HMPV: Symptoms, Transmission and Prevention

What is human metapneumovirus (HMPV)?

Human metapneumovirus (HMPV) is a single-stranded RNA virus that can cause acute respiratory infections in people of all ages¹. HMPV was first discovered by Dutch scientists in 2001, when researchers isolated the virus from respiratory samples taken from young children with respiratory infections. It belongs to the family Pneumoviridae, the same family as respiratory syncytial virus (RSV).² Since its discovery, HMPV has spread worldwide and has become one of the common pathogens causing respiratory infections in both children and adults. ³

Peak Season for HMPV Infection

In Hong Kong, HMPV infections can occur throughout the year, but are more common in spring and summer. ¹

Incubation Period of Human Metapneumovirus (HMPV)

The incubation period for HMPV is usually 3 to 6 days. ¹ During this time, infected individuals may be asymptomatic, even as the virus is already replicating in the body.

Human Metapneumovirus (HMPV): Modes of Transmission

HMPV is primarily transmitted via the following routes¹⁻²:

Droplet transmission: The virus can spread through respiratory droplets when an infected person coughs or sneezes.

Direct contact: This can occur through direct contact with an infected person’s secretions, such as by shaking hands or touching them.

Indirect contact: Touching the mouth, nose, or eyes after contacting contaminated surfaces.

As HMPV spreads in a similar way to other respiratory viruses, good personal hygiene is especially important during seasons when respiratory viruses are more common.

Who is at risk of HMPV infection?

High-risk groups include ^2,4:

Children under the age of 5, especially premature babies
Elderly aged 65 and over
Immunocompromised individuals, including those with HIV/AIDS, cancer, autoimmune diseases, or those taking immunosuppressants, immunomodulators and steroids
People with asthma or chronic obstructive pulmonary disease (COPD)

Common symptoms of human metapneumovirus (HMPV) infection

Symptoms caused by HMPV are usually mild, and most people can recover on their own. Common symptoms include ^1,2,4:

Fever
Cough
Stuffy nose
Shortness of breath
Sore throat
Wheezing
Rash

As these symptoms can be similar to those of other respiratory viruses, such as influenza, parainfluenza or RSV, it can be difficult to tell HMPV apart based on symptoms alone.

Complications Caused by HMPV

In rare cases, HMPV may lead to more serious complications requiring hospitalisation, including⁴:

Bronchiolitis

Bronchitis

Pneumonia

Recurrence of asthma or chronic obstructive pulmonary disease (COPD)

Otitis media

Acute gastroenteritis with nausea, vomiting and diarrhea

As the immunity developed following an HMPV infection wanes over time, people can become infected again, even if they have previously had HMPV.²

Diagnosis and Testing for Human Metapneumovirus (HMPV)

As there is currently no specific antiviral treatment for HMPV, healthcare professionals may not routinely test patients for HMPV. However, testing helps to distinguish HMPV from other respiratory infections and assists doctors in devising appropriate treatment and infection control measures, including the need for isolation, the use of antibiotics or the arrangement of further investigations².

HMPV infection is usually diagnosed by collecting samples of nasopharyngeal swabs or respiratory secretions. The virus is then detected using the following methods²:

Molecular testing (nucleic acid amplification tests): The preferred testing method

Antigen testing: including rapid diagnostic tests and immunofluorescence assays

Treatment for HMPV

There is currently no specific antiviral treatment for HMPV. Treatment is usually supportive and focuses on relieving symptoms, such as getting plenty of rest, staying well hydrated and taking medicines to ease discomfort.

Severe cases may require the following treatments, including⁴:

Oxygen therapy: If breathing difficulties occur, a doctor may administer oxygen via a nasal cannula or oxygen mask.

IV drip: Hydration and electrolyte replacement via intravenous injection to prevent or alleviate dehydration.
Corticosteroids: May be used in some cases to reduce respiratory inflammation and alleviate associated symptoms.

Preventing HMPV

The following are the preventive measures recommended by the Hong Kong Centre for Health Protection¹:

Maintain good personal hygiene

Wash your hands frequently with soap and running water, rubbing for at least 20 seconds. If handwashing facilities are not available, use hand sanitiser containing 70% to 80% alcohol instead
Cover your mouth and nose with tissue paper when coughing or sneezing, and dispose of used tissues in a lidded bin
Avoid touching your mouth, nose or eyes with your hands
If you develop respiratory symptoms, wear a surgical mask, avoid going to work or school, and seek medical attention as soon as possible

Maintain good environmental hygiene

Regularly clean and disinfect frequently touched surfaces

Ensure good ventilation indoors
Clean and disinfect tableware

Human Metapneumovirus (HMPV) Infection: Frequently Asked Questions (FAQ)

1. How long does it take to recover from an HMPV infection?

Most mild HMPV infections are similar to the common cold. Symptoms usually improve gradually over a period of a few days to a week. If more serious complications such as pneumonia develop, recovery may take longer. ⁴

2. Is there currently a vaccine available for HMPV?

There is currently no vaccine approved for the prevention of HMPV.²

3. What are the most susceptible age groups for RSV and HMPV infections?

Both HMPV and RSV can cause severe respiratory infections, but the peak age groups for severe illness in children differ slightly.⁴

HMPV: Severe cases are most common in infants aged between 6 and 12 months.
RSV: Severe cases are most common in infants under 6 months of age.

4. Do you need to take antibiotics for an HMPV infection?

Not in most cases. HMPV is a viral respiratory infection, and as antibiotics are only effective against bacterial infections, they cannot effectively treat HMPV itself. ⁴ However, some patients may develop secondary infections, such as bacterial pneumonia; in such cases, a doctor may prescribe antibiotics based on the clinical presentation. ⁴

If you or a family member develops respiratory symptoms, particularly during the HMPV season, it is advisable to consult your GP for a proper assessment and treatment.

References

Centre for Health Protection. (2026). Human Metapneumovirus Infection. https://www.chp.gov.hk/en/healthtopics/content/24/12284.html (Accessed 6 July 2026)
Centers for Disease Control and Prevention. (2026). About Human Metapneumovirus. https://www.cdc.gov/human-metapneumovirus/about/index.html (Accessed 6 July 2026)
Gao, G., Lin, R. and Ma, D. (2025). 'Human metapneumovirus: pathogenesis, epidemiology, diagnostic technologies, and potential intervention strategies', Virology Journal, 22(1), p. 376. Available at: https://doi.org/10.1186/s12985-025-02983-5 (Accessed 6 July 2026)
Cleveland Clinic. (2024). Human Metapneumovirus (HMPV). Available at: https://my.clevelandclinic.org/health/diseases/22443-human-metapneumovirus-hmpv (Accessed 6 July 2026)