV) primarily leading to pneumonia and bronchiolitis [8]
Summary
Respiratory tract infections are a global public health concern and in Canada is the eighth leading cause of death in 2009 [1]. Panel (RVP) classic assay, a multiplexed assay which detects multiple respiratory viral pathogens including FLUA, FLUB, PIV, ERV, ADV, 4 types of CRV, RSV, and hMPV [15]. Exceptions to this testing policy include samples submitted from a provincial influenza-like-illness surveillance program (Tarrant Viral Watch) and some samples from patients with severe illness and admission to the intensive care units. In this study we used DIAL to select specimen-based data and investigated the proportions of mono vs mixed infections for hMPV as compared to ADV, CRV, ERV, PIV and RSV for a period of three years, 1 July 2009 to 30 June 2012. In order to create a uniform dataset for this study, we excluded all samples that tested positive for influenza A or B by the in-house real-time PCR assays and included only samples that had undergone RVP testing
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