HMPV Alert: Experts’ Advice About the Rising Respiratory Threat

In a recent announcement, the Health Ministry of India confirmed two cases of Human Metapneumovirus (HMPV) in Bengaluru, Karnataka has raised alarms among the public, especially with a rising number of respiratory infections. An eight-month-old who is recovering in the hospital and a three-month-old who has been discharged are the first reported cases of  HMPV in India. This has led to growing concerns as the virus has been circulating globally.  Despite the heightened awareness, health experts have reassured the public that while HMPV is contagious and flu-like, it is not a new or exceptionally dangerous virus. However, vulnerable populations, including young children, the elderly, and immunocompromised individuals, need to be particularly cautious.

What Is HMPV?

Human Metapneumovirus (HMPV), identified for the first time in 2001, is a respiratory virus that causes flu-like symptoms. It spreads primarily through direct contact, including coughing, sneezing, or touching contaminated surfaces. The symptoms of HMPV are quite similar to those of the common cold and flu, including cough, fever, sore throat, and nasal congestion. However, it can cause more severe respiratory issues in some cases, particularly in vulnerable individuals. The virus typically affects the upper and lower respiratory tracts and can lead to conditions like pneumonia or bronchiolitis. Although fatal cases are rare, the severity of illness can vary depending on a person’s health status.

Expert Advice from Healthcare Professionals

Several leading healthcare professionals have spoken out about the current scenario to provide clarity and expert advice. Dr. Sivaranjani Santosh, a Pediatrician at Magna Centres for Obesity, Diabetes, and Endocrinology at Film Nagar, Hyderabad. She has been treating HMPV patients since 2022 and provided some important insights on how the virus operates and how people should respond. Dr. Santosh emphasized that while the virus is circulating more widely at present, it is not new. She pointed out that HMPV is a regular feature of the respiratory virus landscape and has been known to cause illnesses on an annual basis.

Dr. Santosh stressed that there is no immediate cause for panic and that the virus’s presence in India should be taken in stride. However, she also pointed out the importance of vigilance, particularly in light of concerns about possible mutations. She explained, “If there are new mutations of HMPV, there is no data yet to suggest they would lead to more severe disease, but we must remain cautious.”

According to Dr. Santosh, most cases of HMPV are mild, and treatment generally involves supportive care, such as rest, hydration, and over-the-counter medications for fever and congestion. She also emphasized the need for public education on preventing the spread of respiratory viruses. “People should be educated on the importance of hygiene, avoiding close contact with sick individuals, and maintaining good respiratory hygiene, such as covering the mouth when coughing or sneezing,” she noted.

Symptoms of HMPV

HMPV manifests through several symptoms, which usually appear 3 to 6 days after exposure to the virus. The common symptoms include:

• Cough
• Fever
• Sore throat
• Nasal congestion
• Shortness of breath

While many individuals experience mild symptoms, severe illness can occur, especially in those with weakened immune systems, such as young children (under 5 years), older adults, and those with pre-existing respiratory conditions. Hospitalization may be required for those who develop severe respiratory symptoms, including wheezing and significant difficulty breathing.

Transmission of HMPV

HMPV spreads easily from person to person. The virus can be transmitted through:

• Direct contact: Shaking hands or touching surfaces contaminated with respiratory droplets from an infected individual.
• Coughing and sneezing: These actions release viral particles into the air, which can then be inhaled by nearby individuals.
• Close personal contact: Hugging, kissing, or being in close proximity to an infected person can facilitate the spread.

In environments with a high concentration of people, such as hospitals or public transport, the chances of transmission are increased. Therefore, it is crucial to follow appropriate hygiene measures and avoid contact with those showing respiratory symptoms.

