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Human metapneumovirus (HMPV) is a cause of both upper and lower respiratory tract infections, including bronchiolitis and pneumonia, particularly among young children and older adults. In the United States, HMPV season extends from November to February through May to July. It is responsible for 5% to 15% of hospital admissions for lower respiratory tract infection in infants and young children.

Transmission likely occurs as a result of direct or indirect contact with infected secretions spread by fomites or through large particle aerosols. Incubation period for hMPV is 5 to 6 days. Clinical characteristics range from mild upper respiratory infection to respiratory failure and death. Reported fatality rates have ranged from 0% to 31% of cases.

Even though almost all adults have HMPV antibody HMPV can cause symptomatic reinfection throughout life, especially among older adults and immunocompromised persons. Risk factors for severe illness in adults include advanced age and underlying cardiopulmonary disease.

Due to the length of time required to detect HMPV, respiratory viral cultures are impractical for diagnostic purposes. Reverse transcriptase polymerase chain reaction (RT-PCR) is the most sensitive and commonly used method for diagnosis of HMPV infection. Collection of a respiratory specimen within 3 to 4 days after symptom onset can increase detection of respiratory viruses by molecular diagnostic tests. HMPV is detected by the Biofire Filmarray for respiratory pathogens. Specimen requirement is a nasopharyngeal swab, nasal wash or bronchoscopy specimen.   

  1. Williams JV, Harris PA, Tollefson SJ, et al. Human metapneumovirus and lower respiratory tract disease in otherwise healthy infants and children. N Engl J Med 2004;350:443–50.
  2. Hamelin ME, Côté S, Laforge J, et al. Human metapneumovirus infection in adults with community-acquired pneumonia and exacerbation of chronic obstructive pulmonary disease. Clin Infect Dis 2005;41:498–502.
  3. Haynes AK, Fowlkes AL, Schneider E, Mutuc JD, Armstrong GL, Gerber SI. Human metapneumovirus circulation in the United States, 2008 to 2014. Pediatrics 2016;137:e20152927.
  4. Haas LE, Thijsen SF, van Elden L, Heemstra KA. Human metapneumovirus in adults. Viruses 2013;5:87–110
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