HMPV cases surge in Malaysia, India and Hong Kong: Is it a new disease?

The HMPV cases are now reportedly rising in Malaysia. In 2024, 327 HMPV cases were reported in the country, a 45% increase compared to 225 cases in 2023. This increase comes amidst reports of rising respiratory illnesses in other countries, including China.

According to the Straits Times, Malaysia’s Health Ministry urged the public to practice preventive measures, including frequent handwashing with soap, wearing face masks, and covering the mouth and nose when coughing or sneezing.

“The public is advised to proactively take care of their health and prevent infection to others, especially in enclosed and crowded areas,” the ministry stated. “This includes those planning to travel to countries at risk.”

Meanwhile, India has reported two cases of human metapneumovirus (HMPV). Two infants were infected with the virus in Karnataka’s Bengaluru, the Union Health Ministry said on Monday (January 6). One case is also suspected in Gujarat.

The HMPV infection in India was detected in a three-month old girl and an eight-month old boy who were treated at Baptist hospital-Bengaluru. Both the children came in with symptoms of pneumonia, the girl has since been discharged and the boy is recovering, the Indian media reported.

Clarifying the status of the virus, the Indian Health Ministry issued a statement, saying, “HMPV is already in circulation globally, including in India, and cases of respiratory illnesses associated with HMPV have been reported in various countries.” 

It added that there was no history of international travel in the two cases that were picked up during surveillance, meaning that these infections have no connection to the reported surge in respiratory infections in China.

This comes amid a surge in HMPV cases in China, leading to overcrowded hospitals and fears of a wider outbreak. The respiratory virus, which causes symptoms similar to a cold, was also detected in Malaysia last year.

Five years after the outbreak of the deadly Covid-19 pandemic that claimed over 7 million lives across the global, the HMPV virus in China is being monitored by several countries.

HMPV infections have been documented nationwide in China as the government has ramped up screening, identification and isolation procedures to address unidentified infections. Various videos on social media depicted a scary scene at hospitals, with individuals wearing masks crammed into waiting areas. 

Frightening videos show patients coughing at the hospitals amid a spike in respiratory illness. Officials have said that China seen an increase in HMPV cases, particularly among children under the age of 14 in northern areas, reported news agency Reuters.

Rising cases of HMPV in China

The spike in cases coincides with colder weather and increased indoor activity, conditions that typically fuel the spread of respiratory viruses. Health officials emphasize that this surge is consistent with seasonal trends.

China’s National Disease Control and Prevention Administration recently reported an increase in respiratory infections, including HMPV, during the winter. The World Health Organisation (WHO) has not flagged the situation as a global health emergency, but the rise in cases has prompted authorities to bolster monitoring systems.

A pilot programme has been launched to track pneumonia of unknown origin, ensuring labs and health agencies report and manage cases more effectively, state broadcaster CCTV reported, quoting an administration official at a news conference.

Can HMPV virus spread to other countries?

Hong Kong has reported a few cases of HMPV. Neighbouring countries like Cambodia and Taiwan are keeping a close watch on the situation. Cambodia’s Communicable Disease Control Department has issued warnings about HMPV, noting its similarity to Covid-19 and influenza.

Taiwan’s Centers for Disease Control has said the virus’s higher risks for children, the elderly, and immune-compromised individuals.

In neighbouring India, officials said there is no need for panic as HMPV is “like any other respiratory virus”.

Why is HMPV in the news?

China is currently experiencing a surge in HMPV cases, alongside other respiratory illnesses like influenza A, Mycoplasma pneumoniae, and COVID-19. Reports suggest hospitals in some regions are overwhelmed, but Chinese authorities and the World Health Organization (WHO) have not declared a state of emergency.

Who is most at risk from HMPV?

HMPV can affect people of all ages, but the most vulnerable groups include:

-Children under five, particularly infants.
-Older adults, especially those over 65.
-People with weakened immune systems or chronic respiratory conditions like asthma or COPD.

How does HMPV spread?

HMPV spreads through:

-Respiratory droplets from coughing or sneezing.
-Close contact, such as shaking hands or touching someone infected.
-Contact with contaminated surfaces, followed by touching the mouth, nose, or eyes.
-The virus often circulates seasonally, peaking in late winter and spring in temperate regions.

What are the symptoms of HMPV?

According to the CDC, symptoms include:

-Cough and runny or stuffy nose.
-Fever.
-Sore throat.
-Wheezing or shortness of breath in severe cases.

In more serious cases, it can escalate to bronchitis, pneumonia, or asthma exacerbations.

How is HMPV diagnosed?

Testing is rare unless symptoms are severe or part of an outbreak. Diagnostic methods include:

-Nucleic Acid Amplification Test (NAAT): Detects viral genome in respiratory secretions.
-Immunofluorescence or Enzyme Immunoassay: Detects viral antigens.

How can HMPV be prevented?

-The CDC recommends the following precautions:
-Wash hands frequently with soap and water for at least 20 seconds.
-Avoid touching your face with unwashed hands.
-Wear masks in crowded areas during outbreaks.
-Stay home when sick to prevent spreading the virus.
-Clean frequently touched surfaces regularly.

Is there a treatment for HMPV?

There is no specific antiviral treatment or vaccine for HMPV. Symptom management includes:

-Staying hydrated and getting adequate rest.
-Using over-the-counter (OTC) medications for pain, congestion, and fever.
-Severe cases may require hospitalization for oxygen therapy or intravenous fluids.

How does HMPV compare to COVID-19?

-Both HMPV and COVID-19 cause respiratory symptoms such as coughing, fever, congestion, and shortness of breath. They also spread through respiratory droplets.

-HMPV: Peaks during winter and spring.

-COVID-19: Spreads year-round due to evolving variants.

-Post-COVID-19 lockdowns, surges in HMPV cases have been observed as populations re-expose themselves to respiratory pathogens.

When should you seek medical attention?

Consult a healthcare provider if symptoms:

-Worsen after a few days.
-Include difficulty breathing or cyanosis (bluish skin).
-Occur alongside chronic health conditions like asthma or COPD.

Is HMPV a new pandemic threat?

No, HMPV is not a new virus or an imminent pandemic threat. Seasonal surges are common, particularly during the winter months. However, the increase in cases post-COVID-19 restrictions has raised concerns.

The HMPV virus was first identified in children in 2001 in the Netherlands. Infection with HMPV usually occurs by the age of five years with reinfection occurring throughout life as immune protection induced by the virus is too weak to prevent repeated infections. 

The virus causes upper and/or lower respiratory tract infections, with lower respiratory tract infections being among the most common. While the virus often causes only mild disease, it can lead to severe illness requiring hospitalisation in children, immunocompromised populations and the elderly.

Globally, 3%-10% of hospital admissions and 1% of acute lower respiratory infection-related deaths in children under age five in 2018 are attributed to HMPV, as per a 2021 paper. The study also found that children younger than six months, especially those in low- and lower-middle-income countries, are at greater risk of death caused by the HMPV virus. 

Detection of a large number of HMPV cases among children aged less than 14 years in China is a reflection of the heightened surveillance and testing for the virus.

--With agencies inputs