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Human metapneumovirus: All you need to know · Health Matters

• 0:00
  Speaker 1: Now,
• 0:01
  Speaker 1: Health Matters
• 0:01
  Speaker 2: with Daniel Martin. It's Health Matters right here on CNA 938.
• 0:06
  Speaker 2: New year, new virus, maybe. Everybody, welcome to the show.
• 0:10
  Speaker 2: It's not that new after all, but it has been
• 0:13
  Speaker 2: making the news, and that is HMPV. I'm going to
• 0:19
  Speaker 2: attempt to pronounce what it stands for, human metapneumovirus, and
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  Speaker 2: there are numbers surging in China.
• 0:28
  Speaker 2: As well as just across the causeway in Malaysia. What
• 0:33
  Speaker 2: do we need to understand about this? Is this the
• 0:35
  Speaker 2: next pandemic?
• 0:37
  Speaker 2: Is this that new after all? Joining us once again,
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  Speaker 2: Doctor Leon Honam, who's an infectious disease physician out of
• 0:45
  Speaker 2: the Roy Clinic. Doc, always good to connect. New year,
• 0:48
  Speaker 2: new virus? How? Is it true or not?
• 0:51
  Speaker 1: is a relatively new virus in terms of discovery. I mean,
• 0:55
  Speaker 1: we've known flu for hundreds of years and.
• 0:59
  Speaker 1: It was discovered somewhere in the late 19th century and
• 1:02
  Speaker 1: early 20th century, but this virus, human me pneumovirus was
• 1:06
  Speaker 1: discovered only in 2001.
• 1:08
  Speaker 1: But if you look at the sequencing, the chances are
• 1:11
  Speaker 1: they've been around for at least 50 years. So, relatively
• 1:14
  Speaker 1: new in discovery, but honestly, it's been around for a
• 1:18
  Speaker 1: very long time. So, this virus, every time when someone
• 1:23
  Speaker 1: gets it, I say, congratulations, you must be young because
• 1:26
  Speaker 1: it tends to affect the children more. The younger children,
• 1:30
  Speaker 1: by the time they're 12 months old, there's a good
• 1:32
  Speaker 1: chance 80 to 90% of the children will have been infected.
• 1:37
  Speaker 1: This is responsible for about 10 to 15% of children
• 1:41
  Speaker 1: going to the emergency department with a cough, cold, runny nose,
• 1:47
  Speaker 1: and uh then he's gonna ask you, how do you
• 1:49
  Speaker 1: differentiate it from flu? He says, you can't because you
• 1:53
  Speaker 1: have your cough, your runny nose, your sore throat.
• 1:57
  Speaker 1: And it's not like any other common cold or even influenza.
• 2:02
  Speaker 2: So some of us might have had it and didn't
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  Speaker 2: even realize we had it.
• 2:04
  Speaker 1: In
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  Speaker 1: all likelihood, Daniel, you and I, we've been living around
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  Speaker 1: for a few decades at least. We've had it before. Yeah.
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  Speaker 2: So why are we suddenly talking about it now? Why
• 2:14
  Speaker 2: are we talking about surging numbers?
• 2:16
  Speaker 1: OK, two things. Number one, even though you have had
• 2:19
  Speaker 1: it in the past, you can have it again and
• 2:22
  Speaker 1: again and again. It sounds like a broken old, um,
• 2:27
  Speaker 1: broken turn around, turntable. It's going to play through again
• 2:31
  Speaker 1: and again and again. And it's just like the COVID
• 2:34
  Speaker 1: story where you have it again and again. Rather, the
• 2:37
  Speaker 1: immunity to the same virus isn't persistent. After a while,
• 2:43
  Speaker 1: you get infected with it again and again.
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  Speaker 1: But we tend not to notice it because Daniel and
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  Speaker 1: I are rather healthy.
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  Speaker 1: It is rather those people with existing asthma, existing lung disease,
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  Speaker 1: they are prone to having it and having it bad.
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  Speaker 1: So you have an elderly at home, you have an
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  Speaker 1: immunocompromised homes, you're talking about cancer survivors, those who are
• 3:06
  Speaker 1: on different forms of medications. There's
• 3:09
  Speaker 1: Depressed immunity, you're going to have a worse bout of illness.
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  Speaker 1: In fact, you can be admitted to hospital for pneumonia
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  Speaker 1: for human me pneumovirus, even though you are 65 or
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  Speaker 1: 70 years
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  Speaker 1: old.
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  Speaker 2: With the pneumo in the name there, is it linked
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  Speaker 2: to pneumonia in some way?
