Sunday | 12 January 2025 | Reg No- 06
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Sunday | 12 January 2025 | Epaper
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Are we prepped for HMPV?

Published : Sunday, 12 January, 2025 at 12:00 AM  Count : 130
Md Al-Mamun
In the backdrop of Bangladesh's annual struggles with respiratory disease outbreaks, a new adversary has quietly entered the scene: Human Metapneumovirus (HMPV). Discovered in 2001, this virus has gradually become a global contributor to respiratory illnesses, particularly endangering the most susceptible populations-children, the elderly, and those with compromised immune systems. For a country like Bangladesh, where respiratory infections are among the leading public health challenges, the emergence of HMPV presents a pressing issue that cannot be ignored.

Respiratory infections are responsible for significant morbidity and mortality in Bangladesh, especially among children under five. While respiratory syncytial virus (RSV) and influenza dominate the headlines, HMPV frequently goes undiagnosed due to its clinical similarity to other viruses and limited diagnostic capabilities in the country. According to global estimates, HMPV is the second leading cause of acute respiratory infections (ARIs) after RSV, contributing to hospitalizations and deaths in vulnerable populations. Yet, in Bangladesh, the virus remains an understudied and underreported health issue.

Studies from neighboring South Asian countries reveal that HMPV is a significant cause of bronchiolitis and pneumonia, raising concerns that Bangladesh might be underestimating its impact. Despite its prevalence, a lack of awareness among healthcare providers and limited research have kept this virus from receiving the attention it deserves.

Bangladesh presents an ideal breeding ground for HMPV transmission. Overcrowded urban environments, poor air quality, high rates of malnutrition, and inadequate access to healthcare amplify the risks. Seasonal weather patterns, with spikes in respiratory infections during winter and spring, further exacerbate the situation. Frequent flooding and climate-related disasters displace millions, forcing them into overcrowded shelters where respiratory viruses can spread rapidly.

Adding to these challenges are systemic gaps in healthcare infrastructure. Most rural healthcare facilities lack the molecular diagnostic tools needed to identify HMPV, resulting in misdiagnoses and delayed treatment. The socio-economic burden of respiratory infections, including lost productivity and healthcare costs, weighs heavily on low-income families, further complicating the public health response.

Children, particularly those with malnutrition or other underlying health issues, are at significant risk of severe illness from HMPV. In low-resource settings, untreated HMPV infections can quickly progress to life-threatening conditions such as bronchiolitis and pneumonia. According to UNICEF, pneumonia is already the leading infectious cause of death among children under five in Bangladesh, and HMPV's contribution to this statistic remains largely unquantified.

For the elderly, who often grapple with chronic respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD), the virus can turn life-threatening. Immunocompromised individuals, including those with diabetes, HIV/AIDS, or cancer, face heightened vulnerability, making early detection and prevention crucial.

The COVID-19 pandemic highlighted the critical need for robust surveillance systems, timely diagnostics, and public health preparedness to combat respiratory viruses. Bangladesh's experience with COVID-19 offers valuable lessons that can be applied to address HMPV. Strengthening diagnostic capacity, increasing healthcare worker training, and investing in research can help the country stay ahead of this emerging threat. The pandemic also emphasized the importance of public awareness campaigns, which can play a pivotal role in curbing the spread of respiratory infections.

HMPV is not yet a household name in Bangladesh, but the country's health system cannot afford to wait for it to become one. Proactive measures are needed to prevent this virus from escalating into a major public health crisis.

1. Strengthening Surveillance
Bangladesh must invest in laboratory-based surveillance to accurately track HMPV infections. Incorporating the virus into existing respiratory disease monitoring programs, such as influenza or RSV surveillance, is a practical first step. Establishing partnerships with international health organizations can provide the technical and financial support needed to build a robust surveillance system.

2. Enhancing Diagnostic Capacity
Molecular diagnostic tools, like polymerase chain reaction (PCR) testing, must be made accessible at public hospitals and community health centers. This will allow clinicians to differentiate HMPV from other respiratory viruses and provide targeted care. Mobile diagnostic units could be deployed in remote and underserved areas to bridge the gap in healthcare access.

3. Public Awareness Campaigns
Educating the public about respiratory hygiene-such as handwashing, wearing masks during illness, and avoiding crowded places-can curb the spread of HMPV. These campaigns should be tailored to reach rural and urban populations alike, leveraging mass media, community health workers, and religious institutions to disseminate information.

4. Healthcare Preparedness
Hospitals need to be equipped with resources to handle spikes in respiratory illnesses during peak seasons. Training healthcare workers to recognize the symptoms and severity of HMPV can prevent complications and save lives. Expanding the availability of oxygen therapy and other supportive treatments in rural healthcare facilities is equally critical.

5. Investing in Research and Vaccines
While there is no approved vaccine for HMPV yet, global efforts to develop one are underway. Bangladesh should engage with international health organizations to stay at the forefront of these developments, ensuring future access to preventive tools. Local research institutions must prioritize studies on HMPV's epidemiology, clinical characteristics, and socio-economic impact in Bangladesh.

Bangladesh has faced formidable public health challenges before, from cholera outbreaks to the ongoing battle against dengue. The emergence of HMPV as a potential public health threat is a reminder of the ever-evolving nature of infectious diseases. By investing in surveillance, diagnostics, and public health awareness, we can address this threat head-on and safeguard the health of millions.

The writer is a researcher and social scientist at BIGD, an applied social science research and teaching institute of BRAC University




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