Human metapneumovirus outbreaks in healthcare facilities: a review of the literature

Abstract

Human metapneumovirus (hMPV) is a significant cause of acute lower respiratory infections (ALRIs), and outbreaks have occurred in healthcare settings. We reviewed 22 articles presenting original data on hMPV outbreaks in healthcare facilities published in PubMed until 1 October 2025. The outbreaks occurred in various healthcare environments, mainly hospital settings and long-term care facilities (LTCFs), and affected from 2 to 96 patients. Outbreaks in LTCFs extended for a median of 33 days and had a median attack rate (AR) of 19%. The highest AR (73%) was noted in a rehabilitation center housing institutionalized chronic alcoholics, while the longest outbreak (10 weeks) in a LTCF. On several occasions, severe ALRIs and fatalities occurred among patients, particularly among residents in LTCFs and a hematology/oncology unit caring for severely immunocompromised patients. The hMPV outbreaks were often traced to patients with respiratory symptoms entering the facility from the community. Healthcare personnel frequently contributed to transmission. Currently there are no approved antiviral agents and vaccines against hMPV, which enhances the importance of infection control measures. Access to rapid molecular diagnostics is essential to guide infection control and mitigate the burden of hMPV outbreaks in healthcare facilities. Antiviral agents specifically against hMPV and vaccines are needed.