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Objectives The genotypic analysis of human metapneumo‐(HMPV) and boca‐(HBoV) viruses circulating in Greece and their comparison to reference and other clinical strains. Design Genetic analysis of representative strains over three consecutive winter seasons of the years 2005–2008. Setting Representative positive specimens for HMPV and HBoV from paediatric patients of healthcare units and hospitals in Southern Greece with influenza‐like illness or other respiratory tract infections. Sample Seven to ten positive specimens for either HMPV or HBoV from each winter period. In total, 24 specimens positive for HMPV and 26 for HBoV, respectively. Main outcome measures Sequence diversity of HMPV and HBoV strains by sequencing the complete G and VP1/VP2 genes, respectively. Results In total, 24 HMPV strains were found to have a 92–100% nucleotide and a 85.9–100% amino acid identity. Phylogenetic analysis based on the number of amino acid differences, revealed circulation of 4 different subclusters belonging to genetic lineage B2. Similarly, analysis of 26 HBoV strains indicated that 22 clustered within genotype St2, 2 into genotype St1 and the remaining 2 formed a third cluster derived from potential recombination between different St1 genotype strains. St2 HBoV genotype was observed throughout the whole observation period whereas St1 only during the second and the third winter period. Higher levels of heterogeneity were observed between HMPV compared to HBoV strains. Conclusions Phylogenetic analysis revealed circulation of one single lineage (B2) for HMPV viruses and predominance of St2 genotype for HBoV viruses. A possible recombination between St1 genotype strains of HBoV was observed.

Human metapneumovirus (hMPV), a respiratory pathogen identified in 2001, is a substantial cause of community-acquired respiratory infections across all age groups. This Review explores the impact of hMPV after the COVID-19 pandemic, emphasising its resurgence as a public health concern. Epidemiological shifts, as well as unusual seasonal patterns, increased co-infection rates, and altered age distributions, have been observed globally. Phylogenetic analysis has shown the variation across three distinct periods, especially before and after the COVID-19 pandemic, in terms of genotypic distribution. Clinical manifestations of hMPV infection range from asymptomatic to severe lower respiratory tract infections, particularly in vulnerable populations. Specific antivirals or vaccines are currently unavailable; consequently, treatment remains supportive. The development of monoclonal antibodies and vaccines leveraging cross-protective strategies against hMPV and related viruses is underway. This Review advocates prioritising research and public health measures to address the evolving epidemiological and clinical challenges associated with hMPV in the post-COVID-19 era.

Avian metapneumovirus (aMPV), classified within the Pneumoviridae family, wreaks havoc on poultry health. It typically causes upper respiratory tract and reproductive tract infections, mainly in turkeys, chickens, and ducks. Four subtypes of AMPV (A, B, C, D) and two unclassified subtypes have been identified, of which subtypes A and B are widely distributed across the world. In January 2024, an outbreak of severe respiratory disease occurred on turkey and chicken farms across different states in the US. Metagenomics sequencing of selected tissue and swab samples confirmed the presence of aMPV subtype B. Subsequently, all samples were screened using an aMPV subtype A and B multiplex real-time RT-PCR kit. Of the 221 farms, 124 (56%) were found to be positive for aMPV-B. All samples were negative for subtype A. Six whole genomes were assembled, five from turkeys and one from chickens; all six assembled genomes showed 99.29 to 99.98% nucleotide identity, indicating a clonal expansion event for aMPV-B within the country. In addition, all six sequences showed 97.74 to 98.58% nucleotide identity with previously reported subtype B sequences, e.g., VCO3/60616, Hungary/657/4, and BR/1890/E1/19. In comparison to these two reference strains, the study sequences showed unique 49–62 amino acid changes across the genome, with maximum changes in glycoprotein (G). One unique AA change from T (Threonine) to I (Isoleucine) at position 153 in G protein was reported only in the chicken aMPV sequence, which differentiated it from turkey sequences. The twelve unique AA changes along with change in polarity of the G protein may indicate that these unique changes played a role in the adaptation of this virus in the US poultry. This is the first documented report of aMPV subtype B in US poultry, highlighting the need for further investigations into its genotypic characterization, pathogenesis, and evolutionary dynamics.

