Epidemiology, Clinical Features, and Molecular Characteristics of Human Metapneumovirus (HMPV): A Meta-Analysis

Authors

  • Rajan Ethiraj Ugandar Santhiram College of Pharmacy, Nandyal, Andhra Pradesh-India Author https://orcid.org/0000-0002-7014-0864
  • Dasari Lakshmi Santhiram College of Pharmacy, Nandyal, Andhra Pradesh-India Author https://orcid.org/0009-0002-3479-3873
  • Kandukuri Nandini Santhiram College of Pharmacy, Nandyal, Andhra Pradesh-India Author
  • Peddi Phaneendra Santhiram College of Pharmacy, Nandyal, Andhra Pradesh-India Author
  • Pendela Preethi Santhiram College of Pharmacy, Nandyal, Andhra Pradesh-India Author

DOI:

https://doi.org/10.56450/JEFI.2025.v3i01.004

Keywords:

Human metapneumovirus, Pneumoviridae, Respiratory Tract Infections, Pneumonia, Viral Bronchiolitis, Epidemiology, Genetic Variation, Virus Classification, Glycoproteins, Antigenic Variation and Host-Pathogen Interactions

Abstract

Human Metapneumovirus (HMPV) was first described in 2001 in the Netherlands and has become an important pathogen in the Pneumoviridae family, causing significant paediatric and adult respiratory infections worldwide. This review synthesizes the clinical manifestations, genetic diversity, epidemiology, and pathogenesis of the virus based on findings of more than two decades' worth of research. HMPV is not only highly infectious, but it carries a burden in the form of its tendency to result in severe respiratory disease in children, the elderly, and the immunocompromised, often causing lengthy hospitalizations and remarkable expenditures in healthcare. Unlike RSV, HMPV has defined age-related infection patterns and a unique genetic architecture, with the G glycoprotein that is highly variable making subclassification and antigenicity dependent upon this variation. Current subtypes (such as A2b1) demonstrate the scourge of the virus’s adaptability and thus raise obstacles to its vaccine development. HMPV pathogenetically infects ciliated epithelial cells, disrupting mucociliary function, producing robust inflammatory responses, and worsening disease severity. Advanced molecular diagnostics and therapeutic approaches have nonetheless been accompanied by little progress in developing specific antiviral treatments or vaccines, a need underscored by the urgency of such focused research and public health interventions. Finally, these findings are integrated to achieve a complete picture of HMPV and to progress future research and clinical approaches regarding this important respiratory pathogen.

Downloads

Download data is not yet available.

References

1. Panda S, Mohakud NK, Pena L, Kumar S. Human metapneumovirus: review of an important respiratory pathogen. Int J Infect Dis. 2014;25:45-52.2.

2. Chen G, Lan M, Lin S, Zhang Y, Zhang D, Weng Y, Zheng K. Genome analysis of human respiratory syncytial virus in Fujian Province, Southeast China. Infect Genet Evol. 2022 Sep;103:105329

3. Gálvez NMS, Andrade CA, Pacheco GA, Soto JA, Stranger V, Rivera T, Vásquez AE, Kalergis AM. Host Components That Modulate the Disease Caused by hMPV. Viruses. 2021;13(3):519.

4. Forni D, Moltrasio C, Sironi M, Mozzi A, Quattri E, Venegoni L, Zamprogno M, Citterio A, Clerici M, Marzano AV, Cagliani R. Whole-genome sequencing of hMPXV1 in five Italian cases confirms the occurrence of the predominant epidemic lineage. J Med Virol. 2023;95(2):e28493.

5. Gálvez NMS, Soto JA, Kalergis AM. New Insights Contributing to the Development of Effective Vaccines and Therapies to Reduce the Pathology Caused by hRSV. Int J Mol Sci. 2017 11;18(8):1753.

