Head’s Up America: There’s A New “China Flu” Outbreak. What To Look For In The Homeland

As of early January 2025, China is experiencing a significant surge in Human Metapneumovirus (HMPV) infections, leading to overcrowded hospitals and raising global health concerns. In particular, reports suggest that children’s hospitals are being overwhelmed, and there is an increase in the reporting of the number of “white lung” cases ( a term often used to describe severe pneumonia symptoms). 

Understanding HMPV

Human Metapneumovirus is a respiratory virus that causes symptoms similar to the common cold, including cough, runny nose, and fever. It can lead to more severe respiratory illnesses such as bronchiolitis and pneumonia, especially in young children, the elderly, and individuals with weakened immune systems. 

This virus is prone to mutation, which could cause more serious illnesses in the infected population.

Currently, there is no licenced vaccine available for HMPV.

Why Report on This?

My intent is to inform, not to cause panic. I am in no way saying this is the second coming of COVID (Heaven forbid). SOFREP readers like to be informed about what is going on in the world, and this is most certainly an issue in the Northern provinces of China, and it is spreading.

I do know a bit about the topic. In addition to being a medical operations officer in the Army, I was a certified infection control practitioner in a large urban medical center for a number of years. I’ve worked closely with the CDC on a number of unusual and significant cases. This ain’t my first rodeo.

At this time, there are no reports of an increased incidence of HMPV in the US. As stated in the title, this is just a “heads up”, a “be advised”.

Signs and Symptoms

The symptoms of HMPV infection typically appear within 3 to 6 days after exposure and can range from mild to severe. Common symptoms include:

• Cough
• Runny or stuffy nose
• Sore throat
• Fever and/or chills
• Wheezing
• Shortness of breath

In severe cases, especially among high-risk groups, HMPV can lead to acute bronchitis, bronchiolitis, or pneumonia.

Morbidity and Mortality

While HMPV infections are often mild, they can be severe in certain populations. Children under the age of 5, particularly those with underlying health conditions, are at higher risk for severe disease. Older adults, especially those over 65 or with chronic health issues, and immunocompromised individuals are also more susceptible to severe outcomes. Studies have shown that HMPV is a leading cause of acute respiratory infections in children, contributing significantly to hospitalizations.

Transmission and Prevention

HMPV spreads through respiratory droplets when an infected person coughs or sneezes, direct contact with an infected individual, or by touching contaminated surfaces and then touching the face. Preventive measures include:

• Regular handwashing with soap and water. The correct duration of handwashing is the amount of time it takes to sing the “Happy Birthday” song twice. I know this sounds kind of silly, but it is accurate and easy to remember. If you are in a place where you can’t wash your hands right away, break out those old bottles of hand sanitizer and put them to good use. You’re not just protecting yourself from HMPV but from a host of other seasonal viruses out there.
• Avoiding close contact with individuals exhibiting respiratory symptoms.
• Disinfecting frequently touched surfaces regularly.

Currently, there is no specific antiviral treatment or vaccine for HMPV; management focuses on supportive care to relieve symptoms.

Potential Impact on the United States

Given the interconnected nature of global travel and commerce, the HMPV outbreak in China could have implications for the United States:

• Enhanced Surveillance: U.S. health agencies may need to increase monitoring for HMPV cases, particularly during the winter and early spring when respiratory viruses are more prevalent.
• Healthcare System Preparedness: Hospitals should be prepared for potential increases in respiratory infections, ensuring adequate resources and staffing.
• Public Education: Raising awareness about HMPV, its symptoms, and preventive measures can help reduce transmission.

Military Considerations

While there is no direct evidence linking HMPV to military operations, certain factors warrant attention:

• Close Living Quarters: Military personnel often live and work in close-contact environments, which can facilitate the spread of respiratory viruses.
• Deployment Risks: Troops deployed to regions experiencing HMPV outbreaks may be at increased risk. This will be covered in environmental health briefings given to the troops. 
• Training and Readiness: Respiratory outbreaks can impact training schedules and overall military readiness.