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  Speaker 1: Actually, most of the time, it doesn't cause a pneumonia.
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  Speaker 1: But for the immunocompromise and the risk it is, truly
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  Speaker 1: the ones who are really at greatest risk are again
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  Speaker 1: at the extreme of ages. The older ones, because the
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  Speaker 1: immunity are poorer, but the younger ones, those are less
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  Speaker 1: than one year old, are particularly susceptible.
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  Speaker 1: You see, the virus attacks the lining of the airways,
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  Speaker 1: choke up the airways. For 1 year old child or
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  Speaker 1: 6 month year old child, the airways are very small
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  Speaker 1: and the whole airways are choked up like a choked brain.
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  Speaker 1: The child will have difficulty breathing, and in turn develop pneumonia,
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  Speaker 1: in turn, developed breathlessness, requiring hospitalization.
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  Speaker 1: But as you grow older, you always become bigger, you're
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  Speaker 1: less immune, or rather, you're less at risk for getting
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  Speaker 1: bad outcomes of these illnesses.
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  Speaker 2: OK. But in, in, in bad outcomes, it could be
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  Speaker 2: bronchitis or pneumonia, is it?
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  Speaker 1: Yes, you could get bronchitis. As the airways get choked up,
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  Speaker 1: you get pneumonia at the same time.
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  Speaker 2: So this is in the same family as RSV. And
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  Speaker 2: last year, we heard a lot about an RSV vaccine.
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  Speaker 2: Could that be effective against this?
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  Speaker 1: Oh, I wish it was, it attacks the airways very
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  Speaker 1: similarly to RSV. So we're kind of boring a lot over,
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  Speaker 1: and it applies very well. It is, however, a different
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  Speaker 1: virus altogether. What works for the RSV and the RSV
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  Speaker 1: vaccine will not work for the human mene virus.
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  Speaker 2: So, outbreaks like this, should we be concerned because again,
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  Speaker 2: here's the thing, we see the headline, we see the story,
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  Speaker 2: and the average person sees, huh, virus, China alarming numbers,
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  Speaker 2: and across the coast in Malaysia, respiratory infection. Oh no,
• 5:24
  Speaker 2: it's the new COVID.
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  Speaker 2: Is this the new COVID?
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  Speaker 1: Right? It's almost like deja vu,
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  Speaker 2: deja
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  Speaker 1: vu. OK, first of all, you more you kind of
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  Speaker 1: new to it because you have to use PCR testing
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  Speaker 1: to diagnose it.
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  Speaker 1: It was not available in previous testing because PCR wasn't
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  Speaker 1: so available. In the last 5 years, we have this
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  Speaker 1: PCR swab test now, which are available even to the
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  Speaker 1: GP clinic by your block or your neighborhood center.
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  Speaker 1: It is available, you test it and you can diagnose it.
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  Speaker 1: So there's increasing awareness, availability of testing, and similarly, the
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  Speaker 1: same advancements are available in China, you are seeing it.
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  Speaker 1: So you are picking up, you're diagnosing it, and in turn,
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  Speaker 1: we know the numbers. So
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  Speaker 2: is this a
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  Speaker 2: case of maybe these were always the numbers, but we
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  Speaker 2: just didn't test for it before.
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  Speaker 1: So 10 years ago, the numbers were always there.
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  Speaker 1: But there was no diagnostic capabilities and certainly, the hospital
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  Speaker 1: administration or the government wasn't interested in what was in
• 6:32
  Speaker 1: their backyard.
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  Speaker 1: As long as people were not dying, they didn't really care.
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  Speaker 1: But now with the outbreak of COVID, you really want
• 6:41
  Speaker 1: to try to identify any mysterious events that's occurring with
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  Speaker 1: any particular age group.
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  Speaker 1: So there is a determination to try to work out
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  Speaker 1: as much of the infections as possible, or at least
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  Speaker 1: do some form of screening.
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  Speaker 2: See now, this is why people always, this is the
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  Speaker 2: nineteen-year battle I've had on my health programs, like people
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  Speaker 2: always say,
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  Speaker 2: I don't want to test and find out because then
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  Speaker 2: I'll find some things it's better not to know. In
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  Speaker 2: this case, that's actually
• 7:08
  Speaker 2: happening here.
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  Speaker 1: Ignorance is this. OK, let's, let's be honest. The whole
• 7:14
  Speaker 1: world is getting connected. What's happening in China, France, America, anywhere,
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  Speaker 1: you can bring over to any part of the world.
