Clinical Study
Human Metapneumovirus (hMPV): Symptoms, Risk Factors, and Why Testing Matters
Allie Priego, PA-C • Published: April 10, 2026 • Last Reviewed: April, 2026
What Is hMPV?
Human metapneumovirus, also called hMPV, is a common respiratory virus that can infect people of all ages. It usually causes mild to moderate respiratory illness, but it can lead to more serious disease in infants, older adults, immunocompromised patients, and people with underlying heart or lung conditions.1
Although hMPV was first identified in 2001, it is not a new virus. What has changed is our ability to detect it. Broader use of molecular respiratory panels has made hMPV easier to identify, helping clinicians distinguish it from other viruses such as RSV, influenza, and COVID-19.1
Key Takeaways
- hMPV is a common respiratory virus that affects nearly all children by age five
- Human metapneumovirus symptoms often overlap with RSV, influenza, and COVID-19, making clinical diagnosis difficult
- High-risk groups include infants, older adults, and immunocompromised patients
- Cases may appear to be rising due to increased use of molecular testing
- PCR-based molecular testing is the most reliable way to diagnose hMPV
- Early detection supports better patient management and antibiotic stewardship
Understanding Human Metapneumovirus (hMPV)
Human metapneumovirus is a respiratory virus in the Pneumoviridae family, the same family as RSV. It can cause a wide range of illnesses, from mild upper respiratory symptoms to more severe lower respiratory tract infections such as bronchiolitis and pneumonia.2
In healthy children and adults, hMPV often resolves with supportive care alone. But in higher-risk populations, infection can be more severe and may require closer monitoring or escalation of care.
Why hMPV matters
hMPV is less well known than influenza or RSV, but its clinical burden is significant. Nearly all children are infected with hMPV by age five,3 and reinfection can occur throughout life because prior infection does not provide complete or lasting immunity.
There are currently no FDA-approved antivirals or vaccines specifically for hMPV, which makes accurate diagnosis and appropriate supportive management especially important.4
What Are the Symptoms of hMPV?
Symptoms of hMPV often overlap with those of other respiratory viruses, making clinical diagnosis difficult without testing. Common symptoms include:
- Fever
- Cough
- Runny nose
- Nasal congestion
- Sore throat
In some patients, especially those at higher risk, hMPV can progress to more serious lower respiratory illness.2
Who Is Most at Risk for Severe hMPV Illness?
The patients most vulnerable to complications from hMPV include:
- Infants and young children, especially children under age 2
- Adults age 65 and older
- Immunocompromised individuals, including transplant recipients and patients on long-term corticosteroids
- Patients with underlying cardiopulmonary disease, including COPD, asthma, or congenital heart disease
For these groups, timely diagnosis can help guide patient management and support infection prevention efforts.1
Are hMPV Cases Increasing in the United States?
hMPV has received more attention this respiratory season, as recent reports have highlighted rising detection rates in the US.
According to the CDC, the weekly positive test percentage for hMPV increased from 0.42% in late September 2025 to 5.37% by the week of March 7, 2026. During the same period in the prior season, the weekly positive percentage was 3.82%.5
That increase suggests hMPV is being detected more frequently this season. However, the CDC has indicated that this pattern still appears consistent with expected seasonal circulation, rather than signaling an unusual or unexpected outbreak.
A key reason hMPV appears more prevalent now is that molecular diagnostics are more widely used and clinicians are more attuned to testing respiratory pathogens following the COVID-19 pandemic.
Why Is hMPV Difficult to Diagnose Clinically?
hMPV symptoms closely resemble those of RSV, influenza, and COVID-19. Because of that overlap, hMPV cannot be reliably identified solely based on symptoms.
That makes laboratory testing essential, particularly when the result may influence patient management, infection control decisions, or antibiotic stewardship.
How Is hMPV Diagnosed?
Historically, hMPV has been detected by viral culture, antigen-based testing, and molecular methods. In practice, molecular testing has become the preferred approach because it offers better performance and faster, more actionable results.6
Why Molecular Testing Matters for hMPV
Real-time reverse transcription PCR (RT-PCR) is widely regarded as the standard for hMPV detection because it provides strong sensitivity and specificity.7
Even more useful in many care settings is inclusion of hMPV on a multiplex molecular respiratory panel. These panels can detect multiple respiratory pathogens from a single nasopharyngeal specimen, helping clinicians identify hMPV alongside viruses that commonly co-circulate, such as RSV and influenza.1
The Clinical Value of Early hMPV Diagnosis
Early and accurate diagnosis of hMPV can support:
- Better-informed patient management
- More appropriate use of supportive care and follow-up
- Reduced unnecessary antibiotic prescribing
- Improved infection control measures
- Better protection for vulnerable populations
For high-risk patients, identifying hMPV can provide clarity when symptoms are nonspecific, and multiple respiratory viruses are circulating at the same time.
