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As every urgent care clinician knows, acute respiratory illnesses (ARIs) often present with many of the same symptoms, such as cough, fever, and rhinitis. A recent outpatient study of 7,143 patients with ARI published in Open Forum Infectious Diseases found that human metapneumovirus (HMPV) accounted for 4.7%–7.3% of cases during the 5 influenza seasons the authors examined (from 2016–2022), compared with 11.3%–13.6% for respiratory syncytial virus (RSV) and 30.2%–37.1% for influenza. HMPV circulated later in flu season, often peaking in April, and remained relatively stable during the pandemic years, while RSV and influenza declined. Compared with RSV patients, HMPV patients had less congestion, dyspnea, and sore throat. Compared with influenza patients, HMPV patients had less fever but more dyspnea and congestion—they were also more likely to feel worse at 7–14 days. The authors note children recovered from HMPV faster than adults.
Tracking the virus: HMPV was first discovered in 2001 and could be on the differential for ARIs in urgent care. While RSV, influenza, and COVID-19 have vaccines, there is no vaccine to prevent HMPV nor any antivirals to treat it, according to the Centers for Disease Control and Prevention. Even so, it commonly causes only mild illness and spreads in a similar way to influenza and RSV (eg, coughing, sneezing, close contact, etc.). CDC tracks HMPV on its virus dashboard.