印度人偏肺病毒（HMPV）流行病学：一项横断面研究

IF 6.2 Q1 HEALTH CARE SCIENCES & SERVICES

The Lancet regional health. Southeast Asia Pub Date : 2025-09-17 DOI:10.1016/j.lansea.2025.100667

Rizwan Suliankatchi Abdulkader , Neetu Vijay , Varsha Potdar , Joshua Chadwick , Jitendra Narayan , Sabarinathan Ramasamy , Devika Shanmugasundaram , Selvavinayagam Thirumalaicheri Sivaprakasam , Manoj Murhekar , Nivedita Gupta

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引用次数: 0

摘要

印度卫生和家庭福利部卫生研究司于2014年建立了病毒研究和诊断实验室网络（VRDLN），以加强病毒诊断能力并提供常规病毒学监测系统。2022年，我们还启动了泰米尔纳德邦流感综合监测模式（MIST），以加强对选定哨点三级保健医院严重急性呼吸道感染（SARI）病例的病毒学和临床特征的监测。本研究通过分析来自这些不同但相关的监测系统的数据，调查了印度人偏肺病毒（HMPV）的流行病学。方法分析2019 - 2024年VRDLN数据，根据时间、地点和个人特征对HMPV病例进行描述。我们提出了2019年至2023年和2024年两个时期的比较，将历史趋势与当前情景进行比较。我们还检查了2022年至2024年在MIST项目下收集的hmpv阳性SARI病例的详细临床和实验室资料（一个病例系列）。VRDLN下的医院对任何医生转诊的患者进行检测，而MIST只对符合标准化病例定义的严重急性呼吸道感染患者进行检测。VRDLN提供了检测和阳性趋势的总体情况，而MIST提供了实验室参数、阳性病例的临床过程和结果的详细信息。所有实验室都遵守有质量保证的标准化检测方案，并向中央数据库报告数据。在2019年至2023年期间，VRDLN检测了20,625例HMPV患者，其中1030例（3.2%）呈阳性。2024年，11,155例患者接受了检测，其中367例（3.3%）确诊为阳性。在这两个时期，年龄分层分析表明，大多数测试是在儿童中进行的。1-2岁年龄组阳性率最高，2019-2023年阳性率为4.5%(128/2864)，2024年阳性率为4.6%（70/1508）。大多数hmpv阳性病例表现为急性呼吸道感染(ARI)/流感样疾病（ILI）， 2019-2023年占病例的85.4%[566/17,090]，2024年占40.3%[148/1697]，因为大多数检测是在这些患者中进行的。发烧和咳嗽是最常见的症状，2019 - 2023年和2024年分别占70.3%和79.6%(292/8398)，分别占60.5%（401/ 12059）和60.8%（223/5977）。在MIST项目下，我们在2022年至2023年间检测了3599名SARI患者，确定了28例（0.8%）hmpv阳性病例。患者病程中位数为11天（四分位数差[IQR]: 7.5-14.5），住院时间中位数为7天（IQR: 5-9.5）。8例需要重症监护，中位数为3.5天（IQR: 2.5-6）， 12例需要氧气支持，中位数为3天（IQR: 3-5.5）。28例患者出院时临床好转25例（89.3例），1个月随访时健康22例（84.6例）。截至2025年4月，12例患者保持健康，1例出现复发性肺部并发症，6例失去随访。2024年检测的增加和更高的阳性率凸显了印度越来越多的人认识到HMPV是一种重要的呼吸道病原体。然而，我们注意到HMPV的流行病学特征最近没有变化。加强监测网络对于了解这种新出现的病毒性病原体的负担和指导公共卫生政策仍然至关重要。尽管在我们的监测人群中检测到HMPV表明与疾病有潜在关联，但不应将其视为因果关系的明确证据。此外，住院时间应该在潜在的未测量的合并感染和合并症的背景下解释，而不是仅仅归因于HMPV感染。资助：由印度政府卫生和家庭福利部卫生研究司资助。