6. Gilbertson MLJ, Fountain-Jones NM, Malmberg JL, Gagne RB, Lee JS, Kraberger S, Kechejian S, Petch R, Chiu ES, Onorato D, Cunningham MW, Crooks KR, Funk WC, Carver S, VandeWoude S, VanderWaal K and Craft ME. Apathogenic proxies for transmission dynamics of a fatal virus. Front. Vet. Sci. 2022;9:01-13

7. Bowersox, N. W., Williams, V., Kawentel, L., & Kilbourne, A. M. Sustaining effective research/operational collaborations: Lessons learned from a National Partnered Evaluation Initiative.Healthcare. 2021;9(4):1-7

8. Pancer K, Ciaćka A, Gut W, Lipka B, Mierzejewska J, Milewska-Bobula B, Smorczewska-Kiljan A, Jahnz-Rózyk K, Litwińska B. Detection of hMPV antigen by EIA in clinical specimens. Przegl Epidemiol. 2011;65(3):415-9

9. Harrati AC, Bardin S, Mann DR. Spatial distributions in disaster risk vulnerability for people with disabilities in the U.S. International Journal of Disaster Risk Reduction. 2023;87:103571

10. Oruç Ö, Yildirim D, Kocatepe V. Awareness of Infectious Disease Risks and Vaccination Behaviors Among Health Professionals.Clinical and Experimental Health Sciences. 2023;13(2):293-298

11. Wei T, Wang C, Ma F, Guo J, Chen A, Huang Y, Xie Z, Zheng, L. Whole genome sequencing and evolution analyses of Human metapneumovirus. Virus Genes. 2023;59:524-531

12. Barroso P, Relimpio D, Zearra JA, Cerón JJ, Palencia, P, Cardoso B, Ferreras E, Escobar M, Caceres G, López-Olvera JR, Gortázar C. Using integrated wildlife monitoring to prevent future pandemics through one health approach.One Health. 2023;16:01:09

13. Dickmann, P., Strahwald, B. Ein neues Verständnis von Risikokommunikation in Public-Health-Notlagen. Bundesgesundheitsbl 2022;65, 545–551.

14. Li, R., & Ma, Y. The spread of SEIR infectious diseases based on the role of awareness.2nd International Conference on Applied Mathematics, Modelling, and Intelligent Computing (CAMMIC 2022). https://doi.org/10.1117/12.2638731

15. Doubeni, C., Nelson, D., Cohn, E., Paskett, E. D., Asfaw, S. A., Sumar, M., Ahmed, S. M., McClinton-Brown, R., Wieland, M. L., Kinney, A. Y., Aguilar-Gaxiola, S., Rosas, L. G., & Patino, C. M. (2022). Community engagement education in academic health centers, colleges, and universities. Journal of Clinical and Translational Science. 2022;6(1):e109. doi:10.1017/cts.2022.424

16. Samarasekera, U. (2022). New global strategies for HIV, viral hepatitis, and STIs.The Lancet Gastroenterology & Hepatology. 2022;7(8):705

17. Larsson, K., Sota, T., Li, M. C., Jamshid qizi, S. V., Mamak, K., Le, H., Samatovna, R. Z., Karyu, H., Ruhlandt, A., & Li, Q. (2022).An explainable model of host genetic interactions linked to COVID-19 severity. https://doi.org/10.1038/s42003-022-04073-6

18. Patel, M. K., Scobie, H. M., Serhan, F., Dahl, B. A., Murrill, C. S., Nakamura, T., Pallas, S. W., & Cohen, A. L. (2022). A global comprehensive vaccine-preventable disease surveillance strategy for the immunization Agenda 2030.Vaccine. https://doi.org/10.1016/j.vaccine.2022.07.024

19. Bhat, S., Garg, T., Chopade, B. A., & Gupta, V. V. (2023). Insights into the challenging multi-country outbreak of Mpox: a comprehensive review.Journal of Medical Microbiology. https://doi.org/10.1099/jmm.0.001725

20. Prescott, S., Schminkey, D. L., Abukhalaf, D., DeGuzman, P. B., & Dreisbach, C. (2022). A framework to guide research and practice response to emerging infectious diseases: Genomic-to-global considerations.Public Health Nursing. https://doi.org/10.1111/phn.13133

