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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)
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Abstract

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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 

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