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Epidemiology of Human Metapneumovirus (HMPV) in India: a cross-sectional study

Background

The Department of Health Research, Ministry of Health and Family Welfare, India, established the Virus Research and Diagnostic Laboratory Network (VRDLN) in 2014 to strengthen viral diagnostic capabilities and provide a system for routine virological surveillance. In 2022, we also initiated the Model for Integrated Influenza Surveillance in Tamil Nadu (MIST) to enhance surveillance of virologic and clinical characteristics of severe acute respiratory infections (SARI) cases in selected sentinel tertiary care hospitals. This study investigates the epidemiology of Human Metapneumovirus (HMPV) in India by analysing data from these distinct but related surveillance systems.

Methods

We analysed VRDLN data from 2019 to 2024 to describe HMPV cases based on time, place, and personal characteristics. We presented a comparison of two periods—2019 to 2023 and 2024—to compare historical trends with the current scenario. We also examined detailed clinical and laboratory profiles of HMPV-positive SARI cases collected under the MIST project from 2022 to 2024 (a case series). Hospitals under the VRDLN conducted testing of any physician-referred patient, while MIST exclusively tested SARI patients who met a standardised case definition. While the VRDLN provided an overall picture of the testing and positivity trends, MIST provided details on laboratory parameters, and clinical course and outcomes of positive cases. All laboratories adhered to standardised quality-assured testing protocols and reported data to a centralized database.

Findings

Between 2019 and 2023, the VRDLN tested 20,625 patients for HMPV, of whom 1030 (3.2%) were positive. In 2024, 11,155 patients were tested, with 367 (3.3%) confirmed positive. Across both periods, age-stratified analysis indicated that the majority of tests were conducted among children. The highest positivity was observed in those aged 1–2 years, with 4.5% (128/2864) testing positive in 2019–2023 and 4.6% (70/1508) in 2024. Most HMPV-positive cases presented with Acute Respiratory Infection (ARI)/Influenza-like illness (ILI), accounting for 85.4% [566/17,090] of cases in 2019–2023 and 40.3% [148/1697] in 2024, as most testing was carried out among these patients. Fever and cough were the most common symptoms, reported in 70.3% of cases from 2019 to 2023 and 79.6% (292/8398) in 2024, and in 60.5% (401/12,059) and 60.8% (223/5977) of cases, respectively. Under the MIST project, we tested 3599 SARI patients between 2022 and 2023, identifying 28 (0.8%) HMPV-positive cases. Patients experienced a median illness duration of 11 days (interquartile range [IQR]: 7.5–14.5) and stayed in the hospital for a median of 7 days (IQR: 5–9.5). Eight cases required intensive care for a median of 3.5 days (IQR: 2.5–6), while 12 cases needed oxygen support for a median of three days (IQR: 3–5.5). Among the 28 cases, 25 (89.3) showed clinical improvement at discharge, and 22 (84.6) were healthy at a one-month follow-up. As of April 2025, 12 patients remained healthy, one experienced recurrent lung complications, and six were lost to follow-up.

Interpretation

The increased testing and higher positivity rates in 2024 highlight the growing recognition of HMPV as a significant respiratory pathogen in India. However, we noted no recent change in the epidemiological features of HMPV. Strengthening surveillance networks remains critical to understanding the burden of such emerging viral pathogens and guiding public health policies. Although HMPV detection in our surveillance population indicates a potential association with illness, it should not be regarded as definitive evidence of causation. Moreover, hospitalisation duration should be interpreted in the context of potential unmeasured co-infections and comorbidities, rather than being solely attributed to HMPV infection.

Funding

Funded by the Department of Health Research, Ministry of Health and Family Welfare, Government of India.

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来源期刊

The Lancet regional health. Southeast Asia

CiteScore

2.20

自引率

0.00%

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