A Complete Guide To HMPV

In recent years, global healthcare has been grappling with various respiratory illnesses, but one virus that has quietly emerged as a significant concern is the Human Metapneumovirus (HMPV). Although it might not make headlines like COVID-19, the HMPV virus is gaining attention for its growing role in respiratory infections. As we witness an HMPV outbreak affecting more communities and health experts are taking notice, it’s important to understand what this virus is all about. 

The objective of this blog is to provide a complete guide to HMPV, including its symptoms, how it spreads, and the most effective prevention strategies to protect ourselves and our loved ones. Stay with us as we explore how this lesser-known virus is making its mark on public health.
 

What is HMPV?
 

HMPV (Human Metapneumovirus) is a respiratory virus that has gained increasing attention in recent years. Despite being in the same family as well-known viruses such as parainfluenza and respiratory syncytial virus (RSV), HMPV often flies under the radar in public health discussions. However, its ability to cause respiratory infections, particularly in vulnerable populations, makes it an important virus to understand.

Here’s what you need to know about HMPV:
 

• Family: Belongs to the Paramyxoviridae family, alongside RSV and parainfluenza viruses.
• First identified: Discovered in 2001, it has since emerged as a key cause of respiratory infections.
• Target group: Primarily affects young children, the elderly, and individuals with weakened immune systems.
• Symptoms: Ranges from mild cold-like symptoms (fever, cough, runny nose) to more severe conditions like pneumonia and bronchiolitis.
• Transmission: Spread through respiratory droplets, similar to the flu or common cold.
• Public health Impact: While it often gets overshadowed by more widely discussed viruses, HMPV is a significant contributor to seasonal respiratory illnesses and hospitalisations.
   

What are the symptoms of HMPV?
 

HMPV can cause a variety of respiratory symptoms, which can range in severity. Some of the common symptoms include:
 

• Coughing: This is often persistent and may produce mucus.
• Fever: A high fever may accompany the infection, signalling the body's immune response.
• Shortness of Breath: Breathing difficulties or wheezing are frequently reported, particularly in severe cases.
• Sore Throat: This symptom can lead to difficulty swallowing and irritation.
• Runny Nose: Congestion and a runny nose are common early symptoms of infection.
• Fatigue: As with most viral infections, HMPV can lead to extreme tiredness and a general sense of malaise.
   

In more severe cases, particularly among vulnerable groups like infants and older adults, HMPV symptoms are bronchiolitis or pneumonia, leading to significant respiratory distress.
 

How is HMPV Transmitted?
 

Like many respiratory viruses, HMPV mainly spreads through droplets when an infected person sneezes, coughs, or talks. It can also be spread through direct contact with contaminated surfaces or through close contact with an infected person. 

Also, people can become infected by touching their face after handling contaminated objects, such as doorknobs or cell phones.

HMPV has a seasonal pattern, with increased incidences during the fall and winter months, when people tend to gather indoors, increasing the likelihood of transmission. 

Because of its similarity to other common respiratory viruses, it can be difficult to differentiate based on symptoms alone, which highlights the need for accurate diagnostic testing.

Dr Sangeeta V Budur, Consultant - Paediatrics and Paediatric Intensive Care at Aster RV Hospital, said, “It is known to cause a range of illnesses from mild upper respiratory infections to severe pneumonia, bronchiolitis and acute respiratory distress syndrome. About 5 to 25% of the acute pediatric lower respiratory tract infections are associated with HMPV. The viral outbreaks peak in winter and spring season in the northern hemisphere and June and July in the southern hemisphere.”
 

How to Prevent HMPV?
 

HMPV prevention involves simple steps that can significantly reduce the spread of respiratory viruses. While there is no specific HMPV vaccine available yet, researchers are actively exploring options. In the meantime, here are some strategies to prevent HMPV:
 

How to diagnose HMPV?
 

Diagnosing HMPV is primarily based on clinical symptoms and laboratory testing. Due to the similarities in signs & symptoms with other respiratory infections, healthcare providers may recommend:
 

• PCR (Polymerase Chain Reaction) testing: This test is generally used to detect the genetic material of the virus from respiratory samples.
• Antigen testing: A rapid diagnostic test that can detect viral proteins and offer quicker results, though it may be less sensitive than PCR.
• Chest X-ray: For severe cases where pneumonia or other complications are suspected, a chest X-ray may be performed to assess lung health.
   

What is the treatment for HMPV?
 

Currently, there is no specific antiviral HMPV treatment. The management of the infection focuses on symptomatic relief:

• Rest: Adequate rest allows the body to fight off the infection.
• Hydration: Drinking plenty of fluids helps thin mucus and keeps the body hydrated.
• Over-the-counter medications: Medications like acetaminophen or ibuprofen can help alleviate fever and discomfort. Always follow your healthcare provider’s guidance regarding dosage and safety.
• Inhalers or nebulisers: For patients with significant breathing difficulties, bronchodilators may be prescribed to open airways.
   

