Human  metapneumovirus
Upcoming SlideShare
Loading in...5
×
 

Human metapneumovirus

on

  • 2,758 views

What is human metapneumovirus ,features,presentation ,diagnosis ,treatment and prevention

What is human metapneumovirus ,features,presentation ,diagnosis ,treatment and prevention

Statistics

Views

Total Views
2,758
Slideshare-icon Views on SlideShare
2,758
Embed Views
0

Actions

Likes
1
Downloads
28
Comments
0

0 Embeds 0

No embeds

Accessibility

Categories

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

    Human  metapneumovirus Human metapneumovirus Presentation Transcript

    • Human Metapneumovirus Prof. Dr. Saad S Al Ani Senior Pediatric Consultant Head of Pediatric Department Khorfakkan Hospital Sharjah ,UAE [email_address]
    • Human Metapneumovirus (hMPV)
      • hMPV is associated with a substantial number of upper respiratory infections ( URI ) and episodes of acute otitis media ( AOM ).
      Williams JV, Wang CK, Yang CF, et al :  The role of human metapneumovirus in upper respiratory tract infections in children: a 20-year experience.   J Infect Dis   2006; 193:387-395
    • Cont.
      • hMPV was first described in 2001 by Dutch investigators. (1)
      • It is a member of the Pneumovirus subfamily of the Paramyxoviridae that includes respiratory syncytial virus (RSV) .
      ( 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.
    • Cont.
      • It is pleomorphic with a lipid envelope.
      • Single-stranded RNA genome
      ( 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.
    • Cont.
      • These illnesses are neither clinically nor radiographically distinct from the same clinical syndromes caused by other common respiratory viruses .
      • hMPV can cause severe infections in immunocompromised hosts
      • Transmission of hMPV likely occurs via respiratory droplets and secretions, similar to RSV
      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.
    • Cont.
      • Clinical manifestations of hMPV infection are generally similar to those caused by other respiratory viruses and include:
      • * Bronchiolitis
      • * Croup
      • * Pneumonia
      • * Asthma exacerbation.
      Osterhaus A, Fouchier R :  Human metapneumovirus in the community.   Lancet   2003; 361:890-891.
    • Cont.
      • Hospitalizations occur more common in children or adults with underlying conditions such as:
      • * Prematurety
      • * Asthma
      • * Immune compromisation
      • * Cardiopulmonary disease s .
      Williams JV, Tollefson SJ, Heymann PW, et al :  Human metapneumovirus infection in children hospitalized for wheezing.   J Allergy Clin Immunol   2005; 115:1311-1312
    • Bar in the image represents 10 nm. Glycoprotein spikes are visible in viral membrane and extruded nucleocapsid is visible below Human Metapneumovirus
    • Epidemiology
      • Annual epidemics during the late winter and early spring months in temperate locations
      • The peak incidence of hMPV usually occurs 1 to 2 months later than the peak of RSV .
      • The percentage of hMPV detection varies from 6% to 15% among patients with acute respiratory tract infection
      • van den Hoogen BG, van Doornum GJ, Fockens JC, et al: Prevalence and clinical symptoms of human metapneumovirus infection in hospitalized patients.   J Infect Dis   2003; 188:1571-1577.
      • Esper F, Martinello RA, Boucher D, et al: A 1-year experience with human metapneumovirus in children aged < 5 years. J Infect Dis 2004; 189:1388-1396
      • Osterhaus A, Fouchier R: Human metapneumovirus in the community.   Lancet   2003; 361:890-891 .
    • Cont.
      • Peak age of hospitalization for hMPV occurs between 6 and 12 months of age
      • hMPV - infected children have higher rates of underlying disease than RSV - infected children .
      • Thanasugarn W, Samransamruajkit R, Vanapongtipagorn P, et al :  Human metapneumovirus infection in Thai children.   Scand J Infect Dis   2003; 35:754-756
