Is HMPV another Covid-19-like scare in China? What we know so far

Five years after the onset of the Covid-19 pandemic, China is grappling with an outbreak of the human metapneumovirus (HMPV). Reports and social media posts suggest that the virus is spreading rapidly, with allegations of overwhelmed hospitals and crematories. Online videos show overcrowded hospitals, while users claim that multiple viruses — including influenza A, HMPV, Mycoplasma pneumoniae, and Covid-19 — are circulating simultaneously.

What’s happening in China?

Despite the rise in respiratory illnesses, neither the Chinese government nor the World Health Organization (WHO) has issued an official warning or declared an emergency.

The surge in cases is primarily affecting children and the elderly. Young children with developing immune systems are particularly vulnerable, while older adults and those with pre-existing conditions like asthma or COPD face heightened risks of severe complications. Symptoms resemble those of the flu or a cold, including fever, cough, and runny nose, with some patients experiencing wheezing. Severe cases can lead to bronchitis or pneumonia.

Experts attribute this increase in respiratory illnesses, including HMPV, to colder weather and the resumption of normal activities post-Covid-19. Years of strict lockdowns and reduced social interaction had limited the spread of many viruses, leaving people — especially children — less exposed to common pathogens. As social interactions return, many are encountering these viruses for the first time, creating a “catch-up” period.

China’s monitoring system

In response to the rising cases, China’s disease control authorities are adopting proactive measures. According to Reuters, health officials have launched a pilot system to monitor pneumonia of unknown origin. This initiative is aimed at improving preparedness for respiratory diseases during the winter months. The move contrasts with the country’s limited readiness during the initial outbreak of Covid-19.

The National Disease Control and Prevention Administration (NCDPA) has issued protocols requiring laboratories to report cases, while disease control agencies will verify and handle them. Official data indicates an increase in respiratory infections for the week of December 16 to 22.

Expected rise in respiratory diseases

Kan Biao, an NCDPA official, stated that China is likely to face an uptick in respiratory diseases throughout the winter and spring. However, he noted that the total number of cases this year is expected to be lower than in 2024.

Reports highlight that several respiratory pathogens, including rhinovirus and HMPV, are rising, particularly among children under 14. Northern provinces have seen a notable increase in HMPV cases.