Does HMPV threaten a COVID-19 return?
 

As the world continues to recover from the COVID-19 pandemic, many are wondering whether HMPV could play a role in a resurgence of respiratory illnesses. While HMPV is a concerning virus, it does not seem to pose the same level of threat as COVID-19, which was caused by a novel virus with the ability to spread rapidly across populations.
 

• However, co-circulation of HMPV and COVID-19 may lead to a higher burden on healthcare systems, especially during peak viral seasons.
• Both viruses primarily affect the respiratory system, and co-infection with both could lead to more severe symptoms.
• This makes it important to continue monitoring HMPV alongside COVID-19 and other respiratory viruses.
• Moreover, the precautions we have taken for COVID-19, such as wearing masks and practising good hygiene, may also help limit the spread of HMPV, reducing its overall impact.
   

Frequently Asked Questions
 

1. What are the HMPV symptoms in infants under 6 months?

Infants under 6 months with HMPV may experience symptoms such as a cough, fever, and runny nose. In more severe cases, they can show signs of HMPV shortness of breath in children, including rapid breathing and difficulty breathing.
 

2. What are the HMPV home remedies for babies?

For babies with HMPV, ensure they stay hydrated and rest well. Using a humidifier can help ease breathing, and saline nasal drops may relieve congestion. Always consult a healthcare professional before trying any remedies.
 

3. How to treat HMPV in babies? 

To treat HMPV in babies, ensure they stay hydrated, monitor their breathing, and provide fever relief as recommended by a healthcare professional for high-risk infants, discuss the possibility of HMPV vaccination for high-risk infants with a doctor to help prevent severe infections.
 

4. Is HMPV contagious?

Yes, HMPV infection is highly contagious and spreads through respiratory droplets from coughing or sneezing. It can lead to HMPV complications such as pneumonia or bronchiolitis, especially in vulnerable individuals. If symptoms persist, an HMPV test can help confirm the infection.
 

5. How long does HMPV last for?

HMPV typically lasts for about 1 to 2 weeks, with symptoms gradually improving. However, in some cases, especially in young children or the elderly, recovery may take longer if complications arise.
 

6. Why are children more infected by HMPV?

Children, especially infants and young toddlers, are more susceptible to HMPV in children because their immune systems are still developing, and they have smaller airways, making them more prone to respiratory infections. This increases their risk of severe symptoms and complications.
 

7. Is HMPV worse than RSV?

HMPV vs RSV can both cause similar respiratory symptoms, but HMPV is generally less well-known and may lead to less severe cases compared to RSV. However, both viruses can cause serious complications, especially in vulnerable groups like infants and the elderly.
 

8. Is HMPV curable?

There is no specific cure for HMPV, but most cases are resolved with supportive care, such as hydration and fever management. In severe cases, medical treatment may be required to address complications, especially in high-risk individuals.
 

9. Is HMPV a serious disease?

HMPV can be serious, mainly for vulnerable groups like infants, the elderly, and people with weakened immune systems. While many cases are mild, they can cause severe respiratory infections like pneumonia or bronchiolitis in high-risk people.
 

10. How many cases of HMPV in India?

As of 9 January 2025, 11 cases of HMPV have been reported in India. Of the 11 reported cases so far, two were from Bengaluru, one from Gujarat, two from Chennai, and three from Kolkata. Additionally, two cases were reported in Nagpur and one in Mumbai, all testing positive for HMPV.
 

Wrapping up
 

HMPV has recently gained significant attention due to its growing impact, particularly on vulnerable groups. Understanding its symptoms, transmission, and prevention methods is key to reducing its spread. As respiratory infections continue to affect communities, it's more important than ever to practice good hygiene and seek medical advice when needed. By staying informed and taking proactive steps, we can protect ourselves and others from the risks of HMPV and other respiratory viruses.

Stay vigilant, stay safe, and take action to safeguard your health!
 

References
 

1. Uddin S, Thomas M. Human Metapneumovirus. 2023 Jul 17. https://pubmed.ncbi.nlm.nih.gov/32809745/

2. Haas LE, Thijsen SF, van Elden L, Heemstra KA. Human metapneumovirus in adults. Viruses. 2013 Jan 8;5(1):87-110. https://pmc.ncbi.nlm.nih.gov/articles/PMC3564111/

3. Døllner H, Risnes K, Radtke A, Nordbø SA. Outbreak of human metapneumovirus infection in Norwegian children. https://pubmed.ncbi.nlm.nih.gov/15131467/

4. https://www.cdc.gov/human-metapneumovirus/about/index.html