Notes from the Field: Severe Human Metapneumovirus Infections — North Dakota, 2016

Abstract

On 27 May 2016, the US CDC was informed by the North Dakota Department of Health of a recent cluster of severe respiratory illnesses that included two deaths in children at a large hospital (hospital A) in Fargo, North Dakota, caused by human metapneumovirus (HMPV). Overall, six HMPV-positive paediatric inpatients (median age, 2.5 years) were identified at hospital A during April-May 2016. Of these six patients, five had underlying medical conditions, including premature birth (n=3), congenital heart disease (n=3), bronchopulmonary dysplasia (n=2), developmental delay (n=3), and cerebral palsy (n=2). Four children required mechanical ventilation, and two of the four had acute respiratory distress syndrome and pneumothorax. Two of the six patients died. Case finding was expanded to five additional large hospitals throughout North Dakota, which identified 11 additional paediatric cases from three hospitals and 27 adult patients from four hospitals. Of the 11 additional paediatric cases, nine had underlying medical conditions, including chronic lung disease (n=7) and premature birth (n=4). One patient required mechanical ventilation and none died. Of the 27 adult patients identified (median age, 69 years), all had underlying medical conditions, particularly chronic lung disease (n=19) or chronic heart disease (n=16).