under the microscope
under the microscope
By Priya Dhagat , MS , MLS ( ASCP ) CM , CIC
Human Metapneumovirus : A Common Virus Sparking Concerns
While any major increase in respiratory disease is concerning , it is critical to note that HMPV infections typically coincide with colder weather and increased indoor activity , making it consistent with seasonal trends of other viruses circulating this time of the year such as the flu , COVID-19 , and RSV . “
Human Metapneumovirus ( HMPV ) is surging in China , making headlines as a “ mystery illness ” that has sparked fears of a new outbreak on the rise comparable to the COVID-19 pandemic . Recent reports from China indicate that rates of numerous flu-like illnesses are increasing and cases of HMPV infection have risen among people who are younger than 14 years old and living in northern Chinese provinces . While any major increase in respiratory disease is concerning , it is critical to note that HMPV infections typically coincide with colder weather and increased indoor activity , making it consistent with seasonal trends of other viruses circulating this time of the year such as the flu , COVID-19 , and RSV .
HMPV was first discovered by Dutch scientists in 2001 . The virus was isolated from nasopharyngeal aspirates from children and infants suffering from respiratory infection that could not be identified from routine diagnostic assays for known respiratory viruses . Full genome sequencing revealed that HPMV is genetically related to avian pneumoviruses , indicating probable zoonotic spillover from an avian reservoir . HMPV is an enveloped , single-stranded RNA virus belonging to the Pneumoviridae family , which also includes respiratory syncytial virus ( RSV ). Since it was first detected , HMPV has been isolated on every continent and from individuals of all ages .
In the United States , HMPV infections begin circulating in winter and last through spring . Similar to other respiratory viruses , HMPV is spread through secretions from coughing and sneezing , close personal contact with someone who is sick ( e . g ., touching or shaking hands ), or touching objects or surfaces and then touching the mouth , nose , or eyes . HMPV contains several proteins that are responsible for infecting airway epithelial cells and spreading into the respiratory tract which induces an immune response that leads to pulmonary inflammation . HMPV generally causes mild illness that can be treated by supportive care . Symptoms begin as a common cold after an incubation period of three to six days , but may intensify and cause upper and lower respiratory tract infections characterized by high fever , wheezing , severe cough , difficulty breathing , tachypnea , bronchiolitis and pneumonia , and hypoxia . Infants , the elderly , and those who have weakened immune systems are at risk for serious illness or hospitalization . Healthcare personnel should follow contact and standard precautions , which includes wearing a mask , when caring for patients hospitalized with HPMV .
Symptoms are often indistinguishable from other common respiratory viruses , so testing for it may not be considered . However , CDC recommends that
Similar to other respiratory viruses , HMPV is spread through secretions from coughing and sneezing , close personal contact with someone who is sick ( e . g ., touching or shaking hands ), or touching objects or surfaces and then touching the mouth , nose , or eyes .”
clinicians consider testing patients with severe respiratory illness using upper airway or lower respiratory tract specimens . HMPV is commonly included in multi-pathogen PCR respiratory panels .
The National Respiratory and Enteric Virus Surveillance System ( NREVSS ) monitors and tracks viral activity in the United States from participating U . S . laboratories in effort identify patterns and potential outbreaks . As of Dec . 28 , 2024 , HMPV accounted for 1.94 percent of positive tests reported to NREVSS , compared to 1.54 percent the previous week .
The surge of cases in China is a reminder of the seasonality of certain respiratory viruses and emphasizes the importance of routine infection prevention measures such as :
● Washing hands often with soap and water for at least 20 seconds
● Avoid touching eyes , nose , or mouth with unwashed hands
● Avoid close contact with people who are sick
● Cover mouth and nose when coughing and sneezing
● Avoid sharing cups and eating utensils with others
● Stay at home if sick
● Clean frequently touched surfaces ( e . g ., doorknobs , shared toys )
For more information on HPMV : Human Metapneumovirus - StatPearls - NCBI
Bookshelf About Human Metapneumovirus | Human
Metapneumovirus | CDC Zoonotic Origins of Human Metapneumovirus : A Journey from Birds to Humans - PMC
Priya Dhagat , MS , MLS ( ASCP ) CM , CIC , is an infection preventionist and the associate director of the system-wide Special Pathogens Program within the Department of Emergency Management at New York City Health + Hospitals , overseeing special pathogen preparedness and response efforts across New York City Health + Hospitals frontline healthcare facilities . Additionally , she supports and offers subject matter expertise for infection prevention topics for the National Emerging Special Pathogens Training and Education Center ( NETEC ).
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