Human Metapneumovirus in High Risk Populations

描述(申请人提供)：2001年6月，调查人员报告了一个新发现的令人兴奋的发现，即一种新发现的人类副粘病毒，它可能解释很大一部分急性呼吸道疾病。关于这种人类偏肺病毒(HMPV)的流行病学，人们知之甚少。少数已发表的研究仅涉及来自美国以外的患者。现有数据表明，HMPV可能导致多达15%的急性呼吸道疾病，可能导致严重的呼吸系统疾病和死亡，HMPV至少有两种主要基因型，它感染所有年龄段。有关HMPV感染的问题仍然很多。特定人群，如老年人或免疫功能受损者，感染风险是否增加？农村人口感染HMPV的风险更大。特定的HMPV基因型别是否更常与严重疾病有关？HMPV疾病是否存在显著的时间、地理或遗传变异？我们计划启动一系列关于人类偏肺病毒的流行病学研究，长期目标是减少HMPV的发病率。这个应用程序是我们朝着这个目标迈出的第一步。在它中，我们将确定HMPV感染高发的中西部人群，并确定美国中西部HMPV分离株是否与美国以外地区收集的HMPV分离株不同。我们将通过使用RT-PCR来评估2000至2004年间从中西部地区医疗中心的急性呼吸道感染门诊患者和住院患者中收集的1500份病毒培养样本，从而实现这一点。通过单变量和多变量技术，将在1500名被研究的患者中确定HMPV RT-PCR阳性的人口统计学和临床危险因素。RT-PCR阳性的样本将被培养，HMPV分离株将与先前鉴定的HMPV分离株进行遗传变异的系统发育比较。这些数据将有助于开展更全面的流行病学研究，并指导未来减少HMPV发病率的干预研究。

DESCRIPTION (provided by applicant): In June 2001, investigators reported the exciting discovery of a newly recognized human paramyxovirus that may explain a significant portion of acute respiratory illnesses. Relatively little is known regarding the epidemiology of this human metapneumovirus (HMPV). The few published studies have exclusively involved patients from outside of the United States. Available data suggest that HMPV may cause as much as 15% of acute respiratory illness, may cause serious respiratory illness and death, that HMPV has at least two major genotypes, and that it infects all age-groups. There remain many questions regarding HMPV infections. Are specific populations, such as the elderly or the immunocompromised, at increased risk of infection? Are rural populations are greater risk of HMPV infection. Are specific HMPV genotypes more often associated with severe disease? Are there significant temporal, geographical, or genetic variations in HMPV disease? We plan to initiate a series of epidemiological studies of human metapneumovirus with a long term goal of reducing HMPV morbidity. This application is our first step towards that goal. In it we will identify Midwestern populations with a high prevalence of HMPV infection and determine if US Midwestern HMPV isolates genotypically differ from those collected outside of the United States. We will accomplish this by using RT-PCR to evaluate1500 viral culture specimens collected during the years 2000 to 2004 from outpatients and inpatients suffering from acute respiratory infection at a Midwestern regional medical center. Through univariate and multivariate techniques, demographic and clinical risk factors for HMPV RT-PCR positivity will be identified among the 1500 patients studied. Specimens that are RT-PCR positive will be cultured and HMPV isolates will be phylogenetically compared with previously identified HMPV isolates for genetic variation. These data will facilitate the development of more comprehensive epidemiological studies, and guide future intervention studies in reducing HMPV morbidity.