New Delhi: Come winters, come viruses. Although, respiratory illnesses caused by virus is not a new phenomena for the season, or for huge populations, it is the timing of the HMPV (better known as the Human Metapneumovirus) that has got the world on its toes. Just five years have passed since we were taken by a surprise with the COVID-19 variants that caused widespread damage globally, resulting in the death of over 7 million people, and having impacted over 700 million worldwide. The ‘Worldometer’ dashboard that was tracking COVID cases until April 2024 and stopped later due to unfeasibility of data gathering, had reported 22 lakh active cases of the virus globally in 2024. While India has recorded no new active cases till December 2024, epidemiologists have not ruled out the possibility of a mutation comeback anytime.
So, when Chinese citizens sounded an alarm over the present HMPV situation in the country, one is naturally worried. The HMPV has many similar attributes to the COVID variants but is known to be milder of the two. At least, there is some research on the metapneumovirus which dates back to 2001 that scientists are relying heavily on. It is also widely known that the HMPV is a common respiratory virus that almost every one is exposed to before the age of five.
What is HMPV
A typical winter virus belonging to the Pneumoviridae family, the HMPV was first discovered in 2001. The virus is closely related to the Respiratory Syncytial Virus (RSV) and is known to cause upper respiratory symptoms such as cough, runny nose, and sore throat. However, the outcomes resemble that of a common-flu and are very seldom considered to be virulent. “The HMPV that we have studied is particularly mild. It may impact children below 14 years of age a little differently, and so is the case with older people. But the death rate is not alarming. If the virus has not mutated to something disastrous like the Covid variants, there should be no reason to panic,” says infectious disease expert, Dr Ishwar Gilada.
Gilada added that in weakened immune systems, the HMPV may in a worst-case scenario lead to complications, including pneumonia, bronchitis, and exacerbation of chronic respiratory diseases like asthma or COPD.
As with any virus, there is an incubation period for the HMPV as well, which lasts from 3 to 6 days. It is in this period that the symptoms may progress from being mild flu-like conditions to becoming a serious respiratory distress.
It is not the first time that the virus has cause the Chinese healthcare agencies some nerves. It has been around and has existed along side Covid-19. A study in the ‘Virology Journal’ identified a surge had occurred in HMPV infections in regions of Henan, China. This had happened way back in April and June 2023, when HMPV cases were making hospitals busy.
However, whether this resulted in a steep mortality among patients is unknown.
Is human metapneumovirus a common occurrence?
Researchers estimate that about 10-12 per cent of all respiratory illnesses in children are caused by the HMPV and most of these cases are mild. However, it has been noted by the Cleveland Clinic, that about 5-16 per cent of the children may develop a lower respiratory tract infection, including the pneumonia.
Most people get exposed to the metapneumovirus before they turn 5 but it is possible to get it again. The symptoms, however, are known to get better with time and usually milder after the first time one get the infection.
“According to a Harvard research, a human body is exposed to more than a thousand strains of virus, from about 200 virus families in a typical year. There’s a strong possibility that some of us have even had the metapneumovirus growing up. This will only make the symptoms milder if we get attacked by the same virus (without much change in its mutation that is),” adds Gilada.
What are the symptoms of HMPV
As discussed prior, the symptoms of the virus is similar to a common cold. It presents itself as a simple cough and sore throat and can progress into a lower respiratory problem. One must contact a general physician if the cold lasts for more than a week and is accompanied by severe shortness of breath and/or high fever.
Common symptoms of the human metapneumovirus may include the following:
Cough, mostly dry but can become coarser with time
A fever that is not a cause for concern (typically stays within the low grade level)
Runny or stuffy nose
Sore throat may occur in some cases
Wheezing and shortness of breath (dyspnea) is noticed in patients who are already suffering from respiratory diseases or have a weakened immunity
Rashes and cold cut may also present itself.
Gilada informs that most of the times, these symptoms go away on their own but only in a few cases, it may progress into a major complication requiring hospitalisation and artificial oxygen supply.
What are the complications that may arise?
In rarest of rare cases, sometimes the HMPV can cause complications. The situations include:
Bronchiolitis, a severe viral infection which causes inflammation in the small airways of the lungs, making it difficult for patients (especially seen in children) to breathe
Bronchitis, classified under a lung condition that can end up causing inflammation in the bronchi, the main air passages in the lungs
Pneumonia
Asthma or COPD flare-ups
Ear infection (otitis media), an inflammation or infection in the middle ear.
It is only if the virus progresses to such a stage that the patient needs care. Even then fatality is not a major concern regarding the HMPV virus.
Who are ‘risk groups’ for the HMPV?
