What is the treatment for human metapneumovirus (hMPV) infection?

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Last updated: March 30, 2025View editorial policy

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From the Guidelines

Treatment for human metapneumovirus (hMPV) infection is primarily supportive care, as there are no specific antiviral medications approved for this virus. Management focuses on relieving symptoms and includes rest, adequate hydration, and fever control with acetaminophen or ibuprofen 1. For respiratory symptoms, nasal saline drops and gentle suctioning can help clear congestion. Humidified air may ease breathing difficulties. In more severe cases, supplemental oxygen may be required to maintain oxygen saturation above 92%. Hospitalization is necessary for patients with respiratory distress, dehydration, or those at high risk (infants, elderly, immunocompromised individuals). Some centers consider treating hMPV lower respiratory tract infection (LRTID) with ribavirin and/or IVIG, despite the lack of supporting studies 1. However, due to limited clinical evidence and potential toxicity, ribavirin is not routinely recommended. Key considerations in the management of hMPV infection include:

  • Relief of symptoms
  • Maintenance of hydration and oxygenation
  • Prevention of complications, such as respiratory distress and dehydration
  • Prevention strategies, including good hand hygiene, avoiding close contact with infected individuals, and disinfecting frequently touched surfaces, as hMPV spreads through respiratory droplets and can survive on surfaces for several hours. It is essential to note that hMPV infection can be severe in certain populations, such as immunocompromised individuals, and may require more aggressive management, including hospitalization and supportive care 1.

From the Research

Treatment Options for Metapneumovirus

  • Currently, available treatments for human metapneumovirus (hMPV) infections are only supportive, and antiviral drugs are employed in cases of severe disease as a last resort 2.
  • Ribavirin and immunoglobulins have been used in some patients, but the real efficacy of these treatments is unclear 2, 3, 4.
  • A case study reported rapid and complete recovery in a 2-year-old girl undergoing intensive chemotherapy for Burkitt lymphoma who developed severe hMPV pneumonia after treatment with oral ribavirin and intravenous immunoglobulin 3.

Prophylactic and Therapeutic Approaches

  • Several groups are working on the development of immunogens and therapy to manage hMPV infection with promising results under laboratory conditions, but no virus-specific vaccine or therapy has been approved for clinical use 5, 6.
  • Various vaccination strategies are being explored and tested in animal models, and further studies are required to define the best treatment and prevention strategies 2, 6.

Treatment in Immunocompromised Patients

  • Immunocompromised pediatric patients with hMPV infection have high rates of lower respiratory tract infections and mortality 4.
  • The benefits of treatment with ribavirin and intravenous immunoglobulin in immunocompromised patients require further evaluation 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Metapneumovirus Infections and Respiratory Complications.

Seminars in respiratory and critical care medicine, 2016

Research

Respiratory Tract Infections Due to Human Metapneumovirus in Immunocompromised Children.

Journal of the Pediatric Infectious Diseases Society, 2014

Research

New Approaches for Immunization and Therapy against Human Metapneumovirus.

Clinical and vaccine immunology : CVI, 2015

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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