Abstract:
Objective To analyze the epidemiological and etiological characteristics of a cluster of human metapneumovirus (HMPV) infection in a kindergarten in Gongshu District of Hangzhou City in May 2024, and provide reference for the prevention and control of similar outbreaks.
Methods An on-site investigation was conducted using an epidemiological case investigation form. Throat swab specimens collected from cases were screened for 13 respiratory pathogens using real-time PCR. For HMPV nucleic acid positive specimens, the
F gene of HMPV was used as the target gene for sequence amplification and determination. The sequencing results were compared with sequences in GenBank to determine the virus subtypes and perform phylogenetic analyses. Results The outbreak occurred in a bottom class with a total of 28 preschoolers and 3 teachers and childcare workers., A total of 11 cases were identified, 10 preschoolers and 1 teacher, including 8 male cases and 3 female cases. The clinical features were fever in all 11 cases (100.00%), cough in 8 cases (72.72%), catarrhal symptoms in 4 cases (36.36%), and headache in 3 cases (27.27%). All symptoms were mild, and no severe cases were observed. A total of 11 throat swab samples were collected. Real-time PCR test results showed that 3 samples were positive for HMPV nucleic acid, 2 samples were positive for both HMPV and Streptococcus pneumoniae, and 1 sample was positive for both HMPV and rhinovirus. The sequences of the 6 HMPV nucleic acid positive specimens were amplified and analyzed using specific primers, and all were determined to be HMPV subtype A2b. The F gene fragment sequence showed the highest similarity (99.65%) to PV081665.1/Brazil/2024, and also exhibited high similarity to PP683455.1/Indonesia/2021, PV016275.1/Beijing/2024, and PV052230.1/USA/2024 (99.48%, 99.31%, and 99.13%, respectively). Conclusion This cluster of acute respiratory infection was caused by HMPV subtype A2b, accompanied by mixed infections of rhinovirus and
Streptococcus pneumoniae. The
F gene fragment sequences of the HMPV in this outbreak were highly homologous to those of the A2b strains isolated in Brazil, Beijing, Indonesia, and the United States.