HMPV was in the news a great deal at the start of 2025, leaving many families wondering whether a new epidemic had begun. In fact human metapneumovirus (HMPV) is not a new virus; it is one of the common respiratory viruses that, in winter and spring, cause illnesses in children ranging from a cold to pneumonia. In this article we explain the symptoms of HMPV, how it spreads, how to care for a child at home and when to see a doctor without waiting.

What is HMPV?

According to the CDC, HMPV was identified in 2001 and belongs to the same virus family as RSV (Pneumoviridae). It can cause upper and lower respiratory infections in people of all ages. In its assessment at the beginning of 2025, the World Health Organization (WHO) stated that HMPV is a common respiratory virus circulating in many countries from winter into spring, that most infected people have mild symptoms similar to a common cold and that most recover within a few days.

What are the symptoms?

The most common symptoms listed by the CDC are:

  • Cough
  • Fever
  • Blocked and runny nose
  • Shortness of breath

In some children the infection can progress to bronchitis or pneumonia. In young babies, wheezing, reduced feeding and fussiness may be most noticeable. Nasal discharge becoming thicker and coloured within a few days can be part of the normal course of a cold (green snot in children).

Can it be told apart from RSV and flu?

HMPV, RSV and flu cause similar symptoms; it is not possible to tell them apart from symptoms alone. The virus can only be shown by laboratory tests on a nasal swab. Because care for most children does not change depending on the name of the virus, the doctor orders a test when the result would affect treatment or a decision to admit the child to hospital. For flu, see our article on flu in children. With a cough that lasts more than a week and keeps getting worse, walking pneumonia (Mycoplasma), which is caused by a bacterium, should also be considered.

Who is at higher risk?

According to the CDC, the risk of severe illness is highest in:

  • Young children, especially babies
  • Older adults
  • People with weakened immune systems

In children with asthma or chronic lung disease, respiratory viruses can trigger attacks, so symptoms should be watched more closely (asthma in children).

How does it spread?

According to the CDC, HMPV spreads through:

  • Droplets from coughs and sneezes
  • Close contact such as touching or shaking hands
  • Touching contaminated surfaces (toys, door handles, tables) and then the mouth, nose or eyes

Treatment and home care

The CDC states that there is no specific antiviral medicine and no vaccine for HMPV, and that treatment aims to relieve symptoms. Antibiotics do not work against viruses.

  • Give fluids often; breastfeed a breastfed baby frequently.
  • Keep the nose clear with saline, especially before feeds and sleep.
  • Let the child rest, do not overheat the room and air it regularly.
  • Use a fever reducer only as advised by the doctor; do not start cough and cold medicines yourself.

Prevention

The advice of the WHO and the CDC is the same as for other respiratory viruses: washing hands often with soap, covering the mouth with a tissue or the elbow when coughing and sneezing, cleaning frequently touched surfaces, airing indoor spaces and keeping a sick child away from nursery and school until recovered. PCV (the pneumococcal vaccine) protects against pneumococcus, not against HMPV (pneumococcal vaccine).

Siblings, nursery and school

The WHO recommends that people stay at home even when mildly ill. A child with fever or who is unwell should rest at home until the fever has gone and they feel well. If there is a young baby at home, the sick sibling should not bring their face close to the baby, toys should not be shared and hands should be washed before touching the baby. The precautions in our article on RSV and bronchiolitis also apply to HMPV.

When to see a doctor

  • Fast or laboured breathing, the skin pulling in below the ribs, flaring nostrils
  • Bluish lips or face
  • Inability to keep fluids down, clearly fewer wet nappies, unusual drowsiness
  • Fever in a baby younger than 3 months

Book an appointment: fever lasting more than 3 days or a high fever, ear pain, a cough that is not improving or is getting worse. We explain when a fever is dangerous in our article when is a high fever dangerous. If wheezing attacks keep coming back, a paediatric allergy and asthma assessment is recommended. You can book an appointment at Özel Düztepe Yaşam Hospital in Şahinbey, Gaziantep.