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Chapter 83 : Respiratory Syncytial Virus and Human Metapneumovirus

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Abstract:

Respiratory syncytial virus (RSV) is one of the most vulnerable pathogens to environmental changes. RSV is the major cause of lower respiratory tract illnesses such as bronchiolitis, tracheobronchitis, and pneumonia among infants and young children worldwide. Human metapneumovirus (hMPV) is an RNA virus of the family and is part of the subfamily along with RSV. A study of the association of the virus with respiratory disease was performed using prospectively collected data in a cohort of more than 2,000 subjects. This study showed that hMPV is associated with the common cold and with lower respiratory tract illnesses such as bronchiolitis, pneumonia, croup, and exacerbation of reactive airways disease. The signs and symptoms caused by hMPV are very similar to those caused by RSV. Reports in the literature suggest that the virus can be recovered or detected by reverse transcriptase polymerase chain reaction (RT-PCR) from nasal aspirates, nasal washes, nasal or throat swabs, and bronchoalveolar lavage specimens. The most sensitive test for identification of hMPV in clinical samples to date is RT-PCR. The diagnosis of hMPV infection is most likely when a positive nucleic acid test for hMPV infection is obtained when testing a respiratory secretion during late winter or early spring in temperate climates from a patient with acute respiratory illness and negative tests for other respiratory viruses.

Citation: Tang Y, Crowe J. 2011. Respiratory Syncytial Virus and Human Metapneumovirus, p 1357-1371. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch83

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Upper Respiratory Tract Infections
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Human respiratory syncytial virus
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Severe Acute Respiratory Syndrome
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Restriction Fragment Length Polymorphism
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FIGURE 1

Schematic of RSV and hMPV genomic RNAs. The order of the genes from 3′ to 5′ is depicted. The virus-specific proteins encoded by these genes are shown.

Citation: Tang Y, Crowe J. 2011. Respiratory Syncytial Virus and Human Metapneumovirus, p 1357-1371. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch83
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Image of FIGURE 2
FIGURE 2

Microscopic detection of RSV and hMPV in cell cultures. (A) RSV-infected HEp-2 cells showing cells that have fused, forming large syncytia. (B and C) hMPV infection causes a focus of infection with rounding of LLC-MK2 cells and loss of monolayer integrity. (D) Indirect immunofluorescence of an hMPV-infected LLC-MK2 centrifugation culture stained with monoclonal antibody MAb-8 ( ). Images courtesy of http://www.virology.org/hpphoto3.html (A), John Williams (B and C), and David Ferguson (D).

Citation: Tang Y, Crowe J. 2011. Respiratory Syncytial Virus and Human Metapneumovirus, p 1357-1371. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch83
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Tables

Generic image for table
Table 1

Commercial RSV and hMPV DFA reagents and their performance

NA, not applicable; ND, not done; ASR, analyte-specific reagent.

Compared to cell culture unless specifically indicated. In many cases, the culture used for comparison and validation was suboptimal, making the rapid tests artificially look better. It should be recognized that performance in each laboratory may be different.

Citation: Tang Y, Crowe J. 2011. Respiratory Syncytial Virus and Human Metapneumovirus, p 1357-1371. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch83
Generic image for table
Table 2

Main commercially available RSV rapid antigen products and their performance characteristics

Abbreviations: NA, not applicable or not available; NP, nasopharyngeal; NW, nasal wash; CLIA, Clinical Laboratory Improvement Amendments of 1988.

Compared to cell culture unless specifically indicated.

Citation: Tang Y, Crowe J. 2011. Respiratory Syncytial Virus and Human Metapneumovirus, p 1357-1371. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch83
Generic image for table
Table 3

Commercial NAA kits and devices for detection and identification of RSV and hMPV

Abbreviations: ASR, analyte-specific reagent; Flu, influenza virus; ND, not determined; PIV, parainfluenza virus; RhV, rhinovirus; CoV, coronavirus; AdV, adenovirus; EnV, enterovirus; TEM, target-enriched multiplexing; SARS, severe acute respiratory syndrome.

Performance varies significantly due to different standard references used for validation.

Will be available as a research use only device.

Citation: Tang Y, Crowe J. 2011. Respiratory Syncytial Virus and Human Metapneumovirus, p 1357-1371. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch83

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