Metapneumovirus - hMPV

The human metapneumovirus (hMPV) is a recently (2001) discovered agent of viral respiratory infections.

  • Diagnosis
  • Background
  • Lab Tests
  • References
  • Related Topics

Indications for Testing

  • Immunocompromised patients, adults >55 years, and children with severe respiratory illness

Laboratory Testing

  • Collection of high-quality, cellular respiratory specimen required for best results
  • Direct fluorescent antibody (DFA) staining – most rapid and useful test
  • Polymerase chain reaction (PCR) – most sensitive test
    • Use to confirm negative DFA in cases with suspicion
  • Culture – not recommended because organism cannot be isolated from conventionally used cell lines
  • Concurrent viral testing – consider for influenza, respiratory syncytial virus (RSV), adenovirus, bocavirus
  • May also consider testing for atypical pneumonia agents – Mycoplasma pneumoniae, Chlamydophila pneumoniae

Differential Diagnosis

Epidemiology

  • Prevalence – accounts for 5-10% of respiratory infections in hospitalized children and 10-20% of infections in outpatient clinics
  • Age
    • Usually in children <10 years
    • By 5 years, nearly all children show evidence of past infection
  • Occurrence – peak season is November through May
  • Transmission – airborne droplet, close contact

Organism

  • Single-stranded RNA virus
  • Member of the Paramyxoviridae family
  • Strains A and B concurrent

Risk Factors

  • Age – children <10, adults >55
  • Compromised immune system
  • Chronic medical condition (cardiac, pulmonary, hepatic)

Clinical Presentation

  • Clinical symptoms indistinguishable from respiratory syncytial virus (RSV)
  • Symptoms range from common cold to severe lower respiratory tract infections such as bronchitis and pneumonia
  • Usual symptoms include coughing/wheezing, hypoxia, fever
  • May exacerbate asthma and may play an etiological role in its development
  • Coinfection with RSV and adenovirus common and usually associated with more severe disease
Tests generally appear in the order most useful for common clinical situations. Click on number for test-specific information in the ARUP Laboratory Test Directory.

Human Metapneumovirus DFA 0060779
Method: Direct Fluorescent Antibody Stain

Limitations 

Sample requires adequate amount of intact cells

Human Metapneumovirus by RT-PCR 0060784
Method: Qualitative Polymerase Chain Reaction

Explify Respiratory Pathogens by Next Generation Sequencing 2013694
Method: Massively Parallel Sequencing

General References

Hermos CR, Vargas SO, McAdam AJ. Human metapneumovirus. Clin Lab Med. 2010; 30(1): 131-48. PubMed

Kahn JS. Newly identified respiratory viruses. Pediatr Infect Dis J. 2007; 26(8): 745-6. PubMed

Kroll JL, Weinberg A. Human metapneumovirus. Semin Respir Crit Care Med. 2011; 32(4): 447-53. PubMed

Schildgen V, van den Hoogen B, Fouchier R, Tripp RA, Alvarez R, Manoha C, Williams J, Schildgen O. Human Metapneumovirus: lessons learned over the first decade. Clin Microbiol Rev. 2011; 24(4): 734-54. PubMed

The National Respiratory and Enteric Virus Surveillance System (NREVSS). The National Respiratory and Enteric Virus Surveillance System (NREVSS) - Clinical Features. Center for Disease Control and Prevention. Atlanta, GA [Last updated Aug 2016; Accessed: Aug 2017]

References from the ARUP Institute for Clinical and Experimental Pathology®

Couturier MR, Barney T, Alger G, Hymas WC, Stevenson JB, Hillyard D, Daly JA. Evaluation of the FilmArray® Respiratory Panel for clinical use in a large children's hospital. J Clin Lab Anal. 2013; 27(2): 148-54. PubMed

Medical Reviewers

Last Update: October 2017