Human metapneumovirus (HMPV) is a member of the genus Metapneumovirus in the family Pneumoviridae of the order Mononegavirales that can cause upper and lower respiratory tract disease. This retrospective study describes the epidemiology of hMPV based on community viral surveillance results from sentinel sites across Taiwan from 2013 to 2023. A total of 114 hMPV strains were isolated and analyzed to assess viral evolution through sequencing of their fusion protein genes. This study revealed that hMPV cases occur almost year-round in Taiwan, with a peak occurring during spring (March to May). Of the 114 infected patients, 68.4% were children under 4 years old. The geographical distribution of hMPV positivity was highest in Penghu County, followed by Changhua County and Hsinchu County. The clinical symptoms of hMPV infection are nonspecific, with fever (56.1%), cough (44.7%), rhinorrhea (21.1%), and sore throat (14.9%) being the most common. However, a few patients also developed severe central nervous system symptoms (1.8%) or dyspnea (0.9%). Phylogenetic analysis revealed genetic diversity among the 114 isolated hMPV strains, with the A2 lineage (57.9%) being the most frequently observed, followed by the B2 lineage (33.3%), in the Taiwanese community from 2013 to 2023. In conclusion, hMPV causes a serious acute respiratory disease in Taiwan that should not be neglected. Further epidemiological surveillance and investigations of the clinical characteristics of hMPV should be performed continually for prevention and control of this virus.

PurposeThe objective of this study was to examine the molecular epidemiology and clinical characteristics of HMPV infection among children with ARIs in Nanjing.MethodsThe respiratory samples were collected from 2078 children (≤ 14 years) with acute respiratory infections and were tested for HMPV using real-time RT-PCR. Amplification and sequencing of the HMPV G gene were followed by phylogenetic analysis using MEGA 7.0.ResultThe detection rate of HMPV among children was 4.7% (97/2078), with a concentration in those under 5 years of age. Notably, the peak season for HMPV prevalence was observed in winter. Among the 97 HMPV-positive samples, 51.5% (50/97) were available for characterization of the HMPV G protein gene. Phylogenetic analysis indicated that the sequenced HMPV strains were classified into three sublineages: A2c111nt − dup (84.0%), B1 (2.0%), and B2 (14.0%).ConclusionThere was an incidence of HMPV among hospitalized children during 2021–2022 in Nanjing with A2c111nt − dup being the dominant strain. This study demonstrated the molecular epidemiological characteristics of HMPV among children with respiratory infections in Nanjing, China.

A disease called “hydrosalpinx fluid and egg drop syndrome” (HFEDS) was observed in four flocks of Jinding ducks (Anas platyrhynchos domesticus) in Northeast China during the years 2022 to 2023. Here, we investigated the possible involvement of avian metapneumovirus (AMPV) infection. Full-length genome sequencing and sequence analysis of two AMPV strains showed that they belong to Eurasian lineage of AMPV subtype C. Based on surface glycoprotein (G) sequence comparisons, the Eurasian lineage can be divided into two sublineages (E1 and E2), and sublineage E2 is circulating in Jinding duck populations in Northeast China.

Human metapneumovirus (hMPV) is a significant cause of respiratory illness, particularly in children, elderly individuals, and immunocompromised patients. Despite its clinical relevance, hMPV poses diagnostic challenges due to its symptom similarity with other respiratory illnesses, such as influenza and respiratory syncytial virus (RSV), and the lack of specialized detection systems. Traditional diagnostic methods are often inadequate for providing rapid and accurate results, particularly in low-resource settings. This study proposes a novel deep learning framework, referred to as hMPV-Net, which leverages Convolutional Neural Networks (CNNs) to facilitate the precise detection and classification of hMPV infections. The CNN model is designed to perform binary classification by differentiating between hMPV-positive and hMPV-negative cases. To address the lack of real-world patient data, simulated image datasets were used for model training and evaluation, allowing the model to generalize to various clinical scenarios. A key challenge in developing this model is the imbalance within the dataset, where hMPV-positive cases are often underrepresented. To mitigate this, the framework incorporates advanced techniques such as data augmentation, weighted loss functions, and dropout regularization, which help to balance the dataset, improve model robustness, and enhance classification accuracy. These techniques are crucial in addressing issues such as overfitting and generalization, which are common when working with limited datasets in medical imaging tasks. The dataset used for model training and testing consists of 10,000 samples, with an equal distribution of hMPV-positive and hMPV-negative cases. Experimental results demonstrate that the hMPV-Net model achieves a high test accuracy of 91.8%, along with impressive test precision, recall, and F1-score values around 92%. These metrics indicate that the model performs exceptionally well in classifying both hMPV-positive and hMPV-negative cases. Furthermore, the model exhibits superior computational efficiency, requiring only 3.2 GFLOPs, which is significantly lower than other state-of-the-art models such as ResNet-50 and VGG-16. This reduction in computational cost makes the model suitable for deployment in resource-constrained healthcare environments, where computing power and infrastructure may be limited.

