Recent outbreaks of Human Metapneumovirus (HMPV): Prevention, Diagnosis and Therapeutic insights
Abstract
The present review aims to discuss comprehensively about the Human Metapneumovirus (HMPV) which is a respiratory pathogen belonging to the family Paramyxoviridae. Since December 2024, northern China has seen a significant rise of respiratory diseases, including HMPV, particularly among youngsters. The Chinese Center for Disease Control and Prevention stated that HMPV was responsible for 6.2% of positive respiratory disease tests and 5.4% of hospitalizations during this time. Similar increases in HMPV cases have been seen in Malaysia, Kazakhstan, India, and Italy. India verified the first instances in early January 2025, including infections in newborns. Human Metapneumovirus initially identified in 2001 in the Netherlands, HMPV is now recognized as a global cause of respiratory infections, particularly among vulnerable populations such as young children, the elderly, and immunocompromised individuals. Its potential to cause widespread outbreaks has raised concerns about its pandemic potential. Polymerase Chain Reaction (PCR) testing is considered as the most sensitive and specific approach for identifying HMPV. It entails amplifying viral RNA from respiratory specimens (such as throat swabs, nasopharyngeal swabs, and sputum samples). There are currently no licensed antiviral medications for HMPV. However, some supportive therapy may be proved as beneficial in the HMPV infections. Among these, supplemental oxygen therapy, anti-pyretics (Acetaminophen or Paracetamol), Beta-2 agonists (Albuterol etc.), corticosteroids (Prednisolone etc.), Ribavirin (its efficacy against HMPV is not well documented), hydration therapy and antibiotics are included.
Keywords: Human Metapneumovirus, Paramyxoviridae, respiratory pathogen, Polymerase Chain Reaction, oxygen therapy, corticosteroids,
Keywords:
Human Metapneumovirus, Paramyxoviridae, respiratory pathogen, Polymerase Chain Reaction, oxygen therapy, corticosteroidsDOI
https://doi.org/10.22270/jddt.v15i2.7000References
1. Shafagati N, Williams J. Human metapneumovirus-what we know now. F1000Research. 2018; 7. https://doi.org/10.12688/f1000research.12625.1 PMid:29744035 PMCid:PMC5795268
2. Van den Hoogen B. Human Metapneumovirus: Discovery, Characterization and Associated Disease.
3. Jeong S, Park MJ, Song W, Kim HS. Advances in laboratory assays for detecting human metapneumovirus. Annals of Translational Medicine. 2020 May; 8(9). https://doi.org/10.21037/atm.2019.12.42 PMid:32566634 PMCid:PMC7290561
4. Panda S, Mohakud NK, Pena L, Kumar S. Human metapneumovirus: review of an important respiratory pathogen. International journal of infectious diseases. 2014 Aug 1; 25: 45-52. https://doi.org/10.1016/j.ijid.2014.03.1394 PMid:24841931 PMCid:PMC7110553
5. Davis CR, Stockmann C, Pavia AT, Byington CL, Blaschke AJ, Hersh AL, Thorell EA, Korgenski K, Daly J, Ampofo K. Incidence, morbidity, and costs of human metapneumovirus infection in hospitalized children. Journal of the Pediatric Infectious Diseases Society. 2016 Sep 1; 5(3):303-311. https://doi.org/10.1093/jpids/piv027 PMid:26407261 PMCid:PMC5125451
6. Crowe JE, Williams JV. Paramyxoviruses: respiratory syncytial virus and human metapneumovirus. Viral Infections of Humans: Epidemiology and Control. 2014:601-627. https://doi.org/10.1007/978-1-4899-7448-8_26 PMCid:PMC7121911
7. Xie Z, Zhu Z, Xu J, Mao N, Cui A, Wang W, Wang Y, Zhang Z, Xia B, Wang H, Sun Z. Seasonal and Genetic Characteristics of Human Metapneumovirus Circulating-Henan Province, China, 2017-2023. China CDC Weekly. 2024 May 5; 6(20):450. https://doi.org/10.46234/ccdcw2024.087 PMid:38846360 PMCid:PMC11150164
8. Robinson CC. Respiratory viruses. Clinical virology manual. 2009 Jun 5:201-248. https://doi.org/10.1128/9781555815974.ch17 PMid:19419406 PMCid:PMC6932397