Key Takeaway
Human metapneumovirus is not a new virus, and for most healthy people, it is not a cause for alarm. What is new is the broader availability of molecular testing that allows clinicians to detect it more reliably.
For clinicians and patients alike, the priority is clear: accurate diagnosis through molecular testing enables better care and better outcomes.
References
- Centers for Disease Control and Prevention. About human metapneumovirus. Updated February 10, 2026. Accessed March 27, 2026.
https://www.cdc.gov/human-metapneumovirus/about/index.html - Mohammadi K, Faramarzi S, Yaribash S, et al. Human metapneumovirus (hMPV) in 2025: emerging trends and insights from community and hospital-based respiratory panel analyses-a comprehensive review. Virol J. 2025;22(1):150. Published 2025 May 20. doi:10.1186/s12985-025-02782-y
- Adepoju VA, Adnani QES, Jamil S, Mohammadnezhad M, Abdulrahim A. Global Burden of Human Metapneumovirus: Bridging Gaps in Prevention, Diagnostics and Treatment. Public Health Chall. 2025;4(3):e70094. Published 2025 Aug 1. doi:10.1002/puh2.70094
- Principi N, Fainardi V, Esposito S. Human Metapneumovirus: A Narrative Review on Emerging Strategies for Prevention and Treatment. Viruses. 2025;17(8):1140. Published 2025 Aug 20. doi:10.3390/v17081140
- Willmoth H. HMPV detections surge across US: Should you be worried? Newsweek. Published January 2025. Accessed March 27, 2026.
https://www.newsweek.com/hmpv-detections-surge-across-us-should-you-be-worried-11703331 - Mohammadi K, Faramarzi S, Yaribash S, et al. Human metapneumovirus (hMPV) in 2025: emerging trends and insights from community and hospital-based respiratory panel analyses-a comprehensive review. Virol J. 2025;22(1):150. Published 2025 May 20. doi:10.1186/s12985-025-02782-y
- Liu, J. W., Lai, C. C., & Hsueh, P. R. (2025). Resurgence of human metapneumovirus in the post-COVID-19 era: pathogenesis, epidemiological shifts, clinical impact, and future challenges. The Lancet. Infectious diseases, 25(12), e705–e721.
https://doi.org/10.1016/S1473-3099(25)00240-3
References
- Centers for Disease Control and Prevention. About human metapneumovirus. Updated February 10, 2026. Accessed March 27, 2026.
https://www.cdc.gov/human-metapneumovirus/about/index.html - Mohammadi K, Faramarzi S, Yaribash S, et al. Human metapneumovirus (hMPV) in 2025: emerging trends and insights from community and hospital-based respiratory panel analyses-a comprehensive review. Virol J. 2025;22(1):150. Published 2025 May 20. doi:10.1186/s12985-025-02782-y
- Adepoju VA, Adnani QES, Jamil S, Mohammadnezhad M, Abdulrahim A. Global Burden of Human Metapneumovirus: Bridging Gaps in Prevention, Diagnostics and Treatment. Public Health Chall. 2025;4(3):e70094. Published 2025 Aug 1. doi:10.1002/puh2.70094
- Principi N, Fainardi V, Esposito S. Human Metapneumovirus: A Narrative Review on Emerging Strategies for Prevention and Treatment. Viruses. 2025;17(8):1140. Published 2025 Aug 20. doi:10.3390/v17081140
- Willmoth H. HMPV detections surge across US: Should you be worried? Newsweek. Published January 2025. Accessed March 27, 2026.
https://www.newsweek.com/hmpv-detections-surge-across-us-should-you-be-worried-11703331 - Mohammadi K, Faramarzi S, Yaribash S, et al. Human metapneumovirus (hMPV) in 2025: emerging trends and insights from community and hospital-based respiratory panel analyses-a comprehensive review. Virol J. 2025;22(1):150. Published 2025 May 20. doi:10.1186/s12985-025-02782-y
- Liu, J. W., Lai, C. C., & Hsueh, P. R. (2025). Resurgence of human metapneumovirus in the post-COVID-19 era: pathogenesis, epidemiological shifts, clinical impact, and future challenges. The Lancet. Infectious diseases, 25(12), e705–e721.
https://doi.org/10.1016/S1473-3099(25)00240-3
Medical Science Liaison
Related Articles and White papers
Allie Priego, PA-C • Published: April 10, 2026 • Last Reviewed: April, 2026
What Is hMPV?