Military healthcare providers should remain vigilant for signs of HMPV, ensuring prompt diagnosis and isolation of affected individuals to prevent outbreaks within units.

Historical Impact of Infectious Diseases in the Armed Forces

Infectious diseases have profoundly influenced the U.S. military throughout history, shaping both military operations and advancements in medical science. During the American Revolutionary War, smallpox wreaked havoc on the Continental Army, infecting half of the 10,000 soldiers in 1776 and forcing a retreat. This crisis led General George Washington to order the first large-scale inoculation of an army in 1777, a groundbreaking moment in military medicine.

The Civil War highlighted the devastating effects of infectious diseases, with two-thirds of the estimated 660,000 soldier deaths attributed to diseases like pneumonia, typhoid, dysentery, and malaria. These outbreaks not only caused immense suffering but also delayed key campaigns, potentially extending the war by up to two years.

In the Spanish-American War of 1898, typhoid fever became a major threat, infecting one in five soldiers. This crisis spurred the development of the first anti-typhoid vaccine, a pivotal achievement for military and civilian healthcare alike. Around the same time, yellow fever was confirmed to be transmitted by mosquitoes, thanks to the efforts of the U.S. Army Yellow Fever Commission. This discovery paved the way for eradication campaigns and eventually the creation of vaccines.

The Spanish Flu had a catastrophic effect on U.S. troops during World War I, significantly hampering military operations and readiness. The virus sickened over 26% of the Army—more than one million men—before they even reached France. The Navy reported even higher infection rates, estimating that 40% of its personnel were affected.

Influenza and pneumonia combined to kill 45,000 American soldiers and sailors, approaching the toll of enemy weapons, which claimed 53,400 lives.

The epidemic disrupted nearly every aspect of military operations. Induction and training schedules were thrown into chaos, and combat readiness suffered as soldiers fell ill in staggering numbers. In 1918 alone, the Army lost over 8.7 million days of service due to influenza among enlisted men. The virus spread rapidly through military camps and during troop movements across the Atlantic, turning the U.S. military into an unintended vector for the global spread of the disease.

On the battlefield, the flu’s impact was equally devastating. During the Meuse-Argonne Offensive, critical resources were diverted from combat operations to caring for the sick and managing the dead. Overcrowded military camps and trenches created ideal conditions for the virus to mutate and spread aggressively, with each successive wave becoming more severe and virulent.

The Spanish Flu’s reach extended beyond the U.S., affecting both Allied and Central Powers. German forces also suffered significant losses, weakening their military capabilities. For the U.S., the epidemic was so severe that it threatened the country’s ability to effectively participate in the war, undermining domestic operations and frontline combat efforts.

The Spanish Flu serves as a stark reminder of how infectious diseases can disrupt not just health but also military strategy and operations on a global scale.

By World War II, the proportion of deaths caused by diseases and non-battle injuries (DNBIs) had dropped significantly to 25%, compared to 60% during the Civil War. However, DNBIs still represented 95% of Army hospital admissions between 1941 and 1945. These reductions in mortality rates were a testament to advances in military medicine, particularly in disease prevention and treatment.

In modern times, infectious diseases continue to pose challenges.

During the Global War on Terrorism (2001–2021), diseases were nearly three times more prevalent than battle injuries or other non-battle injuries combined.

Respiratory infections and traveler’s diarrhea remain significant concerns, often reducing operational readiness and work performance in deployed units.

The U.S. military’s battle against infectious diseases has had far-reaching effects, driving advancements in vaccines, disease surveillance, and preventive medicine. These efforts not only safeguard troops but also contribute to broader medical practices, benefiting civilian populations worldwide.

Take Away Message

The HMPV outbreak in China underscores the importance of global health vigilance. While the United States has not yet reported a similar surge, we’ve learned from the past that preparedness is crucial. Public health agencies, healthcare providers, and the military must collaborate to monitor the situation, educate the public, and implement preventive measures to mitigate the potential impact of HMPV on the population.