- Sri Lanka’s labs ready to diagnose hMPV
- Seek medical help If severe symptoms prevail
The spread of hMPV, a virus affecting vulnerable communities, especially young children and the elderly, has raised concerns among the public.
To clear doubts and provide accurate information, the Sunday Observer spoke with Dr. Thulani Pattiyakumbura, a Medical Virologist at the National Hospital, Kandy. In this interview, she explains the virus, its risks, and the country’s ability to diagnose it.
Excerpts from the discussion:
Dr. Thulani Pattiyakumbura
Q: Health officials were disturbed by news of a virus (Human metapneumonia Virus- hMPV), which was spreading globally, entering Sri Lanka recently with the first case reported a few days ago. Could you explain what this virus is?
A: It is not a new virus in Sri Lanka. hMPV has been present here for years and mainly causes respiratory infections, especially in children. Recently, it gained media attention because of a rise in cases in other countries like China.
Q: When was it first discovered and where?
A: hMPV was first identified in the Netherlands in 2001 when it was found to cause respiratory symptoms in children.
Q: What is the main causative agent? Is it contagious?
A: Human Metapneumovirus is a RNA virus spread by infectious respiratory droplets. Yes, it is contagious. It spreads through coughing, sneezing, and close contact such as shaking hands, and touching surfaces with the virus and then touching your face.
Q: Who are most vulnerable to it?
A: Although anyone can get it, the following groups are at higher risk.
Young children: especially under five years old
Older adults: especially those over 65
People with weak immune systems: such as cancer patients or those on immunosuppressive treatments
People with lung conditions: like asthma or chronic obstructive pulmonary disease (COPD)
Q: What are the most common symptoms for this infection?
A: Most people experience mild symptoms like:
Cough
Fever
Sore throat
Runny or stuffy nose
Body aches and headaches
However, in severe cases, it can cause:
Wheezing
Difficulty in breathing
Chest pain
Severe fatigue
Persistent fever
Q: Lower respiratory tract infection is said to be the second leading cause of paediatric viral infection. Do you agree?
A: Yes, I agree. Respiratory diseases, including both upper and lower respiratory tract infections, are the leading cause of hospital admissions among children in Sri Lanka and globally. Lower respiratory infections, such as pneumonia and bronchiolitis, are particularly concerning because they can cause more severe symptoms and complications compared to upper respiratory infections like the common cold. Early detection and appropriate care are essential to reduce complications and hospital stays.
Q: What are the adverse symptoms to look out?
A: Human Metapneumovirus usually causes cold or flu-like symptoms, but the severity can vary depending on factors such as age and overall health.
In infants, severe signs to watch for include wheezing, fast or laboured breathing, blue-tinged lips, and dehydration, while pre-schoolers may show persistent high fever, breathing difficulties, and fatigue. Primary school children often present with cold-like symptoms, but chest pain, difficulty in breathing, and persistent fever are warning signs.
In adolescents, while symptoms may mimic the flu, severe manifestations like shortness of breath, dehydration or prolonged fever require attention.
The elderly, particularly those with comorbidities, are at higher risk, with confusion, difficulty in breathing, persistent chest pain, and extreme fatigue as critical signs of severe illness. Immunocompromised individuals across all age groups should seek prompt medical care if symptoms escalate, as they are more vulnerable to complications.
Q: How early do these symptoms begin to show?
A: Symptoms usually start three to five days after exposure to the virus, but there can be individual variations depending on their age and overall health condition.
Q: Are there different levels of severity in the symptoms?
A: Yes, it depends on factors like age and the person’s immune system. Those with weaker immune systems or underlying conditions may experience more severe complications, including pneumonia and other lower respiratory tract infections.
Q: Can the effects be reversed if detected early and treated early?
A: Early detection and timely supportive care can help mitigate complications and improve outcomes, as with most viral infections.
Q: How is it diagnosed?
A: Diagnosis is primarily clinical and supported by laboratory tests. There are no specific chest X-ray features or blood count abnormalities exclusive to hMPV, although pneumonia-like changes may be present in severe cases.
Doctors usually diagnose it based on symptoms. In hospitals, tests like RT-PCR from nasal swabs can confirm the infection.
Q: What does the treatment involve?
A: There is no specific cure. Treatment focuses on relieving symptoms, such as taking Paracetamol for fever, staying hydrated with plenty of fluids, and using oxygen therapy for severe cases.
Q: What is the best way to protect ourselves from this virus? Has the Health Ministry laid out guidelines which the public can follow?
A: You can reduce the risk by following these simple steps.
Wash hands often: Use soap and water for at least 20 seconds.
Avoid touching your face: especially if your hands aren’t clean.
Avoid close contact: Stay away from people who are sick.
Cover your coughs and sneezes: Use a tissue or your elbow.
Clean surfaces: Wipe down frequently-touched items like doorknobs.
Q: Is wearing masks a must for those who have direct contact with hMPV patients?
A: As same as for any other respiratory viral infection, necessary precautions should be taken when dealing with suspected/ confirmed HMPV patients to prevent further transmission of the infection. Wearing masks can help reduce the risk of infection, especially when combined with other precautions like washing hands and avoiding close contact.
Q: Are there sufficient facilities for safe disposal of waste material in our hospitals of patients with hMPV?
A: Yes. Our healthcare system has experience in handling respiratory infections, including hMPV. Hospitals have the facilities for safe waste disposal and diagnostics for the virus.
Q: Do you see any gaps in our present health system regarding the quality care of hMPV patients?
A: Since this is not a deadly virus most of the time, additional infrastructure or facilities are not necessarily needed to combat the infection.
The virology laboratories in Sri Lanka have diagnostic facilities for this virus. All healthcare workers have knowledge in infection prevention and control aspects.
Q: Do you have a message for our readers on how they can minimise risks of exposure to this virus?
A: There is no need to panic. Supportive care is enough to recover. However, if someone shows severe symptoms, they should seek medical help immediately.
Let us follow good hygiene practices and take care of vulnerable groups.
