It might not be hay fever. Which of the four spring viruses have you got?

Telegraph

09-04-2025

The sun may be shining but winter viruses are still spreading. Despite the change in season, Covid hospitalisations are at the highest levels seen this year and colds, the flu and respiratory syncytial virus (RSV) are still triggering infections.
'We consider a lot of these viruses 'winter bugs' but they do circulate at low levels during the year,' says Dr Lindsay Broadbent, a virologist at the University of Surrey. Let's not forget human metapneumovirus (HMPV), the cold-causing virus which is in it's peak season and can lead to complications like bronchitis and pneumonia.
Throw hay fever season into the mix (much of the country is expected to have very high pollen counts this week, according to the Met Office) and it can be difficult to know the source of your sneezing, blocked nose and headache.
'Not only do hay fever and viruses share some symptoms, but a lot of respiratory viruses make you feel sick in a similar way,' Dr Broadbent says. If you only start sneezing when you go out into your garden, it's likely that you have hay fever, she notes.
Here, experts detail how to know which one you've been struck with and what you can do to aid your recovery.
The signs it's hay fever
' Hay fever is a common allergy,' Dr Broadbent notes. 'If you are exposed to the allergen (tree, grass or weed pollen) you will experience symptoms.'
These typically include itchy, watery eyes, a blocked nose, sneezing and nasal mucus, says Prof Peter Openshaw, a respiratory physician and mucosal immunologist at Imperial College London.
It can be hard to tell, especially in the early stages, whether you're suffering from hay fever or a cold. 'The viruses that cause colds (of which there hundreds of different species and strains) can present just like hay fever,' he notes.
However, if a fever develops, it's a sure sign that the cause is not, in fact, hay fever. 'Hay fever is a confusing term,' Prof Openshaw says. 'It doesn't cause 'fever' (a raised body temperature) and is very rarely anything to do with hay.'
If symptoms disappear within a few days, or up to two weeks from when they started, that's another sign that the cause is a virus. On the other hand, hay fever symptoms will occur whenever there is exposure to pollen, which is typically between March and September. 'If you feel fine, then go out to cut the grass and then start rubbing your eyes and sneezing, it is likely hay fever,' Dr Broadbent adds.
How to treat it
While there's no cure for hay fever and it can't be prevented, there are medicines and actions that can help to make symptoms more manageable.
'Soothing eye drops, antihistamine tablets, anti-allergy eyedrops and nasal sprays and nasal steroid sprays (which should be used regularly if you have hay fever during the pollen season) are very safe and very effective, if used properly,' Prof Openshaw notes.
Pharmacists recommend rubbing Vaseline around the nostrils to trap pollen, drying laundry indoors to prevent bringing pollen inside, and keeping windows shut in the early morning and early evening, when pollen counts are at their highest.
The signs it's Covid
Covid symptoms have become milder over time and many people now report only suffering from cold-like symptoms. This is a result of a build up in immunity against the virus due to vaccines and past infections, Prof Openshaw explains.
Famously, the virus can also cause a change in taste or smell. However, this symptom is not only a Covid hallmark and can occur with other respiratory viruses as well, making it impossible to know for certain what bug you have without a test.
Some will also experience fever or chills, a continuous cough, shortness of breath, tiredness, body aches, a headache, sore throat, blocked nose, loss of appetite, nausea or diarrhoea.
In severe cases, patients are hospitalised due to the effects of the virus. Latest NHS figures show that 1,174 patients were in hospital with Covid in the last week of March – the highest figure recorded this year and an increase of 11.9 per cent in a week.
'There are now rapid tests that can be done at home to tell if you have Covid, RSV or flu which might help to narrow the diagnosis,' Prof Openshaw notes.
At-home lateral flow tests that detect Covid are sold in pharmacies for £2, while gold standard PCR tests, which are more accurate and processed in a lab, cost around £80. Single lateral flow tests that can check for more than one virus at once are available from online chemists for around £9.
'The virus continues to evolve and to cause severe disease in some people and has an unusual ability to cause long-term effects in a few (Long Covid), but it is joining the many viruses that need to be considered if someone presents with viral infections.'
How to treat it
Most people recover from Covid within days or weeks without specific treatment. The NHS recommends resting, drinking plenty of water and taking paracetamol or ibuprofen to manage symptoms.