9. Bossart KN, Broder CC. Paramyxovirus entry. Viral Entry into Host Cells. 2009.
10. Boivin G, Abed Y, Pelletier G, Ruel L, Moisan D, Cote S, Peret TC, Erdman DD, Anderson LJ. Virological features and clinical manifestations associated with human metapneumovirus: a new paramyxovirus responsible for acute respiratory-tract infections in all age groups. The Journal of infectious diseases. 2002 Nov 1;186(9):1330-1334. https://doi.org/10.1086/344319 PMid:12402203
11. Papenburg J, Boivin G. The distinguishing features of human metapneumovirus and respiratory syncytial virus. Reviews in medical virology. 2010 Jul;20(4):245-260. https://doi.org/10.1002/rmv.651 PMid:20586081
12. Jayaweera JA, Noordeen F, Kothalaweala S, Pitchai FN, Rayes ML. A case series on common cold to severe bronchiolitis and pneumonia in children following human metapneumovirus infection in Sri Lanka. BMC Research Notes. 2018 Dec; 11:1-5. https://doi.org/10.1186/s13104-018-3239-3 PMid:29444701 PMCid:PMC5813322
13. Walsh EE, Peterson DR, Falsey AR. Human metapneumovirus infections in adults: another piece of the puzzle. Archives of internal medicine. 2008 Dec 8;168(22):2489-2496. https://doi.org/10.1001/archinte.168.22.2489 PMid:19064834 PMCid:PMC2783624
14. Wilkesmann A, Schildgen O, Eis-Hübinger AM, Geikowski T, Glatzel T, Lentze MJ, Bode U, Simon A. Human metapneumovirus infections cause similar symptoms and clinical severity as respiratory syncytial virus infections. European journal of pediatrics. 2006 Jul; 165:467-475. https://doi.org/10.1007/s00431-006-0105-4 PMid:16607540
15. El Sayed Zaki M, Raafat D, El‐Metaal AA, Ismail M. Study of human metapneumovirus‐associated lower respiratory tract infections in Egyptian adults. Microbiology and immunology. 2009 Nov; 53(11):603-608. https://doi.org/10.1111/j.1348-0421.2009.00162.x PMid:19903260
16. Crowe Jr JE. Human metapneumovirus as a major cause of human respiratory tract disease. The Pediatric infectious disease journal. 2004 Nov 1;23(11):S215-S221. https://doi.org/10.1097/01.inf.0000144668.81573.6d PMid:15577576
17. Costa-Filho RC, Saddy F, Costa JL, Tavares LR, Castro Faria Neto HC. The Silent Threat of Human Metapneumovirus: Clinical Challenges and Diagnostic Insights from a Severe Pneumonia Case. Microorganisms. 2025 Jan 2; 13(1):73. https://doi.org/10.3390/microorganisms13010073 PMid:39858840 PMCid:PMC11767637
18. Arruda E, Cintra OA, Hayden FG. Respiratory tract viral infections. Tropical Infectious Diseases. 2006:637. https://doi.org/10.1016/B978-0-443-06668-9.50064-8 PMCid:PMC7152450
19. Proença-Modena JL, Acrani GO, Snider CB, Arruda E. Respiratory viral infections. Tropical Infectious Diseases: Principles, Pathogens and Practice. 2011:378. https://doi.org/10.1016/B978-0-7020-3935-5.00058-6 PMCid:PMC7149827
20. Haas LE, Thijsen SF, Van Elden L, Heemstra KA. Human metapneumovirus in adults. Viruses. 2013 Jan 8;5(1):87-110. https://doi.org/10.3390/v5010087 PMid:23299785 PMCid:PMC3564111
21. Esposito S, Mastrolia MV. Metapneumovirus infections and respiratory complications. InSeminars in respiratory and critical care medicine 2016; 37)4):512-521). Thieme Medical Publishers. https://doi.org/10.1055/s-0036-1584800 PMid:27486733 PMCid:PMC7171707
22. Rudd PA, Thomas BJ, Zaid A, MacDonald M, Kan-o K, Rolph MS, Soorneedi AR, Bardin PG, Mahalingam S. Role of human metapneumovirus and respiratory syncytial virus in asthma exacerbations: where are we now?. Clinical Science. 2017 Jun 30; 131(14):1713-1721. https://doi.org/10.1042/CS20160011 PMid:28667069
23. Ditt V, Lüsebrink J, Tillmann RL, Schildgen V, Schildgen O. Respiratory infections by HMPV and RSV are clinically indistinguishable but induce different host response in aged individuals. PloS one. 2011 Jan 26; 6(1):e16314. https://doi.org/10.1371/journal.pone.0016314 PMid:21298115 PMCid:PMC3027670
