Puumala Virus Infection with Acute Disseminated Encephalomyelitis and Multiorgan Failure

places in the world (2,7), two major HMPV groups exist. The severity of the episodes observed varied from mild upper respiratory symptoms to severe infections requiring hospitalization for 2–6 days. Overall, as reported by other authors (2,8), the clinical picture provoked by HMPV was indistinguishable from that of other respiratory viruses. The fact that HMPV was not detected in any of the samples from patients also positive for other respiratory viruses suggests that coinfection is infrequent. The data reported in our study, obtained during two consecutive winter seasons in a pediatric population of southern Europe, allow us to estimate that the incidence of moderate or severe respiratory infections caused by HMPV is low and that the impact of the other respiratory viruses is considerably greater. Despite these results, we think that this new respiratory pathogen warrants surveillance. HMPV appears to be capable of provoking severe infections, and its role in human respiratory infections is still poorly understood.