Treatment and Vaccination

Currently, there is no vaccine available for HMPV. The treatment for HMPV is generally supportive and aims at alleviating symptoms. This can include:

• Fever reducers like paracetamol
• Cough suppressants
• Hydration to ease throat irritation and keep mucus thin
• Oxygen support for individuals with severe respiratory distress

Since HMPV is a viral infection, antibiotics are not effective. The focus remains on symptom management and monitoring for any escalation in respiratory symptoms. Most individuals recover within 5 to 10 days without needing extensive medical intervention. However, if symptoms worsen, it is vital to seek immediate medical care to prevent complications like pneumonia or bronchiolitis.

Differentiating Between Common Cold and HMPV

Although HMPV causes symptoms very similar to the common cold, there are important differences to note. The first infection with HMPV tends to result in more severe illness, while subsequent infections may present with milder symptoms. It’s important to recognize the following:

• Common cold: Typically causes mild symptoms such as a runny nose, mild cough, and sore throat without causing significant breathing issues.
• HMPV: May cause more intense symptoms, including fever, shortness of breath, and severe cough, particularly in vulnerable individuals.

Healthcare providers are generally able to distinguish between HMPV and common cold based on the severity of symptoms, medical history, and in some cases, laboratory tests.

Public Reassurance from Health Authorities

Despite the emergence of HMPV cases in Bengaluru, health experts are urging the public not to panic. Dr. Atul Goel, Director-General of Health Services, emphasized that while the virus is circulating, there is no cause for widespread alarm. He reiterated that HMPV is a flu-like virus and is something healthcare professionals are already familiar with. Hospitals are well-prepared for such seasonal outbreaks, and most cases can be managed without hospitalization.

Dr. Ranga Reddy Burri, the President of the Infection Control Academy of India, added that while the virus can lead to severe complications in high-risk groups, fatalities remain rare. He further explained that hospitals have the capacity to handle this type of respiratory virus, and the overall situation does not warrant undue concern.

Preventing HMPV and Respiratory Illnesses

To reduce the risk of contracting HMPV or any other respiratory virus, individuals can follow simple preventive measures:

• Hand hygiene: Wash hands frequently with soap and water for at least 20 seconds, especially after being in public places or touching potentially contaminated surfaces. If soap and water are unavailable, use an alcohol-based hand sanitizer.
• Cover your cough or sneeze: Use a tissue or the inside of your elbow to cover your mouth and nose when coughing or sneezing to prevent the spread of respiratory droplets.
• Wear a mask: Wearing a mask, especially in crowded or enclosed spaces, can significantly reduce the transmission of viruses like HMPV.
• Avoid close contact with sick individuals: If someone is showing signs of a respiratory illness, it’s best to avoid close contact with them until they recover.
• Self-isolation if symptomatic: If you feel sick, practice self-isolation to prevent infecting others, especially those in vulnerable groups.
• Vulnerable groups: Individuals with pre-existing lung conditions, older adults, and young children should be extra cautious and consult with their healthcare provider about additional preventive measures.

Vulnerable Groups and Special Precautions

While HMPV typically causes mild symptoms in healthy individuals, certain groups are at a heightened risk of developing severe illness. These include:

• Children under 5 years: Young children, especially infants, are more susceptible to respiratory infections and may require hospitalization for severe symptoms.
• Elderly individuals: Older adults, particularly those with underlying health conditions, are more likely to experience complications from respiratory viruses.
• Immunocompromised individuals: People with weakened immune systems, such as those undergoing cancer treatment or living with HIV/AIDS, are at a higher risk for severe illness from HMPV.
• People with preexisting lung conditions such as asthma or chronic obstructive pulmonary disease (COPD) should be especially cautious during an outbreak of respiratory illnesses.

The detection of two HMPV cases in Bengaluru has brought attention to the ongoing circulation of respiratory viruses worldwide. While HMPV is not new and typically causes mild symptoms, it is important for the public to stay informed about the virus, its symptoms, and prevention methods. Vulnerable individuals must take extra precautions, and everyone should adhere to basic hygiene practices to limit the spread of this and other respiratory infections. By staying vigilant and informed, we can manage the current situation effectively and minimize the impact of HMPV on public health.