Medical Care
No specific FDA approved antiviral therapy is currently available for human metapneumovirus (hMPV) infection. Routine treatment includes symptomatic care, with respiratory support when required.
Ribavirin, which has broad antiviral activity, has been shown to have activity against hMPV in vitro. [42] Additionally, treatment with ribavirin in hMPV-infected cotton rats demonstrated decreased viral replication in the lungs and decreased pulmonary inflammation. [43] Case reports have supported oral ribavirin therapy with concomitant intravenous immunoglobulins (IVIG) for improving symptoms in immunosuppressed persons. [50] IV ribavirin was used in an adult immunocompromised population with uncertain benefits. However, the use of ribavirin in any viral infection remains controversial, and no randomized controlled trials were conducted to assess the benefits of ribavirin. [78]
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Phylogenetic tree showing sequence analysis of human metapneumovirus (hMPV).
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Phylogenetic tree of human metapneumovirus (hMPV) strains. Courtesy of Microorganisms [Nao N, Saikusa M, Sato K, et al. Recent Molecular Evolution of Human Metapneumovirus (HMPV): Subdivision of HMPV A2b Strains. Microorganisms. 2020 Sep;8(9):1280. Online at: https://www.mdpi.com/2076-2607/8/9/1280.].
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Phylogenetic analysis of the L-proteins of members of the family Paramyxoviridae. Courtesy of ICTV 9th Report on Virus Classification and Taxon Nomenclature (2011) [https://talk.ictvonline.org/ictv-reports/ictv_9th_report/negative-sense-rna-viruses-2011/w/negrna_viruses/200/paramyxoviridae-figures].
Tables
Varvara Probst, MD Resident Physician, Department of Pediatrics University of Florida College of Medicine
Varvara Probst, MD is a member of the following medical societies: American Academy of Pediatrics
Disclosure: Nothing to disclose.
Ayesha Mirza, MD Associate Professor of Pediatric Infectious Diseases, University of Florida College of Medicine-Jacksonville
Ayesha Mirza, MD is a member of the following medical societies: American Academy of Pediatrics, American Society of Tropical Medicine and Hygiene, HIV Medicine Association, Infectious Diseases Society of America, Pediatric Infectious Diseases Society
Disclosure: Nothing to disclose.
Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference
Disclosure: Received salary from Medscape for employment. for: Medscape.
John W King, MD Professor of Medicine, Chief, Section of Infectious Diseases, Director, Viral Therapeutics Clinics for Hepatitis, Louisiana State University School of Medicine in Shreveport; Consultant in Infectious Diseases, Overton Brooks Veterans Affairs Medical Center
John W King, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Federation for Medical Research, American Society for Microbiology, Association of Subspecialty Professors, Infectious Diseases Society of America, Sigma Xi, The Scientific Research Honor Society
Disclosure: Nothing to disclose.
Pranatharthi Haran Chandrasekar, MBBS, MD Professor, Chief of Infectious Disease, Department of Internal Medicine, Wayne State University School of Medicine
Pranatharthi Haran Chandrasekar, MBBS, MD is a member of the following medical societies: American College of Physicians, American Society for Microbiology, International Immunocompromised Host Society, Infectious Diseases Society of America
Disclosure: Nothing to disclose.
Michael Rajnik, MD Associate Professor, Department of Pediatrics, Program Director, Pediatric Infectious Disease Fellowship Program, Uniformed Services University of the Health Sciences
Michael Rajnik, MD is a member of the following medical societies: American Academy of Pediatrics, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Armed Forces Infectious Diseases Society
Disclosure: Nothing to disclose.
Ashley Maranich, MD Pediatric Infectious Disease Staff, San Antonio Military Medical Center, Wilford Hall Medical Center
Disclosure: Nothing to disclose.
Aliyah Baluch, MD, MSc, FACP Assistant Professor of Medicine, Department of Oncologic Sciences, University of South Florida Morsani College of Medicine; Assistant Member, Division of Infectious Diseases, Department of Internal Medicine, Moffitt Cancer Center
Aliyah Baluch, MD, MSc, FACP is a member of the following medical societies: American College of Physicians, American Society for Blood and Marrow Transplantation, American Society of Transplantation, Infectious Diseases Society of America
Disclosure: Nothing to disclose.
The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors Michael D Nissen, MBBS, FRACP, FRCPA, Theodorus P Sloots, PhD, and David Siebert, MD, to the development and writing of this article.
