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Home / World

Overblown fears of HMPV cases in China reflect pandemic scars

By Fenit Nirappil
Washington Post·
7 Jan, 2025 09:08 PM5 mins to read

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Te Pāti Māori calls for deadline extension for Treaty Principles Bill submissions and Canada's Liberal Party in need of new leader following Justin Trudeau's resignation.
  • Public health experts say the rise in human metapneumovirus (HMPV) cases in China is typical for the season.
  • HMPV, similar to RSV, causes cold-like symptoms and poses higher risk to young children and older adults.
  • Experts advise standard precautions like handwashing, as there is no vaccine or specific treatment for HMPV.

An uptick of a routine virus in China ignited dire headlines and social media posts, but public health experts caution that the human metapneumovirus cases are part of the typical ebb and flow of respiratory virus seasons and are no reason to be alarmed.

Chinese authorities in late December reported a rising rate of children aged 14 and under testing positive for human metapneumovirus, or HMPV, as part of a broader update on the respiratory virus season. Videos posted on social media of crowded hospitals prompted speculation about the start of another global outbreak.

But respiratory diseases in China this season appear less severe and are spreading at a smaller scale compared with last year, Foreign Ministry spokeswoman Mao Ning said on Friday. Public health experts and officials in the United States shared similar assessments that the situation in China does not appear unusual.

The discourse surrounding HMPV illustrates how perceptions of infectious-disease threats have become skewed in the aftermath of Coovid – particularly when images of sick people emerge from China. Viruses well known among infectious-disease experts but obscure to the public now attract outsize attention.

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People wearing face masks are seen in Beijing this month. Chinese media reports that the respiratory infection human metapneumovirus (HMPV) is spreading in China. Photo / AFP
People wearing face masks are seen in Beijing this month. Chinese media reports that the respiratory infection human metapneumovirus (HMPV) is spreading in China. Photo / AFP

The HMPV worries are reminiscent of panic last winter over childhood pneumonia cases in China caused by the common Mycoplasma pneumoniae bacterium that periodically spike in countries. Public health experts said those concerns, including a call for a travel ban, were also overblown.

“There’s just this tendency post-Covid to treat every infectious-disease anything as an emergency when it’s not,” said Amesh Adalja, an infectious-diseases physician and senior scholar at the Johns Hopkins Centre for Health Security. “You wouldn’t probably be calling me in 2018 about this.”

What is HMPV?

HMPV is nowhere close to SARS-CoV-2 (the virus that causes Covid-19) or pandemic material. It’s among the long-standing, usually anonymous viruses that cause cold- or flu-like symptoms in the winter.

“How many times do you get sick in the winter and you have no idea what you’ve got?” said Jennifer Nuzzo, a professor of epidemiology and director of the Pandemic Centre at the Brown University School of Public Health. “It’s a virus you’ll get. You’ll probably get it multiple times in your life.”

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HMPV has zoonotic origins spilling over from an avian species centuries ago before it was discovered in the Netherlands in 2001. It is part of the same pneumoviridae family as respiratory syncytial virus (RSV), which often infects young children and sparks outbreaks at daycares.

Andrew Pavia, chief of the division of paediatric infectious diseases at University of Utah Health, said HMPV behaves similarly to RSV, with caseloads more severe some years than others. It can put strain on hospitals, especially when coinciding with upticks of Covid, flu and RSV.

Why are health experts not too worried about HMPV in China?

Kevin Griffis, a spokesman for the US Centers for Disease Control and Prevention, said the agency is monitoring the outbreak in China but does not think it is novel, and said that most respiratory virus hospitalisations are caused by influenza A.

In the United States, less than 2% of patients tested for respiratory viruses in late December had HMPV, which ranked last among the usual culprits, according to CDC data.

China underwent one of the world’s most restrictive and prolonged lockdowns in response to Covid, reducing people’s exposure to other viruses such as HMPV. That created a situation where people became more susceptible during a surge, experts said, leading to unusual cases even in young and middle-aged adults.

“Even though you say it’s typically affecting the very young and very old, it doesn’t mean exclusively,” Nuzzo said. “When you have a lot of people getting sick at once, you see things you may not see when it’s spread out over time.”

Nuzzo said she has not heard reports of unusually large numbers of hospitalisations and deaths in otherwise healthy young and middle-aged adults that would raise alarms, as clinicians in China did during the early days of Covid.

Improved testing and disease surveillance have also made it easier to spot upticks in HMPV that would have gone unnoticed years ago.

“People don’t realise that metapneumovirus virus is just one of those cadre of viruses that causes upper respiratory infections and has been doing so for a very long time. We’re just getting better about testing it and naming it,” said Adalja, the infectious-diseases physician. “That can sometimes lead to stories that can be sensationalistic.”

What are the symptoms and treatment?

Just because a virus is routine doesn’t mean it’s mundane. Like other respiratory viruses, HMPV can progress to more serious symptoms, including pneumonia, and poses elevated risk to young children, older adults and immunocompromised people.

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But most cases remain mild, with symptoms such as cough, fever and nasal congestion.

There is no vaccine or antiviral treatment for HMPV. Doctors and public health authorities offer no special advice for preventing HMPV: it’s the usual mix of washing your hands, covering your mouth when sneezing, and avoiding sick people.

“This is typically less severe than flu or covid. It’s basically like the common cold,” said Katelyn Jetelina, a California epidemiologist who writes a weekly newsletter on infectious diseases. “There’s very little people can do about it. There’s no drugs, there’s no vaccine. Masking probably works like it does with the other viruses. But that’s about it.”

Fenit Nirappil is a Washington Post reporter for the Health & Science team who covers public health, infectious diseases and LGBTQ issues. He previously covered local politics.

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