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  Speaker 1: After COVID-19, there is a declaration from WHO saying that
• 7:27
  Speaker 1: we ought to be working together in terms of collaboration,
• 7:32
  Speaker 1: in terms of spreading information and understanding these diseases, and
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  Speaker 1: not just keep quiet about it.
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  Speaker 1: Let's be honest, there's a lot of pressure on China,
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  Speaker 1: what's happening. So China is trying to be transparent by
• 7:46
  Speaker 1: doing more and there's a lot more information coming out.
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  Speaker 1: Let me tell you what's difficult. It's easy to know
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  Speaker 1: the knowns. It's difficult to know the unknowns. And very
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  Speaker 1: often the unknowns are truly unknown unknown.
• 8:03
  Speaker 1: So searching the unknown is even more difficult. At least
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  Speaker 1: the Chinese have given us this information. I will be
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  Speaker 1: monitoring the space very closely.
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  Speaker 1: A new virus can break up anywhere, even in Singapore's
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  Speaker 1: own backyard or Malaysia. So let's all be careful, let's
• 8:24
  Speaker 1: all be mindful. Go for the vaccination system when you
• 8:27
  Speaker 1: have to. And listen to Daniel Martin's program. He teaches
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  Speaker 1: lots of good stuff on how to keep
• 8:33
  Speaker 1: you healthy.
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  Speaker 2: You're very kind and let's let's back that up right now.
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  Speaker 2: How do I prevent myself from contracting HMPV?
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  Speaker 1: It's very difficult. In all likelihood you have been exposed
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  Speaker 1: to it. If your antibody levels are really high, you'll
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  Speaker 1: probably be protected. But if your immunity is poor, say,
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  Speaker 1: I've got a 6 month old child at home. Number one,
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  Speaker 1: no visitors or few visitors. If anyone's visiting, make sure
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  Speaker 1: the person is well. There is no guarantee because you
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  Speaker 1: could actually have a mild illness which you are not
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  Speaker 1: aware of and you're spreading even before the onset of symptoms.
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  Speaker 1: Few visitors and the visitors must be well. After one year,
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  Speaker 1: the risk falls thereafter.
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  Speaker 1: If you are 60, 65 years old and above, if
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  Speaker 1: you are going for chemotherapy, etc. again, visitors must be healthy.
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  Speaker 1: If you are really paranoid, wearing a mask, safe distancing
• 9:33
  Speaker 1: still works very well for this human metapneumovirus. Not only
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  Speaker 1: human metapneumoviruses, but all the other viruses from influenza, rhinovirus, RSV, etc.
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  Speaker 1: The worse the immunity is or the worse the lungs are,
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  Speaker 1: or the more mass and safe distancing works. One additional point,
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  Speaker 1: which Daniel loves to mention is keeping your hands
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  Speaker 1: clean.
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  Speaker 2: I got my sanitizer on there.
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  Speaker 1: Yup. So hand contact, you may touch the doorknob thinking
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  Speaker 1: it's clean, but when you touch your nose, it's actually
• 10:07
  Speaker 1: you are reading in someone's knot.
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  Speaker 2: Ah, because this is also transmitted through droplets in the air.
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  Speaker 1: It's translated by droplets. It's also translated by contact.
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  Speaker 2: You mentioned earlier on the, I mean, those are the
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  Speaker 2: great precautions and that will help you.
• 10:22
  Speaker 2: Keep healthy in general. There are so many things that, that,
• 10:26
  Speaker 2: those doing those key things that Doctor Leo mentioned will
• 10:28
  Speaker 2: help you in general with so many things. Early on,
• 10:30
  Speaker 2: you mentioned the vaccination component. If I take my yearly
• 10:34
  Speaker 2: influenza vaccine, does that help in any way with this one?
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  Speaker 1: OK, influenza vaccines will get the influenza. It's not 100%.
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  Speaker 1: We'll talk about 50 to 60% effectiveness. Even if you
• 10:45
  Speaker 1: fall sick with influenza, you only end up with a
• 10:49
  Speaker 1: milder illness.
• 10:51
  Speaker 1: Uh, there's still the pneumonia vaccines, there's still the RSV vaccine.
• 10:55
  Speaker 1: There's also the Pertussis vaccine. I think someone talked about
• 10:59
  Speaker 1: pertussis on your program, and it is a whooping cough.
• 11:02
  Speaker 1: And guess what? The whoops can happen every 5 to
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  Speaker 1: 10 years, even in adults like uh Daniel and myself.