Severe risk category for all respiratory viruses remains the same. Patients with compromised immunity will always be in the danger/red zone for any and all viruses that are known to attack the respiratory systems. Even for the HMPV, the risk groups are known to be similar:
Those who are younger than 5 years
Premature infants
Pregnant women
Women who are on IVF
Women who have had ectopic pregnancies prior
People who are older than 65 years
Those who are immunocompromised from conditions like HIV, cancer or autoimmune disorders
People who are on medications that are known to suppress the immune system
Asthma or COPD patients may have severe outcomes of the HMPV if they do not take care of the infection in its early stages.
Is it similar to COVID-19?
While both can cause respiratory duress, the HMPV and SARS-CoV-2 belong to different viral families. The similarity that they may share is only in terms of virulence, fatality and occurrence.
Both the viruses are known to target respiratory system
Both HMPV and Covid cause mild to severe infections depending on a person’s immune response
Both of these viruses spread via respiratory droplets and contact with contaminated surfaces
Fever, cough, sore throat, wheezing, and shortness of breath are common symptoms for both
So are the vulnerable groups, which comprise of children, elderly, and immunocompromised individuals.
The only big differences between the two can be seen in the treatments available for the cure of the two. While there is a vaccine available for the prevention of a severe outcome of COVID-19, there is none at present for HMPV. So is the case for antiviral treatments that have been found in abundance to treat the symptoms of COVID but are in limited supply for HMPV.
Is HMPV the same as RSV?
No, it is not the same as respiratory syncytial virus although both HMPV and RSV are a part of the same genus (scientific grouping) called Pneumovirus. They both can result in similar symptoms but the difference lies in the fact that the peak age for severe illness from HMPV is between 6 and 12 months, whereas the RSV is more likely to cause severe illness in infants younger than 6 months.
What causes HMPV and how does it spread?
Two Dutch scientists discovered the HMPV virus in 2001. It is described by them as a small germ that uses the cells to make more copies of itself. It’s part of the same group of viruses that cause RSV, measles and mumps. It is also considered to be extremely transmissible, which is what makes the virus more deadly. It can be transmitted from human to human via:
Coughing and sneezing.
Shaking hands, hugging or kissing.
Touching surfaces or objects like phones, door handles, keyboards or toys.
Is there a treatment for the same? Can we use antibiotics?
Dr Gilada warns that there are NO antiviral medications that treat human metapneumovirus. The only way people can recuperate is by managing the symptoms at home. Although, it is best to avoid home remedies to treat the virus at an early stage.
Have proper rest and treat your fever at home
Look at ways to comfort your nose and throat if they are not severely impacted
Gargling and taking steam takes the dryness away from the throat.
If your condition gets worse, visit a hospital
Your healthcare provider may put you up for oxygen therapy, give you extra oxygen through a tube in your nose or mask on your face
IV fluids, or fluids delivered directly to your vein (IV) can keep you keep hydrated
In some extreme cases, medical experts may give you corticosteroids, or steroids that will reduce inflammation and might ease some of your symptoms.
As for the antibiotics question, Dr Gilada says a strict No. Antibiotics only treat bacteria. Since HMPV is a virus, antibiotics won’t get rid of it. However, it is not new that when a person gets pneumonia from HMPV, they also get a bacterial infection at the same time which is a secondary infection. Your doctor may prescribe antibiotics, only to treat any secondary infections and not for HMPV.
Should India be worried?
Paediatricians in the Capital are keeping a tab on the news that is coming from China. Because this is a respiratory disease which can cause severest outcomes in children below 5 years, doctors say they are monitoring the case very acutely. Dr Ravi Gupta, head of paediatrics at Apollo Noida and Dr Deepa Passi in the same hospital believe there is no cause for panic. “This is a known virus which has been around for over 20 years and we have seen it doing the round during winter season and presents itself like the influenza virus or a common viral fever,” says Dr Gupta.
His colleague nods, according to Dr Passi, “The HMPV is not new in India either. It has been observed multiple times, especially during winters and the cases we have seen here have been mild. The strain of this virus found in India is generally not virulent and possess symptoms of mild viral fever.”
The ICMR, meanwhile, has announced an expansion in the number of laboratories for testing of the HMPV. They are well equipped to monitor trends throughout the year. The Indian health ministry has also held multiple press conferences to reassure the public that India is well prepared to manage a situation arising from the HMPV.
There is nothing in the present situation that warrants panic. The Centre has already deployed measures to monitor and manage respiratory illnesses effectively.
News9live’s ready reckoner on the HMPV is here: China, currently is overwhelmed with cases of the Human Metapneumovirus (HMPV) that causes a typical respiratory illness with flu-like symptoms. It is dangerously similar to the Covid variants that we have experienced not so long ago. Indian health experts have, however, allayed our fears on the fatality and virulence of this type of an rNA virus. They say, there’s no reason for us in India to panic as of now because the HMPV is well-known and typically mild. Health News Health News: Latest News from Health Care, Mental Health, Weight Loss, Disease, Nutrition, Healthcare