21. Stangl, J. M. (2022). The Importance of Community Social Capital in Building Sustainable and Resilient Health Systems.Journal of Quality in Health Care & Economics. https://doi.org/10.23880/jqhe-16000306

22. Tweed, E. J., Cimova, K., Craig, P., Allik, M., Brown, D., Campbell, M., Henderson, D. C., Mayor, C., Meier, P., & Watson, N. (2022, August 1). P71 Unlocking data to inform public health policy and practice: decision-maker perspectives on the use of cross-sectoral data as part of a whole-systems approach.SSM Annual Scientific Meeting. https://doi.org/10.1136/jech-2022-ssmabstracts.163

23. Haigh, K., Liuzzi, F., Irvine, S., Thompson, A. P., Hepworth, E. J., Hoyle, M.-C., Cruise, J., Hine, P., & Walker, N. (2023). A ‘train the trainers’ approach to infection prevention and control training in pandemic conditions.Clinical Infection in Practice. https://doi.org/10.1016/j.clinpr.2023.100228

24. Van Den Bergh, A., Guillon, P., von Itzstein, M., Bailly, B., & Dirr, L. (2022). Drug Repurposing for Therapeutic Discovery against Human Metapneumovirus Infection.Antimicrobial Agents and Chemotherapy. https://doi.org/10.1128/aac.01008-22

25. Mariappan, V., Pratheesh, P., Shanmugam, L., Rao, S. R., & Pillai, A. B. (2021).Viral hemorrhagic fever: Molecular pathogenesis and current trends of disease management-an update. https://doi.org/10.1016/J.CRVIRO.2021.100009

26. de Hoffer, A., Vatani, S., Cot, C., Cacciapaglia, G., Chiusano, M. L., Cimarelli, A., Conventi, F., Giannini, G., Hohenegger, S., & Sannino, F. (2022). Variant-driven early warning via unsupervised machine learning analysis of spike protein mutations for COVID-19.Dental Science Reports. https://doi.org/10.1038/s41598-022-12442-8

27. Roper, R. L., Garzino-Demo, A., del Rio, C., Bréchot, C., Gallo, R. C., Hall, W. W., Esparza, J., Schinazi, R. F., Parrington, M., Tartaglia, J., Koopmans, M., Osorio, J. E., Nitsche, A., Huan, T. B., LeDuc, J., Gessain, A., Weaver, S. C., Mahalingam, S., Abimiku, A., McFadden, G. (2023). Monkeypox (Mpox) requires continued surveillance, vaccines, therapeutics and mitigating strategies.Vaccine. https://doi.org/10.1016/j.vaccine.2023.04.010

28. Zuo, J. (2021, May 20).Study on Resilience Community Building in Public Health Emergencies. https://doi.org/10.2991/ASSEHR.K.210519.069

29. Chan, Y., Ng, S. W., Singh, S. K., Gulati, M., Gupta, G., Chaudhary, S. K., Hing, G. B., Collet, T., MacLoughlin, R., Löbenberg, R., Oliver, B. G., Chellappan, D. K., Dua, K., & Dua, K. (2021). Revolutionizing polymer-based nanoparticle-linked vaccines for targeting respiratory viruses: A perspective.Life Sciences. https://doi.org/10.1016/J.LFS.2021.119744

30. Huang, X. (2023). Implementation of digital home monitoring and management of respiratory disease.Current Opinion in Pulmonary Medicine. https://doi.org/10.1097/mcp.0000000000000965

31. Burton, C. W., & Pinto, M. (2022). Health Equity, Diversity, and Inclusion: Fundamental Considerations for Improving Patient Care.Clinical Nursing Research. https://doi.org/10.1177/10547738221143230

32. Du, Y., Li, W., Guo, Y., Li, L., Chen, Q., He, L., & Shang, S. (2022). Epidemiology and genetic characterization of human metapneumovirus in pediatric patients from Hangzhou China.Journal of Medical Virology. https://doi.org/10.1002/jmv.28024

33. Mazhul, L. A., Schildgen, O., Isaeva, E. I., & Viazov, S. (2007). Human metapneumovirus as a common cause of respiratory tract disease.Voprosy Virusologii.

