Human metapneumovirus (hMPV)

Both hMPV and respiratory syncytial virus (RSV) are in the Pneumoviridae family. Like RSV (respiratory syncytial virus) and other respiratory viruses, hMPV outbreaks are seasonal. In the United States, hMPV infections most often begin in the fall and run into the spring.

hMPV spreads through tiny droplets that spray into the air when a sick person blows their nose, breathes, coughs, or sneezes. You can catch hMPV if:

• A person with hMPV breathes, talks, sings, sneezes, coughs, or blows their nose near you.
• You touch, kiss, or shake hands with someone who is infected with the virus.
• You touch a surface, such as a doorknob, with the virus on it, then touch your nose, eyes, or mouth.

Symptoms of hMPV usually appear 3 to 6 days after infection.

Young adults and older children often have mild symptoms. Symptoms affect your nose and throat. They may progress to your windpipe and lungs. Common symptoms are similar to a cold and may include:

• Cough
• Fever
• Runny nose or nasal congestion
• Sore throat
• Ear infections in children
• Rash

Symptoms can vary depending on your age and health. In some adults and children, hMPV can cause more serious symptoms such as:

• Wheezing
• Shortness of breath
• Asthma or chronic obstructive pulmonary disease (COPD) flare-ups
• Barking cough (croup)
• Bronchitis
• Bronchiolitis
• Pneumonia
• Encephalitis

Infants, older adults, and people with existing illness are more at risk for complications from hMPV.

Your health care provider will ask about your symptoms and medical history and do a physical exam. Because there is no treatment for hMPV, you may not need any tests. If your provider wants to find out what type of virus you have, a fluid sample from your nose, mouth, or throat may be tested. Knowing what type of virus you have can help determine your treatment.

People with severe symptoms or those at risk for complications may have further tests:

• Bronchoscopy. A tube with a small camera is inserted to see inside the airways and lungs and to obtain a sample of fluid to test for the virus.
• Chest x-ray.

Currently, no antiviral therapy or vaccine is available to treat or to prevent hMPV. In most cases, mild symptoms go away on their own in a week or two. Self-care to help relieve symptoms is the same as for the flu or a cold:

• Take acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) to help lower fever and relieve muscle aches. (Never give aspirin to children or teenagers.)
• Use a nasal decongestant (available without prescription) to help relieve stuffiness and a runny nose.
• Use cough medicines if needed to help you sleep.
• Drink plenty of fluids to stay hydrated.
• Rest and avoid heavy work or exercise.

Always talk with your child's provider before giving over-the-counter medicines to children. Certain medicines should not be given to children, or only after a certain age.

• Do not give cold medicines to children younger than 4 years old.
• Only give cold medicines to children ages 4 to 6 years if your provider recommends it.
• Do not give ibuprofen to children younger than 6 months unless directed by your provider.
• Aspirin should not be used in children and teens due to the risk of Reye syndrome.

Antibiotics are NOT used to treat hMPV. Antibiotics only kill bacteria. So, they won't work on hMPV, which is a virus.

People with a severe infection may need to be admitted to the hospital. Treatment in the hospital may include:

• Supplemental oxygen
• Moist (humidified) air
• Suctioning of nasal secretions (in infants and children)
• Fluids through a vein (by IV) to prevent dehydration
• A breathing machine (ventilator)

Adults or children with mild hMPV symptoms recover within a week with self-care at home. Hospitalization is needed only for people with serious complications. Risk factors for severe hMPV infection include:

• Age (younger than 2 years or older than 65 years)
• Chronic lung disease such as COPD or asthma
• Heart disease (congenital in children)
• Having a weak immune system due to medical conditions such as HIV or cancer
• Long-term steroid use

In people who are at higher risk, hMPV can cause complications:

• Bronchiolitis in children
• Bronchitis or pneumonia in adults

hMPV can also make existing medical conditions worse, such as asthma, COPD, and heart failure.

Contact your provider right away if you or your child have:

• Breathing difficulty or labored breathing
• Bluish skin color due to a lack of oxygen (cyanosis)
• Severe chest pain
• Nasal flaring
• Rapid breathing (tachypnea)
• Persistent cough or wheezing
• Chills or high fever that lasts longer than 3 days

Any breathing problems in an infant are an emergency. Seek medical help right away.

There is no vaccine for use to prevent hMPV. Studies are ongoing to develop a vaccine and antiviral therapy against hMPV.

The virus spreads very fast through contaminated air or surfaces. You can take steps to lower the risk for infection to yourself or spreading it to others.

• Wear a well-fitted face mask or respirator that fits snugly over your nose and mouth without gaps when you go outside, especially during the fall and winter months in the United States.
• Avoid touching "high-touch" areas such as doorknobs, handles, elevator buttons, fixtures in public restrooms, or handrails.
• Wash your hands many times a day with soap and running water for at least 20 seconds. Do this before eating or preparing food, after using the toilet, and after coughing, sneezing, or blowing your nose. Use an alcohol-based hand sanitizer (at least 60% alcohol) if soap and water are not available.
• Do not share personal items such as cups, eating utensils, towels, or bedding with others.

If you get an hMPV infection, protect others from illness by taking these steps for 5 days:

• Stay at home
• Practice good hygiene
• Take steps for cleaner air
• Wear a mask around others
• Practice physical distancing by avoiding close contact and avoiding crowds

You can go back to your normal activities if both of the following things are true:

• For at least 24 hours, you have been feeling better and your symptoms are improving AND
• You have not had a fever for at least 24 hours (and you are not using fever-reducing medicine)

hMPV; HMPV; Pneumovirus - hMPV; URI - hMPV; Upper respiratory illness – hMPV; Bronchiolitis- hMPV, Bronchitis - HMPV

American Lung Association website. Human Metapneumovirus (hMPV) symptoms and diagnosis. www.lung.org/lung-health-diseases/lung-disease-lookup/human-metapneumovirus-hmpv/symptoms-diagnosis. Updated February 24, 2026. Accessed July 24, 2026.

Barrett B. The common cold. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 329.

Branche AR, Williams JV. Human metapneumovirus. In: Blaser MJ, Cohen JI, Holland SM, et al, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 10th ed. Philadelphia, PA: Elsevier; 2026:chap 166.

Centers for Disease Control and Prevention website. About Human Metapneumovirus. www.cdc.gov/human-metapneumovirus/about/index.html#cdc_disease_basics_testing_screening-testing-and-diagnosis. Updated February 10, 2026. Accessed July 24, 2026.

Updated by: Linda J. Vorvick, MD, Clinical Professor Emeritus, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.