Metapneumovirus 2025 – Romania on alert following the first confirmed case

Human metapneumovirus (hMPV) is an emerging threat to respiratory health, and Romania is now facing its first confirmed case. In the context of rising infections in Europe and China, this virus, first discovered in 2001, causes severe respiratory infections with symptoms similar to other respiratory viruses, such as persistent cough, fever, and difficulty breathing.

In this article, you will learn everything you need to know about human metapneumovirus: how it is transmitted, its characteristic symptoms, treatment methods, and prevention measures. Make sure to stay informed to protect your health and that of your loved ones!

The first case of hMPV in Romania

According to a report by the National Institute of Public Health, the first case of human metapneumovirus (hMPV) in Romania was detected in November 2024, in Bucharest, within the SARI (Severe Acute Respiratory Infections Surveillance) system. A second case, also from Bucharest, was confirmed on January 9, 2025, by the "Cantacuzino" National Military Medical Institute for Research and Development. Furthermore, a third case, involving a 67-year-old woman from Oradea with comorbidities and symptoms that appeared on December 26, 2024, is currently being validated. (***, 2025)

What is human metapneumovirus (hMPV)?

Human metapneumovirus (hMPV) is a respiratory virus discovered in 2001 in the Netherlands, holding major importance in causing acute respiratory infections, especially in young children, the elderly, and individuals with a compromised immune system. It belongs to the Pneumoviridae family and has the ability to affect both upper and lower respiratory tracts, potentially leading to severe conditions such as pneumonia or acute bronchiolitis.

Significant study: Metapneumovirus is the second most common viral pathogen causing lower respiratory tract infections in children, after respiratory syncytial virus (RSV). (Miyakawa, et al., 2024)

Current situation in China and Europe

In recent months, human metapneumovirus (hMPV) has recorded a significant increase in China and Europe.

In China, authorities are reporting a wave of respiratory infections, especially in northern regions such as Beijing and Shanghai, putting pressure on the healthcare system.

In the UK, the rate of positive tests for hMPV increased to 4.53% in December 2024, compared to 2.29% in the previous month (Toth, 2025). The ECDC (European Centre for Disease Prevention and Control), the CDC (China's Center for Disease Control and Prevention), and the WHO (World Health Organization) are monitoring the situation and recommending measures to prevent the spread of the virus in hospitals and care centers. (***, 2025)

Symptoms and clinical manifestations

The estimated incubation period is 3 to 6 days, and the average duration of the illness can vary depending on severity, being similar to other viral respiratory infections (***, 2016).

Metapneumovirus infection manifests through a wide range of symptoms, which can vary from mild to severe forms. Common symptoms include (***, 2023):

• Persistent cough
• Fever
• Nasal congestion
• Difficulty breathing
• Wheezing
• Sore throat
• Severe fatigue

In severe cases, the following may occur (***, 2023):

• Pneumonia
• Bronchiolitis
• Acute respiratory distress
• Metabolic imbalances

When to go to the emergency room?

It is essential to seek emergency medical help if you or your child present symptoms of severe illness, such as (***, 2023):

• High fever (above 40°C)
• Difficulty breathing
• Bluish tint to the skin, lips, or fingernails (cyanosis)
• Worsening of other existing health conditions

These signs may indicate a serious complication of metapneumovirus infection and require rapid medical intervention.

How is human metapneumovirus (hMPV) transmitted?

Human metapneumovirus (hMPV) is easily transmitted through direct contact with an infected person or by touching objects contaminated with the virus. The most common modes of transmission include (***, 2023):

• Coughing and sneezing: infected respiratory droplets are released into the air and can be inhaled by those nearby
• Physical contact: shaking hands, hugging, or kissing can facilitate the spread of the virus
• Contaminated surfaces: both personal items and frequently touched surfaces (phones, door handles, keyboards, toys) can be vehicles for the virus

Therefore, it is essential to adopt protective measures, such as frequent hand washing and avoiding contact with infected persons to prevent the spread of hMPV.

Who is at risk of metapneumovirus infection?

Groups of people at high risk include (***, 2023):

• Children under 5 years old: they are the most affected, accounting for 30% of total metapneumovirus cases
• Adults over 65 years old: the hospitalization rate in this group is approximately 15-20% of cases
• People with a compromised immune system: they are much more vulnerable to complications of the infection
• Patients with chronic diseases (e.g., cardiovascular or respiratory conditions)
• Pregnant women

How is human metapneumovirus (hMPV) infection diagnosed?

Diagnosis of hMPV infection is essential for correctly identifying acute respiratory infections, especially due to symptoms shared with other respiratory viruses. The most widely used diagnostic methods include (Jeong, Park, Song, & Kim, 2020):

• RT-PCR: this is the gold standard for detecting viral RNA from respiratory samples, providing highly sensitive results
• Rapid antigen tests: these offer quick results but with lower sensitivity, risking false negatives
• Viral culture and immunofluorescence: older methods, still used as a reference due to their high specificity
• Emerging technologies: nanotechnology and biosensors promise faster and more sensitive diagnostic methods

New diagnostic techniques will significantly improve the management of hMPV infections, especially in high-risk patients.

In addition, additional procedures, such as chest X-rays or bronchoscopy, may be recommended to examine the airways. (***, 2023)

Testing for hMPV is recommended especially during the winter and spring months, when the virus is most active.

