Human metapneumovirus (HMPV), a respiratory virus that circulates during cold and flu season and can be severe in young infants and the elderly, can often be mistaken for influenza or respiratory syncytial virus (RSV).

But a recent study in Open Forum Infectious Diseases describes the important clinical differences between HMPV in an analysis of acute respiratory illness (ARI) during five influenza seasons (2016-17 to 2019-20 pre–COVID-19 pandemic, and 2021-22 during the pandemic).

The study was based on data collected at the Pittsburgh site of the Centers for Disease Control and Prevention–funded US Flu VE Network study, and included patients 6 months older seen for ARI at outpatient clinics in southwestern Pennsylvania. Patients had a new or worsening cough for less than 7 days.

Virus peaks later than flu

HMPV was detected in 4.7% to 7.3% of patients. Detections were usually later than influenza; in 2018-19 and 2021-22, HMPV season seemed to peak in April. For children ages 5 to 17 years, symptoms of HMPV and RSV were indistinguishable, but adults with HMPV reported feeling worse during follow-up than adults with flu.

The authors said clinical understanding of HMPV, which was first discovered in 2001, is of clinical importance now that RSV, flu, and COVID-19 have vaccines that can help prevent infection. There is no vaccine for HMPV, and the virus can cause severe illness and outbreaks.

In related news, the West Coast is currently experiencing large clusters of HMPV activity, with the San Francisco Chronicle reporting school and work absences in the Bay Area due to the virus.

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