In Cote d’Ivoire, the incidence rate of acute respiratory infections (ARIs) rose from 165 cases per 1000 children in 2014 to more than 200 cases per 1000 children in 2015. The genetic diversity, transmission dynamics, and epidemiology of human metapneumovirus (hMPV), a causative agent of ARIs, in Cote d’Ivoire are unknown. This information is key in comprehending the transmission patterns and the role of global strains in establishing local epidemics in the country. Demographic information and biological samples were collected from 3,899 children under five-years-old, from January 1, 2013 to December 31, 2015 through Côte d’Ivoire’s Influenza surveillance network. Phylodynamic modeling was performed on sequences of the surface and attachment glycoprotein genes (F and G, respectively). A total of 6.23% ( n  = 243/3899) of the samples were positive for hMPV. We observed continuous transmission of hMPV in Côte d’Ivoire throughout the year with peaks in the two dry periods from February to March and July to September. Phylodynamic modeling revealed the circulation of the two large groups of genotypes A and B as well as lineages A, B, B1, and B2. Viral introductions into Côte d’Ivoire were estimated to have occurred 2011–2015 for the F gene genotypes and 2007–2014 for G gene genotypes. Through phylogeographic modeling, we estimated at least 14 viral introductions into Côte d’Ivoire during this period frequently from regions with available sequence data (e.g., Asia). Molecular surveillance and characterization of the evolutionary mechanisms and the spread of hMPV in Côte d’Ivoire allows for differentiating the burden caused by this virus and other co-circulating respiratory viruses like RSV and influenza. Our findings may inform potential vaccine designs for hMPV similar to the recent success for RSV. Therefore, larger-scale and continuous genomic and epidemiological surveillance of hMPV globally and in Côte d’Ivoire is essential for identifying viral introductions and implementing control strategies.

Human metapneumovirus (HMPV) is a leading cause of lung infection and pediatric hospitalizations worldwide for which there is no licensed vaccine or therapeutic. Because HMPV mutates rapidly, understanding which mutations enhance its ability to multiply and spread is important for the development of interventions and treatments. We prospectively collected patient data and nasal specimens from children with symptoms of acute respiratory illness. The predominant A2 and B2 HMPV variants circulating in the population contained insertions in the attachment protein, which suggests that these insertions may be advantageous to the virus. Furthermore, our analysis suggests that age, insurance type, and underlying health conditions were associated with HMPV infection. Age and underlying health conditions were associated with elevated HMPV disease severity, whereas HMPV subgroup was not. This large HMPV genomic epidemiological study provides insight into patient factors associated with disease and the emergence of the dominant variants in the USA.

Lower respiratory infections are a leading cause of death in children under five years. Human metapneumovirus (HMPV) is an underestimated causal agent of these infections. In this study, the molecular epidemiology of HMPV associated with respiratory infections in Mexican children between August 2023 and August 2024 was determined. Sequences were also analyzed for predicted N- and O-linked glycosylation sites. Overall, 34 sequences from infants with respiratory infections were obtained; 32 were assigned to the A2b2 genotype, one to A2b1, and one to B2. All but one of the A2b2 sequences carried the 111-nucleotide duplication of the G gene; the remaining sequence carried the 180-nucleotide duplication. The samples assigned to the A2b1 and B2 genotypes did not have a duplication. The HMPV-A phylogeny did not show a clustering of Mexican sequences as a single monophyletic group. Four N-linked glycosylation sites were predicted in the HMPV-A sequences and three in the B sequence. The number of O-linked glycosylation sites predicted in HMPV-A ranged from 61 to 77 and were 61 in the HMPV-B sequence. This first description of HMPV genotypes and the diverse array of G protein N- and O-linked glycosylation patterns found in a Mexican pediatric population in the post-pandemic period contributes to the understanding of the global spread of HMPV.