Respiratory viruses in the spotlight, should you be concerned?

In recent weeks, respiratory infections have captured global headlines with health officials in China reporting a spike in cases of human metapneumovirus (hMPV) and the United States (U.S.) bolstering its pandemic preparedness in response to a resurgence of avian influenza/ bird flu (H5N1) cases.
This newsletter aims to provide insights into the respective viral infections and explore the potential risks these may pose within the local context.

Human Metapneumovirus (hMPV)
The recent outbreak of hMPV in northern China, primarily affecting children, has sparked global concerns of another pandemic. The World Health Organisation (WHO) and Chinese health officials have however assured the public that hMPV is not unusual for this time of year and the numbers seen are nowhere near pandemic proportions. The Chinese Centre for Disease Control (CDC) has urged the public to be vigilant and maintain strict personal hygiene and health practices.

What is the hMPV?:
hMPV is a common respiratory virus belonging to the pneumoviridae family, which also includes the respiratory syncytial virus (RSV). Experts have noted that hMPV differs from COVID-19 in that it has been circulating for decades, providing the global population with some level of immunity from past infections. In contrast, COVID-19 reached pandemic status because it was a new virus with no prior human exposure.
hMPV is transmitted through respiratory droplets released during coughing and sneezing, with cases typically peaking during winter and spring. The symptoms of hMPV are typically mild and short-lived, presenting as flu-like symptoms such as coughing, sneezing, congestion and a sore throat.
Although serious complications are rare, there is an increased risk of bronchitis or pneumonia (among other complications) in vulnerable populations like the elderly, young children, and immunocompromised individuals.

As with most viruses, there is no specific treatment or cure for hMPV. Most symptoms are mild and self-limiting, so supportive care is typically the standard approach. Over-the-counter medications like paracetamol and ibuprofen can help manage pain and fever, while decongestants, inhalers, and nasal corticosteroids are useful for respiratory symptoms. In more severe cases, short courses of systemic corticosteroids may be prescribed. If the situation worsens, more intensive medical interventions like oxygen therapy and hospitalisation might be necessary. Additionally, antibiotics may be indicated to treat any secondary bacterial infections.

Preventing hMPV infections involves proactive measures such as regular handwashing, avoiding close contact with sick individuals, disinfecting frequently touched surfaces and practicing good respiratory etiquette, like covering the mouth when coughing or sneezing.
(1) (2) (3) (4) (5) (7)

Bird flu alert in the U.S.
The U.S is currently facing an outbreak of the H5N1 avian influenza, which has spread across all 50 states. The virus has been detected in wild birds, domestic poultry, and dairy cattle. As of January 7, 2025, there have been 66 confirmed human cases, primarily among individuals who work closely with birds, poultry, or dairy cows. Most cases report mild symptoms with one fatality in Louisiana. Health officials emphasise that the risk to the general public remains low. The CDC continues to monitor the situation closely and advises people to take precautions, such as avoiding contact with sick or dead birds and using personal protective equipment when handling poultry. The CDC is also working on developing vaccines to mitigate the spread of the virus.
(12) (13) (14) (15) (16) (17) (18) (7) (19)

What is Avian Influenza?
Avian influenza (H5N1), also called bird flu, is caused by influenza type A virus and primarily affects birds, cows and other animals. The H5 subtypes of influenza A are the most common strains to cause human infections. While it rarely spreads to humans, infections can occur through exposure to an infected animal’s body fluids, including saliva, milk, respiratory droplets or faeces, or contaminated environments. Avian influenza is rarely contagious from person-to-person, with most cases arising from animalto-human transmission. Individuals working closely with poultry, waterfowl (like ducks or geese) and dairy cows are at the highest risk for avian influenza infection.

Infected individuals may experience mild upper respiratory tract symptoms (e.g. cough, runny nose, sore throat), conjunctivitis (pink eye) and gastrointestinal symptoms (e.g., nausea, vomiting, diarrhoea). In more severe cases, serious complications may manifest as pneumonia, respiratory failure, inflammation of the brain and heart, and seizures (among others).

Treatment for avian influenza involves antiviral medications (such as oseltamivir) and supportive care such as rest and hydration. In severe cases, hospitalisation may be necessary for more intensive care. Preventive measures include good hygiene and public health interventions like culling infected birds and monitoring outbreaks. (8) (9) (10) (11)

South Africa last grappled with an avian influenza outbreak in 2023, primarily the H5N1 and H7N6 strains, affecting both poultry and wild birds across several provinces. The Department of Agriculture, Land Reform and Rural Development (DALRRD) reported multiple outbreaks, leading to the culling of millions of birds to contain the virus. There were no animal-to-human transmissions with this outbreak and the poultry industry has since stabilized.
(20) (21) (22) (23)

What does this mean for South Africa, and should you be concerned?
According to the latest respiratory disease surveillance report by the National Institute for Communicable Diseases (NICD) for week 48 of 2024 (25 November 2024 to 1 December 2024), no cases of avian influenza or RSV were detected; with 4 cases of SARS-CoV-2 in the month of November 2024. The low prevalence of influenza is attributed to the local influenza season usually commencing towards the end of April, peaking in June, and tapering down in October. There are also no reported cases of hMPV in South Africa though there has been a small uptick in COVID-19 cases since October 2024, but nothing concerning.
Professor Cheryl Cohen, head of the Centre for

Respiratory Diseases and Meningitis at the NICD in South Africa, has stated that hMPV currently poses no risk to South Africa. However, the Department of Health and NICD are closely monitoring the situation in China. As it pertains to avian influenza, the government continues to implement strict biosecurity measures and surveillance to monitor and control the spread of the virus. (24).

The recent surge in these respiratory viruses highlights the importance of staying vigilant and taking preventative action.

WORKS CITED
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