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Chapter 37 : Respiratory Syncytial Virus, Human Metapneumovirus, and Parainfluenza Viruses

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Respiratory Syncytial Virus, Human Metapneumovirus, and Parainfluenza Viruses, Page 1 of 2

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Abstract:

Respiratory syncytial virus (RSV), human metapneumovirus (HMPV, MPV), and the parainfluenza viruses (PIVs) are the most important causes of lower respiratory tract illnesses in infants and children. RSV was first isolated from chimpanzees with coryza in 1956 (1) but was soon shown to be the major cause of bronchiolitis and pneumonia in infants (2). RSV was named after the cell fusion that is characteristic of its growth in some continuous cultured cell lines. PIV types 1, 2, and 3 were first recovered in 1956 (3, 4) and were recognized as the major causes of croup, or laryngotracheobronchitis, in children. PIV types 4A and 4B have been recovered from adults and children with upper respiratory illnesses but historically were difficult to isolate in cell culture (5). MPV was first discovered in the Netherlands in 2001 (6) and soon thereafter was documented to be an important cause of lower respiratory tract illness in children worldwide. In older children and adults, these three viruses cause frequent reinfections that are generally mild in healthy persons, but they may cause serious disease in the very young or elderly, immunocompromised patients, and persons with underlying cardiopulmonary diseases.

Citation: Williams J, Piedra P, Englund J. 2017. Respiratory Syncytial Virus, Human Metapneumovirus, and Parainfluenza Viruses, p 873-902. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch37
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Figures

Image of FIGURE 1
FIGURE 1

Cartoon model of the structure of viruses of the family including MPV, PIVs, and RSV. Abbreviations: F, fusion protein; HN, attachment protein for PIV; G, attachment protein for RSV, MPV; M, matrix, L, large protein of the polymerase complex; NP or N, nucleoprotein; P, phosphoprotein.

Citation: Williams J, Piedra P, Englund J. 2017. Respiratory Syncytial Virus, Human Metapneumovirus, and Parainfluenza Viruses, p 873-902. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch37
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Image of FIGURE 2
FIGURE 2

Schematic presentation of the RSV, PIV, and MPV genomes. Abbreviations: NP, nucleoprotein; P, phosphoprotein; P+C, small proteins of the polymerase complex; M, matrix; F, fusion; HN, hemagglutinin-neuraminidase; L, large protein of the polymerase complex; NS, nonstructural proteins; N, nucleoprotein; SH, strongly hydrophobic protein; G, attachment protein; M2, small envelope protein. Gene sizes are roughly to scale.

Citation: Williams J, Piedra P, Englund J. 2017. Respiratory Syncytial Virus, Human Metapneumovirus, and Parainfluenza Viruses, p 873-902. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch37
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Image of FIGURE 3
FIGURE 3

Schematic presentation of the replication strategy of viruses of the family . Abbreviations: (-), negative sense; (+), positive sense.

Citation: Williams J, Piedra P, Englund J. 2017. Respiratory Syncytial Virus, Human Metapneumovirus, and Parainfluenza Viruses, p 873-902. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch37
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Image of FIGURE 4
FIGURE 4

Characteristic histopathologic changes of the airways of an infant with bronchiolitis due to RSV infection. Note the peribronchial mononuclear cell inflammation, relatively normal alveoli, and focal ulceration on top with regenerative epithelial changes. Hematoxylin and eosin stain. Magnification, 45x.

Citation: Williams J, Piedra P, Englund J. 2017. Respiratory Syncytial Virus, Human Metapneumovirus, and Parainfluenza Viruses, p 873-902. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch37
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Image of FIGURE 5
FIGURE 5

Histopathologic features of resolving RSV bronchiolitis in an infant. Note the plug of mucus and cellular debris in a terminal respiratory bronchus. Hematoxylin and eosin stain. Magnification, 144x.

Citation: Williams J, Piedra P, Englund J. 2017. Respiratory Syncytial Virus, Human Metapneumovirus, and Parainfluenza Viruses, p 873-902. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch37
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Image of FIGURE 6
FIGURE 6

Histopathology in an infant with congenital immune deficiency and RSV pneumonia. Note the plugging of a terminal bronchus by cellular debris and parenchymal infiltration with necrosis. Hematoxylin and eosin stain. Magnification, 72x.

Citation: Williams J, Piedra P, Englund J. 2017. Respiratory Syncytial Virus, Human Metapneumovirus, and Parainfluenza Viruses, p 873-902. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch37
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Image of FIGURE 7
FIGURE 7

Chest radiograph of an infant with bronchiolitis due to RSV. Peribronchial thickening with hyperaeration and flattened diaphragms bilaterally are evident. Reprinted from Reference with permission.

Citation: Williams J, Piedra P, Englund J. 2017. Respiratory Syncytial Virus, Human Metapneumovirus, and Parainfluenza Viruses, p 873-902. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch37
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Image of FIGURE 8
FIGURE 8

Posterior-anterior (A) and lateral (B) chest radiographs of an infant with bronchiolitis and pneumonia due to RSV. Bilateral perihilar and peribronchial infiltrations and partial or segmental atelectasis of the right middle and right upper lobes are evident. Reprinted from ( ) with permission.

Citation: Williams J, Piedra P, Englund J. 2017. Respiratory Syncytial Virus, Human Metapneumovirus, and Parainfluenza Viruses, p 873-902. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch37
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Image of FIGURE 9
FIGURE 9

Chest radiograph of a child with croup due to PIV type 1. Peribronchial thickening, scattered infiltrates, and marked narrowing of the superior portion of the trachea (arrow) are evident.

Citation: Williams J, Piedra P, Englund J. 2017. Respiratory Syncytial Virus, Human Metapneumovirus, and Parainfluenza Viruses, p 873-902. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch37
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Image of FIGURE 10
FIGURE 10

Chest radiograph of an infant with pneumonia due to PIV type 3. Right upper lobe atelectasis and multilobar infiltrates are evident.

Citation: Williams J, Piedra P, Englund J. 2017. Respiratory Syncytial Virus, Human Metapneumovirus, and Parainfluenza Viruses, p 873-902. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch37
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Image of FIGURE 11
FIGURE 11

Chest radiograph of a six-month-old infant with bronchiolitis due to MPV. Peribronchial thickening and hyperinflation are evident. From , Williams JV, Harris PA, Tollefson SJ, Halburnt-Rush LL, Pingsterhaus JM, Edwards KM, Wright PF, Crowe JE, Jr., 350:443–50. Copyright © 2004 Massachusetts Medical Society. Reprinted with permission.

Citation: Williams J, Piedra P, Englund J. 2017. Respiratory Syncytial Virus, Human Metapneumovirus, and Parainfluenza Viruses, p 873-902. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch37
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Image of FIGURE 12
FIGURE 12

Cytopathic effect of RSV in cell culture on a continuous human epithelial cell line (HEp-2 cells) after 1 week of incubation. Large syncytial cells are noted, with ballooning and coalescence of RSV-infected cells.

Citation: Williams J, Piedra P, Englund J. 2017. Respiratory Syncytial Virus, Human Metapneumovirus, and Parainfluenza Viruses, p 873-902. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch37
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Image of FIGURE 13
FIGURE 13

Cytopathic effect of MPV in cell culture on a continuous monkey kidney epithelial cell line (LLC-MK2 cells) after 14 days of incubation. Rounding up and detachment of cells are noted, with developing syncytia.

Citation: Williams J, Piedra P, Englund J. 2017. Respiratory Syncytial Virus, Human Metapneumovirus, and Parainfluenza Viruses, p 873-902. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch37
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