Treatment and recovery

Treatment is generally symptomatic (***, 2023):

• Adequate hydration to prevent dehydration
• Antipyretics to control fever
• Nasal decongestants to facilitate breathing
• Humidifying the air to support breathing

For severe cases, the following may be necessary (***, 2023):

• Oxygen therapy
• Respiratory support in hospitals
• Intravenous fluid treatment for rehydration
• Corticosteroid treatment to reduce inflammation and alleviate certain symptoms
• Constant monitoring of the patient's condition

Regarding antiviral treatment, there is no specific therapy for hMPV. However, in serious cases, medications such as Ribavirin (also used in treating RSV and hepatitis C) have been used, often in combination with intravenous immunoglobulins. (***, 2024)

Antibiotics are effective only against bacteria, and since hMPV is a virus, they will not eliminate the viral infection. In some cases, individuals who develop pneumonia due to hMPV may also develop a secondary bacterial infection. If a doctor prescribes antibiotics, they are intended to treat secondary infections, not the hMPV virus itself. (***, 2023)

Stability of human metapneumovirus on surfaces

Human Metapneumovirus (hMPV) can remain infectious on non-porous surfaces for several hours, with a loss of up to 99% of infectivity after 8 hours on metal. On porous surfaces, such as paper and fabrics, the virus degrades rapidly, and after 4 hours, only a small amount of active virus remains. (Tollefson, Cox, & Williams, 2010)

This information is essential for preventing nosocomial transmission, especially in hospitals. hMPV can persist in different environments, which underscores the importance of effective cleaning and disinfection of frequently touched surfaces. In laboratories, knowing the resistance of hMPV is important for the proper handling of samples and obtaining accurate results. (Tollefson, Cox, & Williams, 2010)

Implementing hygiene and infection control measures is essential for limiting the spread of hMPV, especially in healthcare institutions.

Prevention and protective measures

To prevent the spread of metapneumovirus, it is recommended to (***, 2024):

General measures:

• Frequent washing and disinfection of hands
• Wearing a mask in crowded public places
• Avoiding contact with sick people
• Frequent ventilation of rooms

Specific measures:

• Disinfection of frequently touched surfaces
• Proper respiratory hygiene (sneezing or coughing into a tissue or the elbow)
• Social distancing during peak periods of infection
• Strengthening the immune system through a balanced diet, sufficient sleep, and physical exercise

Effective disinfectants and substances

Because human metapneumovirus (hMPV) is an enveloped virus, it is sensitive to disinfectants that attack and destroy its lipid envelope. To prevent contamination with metapneumovirus, the use of certain active substances is recommended:

• Ethyl alcohol (70-85)%
• Sodium hypochlorite
• Hydrogen peroxide
• Peracetic acid

It is also important to follow clear disinfection protocols, such as:

• Disinfecting frequently touched contact surfaces
• Minimum contact time for high efficiency
• Recommended concentrations
• Frequency of application to prevent the spread of the virus

Recommendations for travelers

For travel to high-risk areas, it is recommended to:

• Monitor health alerts for the chosen destination
• Stay up to date with vaccinations for other respiratory conditions
• Personal protection kit (masks, disinfectants)
• Appropriate medical insurance that covers treatment costs in case of infection

Prospects and forecasts

Research into developing a vaccine against metapneumovirus is ongoing (***, 2024). Recent epidemiological studies suggest that the virus could undergo seasonal variations, having a significant impact on public health. Genomic monitoring is crucial for better understanding the evolution of the virus and developing long-term management strategies.

Human metapneumovirus represents an important threat to global public health, especially in the post-pandemic context. Understanding symptoms, prevention methods, and available treatments is essential for protecting individual and collective health. It is important to stay informed and follow the recommendations of health authorities to minimize the risk of infection and transmission.

Bibliography

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***. (2023). Retrieved from https://my.clevelandclinic.org/health/diseases/22443-human-metapneumovirus-hmpv

***. (2023). Retrieved from https://my.clevelandclinic.org/health/diseases/22443-human-metapneumovirus-hmpv

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***. (2024). Retrieved from https://virologyresearchservices.com/2024/05/31/the-most-important-virus-hardly-anybody-talks-about/

***. (2025). Retrieved from https://www.ecdc.europa.eu/en/news-events/increase-respiratory-infections-china

***. (2025). Retrieved from https://insp.gov.ro/2025/01/10/informare-privind-metapneumovirusul-uman-hmpv/

Jeong, S., Park, M.-J., Song, W., & Kim, H.-S. (2020). Advances in laboratory assays for detecting human metapneumovirus. Annals of Translational Medicine.

Miyakawa, R., Zhang, H., Brooks, W. A., Prosperi, C., Baggett, H. C., Feikin, D. R., & al., e. (2024). Epidemiology of human metapneumovirus among children with severe or very severe pneumonia in high pneumonia burden settings: the Pneumonia Etiology Research for Child Health (PERCH) study experience. Clinical Microbiology and Infection. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S1198743X24005056

Tollefson, S. J., Cox, R. G., & Williams, J. V. (2010). Studies of culture conditions and environmental stability of human metapneumovirus. Virus Research. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC2894476/

Toth, A. (2025). Retrieved from https://www.independent.co.uk/news/health/hmpv-virus-uk-symptoms-test-kits-b2675583.html