24. Alter SJ, Bennett JS, Koranyi K, Kreppel A, Simon R. Common childhood viral infections. Current problems in pediatric and adolescent health care. 2015 Feb 1; 45(2):21-53. https://doi.org/10.1016/j.cppeds.2014.12.001 PMid:25703483
25. Bhattacharya S, Agarwal S, Shrimali NM, Guchhait P. Interplay between hypoxia and inflammation contributes to the progression and severity of respiratory viral diseases. Molecular Aspects of Medicine. 2021 Oct 1; 81:101000. https://doi.org/10.1016/j.mam.2021.101000 PMid:34294412 PMCid:PMC8287505
26. Robinson CC. Respiratory viruses. Clinical virology manual. 2009 Jun 5:201-248. https://doi.org/10.1128/9781555815974.ch17 PMid:19419406 PMCid:PMC6932397
27. Clementi N, Ghosh S, De Santis M, Castelli M, Criscuolo E, Zanoni I, Clementi M, Mancini N. Viral respiratory pathogens and lung injury. Clinical microbiology reviews. 2021 Jun 16;34(3):10-128. https://doi.org/10.1128/CMR.00103-20 PMid:33789928 PMCid:PMC8142519
28. Veronese A, Ursic T, Bizjak Vojinovic S, Rodman Berlot J. Exploring Clinical Predictors of Severe Human Metapneumovirus Respiratory Tract Infections in Children: Insights from a Recent Outbreak. Microorganisms. 2024 Mar 23; 12(4):641. https://doi.org/10.3390/microorganisms12040641 PMid:38674586 PMCid:PMC11052206
29. Falsey AR, Erdman D, Anderson LJ, Walsh EE. Human metapneumovirus infections in young and elderly adults. The Journal of infectious diseases. 2003 Mar 1; 187(5):785-790. https://doi.org/10.1086/367901 PMid:12599052
30. Fan E, Brodie D, Slutsky AS. Acute respiratory distress syndrome: advances in diagnosis and treatment. Jama. 2018 Feb 20; 319(7):698-710. https://doi.org/10.1001/jama.2017.21907 PMid:29466596
31. Piukovics K. Epidemiology of most frequent infectious complications in immunocompromised patients: focusing on bacteraemia, CMV and HHV-6 infections in haematological patients, and following autologous stem cell transplantation (Doctoral dissertation, Szegedi Tudomanyegyetem (Hungary)).
32. Ballegeer M, Saelens X. Cell-Mediated Responses to Human Metapneumovirus Infection. Viruses. 2020 May 14;12(5):542. https://doi.org/10.3390/v12050542 PMid:32423043 PMCid:PMC7290942
33. Van Den Hoogen BG, Osterhaus DM, Fouchier RA. Clinical impact and diagnosis of human metapneumovirus infection. The Pediatric infectious disease journal. 2004 Jan 1; 23(1):S25-S32. https://doi.org/10.1097/01.inf.0000108190.09824.e8 PMid:14730267
34. Wilkesmann A, Schildgen O, Eis-Hübinger AM, Geikowski T, Glatzel T, Lentze MJ, Bode U, Simon A. Human metapneumovirus infections cause similar symptoms and clinical severity as respiratory syncytial virus infections. European journal of pediatrics. 2006 Jul; 165:467-475. https://doi.org/10.1007/s00431-006-0105-4 PMid:16607540
35. Karimi Z, Chenari M, Rezaie F, Karimi S, Parhizgari N, Mokhtari-Azad T. Proposed pathway linking respiratory infections with depression. Clinical Psychopharmacology and Neuroscience. 2022 May 5;20(2):199. https://doi.org/10.9758/cpn.2022.20.2.199 PMid:35466092 PMCid:PMC9048006
36. Wilkesmann A, Schildgen O, Eis-Hübinger AM, Geikowski T, Glatzel T, Lentze MJ, Bode U, Simon A. Human metapneumovirus infections cause similar symptoms and clinical severity as respiratory syncytial virus infections. European journal of pediatrics. 2006 Jul; 165:467-475. https://doi.org/10.1007/s00431-006-0105-4 PMid:16607540
37. Kukavica-Ibrulj I, Hamelin ME, Prince GA, Gagnon C, Bergeron Y, Bergeron MG, Boivin G. Infection with human metapneumovirus predisposes mice to severe pneumococcal pneumonia. Journal of virology. 2009 Feb 1;83(3):1341-1349. https://doi.org/10.1128/JVI.01123-08 PMid:19019962 PMCid:PMC2620891
38. Maitre NL, Williams JV. Human metapneumovirus in the preterm neonate: current perspectives. Research and reports in neonatology. 2016 Jul 28:41-49. https://doi.org/10.2147/RRN.S76270 PMid:27891060 PMCid:PMC5120728
