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HMPV (Human Metapneumovirus) is now a global concern due to a rise in cases in multiple countries, including China, where it accounts for 6.1% of respiratory infections.

Understanding the virus’s characteristics, symptoms, and prevention methods is essential for public health, especially for vulnerable groups like children and the elderly.

What is the HMPV Virus?

Human Metapneumovirus (HMPV) is a respiratory virus identified in 2001 in the Netherlands. It belongs to the Paramyxoviridae family and shares characteristics with other respiratory viruses like RSV (Respiratory Syncytial Virus).

Although it was only identified in 2001, researchers estimate that HMPV had been circulating for decades beforehand.

HMPV can cause upper and lower respiratory tract infections, with varying degrees of severity from mild to severe.

The virus can infect anyone, but it more often affects young children under five, the elderly, and those with weakened immune systems, causing serious symptoms.

Are Type A Influenza and HMPV Cases Already in Indonesia?

The Minister of Health, Budi Gunadi Sadikin, has confirmed that the HMPV virus has been found in Indonesia, with all cases detected among children. The public is advised not to panic because HMPV is an existing virus that is similar to the common flu.

From 2005 to 2017, Indonesia reported 200 cases of the H5N1 variant of Type A influenza, resulting in 168 deaths, which gives a Case Fatality Rate (CFR) of 84%.

Since 2018 until now, there have been no new reports of cases in humans. For the H5N6 and H9N2 variants currently circulating in China, they have not yet been detected in Indonesia.

As of week 51 in 2024, data from the Chinese Center for Disease Control and Prevention shows that influenza viruses are still the main cause of respiratory infections in Asia.

In China, HMPV is the third most common cause of respiratory infections at 6.1%, behind influenza (23.1%) and rhinovirus (6.2%).

The Indonesian Ministry of Health continues to monitor through:

  • Sentinel surveillance of Influenza Like Illness (ILI)
  • Health quarantine surveillance at country entry points
  • Laboratory examinations for multipathogen detection, including HMPV

Epidemiologically, Indonesia records about 4 million flu cases annually, resulting in nearly 200,000 flu-related hospitalizations. With the discovery of HMPV cases, the national surveillance system has been enhanced to monitor this situation more closely.

Symptoms of HMPV Virus

HMPV exhibits symptoms similar to other respiratory tract infections, with an incubation period of 3–6 days. Clinical manifestations can range from mild to severe:

– General HMPV Symptoms:

  • Cough (can be dry or with phlegm)
  • Fever with temperature ≥38°C (100.4°F)
  • Nasal congestion and runny nose
  • Sore throat
  • Shortness of breath
  • Fatigue and malaise

– Gastrointestinal Symptoms:

  • Decreased appetite
  • Nausea
  • Vomiting

– Severe HMPV Symptoms:

In severe cases, especially for vulnerable groups like children, the elderly, and those with weakened immune systems, the infection can worsen into:

  • Wheezing
  • Bronchiolitis
  • Pneumonia
  • Severe breathing difficulties requiring intensive care

Causes of HMPV Virus

HMPV spreads through several primary transmission mechanisms:

– Droplet Transmission:

  • Saliva droplets from coughing and sneezing of an infected person
  • Respiratory secretions containing the virus

– Contact Transmission:

  • Direct contact with an infected person
  • Touching surfaces or objects contaminated with the virus and then touching the mouth, nose, or eyes

– HMPV Risk Factors:

  • Young age (especially children under 5 years)
  • Older age (over 65 years)
  • Weakened immune system

This virus exhibits a clear seasonal pattern in temperate regions, with peak activity occurring from late winter to early spring. In Indonesia, the virus can be found throughout the year but with an increase in cases during the rainy season.

Diagnosis of HMPV Virus

Diagnosing HMPV requires a comprehensive approach involving multiple examination methods:

– Clinical Examination:

  • Evaluation of symptoms and physical signs
  • Complete medical history
  • Thorough physical examination, especially of the respiratory system

– Laboratory Examination:

  • Detection of the virus genome using RT-PCR (Reverse Transcription Polymerase Chain Reaction)

Treatment of HMPV Virus

Currently, there is no specific antiviral treatment for HMPV. The main management focuses on supportive therapy:

  • Administration of analgesic-antipyretic such as paracetamol to alleviate fever and pain
  • Adequate rest
  • Use of a humidifier
  • Oxygen administration in cases with severe respiratory distress

Hospitalization Indications:

  • Severe breathing difficulties
  • Dehydration
  • Decreased oxygen saturation
  • Symptoms not improving after treatment

Most cases of HMPV will recover within 2–5 days with appropriate supportive care. However, close monitoring is necessary, especially in high-risk groups such as children, the elderly, and immunocompromised patients.

Prevention of HMPV Virus

Since there is no specific vaccine available for HMPV, prevention is the key to controlling the spread of this virus. Here are some preventive steps you can take:

– Personal Hygiene:

  • Regularly wash hands with soap and running water for at least 20 seconds
  • Use alcohol-based hand sanitizer if water and soap are not available
  • Avoid touching the face area, especially the eyes, nose, and mouth with unclean hands
  • Cover mouth and nose when coughing or sneezing with a tissue or the inside of the elbow

– Environmental Preventive Measures:

  • Clean and disinfect surfaces frequently touched like door handles, phones, and tables
  • Ensure good air ventilation indoors
  • Avoid crowded areas, especially during respiratory disease season
  • Maintain distance from individuals showing symptoms of respiratory diseases

– Isolation and Quarantine:

  • Self-isolate if experiencing symptoms
  • Avoid sharing eating and drinking utensils with others
  • Refrain from close contact such as shaking hands while sick

– Use of Protective Gear:

  • Wear masks when in public places or when ill
  • Properly dispose of used tissues
  • Change masks regularly as recommended

– Healthy Lifestyle:

  • Maintain adequate fluid intake
  • Eat a nutritious and balanced diet
  • Get enough rest to keep the immune system strong
  • Manage stress effectively

For vulnerable groups like the elderly, children, and those with weak immune systems, these preventive measures should be followed more carefully.

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