New virus from China?

Human metapneumovirus (hPMV)

HMPV, first identified in 2001, children in the Netherlands

(Some serologic evidence, the virus has been widespread since at least 1958)

A very similar metapneumovirus was already known in birds (zoonosis)

Estimated incubation period, 3 to 6 days

Spread, mostly close contact, air and objects

United States

Human metapneumovirus, associated with 20,000 under 5s hospitalizations per year

Peak age of hospitalization for infants 6 to 12 months,

(RSV, 2 to 3 months)

Infection can also progress to the lower respiratory tract, bronchiolitis and pneumonia.

China reportedly overwhelming hospitals in northern provinces, (cold winter time)

Incidence in China not greatly raised

China OPD visits for respiratory virus (China CDC)

China hospital visits for respiratory virus, (China CDC)

Unlikely pandemic potential

Does mutate, (RNA virus) but no animal reservoir

Serological studies

By the age of five, virtually all children worldwide have been exposed

Reinfections are common in older children and adults

Risk groups, very young, premature babies, old, immunocompromised, comorbidities, asthma, COPD, outbreaks occur in care facilities of old and young.

Current UK hospital situation

‘With depressing predictability,

health services are in the depths of the annual NHS winter crisis.

There are already reports of patients waiting more than two days to be seen in A&E,

and long ambulance handover delays,

and critical incidents have been declared at hospitals up and down the country.

The consequence is that patients are being cared for in unsuitable conditions,

such as trolley beds in hospital corridors.’

Are these winter episode optional

non typable Haemophilus influenzae (NTHi)

Mycobacterium vaccae (VAKI)

Vitamin D replete