While cases of COVID-19 and RSV have declined in recent months, another lesser-known respiratory virus has increased this past spring.
A report released by the Centers for Disease Control and Prevention (CDC) on May 31 showed that positive PCR laboratory tests for human metapneumovirus (HMPV) in early March reached nearly 11%.
During the four years leading up to the pandemic, positive HMPV test results peaked at between 6.2 and 7.7 percent in March and April, according to the CDC. As the pandemic took off in spring 2020, HMPV declined and remained low until May 2021.
Human metapneumovirus has been around for a while, but these numbers are higher than they have been in recent years, so the virus is garnering attention, says Panagis Galiatsatos, MD, a pulmonologist and critical care physician at Johns Hopkins Medicine. of Baltimore and a medical spokesperson for the American Lung Association.
Testing for HMPV is not common
A member of a family of viruses that also includes respiratory syncytial virus (RSV), HMPV is relatively new having been first detected in 2001 in the Netherlands, according to the CDC. Tests of archived blood samples, however, have revealed the virus has been circulating since at least the 1950s, according to previous research.
Because HMPV is a recently recognized respiratory virus, healthcare professionals may not routinely consider or test for HMPV, the CDC says.
However, health care providers should consider testing for HMPV during the winter and spring, especially when HMPV is commonly circulating, the CDC advises.
HMPV is similar to a bad cold
Like other viruses that cause upper and lower respiratory infections, HMPV is spread by respiratory droplets from coughs and sneezes. People can also convey it through touching like shaking hands.
Research suggests that the virus can be transmitted by an infected person even when they have no symptoms or are asymptomatic. There is quite significant asymptomatic shedding; about 40 percent of people with human metapneumovirus don’t know they have it and could spread it, says Dr. Galiatsatos.
HMPV can also survive on surfaces for many hours, according to the Wisconsin Department of Health Services. This means that people can become infected by touching contaminated surfaces and then touching their mouth, nose or eyes.
Public health officials are keeping a close eye on the disease but aren’t overly alarmed. Typically, HMPV infection causes mild symptoms, including:
For the general public, it will look like a bad cold, and probably a little more focused on coughing, says Galiatsatos. Then you will feel quite miserable and HMPV can persist for some time so it can be frustrating.
In some cases, however, the physical effects of the disease can be severe and lead to:
- difficult breathing
- aggravation of asthma
It is also possible for the disease to progress to bronchitis or pneumonia, which may require hospitalization.
The American Lung Association notes that in hospitalized severe cases, doctors may perform a bronchoscopy, in which a small, flexible camera is inserted into the lung and a sample of fluid is taken to test for viruses.
Anyone can get HMPV, but the Cleveland Clinic says people most at risk for complications are infants, children under 5, seniors 65 and older, people with asthma who take steroids, patients with COPD and the immunocompromised, such as those who take cancer medications or have had organ transplants.
Get supportive treatment for HMPV infection
There is no specific antiviral therapy or cure to treat HMPV, so most treatments are supportive. Suggested therapies include decongestants, fever relievers, antihistamines, and other means of providing comfort until the illness resolves, such as rest and drinking plenty of fluids.
People hospitalized with HMPV may require supplemental oxygen and assisted ventilation. When vomiting and diarrhea occur, intravenous fluids can be used for hydration. If HMPV makes your asthma or chronic obstructive pulmonary disease (COPD) worse, bronchodilators and steroids can relieve symptoms.
Galiatsatos suggests doctors tend to test for flu, COVID-19, and RSV (to some extent) because treatments and vaccines are available: US Food and Drug Administration (FDA) has approved Tamiflu as an oral antiviral drug for flu acute and Paxlovid for COVID-19. Plus, there are now vaccines for all three.
There is currently no vaccine for HMPV, but there is at least one in the works. In May, the pharmaceutical company Icosavax announced positive results from the first tests of its vaccine candidate to prevent RSV and HMPV in the elderly.
As with other respiratory viruses, healthcare professionals are encouraging the public to take precautions to avoid getting sick in the first place. These measures include covering your nose and mouth when sneezing or coughing, washing your hands often, not touching your face with unwashed hands, and avoiding close contact with sick people.
As for why the number of cases increased last spring, Galiatsatos speculates that hospitals have conducted more intensive testing due to an increase in respiratory viruses in general. I think the interest comes in the wake of the pandemic at a time where we’ve seen a lot of people quite sick with respiratory infections, she says.
Furthermore, respiratory viruses in general have reemerged after most people abandoned pandemic precautions, such as masking and social distancing. This too may have contributed to the HMPV spike.
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