Human metapneumovirus, also called hMPV, is a common respiratory virus that can infect people of all ages. It usually causes mild to moderate respiratory illness, but it can lead to more serious disease in infants, older adults, immunocompromised patients, and people with underlying heart or lung conditions.1
Although hMPV was first identified in 2001, it is not a new virus. What has changed is our ability to detect it. Broader use of molecular respiratory panels has made hMPV easier to identify, helping clinicians distinguish it from other viruses such as RSV, influenza, and COVID-19.1
Key Takeaways
- hMPV is a common respiratory virus that affects nearly all children by age five
- Human metapneumovirus symptoms often overlap with RSV, influenza, and COVID-19, making clinical diagnosis difficult
- High-risk groups include infants, older adults, and immunocompromised patients
- Cases may appear to be rising due to increased use of molecular testing
- PCR-based molecular testing is the most reliable way to diagnose hMPV
- Early detection supports better patient management and antibiotic stewardship
Understanding Human Metapneumovirus (hMPV)
Human metapneumovirus is a respiratory virus in the Pneumoviridae family, the same family as RSV. It can cause a wide range of illnesses, from mild upper respiratory symptoms to more severe lower respiratory tract infections such as bronchiolitis and pneumonia.2
In healthy children and adults, hMPV often resolves with supportive care alone. But in higher-risk populations, infection can be more severe and may require closer monitoring or escalation of care.
Why hMPV matters
hMPV is less well known than influenza or RSV, but its clinical burden is significant. Nearly all children are infected with hMPV by age five,3 and reinfection can occur throughout life because prior infection does not provide complete or lasting immunity.
There are currently no FDA-approved antivirals or vaccines specifically for hMPV, which makes accurate diagnosis and appropriate supportive management especially important.4
What Are the Symptoms of hMPV?
Symptoms of hMPV often overlap with those of other respiratory viruses, making clinical diagnosis difficult without testing. Common symptoms include:
- Fever
- Cough
- Runny nose
- Nasal congestion
- Sore throat
In some patients, especially those at higher risk, hMPV can progress to more serious lower respiratory illness.2
Who Is Most at Risk for Severe hMPV Illness?
The patients most vulnerable to complications from hMPV include:
- Infants and young children, especially children under age 2
- Adults age 65 and older
- Immunocompromised individuals, including transplant recipients and patients on long-term corticosteroids
- Patients with underlying cardiopulmonary disease, including COPD, asthma, or congenital heart disease
For these groups, timely diagnosis can help guide patient management and support infection prevention efforts.1
Are hMPV Cases Increasing in the United States?
hMPV has received more attention this respiratory season, as recent reports have highlighted rising detection rates in the US.
According to the CDC, the weekly positive test percentage for hMPV increased from 0.42% in late September 2025 to 5.37% by the week of March 7, 2026. During the same period in the prior season, the weekly positive percentage was 3.82%.5
That increase suggests hMPV is being detected more frequently this season. However, the CDC has indicated that this pattern still appears consistent with expected seasonal circulation, rather than signaling an unusual or unexpected outbreak.
A key reason hMPV appears more prevalent now is that molecular diagnostics are more widely used and clinicians are more attuned to testing respiratory pathogens following the COVID-19 pandemic.
Why Is hMPV Difficult to Diagnose Clinically?
hMPV symptoms closely resemble those of RSV, influenza, and COVID-19. Because of that overlap, hMPV cannot be reliably identified solely based on symptoms.
That makes laboratory testing essential, particularly when the result may influence patient management, infection control decisions, or antibiotic stewardship.
How Is hMPV Diagnosed?
Historically, hMPV has been detected by viral culture, antigen-based testing, and molecular methods. In practice, molecular testing has become the preferred approach because it offers better performance and faster, more actionable results.6
Why Molecular Testing Matters for hMPV
Real-time reverse transcription PCR (RT-PCR) is widely regarded as the standard for hMPV detection because it provides strong sensitivity and specificity.7
Even more useful in many care settings is inclusion of hMPV on a multiplex molecular respiratory panel. These panels can detect multiple respiratory pathogens from a single nasopharyngeal specimen, helping clinicians identify hMPV alongside viruses that commonly co-circulate, such as RSV and influenza.1
The Clinical Value of Early hMPV Diagnosis
Early and accurate diagnosis of hMPV can support:
- Better-informed patient management
- More appropriate use of supportive care and follow-up
- Reduced unnecessary antibiotic prescribing
- Improved infection control measures
- Better protection for vulnerable populations
For high-risk patients, identifying hMPV can provide clarity when symptoms are nonspecific, and multiple respiratory viruses are circulating at the same time.
