Two infectious disease physicians detail what you need to know about influenza, RSV, and COVID as the colder months arrive and more people get infected with these viruses.
In the fall and winter, influenza and COVID-19 gain an ally as the respiratory syncytial virus spreads across the United States, creating a “triple case” of respiratory illness.
Jane Marrazo, MD, Director The University of Alabama at Birmingham Infectious Diseases Departmentalthough hospital admissions for COVID-19 are in “a very good place,” the flu is increasing in Alabama and throughout the Southeast.
“We are seeing a gradual decline in the latest increase in Omicron, and we are seeing lower double-digit COVID entries in the UAB,” Marrazo said. “However, this winter we may be seeing new types of COVID, and we are now seeing an increase in hospitalizations and RSV influenza.”
Claudette Paul, MD, associate program director at Pediatric Infectious Diseases With the UAB and Children of Alabama, he said that due to the COVID-19 pandemic, RSV cases are “playing a bit of a catch up.”
“We are now seeing double the volume of influenza and respiratory syncytial virus in children who are going to be exposed and have symptoms,” Ball said.
Respiratory syncytial virus season, like influenza season, usually runs from October to March; But what’s unusual for Paul is that doctors across the country are seeing an increase in these viruses so early in the season.
“This may put people off because this winter could be long and full of a lot of disease,” she said.
While many advances are being made, unfortunately unlike influenza, there is no vaccine on the market or a viable course of treatment for RSV.
“RSV is a virus to which we do not develop a permanent immunity,” Ball said. “As adults, we can keep getting the same strain of RSV year after year; but it doesn’t cause significant symptoms, it’s basically a mild cold-like illness that lasts for a few days. However, it is usually young children, medically fragile individuals, or the elderly who are most susceptible. to acute illness.
Respiratory syncytial virus begins as a respiratory infection, like the common cold. However, RSV congestion can lead to infections, most commonly ear infections.
What about COVID-19 boosters?
Marrazzo advises waiting about three months to get a booster dose of COVID-19 after being infected or receiving a previous vaccine.
“It can also lead to sinusitis, but that usually happens later,” Ball said. “In younger age groups under two years of age, RSV can lodge in the lungs, and if they have trouble breathing, it’s an indication that you need to take your child to the emergency room if your primary care doctor is out of reach.”
Marrazzo says that as of October 28, 2022, UAB Hospital cares for roughly the same number of COVID patients as those with influenza.
“We’re seeing these cases a little earlier – which is a bit unusual at this time of year – and it’s concerning,” Marazzo said.
She adds that a worse-than-average flu season in Australia suggests the United States could suffer the same. Additionally, she says, data on how effective flu vaccines are is still unclear.
“What we do know about the flu vaccine is that it is incredibly effective in reducing flu symptoms,” Ball said. “The best thing you and your child can do is get vaccinated.”
Ball recommends early influenza diagnosis as another preventative measure, because starting antiviral treatment will reduce its spread and severity.
“You should also stay home and not work or school if you are sick,” Paul said. “Good hand hygiene is key.”
Marazzo adds that pregnant women should get the flu shot, while
Paul recommends that new parents should reduce the amount of exposure to their newborn.
“Pregnant women with influenza have a higher mortality rate than those who get vaccinated,” Marazzo said. “The babies most likely to die from the flu are babies who are six months old or younger because they can’t get vaccinated.”
It’s never too late to get your own COVID booster
“The current booster vaccination that we have now that is targeting it [Omicron subvariants] It will potentially help mitigate or help prevent the most severe consequences of COVID, regardless of which lineages come down the line,” Marrazzo said.
Marrazzo adds that those interested in getting a boost should wait about three months after infection or receiving a previous boost, citing data showing that immunity begins to decline after the three-month mark.
At UAB Marrazzo is the C. Glenn Cobbs Chair Conferred on Infectious Diseases.
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