34. Tsamatsoulis, D. C. (2022). Comparing the Robustness of Statistical Estimators of Proficiency Testing Schemes for a Limited Number of Participants.Computation (Basel). https://doi.org/10.3390/computation10030044

35. Wang, B., Yang, L., & Han, Y. (2022). Intervention strategies for epidemic spreading on bipartite metapopulation networks.Physical Review. https://doi.org/10.1103/physreve.105.064305

36. Harvey, L. S., Sliwinski, S. K., Flike, K., Boudreau, J., Gifford, A. L., Branch-Elliman, W., & Hyde, J. (2022). 2093. Utilizing Implementation Science to Identify Barriers and Facilitators to Implementing Harm Reduction Services in the Veterans Health Administration (VHA).Open Forum Infectious Diseases. https://doi.org/10.1093/ofid/ofac492.1715

37. van den Hoogen, B. G. (2007). Respiratory Tract Infection Due to Human Metapneumovirus among Elderly Patients.Clinical Infectious Diseases. https://doi.org/10.1086/513295

38. Upadhyay, R. K., Chatterjee, S., Saha, S., & Azad, R. K. (2020). Age-group-targeted testing for COVID-19 as a new prevention strategy.Nonlinear Dynamics. https://doi.org/10.1007/S11071-020-05879-X

39. Cilloniz, C., Pericàs, J. M., Rojas, J. R., & Torres, A. (2022). Severe Infections Due to Respiratory Viruses.Seminars in Respiratory and Critical Care Medicine. https://doi.org/10.1055/s-0041-1740982

40. Li, Z. (2023). Addressing vaccine-preventable encephalitis in vulnerable populations.Current Opinion in Neurology. https://doi.org/10.1097/wco.0000000000001158

41. Alshahrani, A. (2023). The expected economic burden on the healthcare system because of quarantining patients with monkeypox virus.Saudi Medical Journal. https://doi.org/10.15537/smj.2023.44.3.20220515

42. Pierangeli, A., Piralla, A., Uceda Renteria, S. U., Giacomel, G., Lunghi, G., Pagani, E., Giacobazzi, E., Vian, E., Biscaro, V., Piccirilli, G., Lazzarotto, T., Menzo, S., Ferreri, M. L., Novazzi, F., Petrarca, L., Licari, A., Ferrari, G., Oliveto, G., Antonelli, A., … Baldanti, F. (2022). Multicenter epidemiological investigation and genetic characterization of respiratory syncytial virus and metapneumovirus infections in the pre-pandemic 2018–2019 season in northern and central Italy.Clinical and Experimental Medicine. https://doi.org/10.1007/s10238-022-00973-3

43. Van Den Bergh, A., Bailly, B., Guillon, P., von Itzstein, M., & Dirr, L. (2022). Antiviral strategies against human metapneumovirus: Targeting the fusion protein.Antiviral Research. https://doi.org/10.1016/j.antiviral.2022.105405

44. Emektar, E., Koç, F., Göktaş, E. F., Dagar, S., & Uzunosmanoğlu, H. (2022). Factors in Relation with in-Hospital Mortality in Geriatric Patients with COVID-19.Cyprus Journal of Medical Sciences. https://doi.org/10.4274/cjms.2022.2021-181

45. Gaillet, M., Shankland, R., Fournier, J., Boussat, B., & Francois, P. (2023). Healthcare students’ prevention training in a sanitary service: analysis of health education interventions in schools of the Grenoble academy.BMC Medical Education. https://doi.org/10.1186/s12909-023-04235-y

46. Youssef, D. (2023).Preventing and controlling outbreaks and AMR: From counting cases to monitoring risks. https://doi.org/10.33540/1609

47. Esposito, S., & Mastrolia, M. V. (2016). Metapneumovirus Infections and Respiratory Complications.Seminars in Respiratory and Critical Care Medicine. https://doi.org/10.1055/S-0036-1584800

