China Grapples with HMPV Outbreak: Symptoms, Prevention, and Latest Updates

China is currently witnessing a surge in human metapneumovirus (HMPV) infections, creating concerns reminiscent of the COVID-19 pandemic. Overwhelmed hospitals, reports of severe respiratory infections, and speculations on social media have added to the alarm. However, no official state of emergency has been declared by Chinese authorities or the World Health Organization (WHO).

Understanding HMPV:

HMPV is a respiratory virus belonging to the Pneumoviridae family, first identified in 2001. It is closely related to respiratory syncytial virus (RSV) and typically causes upper and lower respiratory infections. Symptoms are often mild but can become severe, especially for vulnerable groups. The virus is seasonal, with peaks in winter and early spring.

Symptoms of HMPV:

HMPV symptoms are similar to those of the common cold or flu, making it difficult to differentiate from other respiratory illnesses like COVID-19 or influenza. Common symptoms include:

• Cough (often with mucus)

• Fever

• Nasal congestion or runny nose

• Sore throat

• Shortness of breath (in severe cases)

Incubation Period: Typically, 3-6 days.
Duration: Symptoms usually last 7-10 days but can persist longer for severe cases.

High-Risk Groups for HMPV:

Certain populations are more vulnerable to severe outcomes:

• Young children (especially under 5 years old)

• Older adults (aged 65 and above)

• Individuals with chronic respiratory conditions (e.g., asthma, COPD)

• Those with weakened immune systems (e.g., cancer patients, organ transplant recipients)

• Pregnant women

How HMPV Spreads:

HMPV is transmitted via respiratory droplets, close personal contact, and by touching surfaces contaminated with the virus. Modes of transmission include:

• Coughing or sneezing by an infected person.

• Contact with contaminated surfaces followed by touching the eyes, nose, or mouth can lead to infection.

• Close physical contact, such as shaking hands.

The virus is highly contagious, particularly in crowded or poorly ventilated areas.

Diagnosis and Testing:

HMPV symptoms overlap with other respiratory infections, making laboratory tests crucial for confirmation. Diagnostic methods include:

• PCR tests: Highly accurate detection of the viral genome.

• Rapid Antigen tests: Faster but less sensitive than PCR.

• Imaging and bronchoscopy: For severe cases to assess lung conditions.

Complications of HMPV:

While most recover without complications, vulnerable groups may experience severe health issues:

• Bronchiolitis and bronchitis: Inflammation of airways, causing wheezing and difficulty breathing.

• Pneumonia: Viral pneumonia may require hospitalisation.

• Exacerbation of chronic conditions: Worsening asthma or COPD.

• Secondary bacterial infections, such as bacterial pneumonia.

• Pregnancy risks, potentially affecting maternal and foetal health.

Preventive Measures:

With no specific antiviral treatment or vaccine, prevention focuses on hygiene and limiting exposure:

1. Maintain Hand Hygiene: Regularly wash your hands with soap and water for a minimum of 20 seconds.

2. Mask Wearing: Use masks in crowded or high-risk areas.

3. Disinfect Surfaces: Clean frequently touched objects like doorknobs, phones, and countertops.

4. Avoid Contact: Stay away from symptomatic individuals.

5. Self-Isolation: If symptomatic, stay home to prevent spreading the virus.

Treatment and Care:

Management of HMPV is symptom-focused:

• Rest and hydration: Key to recovery.

• Over-the-counter medications: Relieve fever, congestion, and pain.

• Hospitalisation: Severe cases may require oxygen therapy or intravenous fluids.

Current Outbreak in China: Key Updates

China has seen a surge in respiratory infections, including HMPV, influenza A, and Mycoplasma pneumoniae. Most cases have been reported in children under 14, with northern provinces particularly affected. Chinese authorities are closely monitoring the situation.

China's Surveillance Efforts:

China's National Disease Control and Prevention Administration (NCDPA) has introduced a pilot monitoring system aimed at tracking and managing pneumonia cases of unknown origin. A recent statement from the NCDPA revealed a notable surge in respiratory infections during the week of December 16-22.

Under the updated protocols, laboratories are required to report infections, while disease control agencies are tasked with overseeing and managing the cases to ensure a coordinated response to the ongoing health concern.

While official reports have not deemed the situation critical, the NCDPA has acknowledged the increase in respiratory infections during the period from December 16 to 22.

HMPV vs. COVID-19:

While both viruses spread through respiratory droplets and cause similar symptoms, there are key differences:

• Seasonality: HMPV peaks in winter and spring, whereas COVID-19 spreads year-round.

• Severity: HMPV primarily affects young children and the elderly, while COVID-19 has widespread implications due to evolving variants.

• Long-term immunity: Reduced exposure to viruses during COVID-19 lockdowns may have weakened immunity to HMPV.

(Input from various sources)

(Rehash/Sai Sindhuja K/MSM)