What you need to know about the ‘quadruple’ threat that could hit this winter

No one wants a blue Christmas, but a Christmas with the flu can be much, much worse.

Colds, flu and other respiratory illnesses are more common in winter. Flu viruses can survive longer in cold, dry air – and people spend a lot of time indoors in the cold months, giving the viruses more opportunity to spread.

While the respiratory season has gotten off to a slow start in the U.S. this year, the Centers for Disease Control and Prevention reported Friday that emergency room visits for COVID-19, the flu and respiratory syncytial virus are on the rise.

Unfortunately, it is possible to get two respiratory viruses at the same time – a phenomenon known as co-infection. Sequential infection is when you get them one after the other.

Fortunately, virologists say that respiratory viruses and COVID-19 “don’t go very well together,” and when you get one of these viruses, it can block or limit infection from another virus. This is called viral interference.

Here’s a look at the top four viruses that can ruin your holiday fun, or what the Brits call the “quad-demic,” which could stress emergency rooms this winter.

flu

Flu season generally runs from October to April or May.

There has been a recent increase in people, especially the elderly, going to the emergency room or visiting their doctor and testing positive for the flu, according to the Center for Infectious Disease Research and Policy at the University of Minnesota.

Outpatient visits for flu-like illnesses were significantly higher last week in Arizona, California, Louisiana, New Jersey, Oregon and the District of Columbia, CIDRAP reported.

Influenza A has been the most common culprit – seasonal flu is usually caused by influenza A or B viruses.

Fever, chills, sore throat, and dry cough are often symptoms of influenza A, as well as headache, muscle aches, runny or stuffy nose, and fatigue. The flu tends to have more intense symptoms than a cold.

The American Heart Association recommends getting a flu shot if you’re over 6 months old, staying away from sick people, washing your hands often, keeping your hands away from your face, and seeing a doctor if you suspect you have the flu so you can start treatment right away.

COVID 19

The CDC noted last week that COVID-19 activity has begun to rise from low levels in some parts of the country.

“Based on CDC’s modeling estimates of epidemic growth, we anticipate that COVID-19 disease will increase in the coming weeks as it typically does in the winter,” the agency said.

Sewage disclosures are highest in the Midwest, followed by the West and then the South, according to CIDRAP.

Symptoms of COVID-19 include fever or chills, cough, trouble breathing, sore throat, congestion or runny nose, loss of taste or smell, fatigue, muscle or body aches, headache, nausea or vomiting, and diarrhea.

The CDC suggests staying up-to-date on COVID-19 vaccines, practicing good hygiene, and seeing a doctor if you’re at higher risk for serious illness.

RSV

RSV is a highly contagious virus that infects the lungs and respiratory tract. It usually causes mild, cold-like symptoms in adults, but it can be serious—even life-threatening—in infants and older adults.

The RSV season usually runs from December to April, with a peak of infections in the winter.

The CDC describes national RSV activity as “moderate” although it continues to increase in most areas of the country, especially among young children.

Symptoms of RSV include runny nose, congestion, less appetite, fever, cough, sneezing and wheezing.

The American Lung Association endorses RSV vaccination for adults 75 years of age and older and adults between the ages of 60 and 74 at increased risk of severe RSV. A preventive antibody is recommended for infants younger than 8 months.

The lung association also suggests staying away from infected people, avoiding glasses, bottles or toys that may be contaminated with the virus, washing your hands thoroughly, staying home when sick and cleaning high-touch surfaces.

Norovirus

Norovirus, also known as the “winter vomiting bug,” is a highly contagious virus that is the leading cause of foodborne illness, vomiting, and diarrhea in the US. Cases and outbreaks are most common from November to April.

More norovirus outbreaks have been reported this year through early November than in years past, according to the CDC.

In addition to vomiting and diarrhea, norovirus tends to cause stomach cramps, nausea, low-grade fever or chills, headache, and muscle aches.

New York health officials said last week that they are conducting “several gastrointestinal illness investigations” across the state, with some of those cases confirmed to be norovirus.

“It’s not unusual to see norovirus outbreaks this time of year,” the state health agency told the media.

To avoid getting norovirus, the CDC suggests cooking shellfish properly, washing fruits and vegetables well, avoiding preparing food for others when they are sick, and following good food safety practices.

Also be sure to wash your hands, clean contaminated surfaces and clothing, and stay home when you are sick.