At Home Sick

Three viruses to watch for this winter

3 Nov 2022 12:00

University of Utah Health Communication

At Home Sick

Diseases due to circulating respiratory viruses are increasing rapidly across the country. Prevention measures implemented at the beginning of the COVID-19 pandemic limited seasonal respiratory diseases. Now that security measures are more relaxed, healthcare systems have seen an early start to some of these viruses. There is concern in the health care community about a potential “triedemic.”

“The real concern in this term ‘tripledemic’ comes from the idea that they can all hit around the same time,” said Andrew Pavia, MD, chief of the division of pediatric infectious diseases at University of Utah Health. “It can overwhelm many of our health systems.” These systems are already struggling with staff shortages and attrition after nearly three years of COVID-19.

The combination of an increase in illness and staff shortages can cause a crippling impact on health systems. This has already happened in some areas of the country. That’s why it’s important to take steps to protect ourselves and others in the months ahead. Here are three respiratory viruses that are on the rise across the country.

1. RSV (respiratory syncytial virus)

RSV is a common infection that causes cold-like symptoms in most people. Cases of RSV typically increase from late fall to early spring. Both adults and children can become infected with RSV, but the virus can be more serious for young children and older adults. RSV can cause bronchiolitis and pneumonia in children younger than one. About 50,000 children are hospitalized for RSV each year.

“Most of us get RSV many times in our lives,” says Pavia. “But when you get it in the first two to three years of your life, it can cause a nasty infection with wheezing, copious discharge and difficulty breathing and eating.”

RSV also threatens older adults. About 177,000 older adults (age 70 and older) are hospitalized for RSV each year. While RSV is a mild cold for most people, it can cause very serious illness in people with weakened immune systems, including pregnant women.

2. Flu

Influenza or Influenza is an infection of the nose, throat and lungs. It causes 20,000 to 50,000 deaths in the US each year, with the exception of the past two years due to the COVID-19 pandemic. Flu was largely absent in the winter of 2020-21 and relatively mild last winter.

The flu can cause serious illness, hospitalization and death in people of all ages – but children under the age of two, adults over 65, pregnant women, people with conditions such as heart disease, lung disease and diabetes, and people with weakened immune systems are more vulnerable and more likely to become seriously ill.

The good news is there is a vaccine. “While the vaccine is not perfect, it is a good tool,” says Pavia. “For nearly two decades, we have been recommending the flu vaccine to all children to prevent serious illness and hospitalization.” According to Pavia, you become more vulnerable to the flu as you age — your risk for severe flu increases significantly in your 50s and even more so in your 60s and beyond. The CDC recommends that everyone six months and older get a flu shot every year.

3. COVID-19

COVID-19 is a respiratory disease that causes a wide range of symptoms ranging from mild to severe and often fatal infection. Cases of COVID-19 typically increase in the fall and peak in the winter, although this may depend on new emerging variants of the COVID-19 virus. Infectious disease experts like Pavia anticipate a coming surge due to the emergence of various subvariants of Omicron.

Anyone can get COVID-19, but older adults, people with certain medical conditions, pregnant women, and young babies are at high risk of developing serious illness. Although children are not as likely to become seriously ill with COVID-19 as adults, some children can still become seriously ill.

“Most children who get COVID-19 probably won’t end up in the hospital or the intensive care unit,” says Pavia. “But at any given time, we have about a dozen kids in the hospital with COVID-19, so it’s not mild or trivial.”

The COVID-19 vaccine is available to anyone six months and older. And anyone five years and older can get an updated booster. Similar to the flu vaccine, COVID-19 vaccines do not prevent you from getting the virus, but help prevent serious illness, hospitalization and death.

How can you tell the difference between RSV, flu and COVID-19?

The three respiratory viruses can all cause cold-like symptoms as well as fever, cough and difficulty breathing. Although there are differences between all three viruses, it is difficult to tell from their symptoms alone. The best way to determine which infection you have is to see a doctor and get tested.

It is possible to be infected with more than one virus at a time. Having a virus can lower immunity and increase the risk of getting another infection. If infections occur together, symptoms may worsen.

“Last year we saw some RSV combined with COVID-19 infection,” says Pavia. Some data show that if children get two viruses at the same time, they are sicker than if they get one of them alone. Pavia says many of the children admitted to the pediatric ICU at Intermountain Primary Children’s Hospital last year had both RSV and COVID-19.

Can masks help prevent the spread of respiratory viruses?

Wearing a face mask has become common during the COVID-19 pandemic. But Pavia says masks are even more effective at preventing the spread of flu. “Influenza almost completely disappeared in the first year of the pandemic,” says Pavia. “This is because flu is not as transmissible as COVID-19, so masks have proven to work very well.” Masks also help prevent RSV because they can contain highly contagious snot, which can spread when you sneeze.

It is always good to be considerate of who is next to you. “You never know if the person standing next to you is the parent of a child with cancer or someone who is immunocompromised,” says Pavia. “You may be putting them at tremendous risk.”

What can someone else do to protect themselves?

Preventive measures such as wearing a high-quality mask in crowded areas, physical distancing, frequent hand washing and staying home if you are sick are all good ways to help protect yourself and others. But the best way to protect yourself is by getting vaccinated.

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