Carpha recommends vigilance among HMPV concerns

AS reports of increases in respiratory illnesses including Influenza A, Human Metapneumovirus (HMPV), Mycoplasma pneumoniae and covid19 circulate in China, the Caribbean Public Health Agency (Carpha) says, while the current risk is low, there is potential for an increased risk to the Caribbean. It strongly recommends enhanced surveillance across member states.

A statement from Carpha said respiratory illness activity in the Caribbean showed a mixed pattern at the end of December 2024.

“The Caribbean region is currently experiencing peak travel and tourism season, marked by increased air and cruise-ship travel, which is typically associated with a rise in respiratory illnesses among both travellers and local populations. The concurrent occurrence of multiple respiratory outbreaks, as seen in China, poses a risk of straining health systems and response efforts.

“Overall cases have slightly increased, though severe acute respiratory infection (SARI) cases remain low. Influenza activity is rising, driven primarily by Influenza A(H1N1), while respiratory syncytial virus (RSV) activity, although elevated, has declined over the past four epidemiological weeks, covid19 activity continues at low levels.”

Carpha says it will continue to monitor the evolving epidemiological situation and analyse syndromic data related to fever and respiratory symptoms and is focused on bolstering national and regional capacity to respond to potential outbreaks and pandemics.

Given the situation, Carpha recommends that member states strengthen respiratory disease surveillance systems and public-health capacity to promptly detect and respond to suspected cases, ensuring the health system is well equipped to deal with any possible increase in respiratory illness cases.

It also recommends appropriate non-pharmaceutical measures be used where there is suspected exposure or risk in keeping with established protocols in addition to enhanced tourism-based surveillance for travellers arriving by air and sea.

“Carpha recognises that its member countries may have molecular testing capacity for the detection of HMPV included in special viral panels such as the BioFire. For respiratory samples sent to Carpha, the Carpha Medical Microbiology Laboratory (CMML) follows its algorithm for respiratory testing.

“As such, samples are first screened for influenza viruses; if negative for covid19 and Influenza and the samples meet the special criteria of patients under five years and over 65 yers with special respiratory conditions such as pneumonia, bronchopneumonia, bronchiolitis etc, same sample will then be tested for non-Influenza viruses, of which HMPV is one of seven.”

In 2024, the CMML performed 313 tests for non-influenza viruses of which 11 were positive for HMPV.

HMPV is a respiratory virus in the family with RSV. It generally causes upper and lower respiratory disease in people of all ages, especially among children under five, older adults and those with weakened immune systems.

Symptoms include cough, fever, nasal congestion and shortness of breath which may progress to bronchitis or pneumonia, similar to other viruses that cause upper and lower respiratory infections.

The estimated incubation period is three to six days but can extend to 14 days and the median duration of illness can vary depending upon severity but is similar to other viral respiratory infections.

In a statement on January 8, the Health Ministry said Health Minister Terrence Deyalsingh was working with his team to actively monitor the situation in China.

The ministry consulted with Pan American Health Organization (PAHO) and received a report which said, "According to surveillance data from China CDC for the week of 23-29 December 2024, there continues to be a rise in acute respiratory infections, including seasonal influenza, HMPV, rhinovirus and adenovirus.

“However, the overall scale and intensity of these infections remain lower than during the same period last year. A seasonal increase in respiratory pathogens is expected in countries of the northern hemisphere, particularly during the winter period.

On January 2, through communication with the Chinese Center for Disease Control and Prevention (China CDC), it was confirmed that there was no state of emergency declared by the country".

The Influenza vaccine is available at the following vaccination sites from January 11-19.

Locations and times are as follows;

North Central Regional Health Authority (NCRHA): Divali Nagar, 12pm-6pm.

North West Regional Health Authority (NWRHA): Paddock Area Queen's Park Savannah, 8am-4pm.

South-West Regional Health Authority (SWRHA): Gulf City Mall, 12pm-6pm.

Eastern Regional Health Authority (ERHA): Listed Health Facilities 8am-4pm.