Why nasal congestion is common in HMPV infections

Posted on by Alex

Nasal congestion, often described as a blocked or stuffy nose, is one of the most frequent complaints when people develop respiratory infections. Among these infections is HMPV—human metapneumovirus—a virus discovered in 2001 that has since become recognized as a widespread cause of cold-like illnesses, particularly in children but also in adults. While HMPV remains less well-known than influenza (flu) or respiratory syncytial virus (RSV), it plays a major role in seasonal respiratory infections, and nasal congestion is one of its hallmark symptoms. Understanding why this happens, how to manage it, and how it differs from other illnesses helps families and individuals respond effectively when symptoms arise.

Understanding HMPV and its symptoms

Human metapneumovirus (HMPV) is a respiratory virus in the same family as RSV. It spreads through droplets when an infected person coughs, sneezes, or talks, and it can also survive on surfaces for short periods. Like many respiratory infections, HMPV symptoms range from mild to severe, depending on the person’s age, health status, and immune system strength.

Common HMPV symptoms include:

  • Nasal congestion or runny nose
  • Cough
  • Fever
  • Sore throat
  • Fatigue
  • Shortness of breath or wheezing (more common in children or those with asthma)

In severe cases, especially in infants, older adults, or immunocompromised individuals, HMPV can lead to bronchitis or pneumonia.

Why nasal congestion happens in HMPV infections

Nasal congestion in HMPV infections is not random—it is the body’s immune response to the virus. When HMPV infects the lining of the respiratory tract, the immune system releases chemicals called cytokines to fight off the virus. These chemicals cause inflammation, leading to swelling of the nasal passages and an increase in mucus production. Together, these processes make it difficult for air to pass through freely, resulting in that blocked-nose sensation.

The role of inflammation and mucus

  1. Inflammation: Blood vessels in the nasal tissues dilate and swell in response to the infection, narrowing the airways.
  2. Excess mucus: The body produces extra mucus to trap viral particles and flush them out. Unfortunately, this leads to runny noses and congestion.
  3. Airflow obstruction: The combination of swelling and mucus buildup makes it harder to breathe comfortably through the nose.

This process is very similar to what happens during the flu, RSV, or the common cold, but in HMPV, congestion often lasts longer or appears more stubborn in children.

Comparing nasal congestion in HMPV, flu, RSV, and COVID-19

Nasal congestion is not unique to HMPV. To understand why it’s significant, it helps to compare with other common viral infections:

  • HMPV vs flu: Influenza often causes high fever, muscle aches, and sudden fatigue, while HMPV tends to resemble a prolonged cold. Congestion is more prominent in HMPV than in flu, where systemic symptoms are stronger.
  • HMPV vs RSV: Both cause wheezing and congestion, especially in children. However, RSV is more likely to cause severe bronchiolitis in infants.
  • HMPV vs COVID-19: COVID-19 may cause nasal congestion, but loss of taste and smell or prolonged fatigue are more distinctive compared to HMPV.
  • HMPV vs common cold: Both look very similar, but HMPV can progress to more severe lower respiratory infections, unlike a typical cold.

Recognizing these differences is important for diagnosis and treatment decisions.

How nasal congestion affects children and adults

In children

  • Congestion can interfere with feeding and sleeping.
  • Infants may become irritable due to blocked breathing passages.
  • It increases the risk of ear infections, as mucus buildup affects the Eustachian tubes.

In adults

  • Congestion often disrupts sleep and daily functioning.
  • Adults with asthma or chronic obstructive pulmonary disease (COPD) may find congestion worsens breathing difficulties.
  • Adults usually recover within 1–2 weeks, but fatigue and mild congestion may linger.

Diagnosis of HMPV when congestion is a symptom

Since nasal congestion overlaps with many other illnesses, doctors do not rely on this symptom alone. Diagnosis of HMPV is usually confirmed through laboratory tests, such as polymerase chain reaction (PCR) swabs, especially when symptoms are severe or hospitalization is required.

Doctors may suspect HMPV if:

  • Symptoms appear in winter or spring (common HMPV season).
  • The patient has cold-like symptoms with notable congestion but tests negative for flu and COVID-19.
  • Children present with congestion, wheezing, and difficulty breathing.

Managing nasal congestion from HMPV

While there is no specific antiviral treatment for HMPV, congestion can be managed with supportive care:

  • Hydration: Drinking water, soups, or warm teas helps thin mucus.
  • Saline sprays or drops: Especially useful for children to clear nasal passages.
  • Humidifiers or steam inhalation: Moist air eases nasal swelling and promotes mucus drainage.
  • Rest: Adequate sleep helps the body fight the virus.
  • Over-the-counter relief: Decongestants or antihistamines may help adults but should be used carefully, particularly in children.

Importantly, antibiotics do not work against HMPV because it is a virus, not a bacterial infection.

Preventing HMPV and its nasal congestion

There is no vaccine for HMPV yet, but prevention strategies mirror those for other respiratory infections:

  • Hand hygiene: Frequent handwashing with soap.
  • Respiratory etiquette: Covering coughs and sneezes with tissues or elbows.
  • Avoiding close contact: Keeping distance from sick individuals, especially in high-risk settings like childcare centers.
  • Cleaning surfaces: Regular disinfection of toys, doorknobs, and shared items.
  • Boosting immunity: Healthy diet, exercise, and enough sleep support the immune system’s ability to fight infections.

For families, teaching children these habits reduces the spread not only of HMPV but also of flu, RSV, and colds.

Scientific perspective: why HMPV deserves attention

Although HMPV is well-studied, it receives less public attention compared to influenza or RSV. This lack of awareness means families may mistake it for a stubborn cold or flu and overlook its potential to cause serious illness in vulnerable groups. Research shows HMPV is a leading cause of hospitalization in children under five and can significantly impact older adults. Recognizing congestion as one of its early and common signs allows families to act quickly, manage symptoms, and seek medical care if breathing difficulties develop.

Key takeaways for families

Nasal congestion in HMPV infections is not just an annoyance; it’s a key indicator that the body is fighting off a respiratory virus. While often mild, congestion can become challenging in infants, older adults, or those with existing health conditions. Understanding how HMPV compares to flu, RSV, and other infections empowers families to make better health decisions. Supportive care, prevention habits, and medical attention when necessary can greatly reduce complications. By recognizing HMPV as a distinct and important virus, families are better prepared to respond when symptoms—like nasal congestion—appear.