‘HMPV is not a new virus; no need to panic’: Dr Sandeep Budhiraja

India has confirmed its seven cases of human metapneumovirus (HMPV), detected in Karnataka, Tamil Nadu, Nagpur and Gujarat. While the news has sparked concerns about respiratory illnesses in the ongoing winter season, health experts urge calm. Dr Sandeep Budhiraja, Group Medical Director at Max Healthcare and Senior Director at the Institute of Internal Medicine, spoke to Patriot to demystify the virus and address the public’s concerns.

The Indian Council of Medical Research (ICMR) has reported two cases in Bengaluru, both identified at Bangalore Baptist Hospital. A three-month-old girl, who was admitted in December with symptoms of fever and cold, tested positive for the virus but has since recovered and been discharged. Additionally, an eight-month-old boy, admitted with fever and a minor injury, tested positive for both HMPV and respiratory syncytial virus (RSV). He is currently in recovery.

In Ahmedabad, a two-month-old infant from Dungarpur, Rajasthan, tested positive for HMPV after being admitted with respiratory issues. The child has been treated and discharged.

Nagpur saw two cases involving a seven-year-old and a thirteen-year-old, initially treated for suspected H1N1 (swine flu). However, polymerase chain reaction (PCR) tests confirmed HMPV in both children, who recovered with outpatient care, according to the Meditrina Institute of Medical Sciences. Meanwhile, Tamil Nadu’s Health Secretary Supriya Sahu has confirmed two active cases in Chennai and Salem.

Understanding human metapneumovirus

First identified in the late 1990s, human metapneumovirus (HMPV) belongs to the same family as the respiratory syncytial virus (RSV). While it typically causes mild symptoms such as fever, cough, nasal congestion, and body aches in healthy adults, it can lead to severe illness in vulnerable groups, including young children, the elderly, and individuals with pre-existing medical conditions such as asthma, diabetes, or heart disease. In some cases, it can cause bronchiolitis or pneumonia.

“This human metapneumovirus is not a new virus. It has been recognised since the last few decades and that way it is unlike the COVID virus, which was a novel virus, a newly detected virus. This metapneumovirus has been in existence for many, many years,” Dr Budhiraja explained.

Flu season and respiratory viruses

Dr Budhiraja elaborated on the seasonal nature of respiratory viruses. “Normally, what happens is during winters, it is called the flu season because there are a lot of respiratory viruses which circulate between humans during this time of the year, especially in the Northern Hemisphere. Now, most of these viruses cause symptoms and they are clubbed under the category of respiratory or flu-like viruses. Now, to name some important viruses which cause these diseases are influenza virus, which is the so-called flu virus—influenza A and influenza B—then we have adenovirus, rhinovirus, COVID virus, swine flu virus, and human metapneumovirus is also one of these viruses which cause flu-like illnesses,” he said.

Symptoms and vulnerable groups

“These types of viruses cause similar types of diseases like body ache, fever, headache, stuffy or blocked nose, nasal discharge, nasal congestion, throat pain, and throat congestion. In most cases, the illnesses are upper respiratory illnesses, but in some cases, the disease can become more severe and involve the lungs, and then the person starts having wheezing or bronchiolitis or even pneumonia in the lungs,” he added.

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Dr Budhiraja further highlighted the groups at higher risk of severe illness. “In most adults, the disease caused by all these viruses, including HMPV, is generally a mild disease with symptoms like the upper respiratory illnesses I mentioned earlier. But the problem can be more severe in vulnerable groups of people. These are children less than five years of age, elderly people, and people who have medical conditions such as diabetes, heart disease, liver disease, kidney failure, kidney disease, patients on dialysis, cancer patients, etc.,” he said.

Challenges in treatment and prevention

Dr Budhiraja noted the lack of specific treatment or preventive vaccination for HMPV. “Like any other flu virus, this also spreads from person to person, like when a person coughs or sneezes. But the problem with this virus is that we do not have specific treatment for this or the preventive vaccination for this. Although this virus has been known to us for more than 20 years, we still have not made a vaccine for this virus. So, the treatment is essentially symptomatic and the treatment of the complications as and when they happen,” he explained.

Precautions and public health advice

He outlined measures to reduce the spread of the virus. “The incubation period is 3-6 days. So, the moment you are exposed to a person, within the next few days there is a likelihood that the other person who is exposed develops the symptoms. And again, then he can transmit this infection by sneezing or coughing,” he said.

“One has to follow the same isolation methods as it was during the COVID virus, or for that matter, any flu virus, which includes wearing a mask. If you have symptoms, avoid moving in crowded and congested places, follow coughing and sneezing etiquettes, use disposable tissue, don’t shake hands, and wash your hands frequently with soap and water and sanitise yourself regularly. If you have symptoms, then do seek a medical opinion and best would be to isolate yourself for two to three days,” Dr Budhiraja advised.

Should India worry?

When asked whether India could face a situation similar to China, where hospitals in the northern region are reportedly overwhelmed with HMPV cases, Dr Budhiraja said, “I don’t think anything is to be worried about because, as I said, this is not a new virus. And every year in winter, when you have an increased number of people with flu, there will be a percentage of cases of HMPV virus.”