39. Jeong S, Park MJ, Song W, Kim HS. Advances in laboratory assays for detecting human metapneumovirus. Annals of Translational Medicine. 2020 May;8(9). https://doi.org/10.21037/atm.2019.12.42 PMid:32566634 PMCid:PMC7290561
40. You HL, Chang SJ, Yu HR, Li CC, Chen CH, Liao WT. Simultaneous detection of respiratory syncytial virus and human metapneumovirus by one-step multiplex real-time RT-PCR in patients with respiratory symptoms. BMC pediatrics. 2017 Dec; 17:1-7. https://doi.org/10.1186/s12887-017-0843-7 PMid:28347279 PMCid:PMC5368990
41. Boivin G, Mazzulli T, Petric M, Couillard M. Diagnosis of viral infections. Clinical virology. 2009 Feb 27:265-294. https://doi.org/10.1128/9781555815981.ch13
42. Stefanidis K, Konstantelou E, Yusuf GT, Oikonomou A, Tavernaraki K, Karakitsos D, Loukides S, Vlahos I. Radiological, epidemiological and clinical patterns of pulmonary viral infections. European Journal of Radiology. 2021 Mar 1;136:109548. https://doi.org/10.1016/j.ejrad.2021.109548 PMid:33485125 PMCid:PMC7808729
43. Jeong S, Park MJ, Song W, Kim HS. Advances in laboratory assays for detecting human metapneumovirus. Annals of Translational Medicine. 2020 May; 8(9). https://doi.org/10.21037/atm.2019.12.42 PMid:32566634 PMCid:PMC7290561
44. De Zwart A, Riezebos-Brilman A, Lunter G, Vonk J, Glanville AR, Gottlieb J, Permpalung N, Kerstjens H, Alffenaar JW, Verschuuren E. Respiratory syncytial virus, human metapneumovirus, and parainfluenza virus infections in lung transplant recipients: a systematic review of outcomes and treatment strategies. Clinical Infectious Diseases. 2022 Jun 15;74(12):2252-2260. https://doi.org/10.1093/cid/ciab969 PMid:35022697 PMCid:PMC9258934
45. Bosis S, Esposito S, Niesters HG, Crovari P, Osterhaus AD, Principi N. Impact of human metapneumovirus in childhood: comparison with respiratory syncytial virus and influenza viruses. Journal of medical virology. 2005 Jan; 75(1):101-104. https://doi.org/10.1002/jmv.20243 PMid:15543589
46. Abinash Satapathy, Neha Yadav, Trilochan Satapathy, Kalpana Sen, Shailesh Sahn, Ayushi Gupta, Bharti Pradhan, Shiv Kumar Bhardwaj. H9N2: A Mysterious Avian Influenza Virus: A Global Threat for Respiratory Pneumonia. Research journal of Pharmacology and Pharmacodynamics.Apr 2024;16(2):127-133. https://doi.org/10.52711/2321-5836.2024.00023
47. Ison MG. Antiviral treatments. Clinics in chest medicine. 2017 Mar 1;38(1):139-153. https://doi.org/10.1016/j.ccm.2016.11.008 PMid:28159156 PMCid:PMC7131036
48. Quizon A, A Colin A, Pelosi U, A Rossi G. Treatment of disorders characterized by reversible airway obstruction in childhood: are anti-cholinergic agents the answer?. Current pharmaceutical design. 2012 Jul 1;18(21):3061-3085. https://doi.org/10.2174/1381612811209023061 PMid:22564300
49. Kitanovski L, Kopriva S, Pokorn M, Dolnicar MB, Rajic V, Stefanovic M, Jazbec J. Treatment of severe human metapneumovirus (hMPV) pneumonia in an immunocompromised child with oral ribavirin and IVIG. Journal of pediatric hematology/oncology. 2013 Oct 1; 35(7):e311-e313. https://doi.org/10.1097/MPH.0b013e3182915d2d PMid:23669731
50. Boivin G, Caouette G, Frenette L, Carbonneau J, Ouakki M, De Serres G. Human respiratory syncytial virus and other viral infections in infants receiving palivizumab. Journal of clinical virology. 2008 May 1; 42(1):52-57. https://doi.org/10.1016/j.jcv.2007.11.012 PMid:18164233 PMCid:PMC7172843
51. Deval H, Kumar N, Srivastava M, Potdar V, Mehta A, Verma A, Singh R, Kavathekar A, Kant R, Murhekar M. Human metapneumovirus (hMPV): an associated etiology of severe acute respiratory infection in children of Eastern Uttar Pradesh, India. Access Microbiology. 2024 Sep; 6(9):000829-v4. https://doi.org/10.1099/acmi.0.000829.v4 PMid:39268186 PMCid:PMC11391948
52. Shafagati N, Williams J. Human metapneumovirus-what we know now. F1000Research. 2018; 7. https://doi.org/10.12688/f1000research.12625.1 PMid:29744035 PMCid:PMC5795268
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