New HMPV Outbreak in China: Should We Be Concerned?

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Written by Talha Ibrahim

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January 5, 2025

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Infectious Diseases

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Fact Checked

What is HMPV:

Human metapneumovirus is a single-stranded RNA virus that belongs to the Pneumoviridae family. It is considered to be the subfamily of Paramyxoviridae. Humans, rodents, and cattle are the natural hosts for this virus. ⁽¹⁾

HMPV was first identified in 2001 using PCR technology. ⁽²⁾

Signs and Symptoms:

Human metapneumovirus usually causes upper respiratory tract infections but can also involve the lower respiratory tract. Its symptoms may include, i.e., ^(3,4,5)

Fever
Cough(productive if the lower respiratory tract is involved)
Runny nose
Sore throat
Dyspnea
Wheezing(in Asthma flares)

At Risk Individuals:

The following individuals are more prone to get this virus infection:^(6,7)

Children less than 5 years
More than 65 years
Immuno-compromised patients
Chronic lung diseases, i.e., post-TB lungs, COPD, and Emphysema.

HMPV can be acquired through the community or a hospital. A study conducted between 2014 and 2019 revealed that out of 471 patients, 12.3% had chronic lung disease(mostly elderly patients), and the average age of the children was 3 years and 10 months. ⁽⁸⁾

HMPV Vs COVID-19:

The symptoms of both diseases are similar, and if aggravated, both can result in similar complications.

COVID-19 vaccine has been developed, but not in the case of HMPV. China’s Foreign Ministry spokes on HMPV;

“It looks to be less severe and spreads on small scale as compared to the COVID-19”. ⁽⁹⁾

Common Complications of HMPV:

Human metapneumovirus can land into ⁽¹⁰⁾

Tracheobronchitis
Pneumonia
Pleural Effusion
Acute respiratory distress syndrome

Diagnostic Modalities:

HMPV can be diagnosed from nasopharyngeal secretions through ⁽¹¹⁾

Reverse transcriptasese PCR
Immunofluorescent antibody test(IFA)
Enzyme-linked immunosorbent assay(ELISSA)

PCR is more sensitive than the IFA or ELISSA, but IFA is more rapid.

X-ray and HRCT scans can be carried out to rule out complications of HMPV.

Treatment Options:

Once diagnosed, HMPV treatment is similar to the other syncytial viruses, influenza and COVID-19.

Its treatment is symptomatic, i.e.,⁽¹²⁾

Antipyretics for fever
Decongestants for stuffy nose
Mast-cell stabilizers to relieve cough and sneezing
Oxygen to alleviate dyspnea

Antimicrobials are not recommended until the diagnosis of superimposed bacterial infection is made.

In most cases, antimicrobials are prescribed when bacterial pneumonia-like complications occur.

Current Situation in China:

According to the latest report, 327 cases were reported in 2024, 45% more than in 2023. Beijing has also issued a safety advisory to prevent the dissemination of this disease. ⁽¹³⁾

Some cases have also been reported in Hong Kong; however, the WHO has not declared an emergency or advised imposing restrictions on China.

Preventing HMPV Spread:

Preventive measures for human metapneumovirus are the same as other syncytial viruses and COVID-19, i.e., ⁽¹⁴⁾

Wearing a face mask.
Hand sanitization and washing after handshakes or touching other objects.
Avoid gatherings
Minimize hospital visits
Avoid touching eyes, nose, or face.
Isolate yourself if you are developing symptoms of the common cold or flu.

References:

Medically Reviewed by

Dr. Talha Ibrahim

MBBS(NUMS, Pakistan), RMP

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