PORT OF SPAIN, Trinidad (CMC) – The Trinidad-based Caribbean Public Health Agency (CARPHA) is urging Caribbean countries to enhance their surveillance amid reports of increases in respiratory illnesses including human metapneumovirus (HMPV).

“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,” CARPHA said in a statement.

“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 said 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.

It is recommending 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 years 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 did 313 tests for non-influenza viruses, of which 11 were positive for HMPV, the respiratory virus in the family with RSV, which 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 on severity, but is similar to other viral respiratory infections.