Human Metapneumovirus: let’s all calm down first

Human metapneumovirus (HMPV) is suddenly making headlines, but not for the reasons one might expect. Over the last week, India has witnessed a barrage of sensational media reports claiming the emergence of a “new dangerous virus” supposedly originating from China and spreading across India and the world.

The memories of the early days of the COVID-19 pandemic, which were full of cryptic information and absolute unfamiliarity among experts and the public alike regarding a new dangerous virus, are probably the reason why the news of HMPV is spreading like wildfire in India. This unnecessary media scare has created confusion and anxiety among the public and even among some healthcare professionals. While it is reassuring that some sections of the media continue to adhere to fact-based and scientific reporting, it is disheartening to see others indulging in scaremongering, often without consulting experts or verifying facts.

Public awareness about outbreaks typically comes from experts and organisations such as the Indian Health Ministry. However, in the case of HMPV, the situation seems reversed. Even experts are learning about the so-called “new” virus through media reports. Over the last week, I have received several phone calls from senior doctors across the country enquiring about this “new dangerous virus.” The misinformation has led to unnecessary panic among healthcare providers and the public alike. Surprisingly, many of the hyped-up articles lack any quotes or input from medical experts, raising questions about the credibility of such reporting.

Not a new virus

Let us set the record straight. HMPV is not a new virus. For infectious disease specialists, it is a well-known pathogen and has been circulating in most countries, including India, for quite some time. Claims of the “first case” of HMPV in India, as reported by some prominent media channels, are blatantly false. This virus has been present in India for years, and healthcare professionals are familiar with it. The only reason HMPV seems to be making news now is the availability of expensive PCR-based respiratory panels that detect multiple viruses, including HMPV. Previously, most cases of upper respiratory tract infections caused by HMPV went undetected, not because the virus was absent, but because such advanced and costly diagnostic tests were not routinely used.

HMPV typically causes mild, self-limiting respiratory infections. Most individuals infected with the virus do not require any specific testing or treatment. However, it can cause severe disease in highly vulnerable individuals such as the elderly, young children, and those with suppressed immunity. Identifying the virus can help doctors avoid the misuse of antibiotics and flu medications such as oseltamivir. It also aids in preventing hospital outbreaks by curbing the transmission of the virus from one patient to others. Several studies have identified HMPV as the third leading cause of respiratory viral infections, following influenza and respiratory syncytial virus (RSV). Its severity in vulnerable populations is comparable to that of RSV and flu. However, unlike RSV and flu, for which vaccines and antiviral treatments are available for individuals in the vulnerable categories, there is no specific treatment or vaccine for HMPV.

Misplaced focus

The misplaced focus created by sensational reporting is concerning. Instead of concentrating on influenza and RSV, viruses for which prevention through vaccination and treatment with antivirals are available, we find ourselves overly preoccupied with HMPV. This misplaced focus could divert attention and resources from more pressing public health priorities. Media should engage with experts before publishing such reports. Doctors should not have to learn about supposed new outbreaks or diseases from unverified media reports.

One positive aspect amidst the chaos is the presence of responsible journalism in our country. For instance, a recent editorial in The Hindu provided a balanced, factual perspective on the HMPV situation. It is also reassuring to note that our Health Ministry has been issuing accurate, scientific and factual bulletins to the media. However, the Ministry needs to take a more proactive role in countering misinformation. Perhaps it is time for the Ministry to issue clear guidelines to the media, urging them to rely on credible sources and avoid sensationalism.

The question arises: why has HMPV suddenly garnered so much attention? Some speculate that the hype might have economic underpinnings, as news of new viruses often leads to increased demand for expensive diagnostic tests and heightened dependence on healthcare facilities. The recent news of stock prices of many healthcare companies in the country rising by up to 4% after the HMPV news could be coincidental. However, this coincidence gives us a message that news, whether factual or not, can have economic implications.

India has a thriving ecosystem of start-ups capable of developing low-cost PCR tests for HMPV. Supporting these start-ups and fast-tracking their licensing should be our priority. Affordable diagnostic tests can help us understand the exact prevalence of HMPV and enable appropriate and scientific measures to prevent outbreaks in the community and hospitals. By encouraging innovation and reducing the cost of testing, we can ensure that more hospitals can afford to test for HMPV, ultimately leading to better patient care and infection control.

Vigilance, not panic

What should our approach to HMPV be? First, we need vigilance, not panic. HMPV, like other respiratory viruses, has the potential to cause outbreaks. Surveillance systems should be strengthened to monitor the prevalence and impact of respiratory viruses, including HMPV. Second, we must prioritise evidence-based reporting. Media houses have a responsibility to consult experts and rely on credible sources before publishing articles that could cause unnecessary panic. Third, healthcare professionals should remain updated through reliable channels such as the Health Ministry or scientific journals, rather than relying on media reports for information about new outbreaks or diseases.

Lastly, the public should be educated about respiratory viruses in a balanced manner. Awareness campaigns should focus on the broader spectrum of respiratory viruses, emphasising the importance of vaccination for preventable infections like flu and RSV for individuals in the vulnerable categories. The public must also be made aware that most respiratory infections are self-limiting and do not require unnecessary tests or treatments.

The HMPV episode has highlighted the dangers of sensationalist reporting and showcased the value of responsible journalism and the critical role of organisations like the Health Ministry in disseminating accurate information. Supporting indigenous innovations such as low-cost PCR tests for HMPV can further strengthen our healthcare system. Let us hope this serves as a wake-up call for all stakeholders—media, healthcare professionals, and policymakers alike. By working together, we can ensure that public health discourse remains rooted in science and facts, rather than fear and speculation.

(Dr. Abdul Ghafur is senior consultant in Infectious Diseases, Apollo Hospital, Chennai. drghafur@hotmail.com)