Human metapneumovirus infections among children with acute respiratory infections seen in a large referral hospital in India

Human metapneumovirus (HMPV) is a major etiological agent of acute respiratory infections in humans. HMPV has been circulating worldwide for more than six decades and is currently divided into five agreed-upon subtypes: A1, A2a, A2b, B1, and B2. Recently, the novel HMPV subtypes A2c, A2b1, and A2b2 have been proposed. However, the phylogenetic and evolutionary relationships between these recently proposed HMPV subtypes are unclear. Here, we report a genome-wide phylogenetic and evolutionary analysis of 161 HMPV strains, including unique HMPV subtype A2b strains with a 180- or 111-nucleotide duplication in the G gene (nt-dup). Our data demonstrate that the HMPV A2b subtype contains two distinct subtypes, A2b1 and A2b2, and that the HMPV subtypes A2c and A2b2 may be different names for the same subtype. HMPV A2b strains with a nt-dup also belong to subtype A2b2. Molecular evolutionary analyses indicate that subtypes A2b1 and A2b2 diverged from subtype A2b around a decade after the subtype A2 was divided into the subtypes A2a and A2b. These data support the A2b1 and A2b2 subtypes proposed in 2012 and are essential for the unified classification of HMPV subtype A2 strains, which is important for future HMPV surveillance and epidemiological studies.

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RESPIRATORY SYNCYTIAL VIRUS AND HUMAN METAPNEUMOVIRUS IN CHILDREN WITH ACUTE RESPIRATORY INFECTIONS IN YEMEN

The Pediatric Infectious Disease Journal ◽

10.1097/01.inf.0000172937.80719.7f ◽

2005 ◽

Vol 24 (8) ◽

pp. 734-736 ◽

Cited By ~ 34

Author(s):

Najla Al-Sonboli ◽

Charles Anthony Hart ◽

Ahmed Al-Aeryani ◽

Salem M. Banajeh ◽

Nasher Al-Aghbari ◽

...

Keyword(s):

Respiratory Syncytial Virus ◽

Respiratory Infections ◽

Human Metapneumovirus ◽

Acute Respiratory Infections ◽

Syncytial Virus

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Estimating the Economic Impact of Respiratory Syncytial Virus and Other Acute Respiratory Infections Among Infants Receiving Care at a Referral Hospital in Malawi

Journal of the Pediatric Infectious Diseases Society ◽

10.1093/jpids/piaa157 ◽

2020 ◽

Author(s):

Ranju Baral ◽

Ivan Mambule ◽

Elisabeth Vodicka ◽

Neil French ◽

Dean Everett ◽

...

Keyword(s):

Respiratory Syncytial Virus ◽

Health System ◽

Respiratory Infections ◽

Respiratory Illness ◽

Referral Hospital ◽

Acute Respiratory Infections ◽

Total Cost ◽

The Mean ◽

Syncytial Virus ◽

Household Cost

Abstract Background Respiratory syncytial virus (RSV) is a leading cause of respiratory illness among infants globally, yet economic burden data are scant, especially in low-income countries. Methods We collected data from 426 infants enrolled in the Queen Elizabeth Central Hospital respiratory disease surveillance platform to estimate the household and health system costs of managing RSV and other respiratory pathogens in Malawian infants. Total household cost per illness episode, including direct and indirect costs and lost income, was reported by parents/guardians at the initial visit and 6 weeks post discharge. The total cost to the health system was based on patient charts and hospital expenditures. All-cause acute respiratory infections (ARIs) and RSV costs for inpatient and outpatients are presented separately. All costs are in the 2018 US Dollar. Results The mean costs per RSV episode were $62.26 (95% confidence interval [CI]: $50.87-$73.66) and $12.51 (95% CI: $8.24-$16.79) for inpatient and outpatient cases, respectively. The mean cost per episode for all-cause ARIs was slightly higher among inpatients at $69.93 (95% CI: $63.06-$76.81) but slightly lower for outpatients at $10.17 (95% CI: $8.78-$11.57). Household costs accounted for roughly 20% of the total cost per episode. For the lowest-income families, household cost per inpatient RSV episode was about 32% of total monthly household income. Conclusions Among infants receiving care at a referral hospital in Malawi, the cost per episode in which RSV was detected is comparable to that of other episodes of respiratory illnesses where RSV was not detected. Estimates generated in this study can be used to evaluate the economic and financial impact of RSV and acute respiratory illness preventive interventions in Malawi.

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