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Respiratory viruses are part of our surrounding ecology, with rates increasing and decreasing across seasons and in accordance with the individual virus environmental preferences and human interactions. The SARS-CoV2 pandemic heightened international concern regarding respiratory virus presence and continues to serve as a stark reminder that illness anywhere in the world can have a profound impact on health in the United States. Recent surveillance information from East Asia and the United States have recognized an increase in a respiratory virus that may not be familiar to many, human metapneumovirus (hMPV or HMPV).

Human metapneumovirus is a respiratory virus that belongs to the Paramyxoviridae family, the same family as respiratory syncytial virus (RSV) and parainfluenza viruses. Although hMPV was first identified in 2001, it has not gained as broad name recognition as other respiratory viruses and may still be unfamiliar to many.

This virus causes respiratory tract infections in people of all ages, but it is most common in young children, older adults, and immunocompromised individuals. hPMV infections are common in late winter and early spring. By the age of 5, most children have been exposed to the virus; reinfections can occur throughout life, though they are generally less severe in healthy adults. This respiratory virus is not a nationally reportable disease, so there are limited surveillance data available to provide communities with more precise rates of disease within communities.

Key Features of hMPV.

  1. Just like influenza, RSV, and COVID-19, HPMV transmission occurs via respiratory droplets, direct contact with contaminated surfaces, and close contact with infected individuals. The virus is highly contagious, especially in settings like daycare centers and long-term care facilities.
  2. Symptoms range from mild to severe, are similar to those of other respiratory viral infections, and include runny nose, cough, fever, sore throat, wheezing, and shortness of air. In severe cases, especially in young children and older adults, it can lead to bronchiolitis, pneumonia, or exacerbation of asthma and COPD.
  3. Incubation period typically ranges from 4 to 6 days.
  4. hMPV can be diagnosed by obtaining a nasopharyngeal respiratory specimen, then using PCR (polymerase chain reaction) testing to detect viral RNA.
  5. There is no specific antiviral treatment for hMPV and management is primarily supportive.
  6. Preventive measures include attention to hand hygiene, avoiding close contact with infected individuals, and cleaning and disinfecting frequently touched surfaces.

The role of nurses in prevention and control.

Given the preventive measures just listed, it is clear that nurses play a crucial role in managing and controlling outbreaks of hMPV as well as other respiratory viruses. Basic infection prevention and control activities relevant to care of all patients are summarized in training materials provided by the CDC as part of Project Firstline.

Key actions nurses can take that impact recognition, transmission prevention, and control include the following:

  1. Early Recognition and Assessment

  • Assess patients for respiratory symptoms such as cough, fever, runny nose, and wheezing.
  • If symptoms of respiratory illness are present, recognize potential for transmission opportunities, especially during cough and/or sneezing episodes and during procedures that may generate respiratory aerosols (e.g., suctioning, intubation, respiratory treatments).
  • Notify the facility infection prevention and control department for collaborative assistance.
  • If respiratory specimen collection is indicated, ensure best practice collection and specimen transport practices are used to optimize results.

  1. Infection Prevention and Control

  • Hand hygiene: Ensure proper and frequent handwashing or use of alcohol-based hand sanitizers prior to all patient contact.
  • Avoid hand contamination: Avoid contact with patient body fluids, including respiratory secretions.
  • Personal protective equipment (PPE): Standard precautions should be used to prevent all unprotected contact with body fluids, so select and use appropriate PPE (e.g., masks, gloves, gowns, and eye protection) for all patients, not just those suspected to have a transmissible infection.
  • Isolation precautions:
    • Be prepared to implement droplet and contact precautions for patients with suspected or confirmed hMPV infections.
    • Cohort patients with similar infections to reduce cross-contamination.
  • Environmental cleaning:
    • Support the efforts of environmental services personnel so they are able to regularly clean and disinfect high-touch surfaces and shared medical equipment using an appropriate health care–grade disinfectant.

  1. Patient Education

  • Educate patients and families on:
    • Proper hand hygiene and respiratory etiquette (covering coughs and sneezes).
    • Avoiding close contact with vulnerable individuals if they have respiratory symptoms.
    • When to seek medical care for worsening symptoms, especially in high-risk groups.

  1. Self-Care for Nurses

  • Ensure personal well-being by following safety protocols and reporting symptoms of illness that may indicate a transmissible infection.
  • Stay up-to-date with the latest guidelines and evidence-based practices for hMPV and respiratory outbreaks.

  1. Continued Professional Development

  • Stay informed about the evolving situation through trusted health sources, such as the CDC, WHO, local health departments, and professional associations.
  • Attend training on respiratory infection management, outbreak response, and new preventive measures.

Ruth Carrico, PhD, FNP-C, CIC, FSHEA, FNAP, FAAN, is an adjunct professor in the Division of Infectious Diseases at the University of Louisville School of Medicine and a board certified family nurse practitioner. She has worked in the field of infection prevention and control for more than 30 years and is also board certified in infection prevention and control. Her research and clinical practice focus on disease prevention in all settings where care is delivered and involves public health and care of vulnerable populations. Ruth’s last posts for this blog were “Norovirus, a Formidable and Underappreciated Hazard: What Nurses Need to Know” and “The Critical Role of Nurses in IV Fluid Conservation.”