HMPV- What we all need to know.

By Dr. Anuja Pethe. Consultant  Pediatrician and Lifestyle Medicine Physician.

HMPV ( Human Metapneumo virus) is a much discussed topic these days. It all started when cases of HMPV started rising in Northern China in late 2024. This was seen mainly in children below 14 years and led to increased rate of hospitalization so much so that it caused a strain on the hospital capacities. This was noticed as it had a potential to have public health implications.

Gradually the cases started declining in China. Experts stressed that this was part of the seasonal rise in respiratory infections and was not a cause for alarm. We have till now more than 17 proven cases in India. Most of them are mild and self limiting. But in view of the current scenario it becomes important for us to know about this virus and follow ways to safeguard ourselves and our family.

What is HMPV?

This is a virus which was first detected in 2001 in Netherlands. It has been circulationg since decades and is similar to other viruses such as RSV. It is part of the seasonal viral infections that we typically see and is not a new virus. Then why the hullaballo about it? That is because we have started testing for it as part of the surveillance. But it is important to understand that since this is not a new virus we all have immunity against it. Most children will get this infection by the time they are 5 years old and thus the body will produce immunity against it.

How does it spread?

Like all respiratory viruses, HMPV also spreads by direct contact with a sick person or contact with contaminated surfaces. It is therefore important to avoid contact with known sick individuals and follow frequent handwashing. It becomes important that we avoid touching our face, mouth, eyes and nose with hands which haven’t been recently cleaned. Regularly sanitizing frequently handled areas such as door knobs and buttons in the lift is very important.

What are the symptoms?

HMPV usually causes mild upper respiratory symptoms in most cases. This may involve cough, cold, sore throat, sneezing, runny nose. Some may have fever, bodyache and headache. Most cases get better in 5-7 days and need only symptomatic treatment.

But some people develop a severe infection involving the lungs ( Pneumonia, bronchiolitis, bronchitis) causing severe illness. They may have breathlessness, wheezing, reduced oxygenation, severe fatigue and lethargy. Such cases need to be hospitalized and given supportive treatment.

Who are at higher risk of developing severe HMPV infection?

Extremes of ages are prone to severe infections. Very young children may be vulnerable. Children with chronic health conditions who are taking immunosuppressive medications are at higher risk of developing severe disease. Elderly and those with uncontrolled diabetes or chronic conditions of the heart, liver, kidneys are at a higher risk. Those who are taking chemotherapy or steroids or immunosuppressive treatment are also at an increased risk of severe infection. Patients with COPD (Chronic Obstructive Pulmonary Disease) and Asthma are also at increased risk of severe infections.

It is important to safeguard these populations.

How can we prevent HMPV

HMPV causes symptoms similar to all respiratory viruses and it is difficult to diagnose it only based on symptoms. The mode of transmission is similar too. Hence all routine precautions will also protect against infection with HMPV.

Wearing masks in crowded areas and poorly ventilated areas. Improving ventilation in the room by opening the windows and doors will help.

It is impotant to wash hands frequently with soap and water for 20 seconds atleast. Alcohol based sanitisers can be used only when soap and water are not available. Avoid touching face, eyes, nose and mouth without cleaning the hands first.

Follow strict cough etiquette, cough and sneeze into a tissue paper or handkerchief or the crook of the elbow when none of the above are available. This will prevent spread of respiratory droplets. It is important to dispose off the tissue paper or handkerchief properly.

Stay at home whenever you are sick. This will help you get rest and get better soon. This will also avoid transmission of infection to others.

Sanitise frequently handled areas and surfaces.

What is the treatment for HMPV

There is no specific antiviral against HMPV. Hence the treatment is symptomatic and supportive. It is important to stay well hydrated and rest. It is important to consult a doctor whenever unwell.

Supportive treatment includes medications to relieve cold and cough, medications to reduce fever and bodyache. It is very important to stay hydrated with lots of plain water and oral rehydrating solutions. Nimbu paani, rice kanji and vegetable soups are helpful too. Rest is most important too.

What are the tests to detect HMPV

A PCR test on a throat swab sample is usually performed. It is helpful to do the test only if advised by a doctor. This is because there is no specific antiviral medication and irrespective of the diagnosis, the treatment will remain the same. Doctors will choose to do the test in patients with severe disease and in whom ruling out a diagnosis is helpful in planning further treatment.

What general precautions can all of us follow to prevent HMPV and stay healthy?

Maintaining good health and immunity will help control its infection.

1. Have a nutritious diet rich in colourful vegetables and fruits. Focus on whole foods and completely avoid processed and packaged foods. This will provide antioxidants and phytonutrients which are important for a robust immunity.
2. Regular physical exercise and physical activity will help maintain a good immunity.
3. Ensure you get adequate and good quality sleep. Our body repairs and rejuvenates during sleep and a good sleep is important for optimal functioning and immunity.
4. Stress will lead to reduced immunity and increased risk of infections. Effective stress management strategies are helpful to have a calm mind and a healthy body. This includes activities such as deep breathing, meditation, mindfulness, following a hobby, creativity and activities of self care. It is important to find ways to de-stress periodically.
5. Our environment is full of chemicals which are harmful for us. We need to reduce exposure to harmful chemicals by choosing safe and eco-friendly products. Our focus should be on minimally processed whole foods thus eliminating processed foods and chemical exposure.

We also need to avoid harmful addictive substances such as smoking and tobacco, alcohol and drugs with abuse potential.

Being equipped with the correct knowledge will reduce our anxiety and panic. This will go a long way in keeping us healthy as individuals and as a society.