      • Bosis S, Esposito S, Niesters HG, et al :  Impact of human metapneumovirus in childhood: comparison with respiratory syncytial virus and influenza viruses.   J Med Virol   2005; 75:101-104.
    • Clinical Manifestations
      • * Upper respiratory tract symptoms, including:
      • - Rhinorrhea
      • - Cough
      • - Fever .
      • - Conjunctivitis
      • - Vomiting, Diarrhea , Rash are occasionally
      • reported
      Noyola DE, Alpuche - Solis AG, Herrera - Diaz A, et al :  Human metapneumovirus infections in Mexico: epidemiological and clinical characteristics.   J Med Microbiol   2005; 54:969-974
    • Cont.
      • * Lower respiratory tract syndromes most frequently associated with hMPV infection are:
      • - bronchiolitis
      • - croup
      • - pneumonia
      • - asthma exacerbation .
      Noyola DE, Alpuche - Solis AG, Herrera - Diaz A, et al :  Human metapneumovirus infections in Mexico: epidemiological and clinical characteristics.   J Med Microbiol   2005; 54:969-974
      • Infancy
      • 1.Bronchiolitis
      • 2.Pneumonia 
      • 3.Croup 
      • 4.Exacerbation of asthma 
      • 5. Upper respiratory tract infection 
      • 6.Acute otitis media
      Clinical Manifestations at Various Ages Takao S, Shimozono H, Kashiwa H, et al :  Clinical study of pediatric cases of acute respiratory diseases associated with human metapneumovirus in Japan.   Jpn J Infect Dis   2003; 56:127-129.
    • Cont.
      • Older children / adults
      • 1. Croup
      •   2. Laryngitis 
      •   3. Bronchitis 
      •   4. Asthma exacerbation 
      •   5. Pneumonia (elderly) 
      •   6.Exacerbation of chronic obstructive pulmonary
      • disease (elderly)
      Takao S, Shimozono H, Kashiwa H, et al :  Clinical study of pediatric cases of acute respiratory diseases associated with human metapneumovirus in Japan.   Jpn J Infect Dis   2003; 56:127-129.
    • Diagnosis
      • There is no commercially available rapid antigen test for hMPV
      • In general, reliable diagnosis of hMPV currently depends on molecular techniques based on standard or real-time RT-PCR assays.
      • Bellau - Pujol S, Vabret A, Legrand L, et al :  Development of three multiplex RT - PCR assays for the detection of 12 respiratory RNA viruses .   J Virol Methods   2005; 126:53-63.
      • Lopez - Huertas MR, Casas I, Acosta - Herrera B, et al :  Two RT - PCR based assays to detect human metapneumovirus in nasopharyngeal aspirates.   J Virol Methods   2005; 129:1-7.
    • Treatment
      • The majority of children infected with hMPV can be managed at home with supportive care.
      • For hospitalized infants and children the primary therapies are supplementary oxygen and intravenous hydration.
      • Bronchodilators and corticosteroids ?
      • Ribavirin and polyclonal human immunoglobulin?(1)
      (1)Hamelin ME, Prince GA, Boivin G :  Effect of ribavirin and glucocorticoid treatment in a mouse model of human metapneumovirus infection.   Antimicrob Agents Chemother   2006; 50:774-777.
    • Prevention
      • Recombinant hMPV strains that lack various genes
      • Highly immunogenic, inducing neutralizing antibodies and protection against challenge with wild-type hMPV.
      • Several potential vaccine candidates are in development within 3 years of the discovery of hMPV,
      • Tang RS, Mahmood K, Macphail M, et al :  A host - range restricted parainfluenza virus type 3 ( PIV3 ) expressing the human metapneumovirus (hMPV) fusion protein elicits protective immunity in African green monkeys.   Vaccine   2005; 23:1657-1667.
      • Biacchesi S, Skiadopoulos MH, Yang L, et al: Recombinant human metapneumovirus lacking the small hydrophobic SH and/or attachment G glycoprotein: deletion of G yields a promising vaccine candidate. J Virol 2004; 78:12877-12887 .
      • Thank you