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In this issue of the Journal of Infectious Diseases an article by Pifferi et al. [1] and a brief report by Williams et al. [2] remind us of the impact that respiratory viruses can have on children and adults with asthma. Williams et al. report on the prevalence of human metapneumovirus (hMPV) infection in adults hospitalized for an acute asthma exacerbation. In their prospective observational study conducted over a 4-year period, hMPV was detected in nasal wash specimens from 7 (6.9%) of 101 enrolled adults at the time of hospitalization for an acute asthma exacerbation. Length of hospitalization, asthma severity score, total serum IgE level, and mean forced expiratory volume in 1 s [FEV1] values were not significantly different between the hMPV-infected and the non–hMPV-infected adults. Of the 101 subjects, 75 returned for a follow-up visit 3 months after being discharged from the hospital. None of the 7 adults who were positive for hMPV at hospitalization were positive for hMPV at their follow-up visit. One additional subject (1.3%) tested positive for hMPV at a follow-up visit; this subject had mild nasal discharge with no other symptoms. The data Williams et al. present support the concept that hMPV infection is likely a precipitator of acute asthma exacerbations in a minority of adults. In some studies but not in others, hMPV infection has also been associated with acute asthma exacerbations in children [3–5]. The diagnosis of asthma, however, is oftentimes difficult to make accurately in young children. This population is also most susceptible to hMPV infection that frequently manifests as bronchiolitis or wheezing illness. Additional long-term studies in adults and children are needed to solidify the contribution of hMPV infection to acute asthma exacerbation

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