Are hospitals in China being overwhelmed by HMPV patients? Should India worry?

There seems to be an outbreak of the human metapneumovirus (HMPV) in China.

There are reports that virus, which causes flu-like symptoms, has left hospitals and emergency rooms overwhelmed.

But what do we know?

Let’s take a closer look:

What is happening in China?

A number of posts on social media have gone viral showing hospitals in China being overcrowded.

HMPV, Influenza A, and Mycoplasma pneumonia are among the viruses said to be circulating.

Hospitals in China  Overwhelmed as Severe "Flu" Outbreak, Including Influenza A and HMPV, Resembling 2020 COVID Surge. pic.twitter.com/GWw9u6JxsX

— Boar News (@PhamDuyHien9) December 29, 2024

⚠️ BREAKING:

Hospitals in China 🇨🇳 Overwhelmed as Severe "Flu" Outbreak, Including Influenza A and HMPV, Resembling 2020 COVID Surge.

Hospitals in China are overwhelmed as outbreaks of "influenza A" and "human metapneumovirus" resemble the COVID-19 surge from three years ago. pic.twitter.com/mPF6XGjQCY

— SARS‑CoV‑2 (COVID-19) (@COVID19_disease) December 28, 2024

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However, it is important to note that these videos have not been verified.

There is also no official confirmation from the authorities in China about hospitals being overwhelmed.

Authorities have asked citizens to wear face masks and wash hands frequently.

There are also no reports of any HMPV cases in India.

ANI quoted sources as saying that the National Centre for Disease Control (NCDC) under the Union Health Ministry is closely monitoring respiratory and seasonal influenza cases in the country, and is in touch with international agencies.

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A top Indian official has said there is no need to panic.

NDTV quoted Directorate General of Health Services (DGHS) official Dr Atul Goyal as saying only general precautions against all respiratory infections were needed.

“… Otherwise, there is nothing to be alarmed about the present situation,” Dr Goyal said.

“There has been news doing the rounds about a Metapneumovirus outbreak in China. Let me be very clear on that count. Metapneumovirus is like any other respiratory virus which causes common cold, and in the very old and the very young it could cause flu-like symptoms,” Dr Goyal said.

“We have analysed data of the respiratory outbreaks within the country. There is no substantial increase in December 2024 data and no cases which have been reported in large numbers from any of our institutions,” he said.

One thing I would like to convey to the public is to take general precautions that we use against all respiratory infections, which means if somebody has a cough and cold, you should avoid coming in contact with a lot of people so that the infection does not spread," he added. “Use a distinct handkerchief or towel for coughing and sneezing and take normal medicines that are required for cold or fever whenever it is there, otherwise there is nothing to be alarmed about the present situation.”

“We will continue to monitor the situation closely, validate the information and update accordingly,” the Hindustan Times quoted sources from the WHO as saying, “The data from December 16-22, indicates a recent rise in acute respiratory infections, including seasonal influenza, rhinovirus, respiratory syncytial virus (RSV) and human metapneumovirus (HMPV), however, the overall scale and intensity of respiratory infectious diseases in China this year is lower than last year. A seasonal increase in respiratory pathogens is expected in the northern hemisphere, particularly during the winter period.”

What do we know about the virus?

According to China’s CDC website, the human metapneumovirus is an RNA virus.

It belongs to the Pneumoviridae, Metapneumovirus genus.

It was first discovered by Dutch researchers in 2001.

They were examining samples of children with respiratory infections.

However, studies have indicated that the virus has existed for at least six decades.

It has spread all over the world as a common respiratory pathogen.

It is mainly spread in droplets – through coughing and sneezing.

Transmission may also occur due to close contact with the infected people and exposure to contaminated environments.

The virus has an incubation period of three to five days.

The immune response induced by HMPV is too weak to stop repeated infections.

Though it can be found throughout the year, it is most detected in winter and spring, as per the CDC website.

The HMPV is most likely to infect children, the immunocompromised and the elderly.

It can manifest as symptoms of the common cold – including cough, fever, nasal congestion and wheezing.

However, in severe cases it can also result in bronchitis and pneumonia.

As per Lung.org, doctors in severe cases can perform a bronchoscopy.

Here, small, flexible camera is inserted into the lung and a sample of fluid is removed to test for viruses.

HMPV can kill people who have underlying medical conditions.

A piece in Lancet Global Health in 2021 quoted data as showing that HMPV was responsible for the deaths of 1 per cent of children with acute lowest respiratory under age five.

There are no vaccines against HMPV.

Treatment is usually limited to easing symptoms.

According to Inkl.com, over-the-counter medication such as acetaminophen or ibuprofen can help.

So can decongestants to relieve nasal congestion.

Those with COPD, asthma, and pulmonary fibrosis may get severe symptoms and might need medication to control wheezing and coughing.

In a recent interview with the state-backed National Business Daily, a respiratory expert at a Shanghai hospital warned the public against blindly using antiviral drugs to fight human metapneumovirus, for which there is no vaccine but whose symptoms resemble those of a cold.

What is China doing?

The Star reported that China’s National Disease Control and Prevention Administration in has established protocols for laboratory reporting and case verification.

As per Financial Express, the CDC has issued a slew of recommendations including wearing masks in crowded places, keeping a social distance, frequently washing hands and avoiding crowded areas.

The department also advised maintaining good hygiene, ensuring proper ventilation of indoor spaces and adopting a healthy lifestyle.

China’s diseases control authority previously said that it was piloting a monitoring system for pneumonia of unknown origin.

The move to establish a dedicated system is aimed at helping authorities set up protocols to handle unknown pathogens, in contrast to the lower level of preparedness five years ago when the novel coronavirus that causes COVID-19 first emerged.

The National Disease Control and Prevention Administration will establish a procedure for laboratories to report and for disease control and prevention agencies to verify and handle cases, state broadcaster CCTV reported, quoting an administration official at a news conference.

China is likely to be affected by various respiratory infectious diseases in winter and spring, Kan Biao, another official, said at the news conference. He said without elaborating that the overall number of cases this year would be smaller than last year.

Recent cases detected include pathogens such as the rhinovirus and human metapneumovirus, with cases of the human metapneumovirus among people under the age of 14 showing an upward trend, especially in northern provinces.

“Data from Dec 16-22 indicates a rise in acute respiratory infections, including hMPV, particularly in northern provinces. Recent cases have predominantly involved individuals under 14 years of age,” Reuters reported.

With inputs from agencies