48. Alharbi, S., Aljohani, B. M., Almohmmadi, G., Alsubaihi, A., Alkhouzaie, A. T., Alrashidi, Y., Alhazmi, S. M. A., Beitar, F., Althobait, A., Alzibali, A., & Alsafwani, F. (2022). Prevalence and Types of Respiratory Co-Infections found in COVID-19 Patients.Journal of Healthcare Sciences. https://doi.org/10.52533/johs.2022.21214

49. Janse, M., Sesa, G., & van de Burgwal, L. H. M. (2023). A Case Study of European Collaboration between the Veterinary and Human Field for the Development of RSV Vaccines.Vaccines. https://doi.org/10.3390/vaccines11071137

50. Albani, V. V. L., Loria, J., Loria, J., Massad, E., Massad, E., & Zubelli, J. P. (2021). COVID-19 underreporting and its impact on vaccination strategies.BMC Infectious Diseases. https://doi.org/10.1186/S12879-021-06780-7

51. Valenzuela-Hernandez, L. (2023). National‐Scale Detection of Reservoir Impacts Through Hydrological Signatures.Water Resources Research. https://doi.org/10.1029/2022wr033893

52. Zukurov, J. P., do Nascimento-Brito, S., do Nascimento-Brito, S., Volpini, A. C., Oliveira, G., Janini, L. M., & Antoneli, F. (2014). Estimation of genetic diversity in viral populations from next generation sequencing data with extremely deep coverage.arXiv: Quantitative Methods. https://doi.org/10.1186/S13015-016-0064-X

53. Sundermann, A. J., Chen, J., Miller, J. K., Martin, E. M., Snyder, G. M., Van Tyne, D., Marsh, J. W., Dubrawski, A., & Harrison, L. H. (2022). Whole-genome sequencing surveillance and machine learning for healthcare outbreak detection and investigation: A systematic review and summary.Antimicrobial Stewardship & Healthcare Epidemiology. https://doi.org/10.1017/ash.2021.241

54. Badola, S., & Zettler, B. (2022). The Importance of Genomics Diversity in Research.Journal of Student Research. https://doi.org/10.47611/jsrhs.v11i1.2334

55. Vasconcelos, J. C. S., Cordeiro, G. M., Ortega, E. M. M., & Silva, G. O. (2022). A random effect regression based on the odd log-logistic generalized inverse Gaussian distribution.Journal of Applied Statistics. https://doi.org/10.1080/02664763.2021.2024515

56. Ulloa, J. H., Cifuentes, S., Roig Figueroa, V., & Glickman, M. H. (2023). Two-Year Results of a First-In-Human Study in Patients Surgically Implanted With a Bioprosthetic Venous Valve, the VenoValve in Patients With Severe Chronic Venous Insufficiency.Vascular and Endovascular Surgery. https://doi.org/10.1177/15385744231155327

57. Campera, M., Hedger, K., Birot, H., Manson, S., Balestri, M., Budiadi, B., Imron, M. A., Nijman, V., & Nekaris, K. A. I. (2021). Does the Presence of Shade Trees and Distance to the Forest Affect Detection Rates of Terrestrial Vertebrates in Coffee Home Gardens.Sustainability. https://doi.org/10.3390/SU13158540

58. Furuya-Kanamori, L., Lin, L., & Doi, S. A. R. (2022). Comment on a review of methods to assess publication and other reporting biases in meta‐analysis.Research Synthesis Methods. https://doi.org/10.1002/jrsm.1550

59. Plümper, T., & Traunmüller, R. (2020). The sensitivity of sensitivity analysis.Political Science Research and Methods. https://doi.org/10.1017/PSRM.2018.30

Downloads

Published

2025-03-31

How to Cite

1.
Ugandar RE, Lakshmi D, Nandini K, Phaneendra P, Preethi P. Epidemiology, Clinical Features, and Molecular Characteristics of Human Metapneumovirus (HMPV): A Meta-Analysis. JEFI [Internet]. 2025 Mar. 31 [cited 2026 Feb. 5];3(1):11-2. Available from: https://efi.org.in/journal/index.php/JEFI/article/view/61

Similar Articles

31-35 of 35

You may also start an advanced similarity search for this article.