When a human metapneumovirus (hMPV) case was reported in Bengaluru on 6 January, media outlets quickly dubbed it India's 'first.' Amid concerns over China's hMPV cases, the story sparked fears of a potential health crisis
Published Jan 09, 2025 | 7:00 AM ⚊ Updated Jan 09, 2025 | 7:00 AM
HMPV in India
When a case of human metapneumovirus (hMPV) was reported from Bengaluru on January 6, several media outlets claimed it was the ‘first’ case reported in India.
Within hours, the news was flashed across multiple television screens and widely shared on social media, with headlines declaring it as the first case in the country.
This narrative seems to stem from the unease caused by recent reports of hMPV cases in China. Indian news outlets quickly amplified the story, portraying it as a potential ‘outbreak’ or serious health crisis. By the evening, a company known for producing rapid COVID-19 tests announced the launch of a new test for hMPV.
Amid the flurry of news reports and rising anxiety, memes reminiscent of the Covid-19 era began doing the rounds and the BSE Sensex dropped by more than a percent. Yet, the reality lay somewhere else.
According to data from China, during the 52nd week of 2024 (December 23 to December 29), respiratory samples collected from outpatient influenza-like illness (ILI) cases and hospitalised severe acute respiratory infection (SARI) cases in sentinel hospitals across the country were tested for 10 viruses.
These included the new coronavirus, influenza virus, respiratory syncytial virus (RSV), adenovirus, human metapneumovirus (hMPV), parainfluenza virus, common coronavirus, rhinovirus, and enterovirus, as well as other respiratory pathogens such as Mycoplasma pneumoniae.
Among outpatient cases of ILI, hMPV had a detection rate of 6.2 percent, with a marginal week-over-week increase of just +0.1 percent . In hospitalised SARI cases, the detection rate for hMPV was 5.4 percent, reflecting a slightly more notable week-over-week increase of +1.0 percent.
However, the detection rate of hMPV remains significantly lower compared to the influenza virus, which dominated with detection rates of 30.2 percent in outpatient cases and 17.7 percent in hospitalised cases, impacting both mild and severe respiratory conditions.
“The influenza virus positive rate among outpatient influenza-like cases nationwide increased by 6.2 percent compared to the previous week,” stated the China CDC in its report, emphasising that influenza remains the primary driver of respiratory infections in outpatients.
While hMPV showed a slight upward trend, its role in overwhelming the health system — as some claim — does not align with the reported prevalence. It also does not appear to be driving a significant outbreak.
Data accessed from a private microbiology laboratory in Hyderabad highlights respiratory viral pneumonia cases tested between November and December 2024, revealing that most cases were positive for various respiratory pathogens.
Out of 258 respiratory samples tested, 205 (79.5 percent) returned positive results.
The report identified 11 cases of human metapneumovirus (hMPV A/B) during the testing period, confirming its presence in the community. This challenges the notion of the Bengaluru case being the ‘first’ in India.
Although the absolute number of hMPV cases appears moderate compared to other pathogens like Mycoplasma pneumoniae or rhinovirus, its detection alongside other respiratory viruses indicates it contributes to ongoing respiratory illnesses.
hMPV accounted for approximately 5.3 percent of the positive cases (11 out of 205). This finding aligns with global data, which identifies hMPV as a significant contributor to respiratory illnesses, particularly among pediatric and elderly populations.
The lab data also highlighted that Mycoplasma pneumoniae was the most prevalent pathogen, with 94 positive cases, accounting for 45.8 percent of total positives. This indicates a dominant bacterial cause of pneumonia in many cases, overshadowing viral pathogens like hMPV. Among viral pathogens, rhinovirus emerged as the leading contributor, with 62 cases (30.2 percent), reflecting its high transmissibility in community settings.
The World Health Organisation (WHO) issued a statement late on January 7, noting that trends in acute respiratory infections typically increase during this time of year in many countries across the Northern Hemisphere.
These seasonal surges are primarily driven by respiratory pathogens such as seasonal influenza, respiratory syncytial virus (RSV), human metapneumovirus (hMPV), and Mycoplasma pneumoniae.
WHO highlighted that many countries conduct routine surveillance for acute respiratory infections and common respiratory pathogens. Currently, in some temperate regions of the Northern Hemisphere, rates of influenza-like illness (ILI) and acute respiratory infections (ARI) have risen above baseline levels, consistent with seasonal trends.
RSV detections, however, vary by region, with decreases in most areas except North America.
“Recently, there has been interest in hMPV cases in China, including suggestions of hospitals being overwhelmed. hMPV is a common respiratory virus that circulates in many countries from winter through spring. While some cases may require hospitalisation due to bronchitis or pneumonia, most infections result in mild upper respiratory symptoms similar to the common cold and resolve within a few days,” WHO stated.
The organisation emphasised that the observed rise in respiratory pathogen detections is within the expected range for the winter season in the Northern Hemisphere.
In China, influenza currently remains the most frequently detected respiratory pathogen among individuals with acute respiratory infections.
WHO confirmed that it is in regular contact with Chinese health authorities and has not received reports of unusual outbreak patterns.
“Chinese authorities report that the healthcare system is not overwhelmed, and there have been no emergency declarations or responses triggered. WHO continues to monitor respiratory illnesses at global, regional, and country levels through collaborative surveillance systems and will provide updates as necessary,” the statement concluded.
Amid the buzz surrounding reports of nine human metapneumovirus (hMPV) cases, Union Health Secretary Punya Salila Srivastava issued a statement reassuring the public that “there is no cause for concern regarding hMPV, which has been present globally since 2001.”
She emphasised that a seasonal increase in respiratory illnesses is commonly observed during the winter months and assured that the country is well-prepared to handle any potential surge in respiratory illness cases.
“Human metapneumovirus (hMPV) is one of many respiratory viruses that can cause infections in people of all ages, particularly during the winter and early spring months. The infection is usually mild and self-limiting, with most cases recovering on their own. Adequate diagnostic facilities are available through the ICMR-VRDL laboratories,” the health ministry stated.
(Edited by Rosamma Thomas)