'For most people the cause of a blocked nose and sore throat are treated the same way, with rest, fluids and over-the-counter painkillers if needed (and hot tea with honey and lemon for me),' Dr Broadbent says.
'But some viruses can pose a greater risk to others,' she notes. Covid can be much more serious for older people or for those with underlying health conditions. For these groups, antivirals may be available on the NHS to reduce the severity of their infection.
The signs it's HMPV
Human metapneumovirus (HMPV) is a common respiratory infection that peaks in winter and spring. It caused panic at the start of the year when a surge of cases in China raised fears of another pandemic.
'HMPV causes colds just like many other viruses and is hard to diagnose without molecular testing,' Prof Openshaw notes. Symptoms can include a cough, runny nose, nasal congestion, a fever, sore throat, wheezing and shortness of breath.
'Infections are usually mild, causing symptoms of a common cold and most people have had HMPV by the time they are five years old and catch it again throughout their lives,' according to the UK Health Security Agency (UKHSA).
However, in severe cases, it can cause acute bronchitis (inflammation of the airways of the lungs) and pneumonia (an infection of the lungs).
The virus is currently spreading at expected levels, with 5.7 per cent of people tested for HMPV getting a positive result in the last week of March, UKHSA data shows.
How to treat it
'There's no specific treatment for HMPV,' Prof Openshaw notes. Symptoms can be managed in the same way as other respiratory viruses – resting, hydrating and trying not to spread it to others. The NHS recommends regular handwashing and using a tissue to cover your mouth when coughing or sneezing to avoid spreading it.
'Vaccines are in clinical trials, in the wake of the very successful vaccines we now have for Covid and RSV, but are not yet launched,' Prof Openshaw adds.
The signs it's RSV
Respiratory syncytial virus (RSV) is a common cause of colds. The symptoms can include a cough, wheezing, shortness of breath, tiredness and fever, with most cases clearing up within two to three weeks, according to the UK Health Security Agency (UKHSA).
It's hard to know if you have RSV without either a rapid home test (which you can buy yourself and detect if the virus is present from a nose or throat swab) or a molecular test (still a nose or throat swap but usually confined to hospital patients and processed in a lab), Prof Openshaw says.
RSV tends to spread in the autumn and early winter, though it continues to circulate at low levels throughout the year. The latest UKHSA data shows that 0.9 per cent of people tested for RSV (who are primarily hospital patients) had a positive result during the last week of March.
While the symptoms are usually mild, in babies RSV can cause a serious chest infection called bronchiolitis, which can make it difficult for them to breathe and feed, Dr Broadbent notes.
'In older adults it can cause a deterioration in heart and lung disease,' Prof Openshaw adds.
How to treat it
There is no specific treatment for RSV and it usually gets better on its own in one to two weeks.
Those who develop a serious infection may need to be treated in hospital, where they can be given fluid and oxygen to help with hydration and breathing.
'The best thing is to get vaccinated if you are eligible,' Prof Openshaw says. RSV vaccines, which are available on the NHS for pregnant women and people aged 75 to 79, reduce the risk of a severe infection.
'If you have any respiratory symptoms it is a good idea to avoid getting too close to those that may be more at risk of serious disease,' Dr Broadbent says.
'If you have lingering symptoms it is a good idea to see your GP to make sure the cause of your illness was caused by a common virus and doesn't need further treatment,' she adds.
The signs it's flu
' The symptoms of flu are very variable and range from no symptoms at all to devastating disease,' Prof Openshaw says.
Influenza can cause a sudden fever, an aching body, tiredness, dry cough, sore throat, headache, difficulty sleeping, loss of appetite, diarrhoea and feeling or being sick. 'Testing can tell you if you have the flu but most people get over it without any treatment,' he says.
Flu is circulating at low levels, according to UKHSA figures. The weekly hospital admission rate for the virus dropped to 2.38 per 100,000 (from 2.96 previous week).
How to treat it
Flu can be managed at home with rest, over-the-counter painkillers and drinking plenty of water, according to the NHS.
'Most cases get better without specific treatment but antivirals are an option in those at high risk of complications,' which include older people, Prof Openshaw notes. These drugs oseltamivir (branded as Tamiflu) and zanamivir (branded as Relenza) can reduce the risk of becoming seriously unwell.
'Please do get vaccinated if you are offered a vaccine – they are inexpensive vaccines and can give considerable protection,' he adds.