Human Metapneumovirus in India: Separating fact from fear

The government's clear communication about hMPV helps maintain transparency. (Representational image)

By Dr K Madan Gopal & Prof Dr Suneela Garg

Yesterday, news of a few Human Metapneumovirus (hMPV) cases in India sparked anxiety amongst the public. Social media was abuzz with posts, some alarmist or speculative, and television coverage added to the panic. To address concerns, the Union Health and Family Welfare Minister (HFM) of the Government of India held a press briefing, underscoring that the situation remains under control. The few patients identified received medical attention, and none had severe complications. Officials assured that India's existing disease surveillance and response systems – strengthened during COVID-19 – are actively monitoring the situation. Statements from the Indian Council of Medical Research (ICMR) and the National Centre for Disease Control (NCDC) stressed that awareness, not panic, is crucial.

Experts interviewed in various media outlets also noted that hMPV is not new; it has circulated globally for years, causing mild to moderate respiratory infections in most people. They emphasised that detecting a few cases indicates that India's surveillance is functioning well rather than signalling a widespread threat.

Discovered in 2001 by Dutch scientists, Human Metapneumovirus belongs to the Paramyxoviridae family, which includes viruses responsible for measles, mumps, and respiratory syncytial virus (RSV). The virus likely existed many years ago despite being identified two decades ago.

Key points about hMPV:

* It spreads primarily via respiratory droplets when an infected person coughs or sneezes. Direct contact with contaminated surfaces can also transmit the virus.

* Symptoms often include a runny nose, cough, fever, and sometimes wheezing. While most healthy individuals recover without complications, very young children, older adults, and immunocompromised individuals can experience more severe illness.

* hMPV is believed to be responsible for 5–10% of respiratory infections in children in various parts of the world.

Although seeing new headlines about viruses can be unsettling, it is essential to remember that hMPV is not as virulent as many emerging pathogens. Medical professionals have managed such infections effectively for years, relying on supportive care without specific antiviral treatment.

Human Metapneumovirus has been detected worldwide. In temperate regions, infections peak in late winter or early spring, often overlapping with other respiratory viruses such as influenza and RSV. Seasonality can differ in tropical and subtropical regions, including parts of India, depending on factors like temperature and rainfall.

Because hMPV is part of routine panels for respiratory virus testing, healthcare systems in many countries detect and document its circulation. Outbreaks often occur in daycare centres, schools, or nursing homes, where close contact accelerates transmission.

The small number of cases recently reported in India does not necessarily indicate a surge. It could reflect improved testing and vigilant monitoring. With more labs equipped to identify respiratory pathogens, cases that once might have gone unnoticed are now quickly detected.

India's surveillance for respiratory illnesses has significantly expanded after COVID-19. The ICMR and NCDC operate robust networks of virology labs, which regularly test for pathogens like influenza, SARS-CoV-2, RSV, and hMPV. When clusters of respiratory illness appear unusual, they are rapidly investigated.

Hospitals and healthcare facilities across India are alert to test individuals presenting with persistent or severe respiratory symptoms. Any surge in confirmed cases triggers a coordinated response involving contact tracing and, if needed, isolation measures. Rapid response teams can be dispatched to contain outbreaks, ensuring that even the smallest clusters receive timely attention.

The government's clear communication about hMPV helps maintain transparency. ICMR and NCDC advisories instruct healthcare providers on identification, testing, and patient care. This alertness allows early interventions, reducing the likelihood of large-scale outbreaks.

The World Health Organization (WHO) monitors respiratory viruses that hold the potential for large-scale public health impact. While hMPV does not rank as highly as, for instance, SARS-CoV-2 or emerging influenza strains, WHO still advises countries to maintain routine surveillance. This includes testing for multiple respiratory pathogens when clusters of cases appear.

WHO's stance promotes preparedness rather than panic. By following these guidelines, nations can spot trends, detect mutations, and respond swiftly if the virus shows signs of spreading more aggressively or causing severe disease.

We can draw on our experiences from the COVID-19 pandemic to protect ourselves and our communities. Many of the recommended measures are simple yet highly effective:

1. Hand hygiene: Wash hands thoroughly with soap and water for at least 20 seconds. When soap is unavailable, use alcohol-based sanitisers.

2. Respiratory etiquette: When you cough or sneeze, cover your nose and mouth with a tissue or your elbow. Dispose of used tissues immediately.

3.  Use of masks: If you have cold-like symptoms or are in a crowded setting, wearing a mask can help prevent transmission.

4. Avoid close contact: If someone shows respiratory infection symptoms, keep a distance and encourage them to seek medical care if needed.

5. Clean surfaces: To reduce the risk of contamination, regularly disinfect high-touch surfaces, such as doorknobs, phones, and tables.

6. Stay home if sick: If you're feeling unwell, rest at home and avoid public places to prevent spreading infection.

7. Seek medical advice: If symptoms worsen or persist, consult a healthcare provider promptly for proper guidance.

Looking ahead: remaining vigilant, not fearful

Although Human Metapneumovirus may seem unfamiliar, it has been around for decades. Its detection in India highlights the efficiency of our surveillance network rather than signalling a public health crisis. The Health Ministry's assurances, supported by data from ICMR and NCDC, reinforce that there is no immediate reason to panic.

Building on the lessons of COVID-19, we know how critical consistent hygiene, responsible behaviour, and reliable information can be in preventing widespread infections. Regular handwashing, covering coughs and sneezes, and mask-wearing when necessary remain the best defence against any respiratory virus.

We should stay informed through credible sources, share accurate information, and avoid spreading rumours. If we all follow the principles of preventive healthcare, we can minimise the impact of hMPV and any other respiratory infections that emerge.

Our collective responsibility is to maintain vigilance without succumbing to fear. By adhering to the simple but powerful measures we learned during the pandemic, we can protect ourselves and our communities – now and in the future.

(Dr K Madan Gopal is a Health expert and works as an advisor at the National Health Systems Resource Center, and Prof Dr Sunella Garg is Chair of Program Advisory Committee, NIHFW, MoHFW GOI.)

Views are personal, and do not represent the stand of this publication.