Outbreak of Human Metapneumovirus Infection in a Psychiatric Hospital – Taipei, 2012

Hsiu Wu1、Wan-Chin Chen1、Yi-Chun Lo1、Song-En Huang1、Ting-Chia Lien2、Shih-Tse Huang1、Ming-Tsan Liu3、Shu-Ying Li3

2013 Vol.29 NO.4

Correspondence Author: Hsiu Wu

  • 1. Office of Preventive Medicine, Centers for Disease Control, Taiwan
  • 2. First Branch, Centers for Disease Control, Taiwan
  • 3. Research and Diagnostic Center, Centers for Disease Control, Taiwan


       On April 10, 2012, Taipei City Health Department notified the Centers for Disease Control of a cluster of inpatients with fever and upper respiratory illness in two wards of a psychiatric hospital in Taipei. We aimed to investigate the causative agent and associated factors. We conducted a retrospective cohort study by reviewing medical records of all inpatients hospitalized in the two affected wards during April 2−17. A standardized case report form was used to collect patient demographics, medication, underlying diseases, history of cigarette smoking, attendance of group occupational therapy and clinical presentations. A case was defined as onset of cough, rhinorrhea, or sore throat three or more days after admission in a patient hospitalized between March 26 and April 25. Throat swab specimens tested by multiplex real-time RT-PCR/PCR. This outbreak extent included two wards where shared no common working staff but sessions of group occupational therapy. Twenty-four patients had conditions fulfilled the case definition. The most common symptoms were cough (n = 23; 96%), fever (n = 18; 75%), sore throat (n = 13, 54%), and rhinorrhea (n = 15; 63%). In multivariable analysis, factors associated with respiratory illnesses were diabetic mellitus (relative risk [RR], 2.6; 95% CI, 1.5−4.6), smoking (RR, 2.2; 95% CI, 1.3−4.6) and resident of ward A (RR, 2.3; 95% CI, 1.1−4.7). Six of 10 throat swab specimens from 10 case patients were positive for human metapneumovirus. Human metapneumovirus caused this upper respiratory illness outbreak. Diabetic mellitus and cigarette smoking are two associated factors. The group occupational therapy is speculated where disease transmission from one ward to the other happened.