Experts have revealed the key differences between the winter viruses spreading across the UK, to help decipher whether the virus is the flu, a cold or the new potential threat to the NHS, human metapneumovirus (hMPV).
As the flu continues to reach crisis point, causing “critical incidents” in at least a dozen hospitals across the country, experts have raised the alarm about rising levels of hMPV.
The virus is said to be responsible for images of flooded hospital waiting rooms in China, in scenes eerily similar to the early days of Covid.
Experts have called on Chinese authorities to reveal more information about the virus strain so that UK health chiefs can assess the level of threat to Britons.
However, scientists are almost certain that hMPV symptoms will be very mild for most, similar to a cold.
The flu, on the other hand, tends to be more severe, with a relatively specific illness trajectory.
However, certain vulnerable groups (the elderly, the immunocompromised, and young children, for example) may not have an easy life with hMPV. And the resulting complications differ from those of the flu.
So what are the telltale signs of both infections? And how can you differentiate them?
Scenes of hospitals invaded by people wearing masks have circulated on social media. In the photo, a baby wearing a face mask waits with family members in the pediatric department of a hospital in Hangzhou, east China, on January 6.
hMPV
In the vast majority of cases, the main symptoms of hMPV are very similar to those of a common cold: cough, stuffy or runny nose, sore throat, and mild fever.
As with other viruses, these are caused by the body’s immune system trying to fight them.
However, some may also experience nausea and vomiting.
More serious symptoms may occur, such as bronchitis, bronchiolitis and pneumonia, which usually affect people with compromised immune systems, and sufferers experience shortness of breath, severe cough or wheezing.
Professor John Tregoning, an expert in vaccine immunology at Imperial College London, said that when hMPV infects children, it resembles respiratory syncytial virus (RSV), a common winter virus that usually causes mild symptoms similar to those of a cold.
“It is part of the winter virus cocktail we are exposed to and, like other viruses, it will be transmitted through coughs, sneezes and droplets,” he said.
Like advice related to Covid and RSV, those infected should “rest, stay hydrated and try not to infect others,” he added.
Patients are often not tested for hMPV unless they are in the hospital, where doctors may need to clarify what is causing their symptoms.
This is done through rapid antigen tests, in which a nasal swab is examined, or a PCR test, which looks for traces of genetic material from the virus in nasal swabs.
Experts have warned that hMPV, which produces flu-like symptoms, can remain in the body for days and can therefore easily be transmitted to other people.
The rise of hPMV in the UK mainly affects young children, who are among the most vulnerable to serious complications, official data suggests.
Virus tracking data from the UK Health Security Agency (UKHSA) shows that one in 10 children tested for respiratory infections in hospital tested positive for hMPV as of December 23.
This is more than double the proportion of very young children who tested positive for hMPV at the end of November.
However, experts have repeatedly warned that case numbers are as expected for this time of year.
Dr Conall Watson, consultant epidemiologist at the UKHSA, said: “Our surveillance systems in GP surgeries and hospitals indicate that levels are in line with what we would expect to see.”
“Most people have had hMPV by the time they are five years old and get it again throughout their lives.
‘Infants, older adults and people with weakened immune systems are more vulnerable to more serious episodes.
“As with all respiratory viruses, you can help reduce transmitted infections by washing your hands regularly and trapping coughs and sneezes in disposable tissues and throwing them in the trash.”
He added: “If you have symptoms such as a high temperature, cough and feeling tired and in pain, try to limit your contact with others, especially those who are vulnerable.”
“There are many viruses circulating at the moment, including the flu; if you have symptoms of a respiratory illness and need to go out, our advice remains to consider wearing a mask.”
In the photo, an adult and a child wait to be treated by medical staff at the pediatric department of a hospital in Hangzhou, east China, on January 6.
The graph shows common symptoms (green checkmark), occasional and possible symptoms (orange circle) and symptoms that never occur (red cross) with the common cold, flu and Covid.
Flu
The illness, caused by influenza viruses, usually causes cough, which is the most common symptom of cross-seasonal viruses.
But flu symptoms are usually much more intense than those of a cold and can even cause stomach problems.
In some cases it can be fatal if complications, such as pneumonia, arise among the most vulnerable.
Professor Ron Eccles, who ran Cardiff University’s Common Cold Center before retiring from the university in 2017, told MailOnline: ‘The flu usually causes chills, fever, headaches, muscle aches and pains.
“The flu gets worse because the symptoms affect the entire body and are not limited to the upper respiratory tract.”
And he added: “Gastrointestinal symptoms such as vomiting and diarrhea are also more common in cases of flu.”
Britain is currently battling its own flu wave. Surveillance programs monitoring the outbreak in England suggest that flu hospital admissions are quadrupling from a month ago.
The latest NHS data, covering the week to December 29, shows that flu patients occupied 4,500 beds each day, also 3.5 times more than the same week last year.
Of those, 211 were in critical care, 69 percent more than the previous week.
More than 4,100 Britons also spent Christmas Day in hospital with flu. By December 29, this number had increased to more than 5,000.
The virus is one of the “Quademia” of winter viruses increasing pressure on NHS services along with norovirus, RSV and Covid.
Just like treating a cold, rest and fluids are often recommended to help people with the flu. Over-the-counter medications also help.
Dr Winn said: “Paracetamol or ibuprofen can help with headaches, muscle aches and fever. Guaifenesin can loosen mucus and clear the airways.
‘An antihistamine such as chlorpheniramine can stop a runny nose. And if you have a cough, look for products with dextromethorphan.
“Whether you have the flu or a cold, consider visiting a doctor if your symptoms persist for more than a week or if you have a high temperature, difficulty breathing, or other signs of infection.”
Cold
Rhinoviruses are the most common cause of a cold, but a minor nose and throat infection can be caused by one of more than 200 different viruses.
If symptoms are primarily limited to the upper respiratory tract, it is likely a cold.
“Cold symptoms are more of a cold with a runny nose, sneezing, sore throat and stuffy nose,” Professor Eccles said.
Cold weather alone does not cause a cold. But the body is more susceptible to infections when the immune system is weaker.
London-based GP Dr Ann Nainan told MailOnline: ‘Colds usually develop gradually and can cause cough, congestion and fatigue. They attack you with things like a runny nose or a sore throat.
The illness tends to be “a nuisance,” unlike the flu, which “can knock you down and keep you in bed,” he added.
However, this overlap of symptoms can make clinical diagnosis difficult.
There is no cure for the common cold, but there are some ways to relieve symptoms.
Getting enough rest, drinking plenty of fluids, breathing steam to relieve nasal congestion, and drinking warm lemon and honey to soothe a sore throat are simple ways to treat a cold.