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  Speaker 1: Now, there's, there's good, there is a pitch also for
• 11:14
  Speaker 1: shingles recently. One of Stra Times journalists had a very
• 11:18
  Speaker 1: bad episode of Shingles. So, shingles vaccine, it helps for
• 11:22
  Speaker 1: the 5 uh 50 years and above.
• 11:25
  Speaker 1: It's also a pitch for COVID vaccines. If you had
• 11:28
  Speaker 1: no problems with COVID vaccines in the past, please go ahead,
• 11:32
  Speaker 1: get yourself COVID vaccinated. That's the way forward. Train yourself,
• 11:37
  Speaker 1: train yourself how to fight the viral infections or bacteria
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  Speaker 1: before it strikes. That way, you are armed and ready
• 11:45
  Speaker 1: for the next attack.
• 11:46
  Speaker 2: Yup. I had my latest COVID vaccine in December, right arm,
• 11:50
  Speaker 2: and the same day, left arm, the influenza vaccine. It's fine.
• 11:53
  Speaker 2: It's all, it's all, you do it in one go
• 11:55
  Speaker 2: if you need to.
• 11:56
  Speaker 2: Uh, let's talk a little bit about this idea once
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  Speaker 2: again about.
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  Speaker 2: Do you think that with these rising numbers and with
• 12:03
  Speaker 2: the numbers in Malaysia, so close to our borders as well,
• 12:06
  Speaker 2: in all likelihood is also probably already here.
• 12:09
  Speaker 2: Do you think doctors will start testing for HMPV or
• 12:11
  Speaker 2: is that, is that not gonna happen probably?
• 12:14
  Speaker 1: No, it won't happen.
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  Speaker 1: Simply because the test is ridiculously expensive. If you go
• 12:20
  Speaker 1: to any family clinic or the private hospitals where you
• 12:25
  Speaker 1: can request for one, it cost you at least $550
• 12:29
  Speaker 1: to $600 per test. That's really too expensive. Most people
• 12:34
  Speaker 1: tend to do it only after hospital admission.
• 12:38
  Speaker 1: Or there's a tech wallet with a head of cash.
• 12:44
  Speaker 1: So we tend not to do it. So we will
• 12:46
  Speaker 1: not probably pick up more.
• 12:48
  Speaker 1: If the patient is admitted with the intensive care, it's
• 12:51
  Speaker 1: a different story. We will want to chase it all
• 12:53
  Speaker 1: the way and we might get the answer
• 12:55
  Speaker 2: from that. Because knowing at the early stage really no difference,
• 12:58
  Speaker 2: the treatment will be, there's no specific treatment for HMPV
• 13:01
  Speaker 1: la. Start on. Now, some people get wheeze.
• 13:06
  Speaker 1: Some, some people get wheezing whoop whooping
• 13:10
  Speaker 2: cough up Doctor Leong is well no whooping cough actually.
• 13:15
  Speaker 1: I'm kidding. I'm kidding.
• 13:18
  Speaker 1: So that the wheezing sometimes happens.
• 13:23
  Speaker 1: Or the doctors can hear it. This may be a
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  Speaker 1: sign of human metapneumovirus just as RSV virus. They present
• 13:30
  Speaker 1: very similarly. In such cases, we may do a swab
• 13:34
  Speaker 1: and show it and we may actually end up giving
• 13:37
  Speaker 1: asthma-like medications, from steroids to bronchodilators, and that usually works
• 13:43
  Speaker 1: quite well.
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  Speaker 2: OK. So overall, in, in your opinion, how worried should
• 13:46
  Speaker 2: we be about some of these rising numbers that we're
• 13:48
  Speaker 2: seeing in China? Something like 45% increase there.
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  Speaker 2: 300+ numbers they're in one of the provinces and of
• 13:53
  Speaker 2: course those numbers in Malaysia and other parts of the world.
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  Speaker 2: What's the, what's the, where are we now in terms
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  Speaker 2: of global concern, let's say.
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  Speaker 1: We are probably getting it. It's just that we're not
• 14:03
  Speaker 1: aware of it. We are not monitoring the cases specifically
• 14:07
  Speaker 1: and counting the numbers. I'm not particularly worried, but if
• 14:12
  Speaker 1: my elderly or my child is not well and getting breathless,
• 14:16
  Speaker 1: go and see a doctor, the doctor might do the
• 14:18
  Speaker 1: appropriate test. Please don't direct the doctor what you want
• 14:22
  Speaker 1: to do.
