From the Guidelines
The management approach for human metapneumovirus infection is primarily supportive care, focusing on relieving symptoms and supporting the patient's respiratory and overall health, as there are no specific antiviral treatments approved for this virus. The approach to managing human metapneumovirus (hMPV) infection involves several key components, including:
- Adequate hydration to prevent dehydration, especially in patients with increased respiratory rate or fever
- Rest to help the body recover from the infection
- Antipyretics such as acetaminophen or ibuprofen for fever and discomfort management, with dosing similar to that for other viral infections, such as 10-15 mg/kg every 4-6 hours for acetaminophen, not exceeding the maximum daily dose
- Supplemental oxygen for patients with hypoxemia, aiming for an oxygen saturation above 92% to prevent hypoxia-related complications
- In severe cases, additional respiratory support may be necessary, ranging from high-flow nasal cannula to mechanical ventilation, depending on the patient's condition and the severity of respiratory distress
While some centers consider treating hMPV lower respiratory tract infection (LRTID) with ribavirin and/or intravenous immunoglobulin (IVIG), there is currently no strong evidence to support the routine use of these treatments 1. The use of antibiotics should be reserved for cases where bacterial co-infection is suspected, as they are not effective against viral infections. Prevention measures, including good hand hygiene, avoiding close contact with infected individuals, and proper cough etiquette, are crucial in reducing the spread of the virus.
In patients with compromised immune systems, such as those undergoing hematopoietic stem cell transplantation (HSCT), the risk of severe disease and complications from hMPV infection is higher, and thus, these patients require closer monitoring and more aggressive supportive care as needed 1. The management approach should be tailored to the individual patient's needs, taking into account their underlying health conditions, age, and immune status.
From the Research
Management Approach for Human Metapneumovirus Infection
The management approach for human metapneumovirus (hMPV) infection is primarily focused on supportive care, as there are no approved vaccines or targeted antiviral therapies currently available 2.
- Diagnostic Methods: Molecular methods such as reverse transcriptase PCR (RT-PCR) are the preferred diagnostic modality for detecting hMPV due to the slow growth of the virus in cell culture 3, 4, 5.
- Treatment Options: Some studies have shown that ribavirin, both oral and aerosolized, along with intravenous immunoglobulin (IVIG), may be an effective treatment option for severe hMPV disease, particularly in immunocompromised patients 6.
- Supportive Care: Supportive care, such as hydration, oxygen therapy, and mechanical ventilation, may be necessary for patients with severe respiratory illness caused by hMPV.
- Preventive Measures: Preventive measures, such as hygiene practices and physical distancing, remain critical in reducing the transmission of hMPV, especially in crowded spaces and healthcare facilities 2.
- Future Directions: Promising innovations, including AI-guided vaccine design and portable diagnostic tools, highlight the potential for future breakthroughs in the management and prevention of hMPV infections 2.