From the Guidelines
Treatment for human metapneumovirus (hMPV) infection is primarily supportive care, focusing on relieving symptoms, as there are no specific antiviral medications approved for this virus. Management typically includes rest, adequate hydration, and over-the-counter pain relievers such as acetaminophen (10-15 mg/kg every 4-6 hours for children, not exceeding 75 mg/kg/day; 325-650 mg every 4-6 hours for adults, maximum 3000 mg/day) or ibuprofen (10 mg/kg every 6-8 hours for children; 200-400 mg every 4-6 hours for adults) to reduce fever and discomfort 1. For respiratory symptoms, humidified air and nasal saline drops may help relieve congestion. Severe cases, particularly in high-risk individuals like infants, elderly, or immunocompromised patients, may require hospitalization for oxygen therapy, intravenous fluids, or respiratory support.
While ribavirin has shown some activity against hMPV in laboratory studies, it is not routinely recommended due to limited clinical evidence and potential toxicity 1. Antibiotics are not effective against viral infections but may be prescribed if a secondary bacterial infection develops. Prevention measures include good hand hygiene, avoiding close contact with sick individuals, and covering coughs and sneezes, as hMPV spreads through respiratory droplets and can survive on surfaces for several hours.
Key considerations in managing hMPV infection include:
- Monitoring for signs of severe disease, especially in high-risk populations
- Providing supportive care to manage symptoms and prevent complications
- Avoiding unnecessary use of antibiotics unless a secondary bacterial infection is confirmed
- Implementing preventive measures to reduce the spread of the virus Given the lack of specific antiviral treatment and the potential for severe disease in certain populations, a cautious approach prioritizing supportive care and prevention is recommended 1.
From the Research
Treatment Options for Metapneumovirus Infection
- The current treatment for metapneumovirus infection is primarily supportive, with antiviral drugs used in severe cases as a last resort 2.
- Ribavirin and immunoglobulins have been used in some patients, but their efficacy is unclear 2, 3.
- A case study reported the successful treatment of a 2-year-old girl with severe hMPV pneumonia using oral ribavirin and intravenous immunoglobulin 3.
Severity and Risk Factors
- Metapneumovirus infection can cause severe disease, particularly in individuals with high viral loads, coinfections, or underlying health conditions such as immunodeficiency 2.
- The elderly, young children, and immunocompromised patients are at higher risk of developing severe metapneumovirus infections 2, 4, 5, 6.
Diagnosis and Complications
- Diagnosis of metapneumovirus infection is often based on nucleic acid amplification tests, such as reverse transcriptase polymerase chain reaction 4.
- Complications of metapneumovirus infection can include respiratory failure, pneumonia, and acute exacerbation of chronic obstructive pulmonary disease 5, 6.
- Bacterial coinfections are common in patients with metapneumovirus-associated lower respiratory tract infections, and can contribute to a more complicated course 5.