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New Delhi, January 06, 2025:
What is HMPV (Human Metapneumovirus)
With 71 lakh death due a single virus (COVID) infection, the scare of another lethal pandemic causes `Panic’ which is quite naturalHMPV is an RNA virus and causes illness similar to Covid with fever, sore throat, body ache, cough and breathlessness (if severe)It belongs to the group which is same as Respiratory Syncytial l virus (Pneumoviridae)
The virus, thankfully multiplies only in respiratory tract.Usually it is self-limiting as in many other viral infections. It affects more severely young children below 5 years and elderly and those who are immunocompromised
It is transmitted by droplet infection (most frequent) and also by fomites (non-living objects. The incubation period is 3-6 days. There is no effective drug therapy and no vaccine is yet available. • Diagnosis is by RTPCR . Multiplex PCR is also available. Usually it is a minor illness but can take a serious turn in young children, elderly and those who are immunocompromised
Epidemiology and Clinical features
HMPV usually occurs in winters and characteristically causes typical viral illness like influenza or mild covid in the form of fever, sore throat, running nose, cough body ache when it is confined to upper respiratory tract. However, it can cause lower respiratory tract infection in the form of pneumonia which may require hospital admission including ICU care. It can be fatal in susceptible children including in young children (less than 5 yrs of age), elderly and immunosuppressed.10% of adult patients admitted with pneumonia have HPMV when tested and 4-6 % of virus illness in children is caused by this virus. The facilities of testing are so limited that majority of times it goes unrecognized.HPMV also a common cause of exacerbation of Asthma and COPD (chronic bronchitis) requiring emergency and hospital care
Transmission and Prevention
Most common transmission is by droplet infection (air borne). However, like Covid, it can be transmitted by close contact, touch and fomites (non-living object such as chair, table door handles etc.) Therefore, the prevention is same as we did during Covid times by using mask and following hand hygiene. NO VACCINEIS AVAILABLE.
Diagnosis and Treatment
The diagnosis is by testing throat swab or other respiratory secretions by RTPCR. Multiplex PCR is also available. It grows very slowly in culture, hence not useful in clinical practice. The culture is used only in research of this virus. There is no specific antiviral therapy available. Therefore the treatment is supportive and by preventing and treating secondary infections.
According to Prof G C Khilnani, “The unconfirmed reports from China regarding serious outbreak of HMPV is naturally causing `panic’ in the world as the sad memories of Covid with 71 lakh deaths and suffering which is still fresh in our minds. Many are still suffering from aftereffects of Covid. HPMV is an RNA virus which was recognized in the year 2001 and ever since it is known as a seasonal viral illness occurring in young children and elderly in winters. However, it is potentially lethal especially in immunocompromised and elderly.RNA virus is notorious for `Mutations’ and every mutant have different characteristics of clinical illness, potential for transmission and causing lethality. Therefore, it is important to be vigilant and enhance testing by research laboratories. It is well known that aircraft travel is a big culprit for transmission of airborne diseases (as we with Covid and studies of tuberculosis),the surveillance is of paramount importance. Let us hope that China declares the real situation of this outbreak so that we may not land in to the situation of `DREADED COVID PANDEMIC’
Author: Prof G C Khilnani, Chairman, PSRI Institute of Pulmonary, Critical care and Sleep Medicine. Formerly, Professor and Head, Dept of Pulmonary, Critical care and Sleep Medicine, AIIMS,Member: Technical Advisory Group of WHO Global Air Pollution and Health
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