• 14:24
  Speaker 1: Now, going forwards, uh, why do we keep having this
• 14:27
  Speaker 1: new outbreaks and why does China have this outbreak? It's
• 14:30
  Speaker 1: all because of COVID. When COVID came in, it shut
• 14:34
  Speaker 1: down and a lot of viruses kind of disappeared. So
• 14:38
  Speaker 1: the viruses are all coming back one bit at a time.
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  Speaker 1: So we had a bit of influenza, we had a
• 14:44
  Speaker 1: bit of adenovirus and the different things. Now, the stage
• 14:48
  Speaker 1: is all human metal pneumovirus in China.
• 14:52
  Speaker 1: So that's taking its routes and in turn it will
• 14:55
  Speaker 1: be spreading all over
• 14:56
  Speaker 1: the world.
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  Speaker 2: Do we, do we have enough information to know whether
• 15:00
  Speaker 2: this is
• 15:03
  Speaker 2: But there's a large proportion of people who can have
• 15:06
  Speaker 2: severe outcomes.
• 15:08
  Speaker 1: Yes.
• 15:09
  Speaker 2: There is a.
• 15:10
  Speaker 1: There is, but these are the elderly, 65, 70, 180,
• 15:14
  Speaker 1: 90 years old. Uh, so these are the ones which
• 15:16
  Speaker 1: we are always talking about on the radio. Please get
• 15:19
  Speaker 1: them vaccinated, protect them, etc. Unfortunately, we don't have a
• 15:23
  Speaker 1: vaccine for human me pneumovis yet. One is in development,
• 15:28
  Speaker 1: but it is not available for use currency.
• 15:31
  Speaker 2: OK, OK, prof, at the end of, uh, at the
• 15:34
  Speaker 2: end of the day when it comes to what we
• 15:35
  Speaker 2: see on the horizon, so I've got you here in
• 15:37
  Speaker 2: the New Year's show as well. What, what do you
• 15:39
  Speaker 2: think in, in the health landscape could we be expecting
• 15:41
  Speaker 2: this year? Influenza back up and down, COVID back? What's
• 15:44
  Speaker 2: the latest in terms of the, the, the infectious diseases
• 15:48
  Speaker 2: for 2025?
• 15:50
  Speaker 1: At this point in time, human, the influenza virus is
• 15:54
  Speaker 1: the #1 virus attacking. If you have a fever, cough,
• 15:57
  Speaker 1: and sore throat, there's a 90% probability that it's going
• 16:01
  Speaker 1: to be influenza, it's gonna be either A or B.
• 16:05
  Speaker 1: We're going to be probably
• 16:06
  Speaker 1: Get another peak, a little bit of uh COVID again,
• 16:09
  Speaker 1: probably towards the middle of the year or so, when
• 16:12
  Speaker 1: a new mutant emerges, I honestly have no idea. Our
• 16:16
  Speaker 1: prediction is that we get a new significant mutant every
• 16:19
  Speaker 1: 6 months to a year. And the last one was
• 16:23
  Speaker 1: in about July, August. So it's time for a new
• 16:26
  Speaker 1: one soon, or not again.
• 16:29
  Speaker 1: Um,
• 16:30
  Speaker 2: I'll be calling you when that happens.
• 16:33
  Speaker 1: So the rest of the viruses is really up to God,
• 16:36
  Speaker 1: and God only God knows whether are we going to
• 16:39
  Speaker 1: get a new COVID, or we're going to get a
• 16:41
  Speaker 1: new thing altogether. Well, stay tuned.
• 16:44
  Speaker 1: Because you can get all this answer on Channel NewsAsia
• 16:47
  Speaker 1: 938 with Daniel Martin.
• 16:49
  Speaker 2: You betcha. I mean, I remember talking to Doctor Leong
• 16:52
  Speaker 2: back in 2019 December. It was well it was called
• 16:56
  Speaker 2: the Wuhan virus at that time, and that was the
• 16:58
  Speaker 2: very beginning and nobody was talking about it that much.
• 17:00
  Speaker 2: And look at what became after that, my gosh, uh,
• 17:03
  Speaker 2: we will keep you updated with all the latest. That's
• 17:04
  Speaker 2: why we did today's topic on the first, um, full
• 17:06
  Speaker 2: show back for the new year. Doctor Leong Honam is
• 17:09
  Speaker 2: infectious disease physician at a rofi Clinic. This has been
• 17:12
  Speaker 2: Health Matters.
• 17:18
  Speaker 2: Before making any decisions based on the information in our program,
• 17:21
  Speaker 2: please consult a medical professional.