Key Takeaway
Human metapneumovirus is not a new virus, and for most healthy people, it is not a cause for alarm. What is new is the broader availability of molecular testing that allows clinicians to detect it more reliably.
For clinicians and patients alike, the priority is clear: accurate diagnosis through molecular testing enables better care and better outcomes.
References
- Centers for Disease Control and Prevention. About human metapneumovirus. Updated February 10, 2026. Accessed March 27, 2026.
https://www.cdc.gov/human-metapneumovirus/about/index.html - Mohammadi K, Faramarzi S, Yaribash S, et al. Human metapneumovirus (hMPV) in 2025: emerging trends and insights from community and hospital-based respiratory panel analyses-a comprehensive review. Virol J. 2025;22(1):150. Published 2025 May 20. doi:10.1186/s12985-025-02782-y
- Adepoju VA, Adnani QES, Jamil S, Mohammadnezhad M, Abdulrahim A. Global Burden of Human Metapneumovirus: Bridging Gaps in Prevention, Diagnostics and Treatment. Public Health Chall. 2025;4(3):e70094. Published 2025 Aug 1. doi:10.1002/puh2.70094
- Principi N, Fainardi V, Esposito S. Human Metapneumovirus: A Narrative Review on Emerging Strategies for Prevention and Treatment. Viruses. 2025;17(8):1140. Published 2025 Aug 20. doi:10.3390/v17081140
- Willmoth H. HMPV detections surge across US: Should you be worried? Newsweek. Published January 2025. Accessed March 27, 2026.
https://www.newsweek.com/hmpv-detections-surge-across-us-should-you-be-worried-11703331 - Mohammadi K, Faramarzi S, Yaribash S, et al. Human metapneumovirus (hMPV) in 2025: emerging trends and insights from community and hospital-based respiratory panel analyses-a comprehensive review. Virol J. 2025;22(1):150. Published 2025 May 20. doi:10.1186/s12985-025-02782-y
- Liu, J. W., Lai, C. C., & Hsueh, P. R. (2025). Resurgence of human metapneumovirus in the post-COVID-19 era: pathogenesis, epidemiological shifts, clinical impact, and future challenges. The Lancet. Infectious diseases, 25(12), e705–e721.
https://doi.org/10.1016/S1473-3099(25)00240-3
References
- Centers for Disease Control and Prevention. About human metapneumovirus. Updated February 10, 2026. Accessed March 27, 2026.
https://www.cdc.gov/human-metapneumovirus/about/index.html - Mohammadi K, Faramarzi S, Yaribash S, et al. Human metapneumovirus (hMPV) in 2025: emerging trends and insights from community and hospital-based respiratory panel analyses-a comprehensive review. Virol J. 2025;22(1):150. Published 2025 May 20. doi:10.1186/s12985-025-02782-y
- Adepoju VA, Adnani QES, Jamil S, Mohammadnezhad M, Abdulrahim A. Global Burden of Human Metapneumovirus: Bridging Gaps in Prevention, Diagnostics and Treatment. Public Health Chall. 2025;4(3):e70094. Published 2025 Aug 1. doi:10.1002/puh2.70094
- Principi N, Fainardi V, Esposito S. Human Metapneumovirus: A Narrative Review on Emerging Strategies for Prevention and Treatment. Viruses. 2025;17(8):1140. Published 2025 Aug 20. doi:10.3390/v17081140
- Willmoth H. HMPV detections surge across US: Should you be worried? Newsweek. Published January 2025. Accessed March 27, 2026.
https://www.newsweek.com/hmpv-detections-surge-across-us-should-you-be-worried-11703331 - Mohammadi K, Faramarzi S, Yaribash S, et al. Human metapneumovirus (hMPV) in 2025: emerging trends and insights from community and hospital-based respiratory panel analyses-a comprehensive review. Virol J. 2025;22(1):150. Published 2025 May 20. doi:10.1186/s12985-025-02782-y
- Liu, J. W., Lai, C. C., & Hsueh, P. R. (2025). Resurgence of human metapneumovirus in the post-COVID-19 era: pathogenesis, epidemiological shifts, clinical impact, and future challenges. The Lancet. Infectious diseases, 25(12), e705–e721.
https://doi.org/10.1016/S1473-3099(25)00240-3
Medical Science Liaison
