How Metapneumovirus Is Treated

Medically reviewed by Renee Nilan, MD

Human metapneumovirus (hMPV) is a respiratory virus most common in children that usually clears on its own. Metapneumovirus treatment is mainly geared toward easing symptoms with over-the-counter (OTC) decongestants, cough suppressants, and pain relievers like Tylenol (acetaminophen) or Advil (ibuprofen). Home remedies may also help.

Severe cases of hMPV may require inhaled medications like albuterol or oral steroids like prednisone to open airways and improve breathing. While there is no cure or vaccine for hMPV, treatments like these have generally proven effective.

This article describes the various treatments for hMPV in children and adults and what to expect if you or your child is diagnosed with human metapneumovirus.

Home Remedies for Metapneumovirus

Human metapneumovirus, a virus identified in the Netherlands in 2001, has many of the same characteristics as the common cold. It is most active during late winter and spring, triggering symptoms like cough, runny nose, nasal congestion, sore throat, and fever.

While hMPV symptoms will usually clear on their own within 2 to 5 days, there are things you can do to help speed them along:

• Get plenty of rest: Help your body heal itself by avoiding strenuous activity, which can take its toll on your immune system.

• Keep well hydrated: Drinking plenty of fluids prevents dehydration, a condition that can cause the thickening of nasal mucus and worsening congestion.

• Use a humidifier: A cool-mist humidifier can add moisture to the air, easing nasal dryness and congestion.
  

• Try a neti pot: This involves a container that rinses mucus from your nasal cavity with sterile water or a saline (salt) solution.

• Get a bulb syringe: This is a rubber device with a spout used for nasal suctioning in infants. It is especially useful in children under 2 who cannot use decongestants.

• Sip tea and honey: Warm tea can soothing, but the addition of honey, with its anti-inflammatory effects, can help ease a sore throat and reduce coughing.
  

Over-the-Counter (OTC) Therapies

While there are no antiviral drugs able to cure hMPV, there are OTC medications that can help ease the cold-like symptoms.

These include:

• Tylenol (acetaminophen): This OTC drug has both analgesic (pain-relieving) and antipyretic (fever-reducing) effects.

• Nonsteroidal anti-inflammatory drugs (NSAIDs): These pain and fever reducers are also anti-inflammatory and can help ease sinus and sore throat pain. Options include aspirin, Advil, and Aleve (naproxen).

• Decongestants: These drugs ease congestion by reducing swollen blood vessels in the nasal passages. Options include Sudafed (pseudoephedrine) and Sudafed PE (phenylephrine).

• OTC nasal sprays: These include saline nose sprays that draw moisture out of swollen nasal passages and corticosteroid (steroid) sprays like Flonase (fluticasone) that ease nasal inflammation.

• Cough suppressants: These cough remedies contain dextromethorphan, a drug used in Robitussin and Delsym that temper the cough reflex.

Warning to Parents

Never give aspirin to children or teens with a fever caused by a viral infection. Doing so can lead to a rare but potentially life-threatening complication called Reyes syndrome affecting the brain and liver.

The U.S. Food and Drug Administration (FDA) further advises against the use of OTC cough and cold medicines in children under 2 years as they can cause potentially serious side effects.

Prescriptions for Metapneumovirus

Prescription drugs may be used when hMPV symptoms are severe, although there remains debate as to how effective some of these are. When used, the drugs are typically administered in a hospital under the supervision of a qualified healthcare provider.

Some people are at greater risk of hMPV complications, most notably children 5 and under who have immature immune systems. To a lesser extent, people with compromised immune systems and those with respiratory illnesses like asthma and chronic obstructive pulmonary disease (COPD) are also at risk.

Complications like pneumonia can occur in between 5% and 15% of cases in children with hMPV. Other possible complications include bronchitis (inflammation of the larger airways of the lungs) and bronchiolitis (inflammation of the smaller airways of the lung).

Prescriptions options may include:

• Albuterol: This is an inhaled drug classified as a bronchodilator that is commonly used as a rescue inhaler for people with asthma or COPD.

• Inhaled corticosteroids: These inhaled steroids, often used as a maintenance drug for people with asthma or COPD, work by tempering inflammation in the lungs.

• Oral corticosteroids: Oral steroids like prednisone may be used for a short period if inhaled steroids fail to provide adequate relief.

• Ribavirin: This is an oral antiviral drug traditionally used to treat hepatitis C virus (HCV) that has some action on hMPV. It is especially useful in cases of pneumonia.

Specialist-Driven Procedures

Immunocompromised children are at the highest risk of hMPV complications overall. Of those who are hospitalized, around 6% require treatment in an intensive care unit (ICU).

Even if ICU treatment is not needed, individuals hospitalized for hMPV often need specialist procedures to support breathing and to either treat or prevent dehydration.

This may involve:

• Supplemental oxygen therapy: This is the delivery of oxygen through a nose tube (cannula), mask, or tent.

• Intravenous (IV) fluids: This is the delivery of fluids into a vein, often with sodium and other minerals to maintain the normal balance of electrolytes.

• Mechanical ventilation: This is a machine that takes over breathing when a person is not able to breathe enough on their own.
  

Prognosis

hMPV is most often a relatively mild, self-limited infection that causes no complications or long-term harm.

When complications occur, it usually involves someone with underlying immunodeficiency or a severe, pre-existing condition like asthma.

Even when hospitalization is required, most cases can be effectively managed. Death is uncommon and tends to involve severely immunocompromised children (such as those with organ transplants or leukemia) who run a 5% risk of death by pneumonia.

Prevention

hMPV is thought to be spread by coughing and sneezing, close contact (like shaking hands or kissing), or touching contaminated objects and then your mouth, nose, or eyes.

To prevent getting or passing hMPV, the Centers for Disease Control and Prevention (CDC) recommends the following precautionary measures:

• Wash your hands frequently with soap and water for at least 20 seconds.

• Avoid touching your eyes, nose, or mouth with unwashed hands.

• Avoid close contact with people who are sick.

• Cover your mouth and nose when coughing or sneezing.

• Avoid sharing cups and utensils with others.
  

• Stay at home when are you sick

Summary

While there is no treatment for human metapneumovirus (hMPV), most people will recover from the infection with rest and plenty of fluids. The symptoms of hMPV may be eased with over-the-counter painkillers, decongestants, cough suppressants, and nasal sprays.

Severe cases are uncommon but may require prescription drugs like albuterol, oral or inhaled steroids, or ribavirin. Oxygen therapy, IV fluids, and mechanical ventilation may be needed in severely ill, hospitalized people.