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Pediatric burden and seasonality of Human Metapneumovirus over five years in Managua, Nicaragua.
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  • Kathryn Hacker,
  • Guillermina Kuan,
  • Nivea Vydiswaran,
  • Gerardo Chowell,
  • Mayuri Patel ,
  • Nery Sanchez,
  • Roger Lopez ,
  • Sergio Ojeda,
  • Brenda Lopez,
  • Jarrod Mousa,
  • Hannah Maier,
  • Angel Balmaseda,
  • Aubree Gordon
Kathryn Hacker
University of Michigan

Corresponding Author:kphacker@umich.edu

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Guillermina Kuan
Sustainable Sciences Institute
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Nivea Vydiswaran
University of Michigan
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Gerardo Chowell
Georgia State University
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Mayuri Patel
University of Michigan
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Nery Sanchez
Sustainable Sciences Institute
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Roger Lopez
Sustainable Sciences Institute
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Sergio Ojeda
Sustainable Sciences Institute
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Brenda Lopez
Sustainable Sciences Institute
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Jarrod Mousa
University of Georgia
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Hannah Maier
University of Michigan
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Angel Balmaseda
Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health
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Aubree Gordon
University of Michigan
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Abstract

Background Human Metapneumovirus (hMPV) is an important cause of pediatric respiratory infection. We leveraged the Nicaraguan Pediatric Influenza Cohort Study (NPICS) to assess the burden and seasonality of symptomatic hMPV infection in children. Methods NPICS is an ongoing prospective study of children in Managua, Nicaragua. We assessed children for hMPV infection via RT-PCR. We used classical additive decomposition analysis to assess the temporal trends and Generalized Growth Models (GGMs) were used to estimate effective reproduction numbers. Results From 2011-2016 there were 564 hMPV symptomatic infections yielding an incidence rate of 5.74 cases per 100 person-years (95% CI 5.3, 6.2). Children experienced 3,509 Acute Lower Respiratory Infections (ALRIs), of which 160 (4.6%) were associated with hMPV infection. Children under the age of one had 55% of all symptomatic hMPV infections (62/112) develop into hMPV-associated ALRIs and were five times as likely as children over one to have an hMPV-associated ALRI (Rate Ratio 5.5 95% CI 4.1, 7.4 p <0.001). Additionally, symptomatic reinfection with hMPV was common. In total, 87 (15%) of all observed symptomatic infections were reinfections. The seasonality of symptomatic hMPV outbreaks varied considerably. From 2011-2016, four epidemic periods were observed, following a biennial seasonal pattern. The mean ascending phase of the epidemic periods were 7.7 weeks, with an overall mean estimated reproductive number of 1.2 (95% CI 1.1, 1.4). Conclusions Symptomatic hMPV infection was associated with substantial burden among children in the first year of life. Timing and frequency of symptomatic hMPV incidence followed biennial patterns.
02 Jun 2022Submitted to Influenza and other respiratory viruses
02 Jun 2022Submission Checks Completed
02 Jun 2022Assigned to Editor
14 Jun 2022Editorial Decision: Revise Minor
25 Jul 20221st Revision Received
27 Jul 2022Submission Checks Completed
27 Jul 2022Assigned to Editor
30 Jul 2022Editorial Decision: Accept