Emergency services in England are facing their busiest winter ever with flu cases soaring. More than 2.3m people attended A&E departments across the country last month.
Ambulance services attended over 800,000 incidents making it the highest ever number of call-outs in a single month. And the trend has continued into January with 5,400 hospital beds taken up by flu patients last week, more than 3.5 times higher than during the same week in 2024.
Aside from flu people are suffering from other ailments including norovirus. And now there is a fresh potential threat from the human metapneumovirus – which is known as hMPV.
Further information on the hMPV strain is being sought from China where pictures have shown hospitals packed with patients reportedly suffering from the virus. However experts at present believe it is likely to be mild for most people – more like a bad cold.
Some people however are more vulnerable to both flu and hMPV. The elderly, those with weak immune systems and children are all more at risk.
So how can you tell if you have a cold, hMPV or flu. This is what to look for.
hMPV
HMPV is a virus that will lead to a mild upper respiratory tract infection. According to Prof Antonia Ho, Professor and Hononary Consultant of Infectious Diseases, Medical Research Council-University of Glasgow Centre for Virus Research, it is a respiratory virus that predominantly causes mild flu-like illness.
However she warned it can “cause severe disease, such as bronchiolitis and pneumonia, in those at extremes of age and also those with a compromised immune system, such as individuals who have had an organ or stem cell transplant or individuals with HIV infection”.
She added: “Infection is more common in children than adults; serology studies suggest that most children have been infected by the age of 5. hMPV was first identified by Dutch resesarchers in 2001 in archived children’s respiratory samples in whom no bugs have been isolated, and has since been found worldwide.
“Seasonality is similar to that of influenza, with peak activity in winter/early spring, therefore high case numbers of hMPV identified in China may not be out of the ordinary. hMPV is probably less well studied, compared to other respiratory viruses, such as flu, SARS-CoV-2 than RSV.”
Symptoms
According to the Cleveland Clinic these include:
- cough
- fever
- runny or stuffy nose
- sore throat
- wheezing
- Shortness of breath
- Rash
How is it spread:
MPV spreads through direct contact with someone who has it or from touching things contaminated with the virus. For instance:
- coughing and sneezing
- shaking hands, hugging or kissing
- touching surfaces or objects like phones, door handles, keyboards or toys
Influenza
Flu is a virus that gathers pace over the winter months every year. While most people recover without medical help it can lead to some, including those with weaker immune systems, needing treatment or even hospital admission.
Prof Penny Ward, Visiting Professor in Pharmaceutical Medicine, King’s College London, said: “Hospital admissions for complications of winter viral disorders vary from year to year and are more frequent in high risk patients – pre-school age children or older (>65 year old) adults or adults and children of any age with a range of underlying conditions, including diabetes, renal disorders, heart disease, asthma or other chronic lung diseases.
“A range of viruses circulate in the winter and hospitalisations can occur following infection with any of these viruses, particularly among the higher risk population. The severity of the infection depends on the virulence of the circulating strain of the virus causing the epidemic and whether or not an individual has been vaccinated.
“While we have been hearing about flu admissions for quite a while, the influenza epidemic this year started in the second week of December and has not yet reached its peak. It appears to be a mix of two influenza A virus strains representatives of both of which were included in the vaccine recommended for use this year.
“However, the uptake of vaccine this year has been lower than last year. Around 73% of older adults have been vaccinated but fewer than 35% of higher risk adults of any age have been vaccinated so far. This uptake rate is lower than is needed (90%) to limit the extent of flu outbreaks. Another possible factor is whether the circulating strains are a good or a poor ‘match’ to the strains used in the vaccine- the HSA might have some information on that but has not yet commented.
“We do have access to effective antiviral treatment for influenza but to be effective these treatments must be given within 2 days of first symptom onset. Antiviral treatment can also be used to prevent the spread of infection in hospitals/care homes, but regrettably, it seems that GPs may not use these treatments as effectively as they can to protect care home residents and prevent hospitalisations. If these treatments were used more widely this annual burden of illness could be considerably reduced.”
Symptoms
Flu symptoms come on very quickly, warns the NHS. It says these can include:
- a sudden high temperature
- an aching body
- feeling tired or exhausted
- a dry cough
- a sore throat
- a headache
- difficulty sleeping
- loss of appetite
- diarrhoea or tummy pain
- feeling sick and being sick
The symptoms are similar for children, but they can also get pain in their ear and appear less active.
How is it spread
Flu is very infectious and easily spread to other people. You’re more likely to give it to others in the first 5 days.
Flu is spread by germs from coughs and sneezes, which can live on hands and surfaces for 24 hours.
To reduce the risk of spreading flu:
- wash your hands often with warm water and soap
- cover your mouth and nose with a tissue when you cough or sneeze (if you do not have a tissue, cough or sneeze into the bend of your elbow, not into your hand)
- bin used tissues as quickly as possible
Try to stay at home and avoid contact with other people if you have a high temperature or you do not feel well enough to do your normal activities.
Cold
According to the NHS a cold develops in a different way to flu. You can often treat a cold without seeing a GP and should begin to feel better in about 1 to 2 weeks.
However the symptoms of a cold can last longer in young children. They may also be irritable, have difficulty feeding and sleeping, breathe through their mouth, and get sick after coughing.
Symptoms
Cold symptoms come on gradually over 2 to 3 days.
The main symptoms include:
- a blocked or runny nose
- sneezing
- a sore throat
- a hoarse voice
- a cough
- feeling tired and unwell
You may also have:
- a high temperature
- aching muscles
- a loss of taste and smell
- a feeling of pressure in your ears and face
How is it spread?
Colds are caused by viruses and easily spread to other people, says the NHS. You’re infectious until all your symptoms have gone. This usually takes 1 to 2 weeks. It can be longer in babies and young children.
Colds are spread by germs from coughs and sneezes, which can live on hands and surfaces for 24 hours.
To reduce the risk of spreading a cold:
- wash your hands often with warm water and soap
- use tissues to trap germs when you cough or sneeze
- bin used tissues as quickly as possible