Lesser known symptoms of hMPV: Know what to do about them

Amid human metapneumovirus or hMPV scare, you must have met people warning you about its cold or flu-like symptoms. Generally, individuals infected with hMPV show signs such as cough, fever, and sore throat. While these are the common signs, there are also lesser known symptoms of hMPV, a viral pathogen in the Paramyxoviridae family. It may lead to health issues such as conjunctivitis that can leave you with red, and itchy eyes. Sometimes, kidneys of people with human metapneumovirus also get affected. So, along with the common signs, you should know about the unusual ones.

What is HMPV?

Human metapneumovirus is a respiratory virus from the Paramyxoviridae family that was first identified in 2001. “It primarily affects the upper and lower respiratory tracts, and spreads through respiratory droplets, direct contact, or contaminated surfaces,” shares Dr Arvind Aggarwalwho specialises in internal medicine and infectious diseases.

It mostly targets children, older adults, and people with weak immune systems, but it can infect people of all ages. “It often causes illnesses with flu or common cold-like symptoms, but in severe cases, it may lead to pneumonia,” says Dr Aggarwal.

What are the common symptoms of hMPV?

If you are infected with hMPV, you will have symptoms like:

• Cough
• Fever
• Sore throat often accompanied by hoarseness
• Runny nose
• Body ache
• Headache

Some people can get quite sick after being infected with hMPV. It may lead to inflammation of the airways to the lungs, known as bronchiolitis, according to the World Health Organization.

What are the lesser known symptoms of hMPV?

“In rare or severe cases, hMPV can affect various organ systems beyond the respiratory tract,” says pulmonologist Dr Sneha Tirpude. They can lead to lesser known symptoms of hMPV:

1. Eye symptoms

It may lead to conjunctivitiswhich is the inflammation of the conjunctiva, a thin membrane that protects the eye. It can lead to red, itchy, and watery eyes, which can come under the list of lesser known symptoms of hMPV,” says Dr Aggarwal. During an analysis, published in Clinical Microbiology Reviews in 2011, researchers found the conjunctivitis was reported by some people with hMPV, but the cases were few.

2. Kidney symptoms

Acute kidney injury is experienced by a person when the kidneys suddenly stop filtering waste products from the blood. A 2020 study, published in Respiratory Careshowed that children hospitalised with hMPV may be at risk for acute kidney injury, and that the risk appears to increase with age. Less urine output, and fluid buildup are some of its signs.

3. Gut symptoms

Some of the lesser known symptoms of hMPV may be connected to the gut. “People may have diarrhea, nausea, or vomiting,” says Dr Tirpude. During a 2020 study, published in Pathogensan association was found between hMPV and vomiting, and diarrhea.

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4. Brain symptoms

Neurological signs such as confusion, and lethargy are also lesser known symptoms of hMPV. During a 2023 research, published in Scientific Reportsresearchers found that some of the children aged 1 month to 14 years who were infected with hMPV, showed danger signs. The lesser known symptoms of hMPV included altered consciousness, convulsions, and lethargy.

5. Heart symptoms

“Sometimes, people with hMPV may experience myocarditis (inflammation of the heart muscle), leading to chest pain, irregular heartbeat, or heart failure,” says Dr Tirpude. Symptoms of more severe disease include chest pain, according to the World Health Organization.

What leads to the lesser-known symptoms of hMPV?

These lesser-known symptoms of hMPV may arise due to:

• Immune overactivation: The body’s immune response to the virus may lead to widespread inflammation, affecting multiple organs.
• Direct viral invasion: The virus can affect tissues beyond the lungs, such as the heart, brain, or kidneys.
• Cytokine storm: Excessive release of inflammatory molecules can lead to multi-organ involvement. “It may affect various organs like the brain, kidneys, and heart,” says Dr Aggarwal.
• Hypoxia: Severe respiratory symptoms can lead to reduced oxygen levels, affecting vital organs like the brain and heart.

How to manage the lesser known symptoms of HMPV?

1. Eyes

• Eye drops: In case of eye irritationredness, or excessive tearing, lubricating eye drops can help. “Artificial tears can relieve dryness, irritation, or redness,” says Dr Tirpude.
• Cold compress: Apply a clean, damp, cool cloth over your eyes to reduce inflammation and any discomfort associated with conjunctivitis.

2. Kidneys

• Hydration: Make sure to maintain optimal fluid intake to support kidney function. Avoid getting dehydrated, as it exacerbates kidney strain.
• Electrolyte monitoring: In severe cases, monitor and correct electrolyte imbalances with intravenous therapy.

3. Gut

• Oral Rehydration Solution: Use solutions containing electrolytes and glucose to replenish fluids and salts lost by your body.
• Antiemetics: “Medications like ondansetron can be used to control nausea and vomiting,” says Dr Tirpude.
• Probiotics: They may help restore gut flora balance if you experience diarrhea. So, have yogurt, which is one of the best sources of probiotics.

4. Brain

• Hospitalisation: People with neurological symptoms need to get hospitalised where doctors can monitor them.
• Neuroimaging: Magnetic resonance imaging may help to assess brain inflammation or structural changes.

5. Heart

• Beta-blockers: “These may help to manage irregular heartbeats or reduce heart strain,” says Dr Tirpude.
• Anti-inflammatory drugs: In mild myocarditis, nonsteroidal anti-inflammatory drugs may be prescribed to reduce inflammation.

Human metapneumovirus is spreading in different parts of the world. So, you should know the signs, including the lesser known symptoms of HMPV to get the right treatment.