Outbreaks of Human Metapneumovirus in Western Sydney Aged-Care Facilities in 2018

Authors

  • Christian G Jones Sydney Medical School, The University of Sydney, NSW, Australia; Centre for Population Health, Western Sydney Public Health Unit, North Parramatta NSW, Australia
  • Elizabeth Escarate Centre for Population Health, Western Sydney Public Health Unit, North Parramatta NSW, Australia
  • Elizabeth Clarke Centre for Population Health, Western Sydney Public Health Unit, North Parramatta NSW, Australia
  • Penelope Clark Centre for Population Health, Western Sydney Public Health Unit, North Parramatta NSW, Australia
  • Sophie Norton Centre for Population Health, Western Sydney Public Health Unit, North Parramatta NSW, Australia
  • Shopna Bag Sydney Medical School, The University of Sydney, NSW, Australia; Centre for Population Health, Western Sydney Public Health Unit, North Parramatta NSW, Australia
  • Jen Kok Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Biological Sciences and Sydney Medical School, The University of Sydney NSW, Australia; Centre for Infectious Diseases and Microbiology Laboratory Services, NSW Health Pathology-Institute of Clinical Pathology and Medical Research Westmead Hospital, Westmead NSW, Australia
  • Dominic Dwyer Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Biological Sciences and Sydney Medical School, The University of Sydney NSW, Australia; Centre for Infectious Diseases and Microbiology Laboratory Services, NSW Health Pathology-Institute of Clinical Pathology and Medical Research Westmead Hospital, Westmead NSW, Australia
  • Richaard I Lindley Sydney Medical School, The University of Sydney, NSW, Australia; The George Institute for Global Health, Sydney NSW, Australia
  • Robert Booy Sydney Medical School, The University of Sydney, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Biological Sciences and Sydney Medical School, The University of Sydney NSW, Australia; National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, The Children’s Hospital at Westmead, Westmead NSW, Australia

DOI:

https://doi.org/10.33321/cdi.2022.46.54

Keywords:

viral respiratory illness, aged care, human metapneumovirus

Abstract

Background
Human metapneumovirus (hMPV), first described in 2001, is a cause of acute respiratory tract infection in the elderly, with symptoms ranging from mild to severe, including pneumonia, but outbreaks are rarely described.
Methods
Between 1 July and 31 December 2018, there were three outbreaks of Influenza-like Illness (ILI) where hMPV was the primary pathogen observed, among 64 aged-care facilities (ACFs) in Western Sydney. These outbreaks were investigated by the Western Sydney Local Health District (WSLHD) Public Health Unit (PHU); multiplex polymerase chain reaction (PCR) testing was performed on nasopharyngeal swabs collected by the ACF.
Results
hMPV was the main causative pathogen in three outbreaks (27, 28, and 15 symptomatic cases, respectively) in late winter and early spring. Fifty-five residents and 15 staff cases (70 total cases) were identified; hMPV was detected in 12 of 63 specimens submitted. Of the cases in residents, eight were hospitalised (8/63; 15%), including five with confirmed hMPV and a further one epidemiologically linked to a positive case. Six residents died (6/63; 11%) during the hMPV outbreaks; four of these had laboratory-confirmed hMPV, with a further case epidemiologically linked to a hMPV case, with a primary diagnosis of pneumonia/viral pneumonia. The sixth death was not epidemiologically linked, nor did this case exhibit any respiratory symptoms during the outbreak; however, it was reported in line with public health guidelines.
Conclusion
A major challenge in 2018 was the incompleteness of testing for, and awareness of, hMPV as a viral cause of ILI by facilities, laboratories, and emergency departments, which generally opted for rapid testing for influenza and RSV only. There is no licensed vaccine or approved treatment for hMPV, so efficient infection control measures are most important.

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References

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Published

18/08/22

How to Cite

Jones, Christian G, Elizabeth Escarate, Elizabeth Clarke, Penelope Clark, Sophie Norton, Shopna Bag, Jen Kok, Dominic Dwyer, Richaard I Lindley, and Robert Booy. 2022. “Outbreaks of Human Metapneumovirus in Western Sydney Aged-Care Facilities in 2018”. Communicable Diseases Intelligence 46 (August). https://doi.org/10.33321/cdi.2022.46.54.

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Vol. 46 (2022)

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