Introduction
Human Metapneumovirus (HMPV) is an emerging viral pathogen causing acute respiratory infections across all age groups, particularly affecting young children, the elderly, and immunocompromised individuals. As India experiences seasonal surges in respiratory infections, understanding Human Metapneumovirus in India has become essential for public health preparedness and clinical management.
In this article, we explore the clinical symptoms, transmission routes, recent outbreaks in Indian regions like Maharashtra and Delhi, and evidence-based strategies for prevention.
What is Human Metapneumovirus (HMPV)?
Human Metapneumovirus (HMPV) is a member of the Paramyxoviridae family, first identified in 2001 in the Netherlands. It shares many clinical and epidemiological characteristics with Respiratory Syncytial Virus (RSV). The virus primarily affects the lower respiratory tract, especially in children under five years old.
Comparison to other viruses:
Comparison of Common Viruses
| Virus | Affected Age Group | Common Symptoms | Seasonality |
|---|---|---|---|
| HMPV | Infants, elderly | Cough, fever, wheezing | Winter to early spring |
| RSV | Infants | Runny nose, bronchiolitis | Winter |
| Influenza | All ages | High fever, body aches | Winter |
Key Symptoms of HMPV
The symptoms of HMPV range from mild upper respiratory tract infections to severe bronchiolitis and pneumonia. Recognizing these signs early is crucial for containment.
Common HMPV Symptoms:
- Persistent cough
- Nasal congestion or rhinorrhea
- Fever (mild to high)
- Shortness of breath
- Wheezing or stridor
- Fatigue and body aches
- Otitis media in children
Severe manifestations (especially in high-risk groups):
- Viral pneumonia
- Acute respiratory distress
- Hypoxia
- Secondary bacterial infections
- HMPV in India: Outbreak
HMPV in India: Outbreak Trends and Surveillance
Rising HMPV Cases in Maharashtra and Delhi
According to recent surveillance data from the Integrated Disease Surveillance Programme (IDSP), clusters of Human Metapneumovirus in India have been reported in Delhi NCR and Mumbai during the post-winter months of 2023–2024.
In Maharashtra, pediatric departments in hospitals like KEM and JJ Hospital documented increased HMPV admissions among children under 10. In Delhi, the Lok Nayak Hospital reported more than 60 cases in a single month during February 2024.
Why is HMPV Surveillance Challenging in India?
- Limited diagnostic availability (PCR-based tests are expensive)
- Overlap with other respiratory viruses like COVID-19, Influenza, and RSV
- Underreporting in rural and tier-2 cities
How Does Human Metapneumovirus Spread?
HMPV spreads through respiratory droplets, direct contact with contaminated surfaces, or close interaction with infected individuals.
Modes of Transmission:
- Coughing and sneezing
- Touching contaminated surfaces (e.g., toys, door handles)
- Close personal contact (hugging, kissing)
The virus can survive on surfaces for several hours, making hand hygiene critical in communal settings like schools and hospitals.
High-Risk Populations in India
- Children under 5 (especially those in daycare)
- Elderly above 65
- Immunocompromised patients (e.g., those on chemotherapy, organ transplant recipients)
- Asthmatic or COPD patients
- People living in urban slums with poor ventilation
Diagnosis and Differentiation
Due to its symptomatic similarity with RSV, Influenza, and even mild COVID-19, HMPV requires laboratory confirmation.
Diagnostic Tools:
- RT-PCR assays (gold standard)
- Multiplex respiratory virus panels
- Rapid antigen testing (less reliable)
Healthcare professionals should consider HMPV in cases of recurrent lower respiratory infections where RSV or Influenza tests are negative.
Prevention and Control Measures
Preventive Strategies:
- Frequent handwashing with soap
- Avoiding contact with infected individuals
- Use of masks in hospitals and during seasonal peaks
- Disinfection of commonly touched surfaces
- Isolating symptomatic children at home
No Vaccine Yet
Currently, there is no approved vaccine or antiviral therapy for HMPV. However, vaccine candidates are under development, with trials focusing on attenuated and protein subunit vaccines.
Role of Public Health Initiatives in India
The Ministry of Health and Family Welfare (MoHFW) and ICMR are investing in strengthening viral surveillance systems and training frontline healthcare workers to identify non-influenza respiratory pathogens.
Suggested Public Health Actions:
- Incorporate HMPV in routine viral surveillance panels
- Educate pediatricians and general physicians
- Issue seasonal alerts during peak times (Jan–March)
- Improve access to PCR diagnostics in district hospitals
FAQs About Human Metapneumovirus in India
Q1: What are the symptoms of human metapneumovirus?
A: HMPV symptoms include cough, fever, nasal congestion, wheezing, and in severe cases, pneumonia or respiratory distress.
Q2: Is HMPV common in India?
A: Yes, especially during the post-winter months. Cases have risen in regions like Maharashtra and Delhi in recent years.
Q3: How is HMPV diagnosed?
A: Diagnosis is primarily via RT-PCR testing, though multiplex respiratory virus panels are also used.
Q4: Can HMPV cause pneumonia?
A: Yes, HMPV can lead to viral pneumonia, particularly in children, the elderly, and those with weakened immune systems.
Q5: Is there a vaccine for HMPV?
A: No, but research is ongoing to develop effective vaccines for future use.
Conclusion
Human Metapneumovirus is a significant yet often overlooked contributor to respiratory infections in India. With seasonal outbreaks becoming more frequent and healthcare systems still recovering post-COVID-19, early diagnosis and preventive measures are critical.
Stay informed about respiratory viruses like HMPV—consult your doctor if symptoms arise, and support public health initiatives aimed at improving early detection and prevention.
