Epidemiology of Human Metapneumovirus Infection in a Community Setting, Seattle, Washington, USA
By
Annalyse Elias-Warren
Julia C Bennett
Chidozie D Iwu
Lea M Starita
Jeremy Stone
Ben Capodanno
Robin Prentice
Peter D Han
Zack Acker
Sally B Grindstaff
David Reinhart
Jennifer K Logue
Caitlin R Wolf
Michael Boeckh
Kevin Kong
Hong Xie
Geon Kim
Alexander L Greninger
Amanda C Perofsky
Cécile Viboud
Timothy M Uyeki
Janet A Englund
Pavitra Roychoudhury
Helen Y Chu
July 16, 2025
Clinical Scorecard: Community-Based Epidemiological Study of Human Metapneumovirus Infections in Seattle, Washington, USA
At a Glance
Category Detail
Condition Human metapneumovirus (hMPV) infection causing acute respiratory illness Key Mechanisms hMPV infection detected by RT-PCR; genomic subtypes A2b, A2c, B1, B2 co-circulate; subtype distribution shifts post-COVID-19 pandemic Target Population Community-dwelling individuals with respiratory symptoms across all ages, especially children 0–4 years Care Setting Community settings (childcare, workplaces, transit stations, home-based testing) and clinical settings (urgent care, outpatient clinics, hospitals)
Key Highlights
hMPV positivity higher in clinical specimens (3.9%) than community specimens (0.6%). Children aged 0–4 years had the highest positivity rates in both settings. Lower household income (≤$100,000) and recent international travel were significant risk factors for hMPV positivity. Guideline-Based Recommendations
Diagnosis
Use reverse-transcription polymerase chain reaction (RT-PCR) testing for hMPV detection in symptomatic individuals. Management
Monitor respiratory symptoms in children and adults presenting with acute respiratory illness, especially in high-risk groups. Consider epidemiological context such as recent travel and socioeconomic factors when assessing risk. Monitoring & Follow-up
Perform genomic surveillance to track hMPV subtype circulation and evolution, particularly before and after pandemic periods. Monitor geospatial distribution of hMPV infections to understand transmission dynamics. Risks
Increased risk of hMPV infection associated with lower household income and recent international travel. Young children (0–4 years) are at higher risk of infection. Patient & Prescribing Data
Individuals with respiratory symptoms in community and clinical settings, with emphasis on children aged 0–4 years.
No specific treatment data provided; baseline epidemiological data may inform future vaccine policy and prioritization once vaccines become available.
Clinical Best Practices
Enroll symptomatic individuals with ≥2 new or worsening respiratory symptoms within 7 days for testing. Exclude asymptomatic individuals from routine hMPV surveillance to focus on clinically relevant infections. Use both community-based and clinical specimen collection to capture comprehensive epidemiology. Incorporate genomic sequencing to inform vaccine antigen selection and monitor viral evolution. Consider socioeconomic and travel history factors in risk assessment and public health interventions. References
