A new study in The Lancet Regional Health – Southeast Asia has underscored the impact of the Human Metapneumovirus (HMPV) outbreak that emerged in India earlier this year, with children under the age of two identified as the most affected group.
The study, led by researchers from the Indian Council of Medical Research (ICMR) and the Directorate of Public Health and Preventive Medicine, Tamil Nadu, analysed data collected between 2019 and 2025 under the Model for Integrated Influenza Surveillance programme. It found that while the outbreak drew attention due to rising case numbers, there has been no significant change in the epidemiological profile of HMPV compared to earlier years.
HMPV, first linked to an uptick in respiratory illnesses in China in late 2024, spread to India by January 2025, with cases reported in states including Gujarat and Puducherry. According to estimates, the virus accounted for over six per cent of respiratory illnesses and around five per cent of hospitalisations in China during the same period, raising concerns of wider regional transmission.
In India, researchers tested over 20,000 individuals for HMPV between 2019 and 2023, with 3.2 per cent testing positive. In 2024 alone, more than 11,000 people were tested, of whom 3.3 per cent were positive. Children accounted for the majority of cases, with the highest positivity rates found in those aged 1–2 years—4.5 per cent in the earlier period and 4.6 per cent in 2024.
Clinically, HMPV cases presented with symptoms resembling influenza and acute respiratory illnesses. Fever and cough were the most common, reported in over 70 per cent of cases during 2019–2023 and nearly 80 per cent in 2024. Duration of illness typically lasted around 11 days, with hospital stays averaging seven days, the study noted.
The Virus Research and Diagnostic Laboratory (VRDL) Network, established by the Department of Health Research in 2014, carried out diagnostic testing. Researchers highlighted that the growing volume of tests and detections in 2024 point to increasing recognition of HMPV as a significant respiratory pathogen in India’s public health landscape.
While the study ruled out major epidemiological shifts, experts stressed that consistent surveillance remains essential. Strengthening laboratory networks and integrating data from multiple regions will be critical in identifying emerging viral threats and shaping preparedness strategies.
The findings also highlight broader policy implications. With respiratory infections continuing to account for a substantial proportion of hospitalisations in India, enhancing diagnostic capacity and ensuring real-time reporting systems could help improve outbreak response. For hospital administrators and policymakers, the study reinforces the need to allocate resources toward surveillance infrastructure while simultaneously preparing for potential seasonal surges in respiratory illnesses.
As India continues to strengthen its disease monitoring networks, the HMPV outbreak serves as a reminder of the importance of early detection and coordinated response mechanisms. With children emerging as the most vulnerable group, targeted interventions—ranging from awareness among parents to expanded paediatric surveillance—are expected to remain a priority for healthcare stakeholders.
