‘Quad-demic’ of viral infections stokes rise in illness, medical intervention

“There was a period of time when we were seeing a ton of RSV, COVID and flu come in and norovirus was hot.”
— Dr. Mark Marshall, vice president of medical affairs, Sharon Hospital

SHARON — The expected trio of winter viruses have arrived — and they brought a new friend with them.

Post-holiday cases of influenza, COVID-19 and Respiratory Syncytial Virus — commonly known as RSV — have spiked in recent weeks, joined by widespread cases of norovirus, commonly known as the “stomach bug.”“Definitely we’re seeing plenty of all of them,” said Dr. Mark Marshall, Sharon Hospital’s vice president of medical affairs.

The U.S. Centers for Disease Control and Prevention reported on Friday, Jan. 17, that the amount of acute respiratory illness causing people to seek healthcare remains high across the nation and in Connecticut.

“Emergency department visits related to COVID-19 are elevated compared to fall and highest among young children and older adults,” according to a CDC report. “Visits for RSV are highest among young children, and visits for influenza remain elevated among all age groups.”

In recent weeks, Sharon Hospital has experienced a spike in admissions and people seeking medical care through its Emergency Department for flu, RSV, COVID-19 and norovirus.

“I would say that the last few weeks, from mid- to late-December through the first week of January, were exceedingly busy with a large volume of patients in the emergency department and a large number of admissions to the hospital for respiratory or GI viruses,” Marshall said. “I think we may actually be on the downturn a little bit, but there was a period where we were seeing a ton of RSV and COVID and flu … and norovirus was hot.”

He described norovirus as a gastrointestinal illness which causes severe vomiting and diarrhea. Older adults and very young children, he said, are particularly prone to serious dehydration.

Unlike respiratory viruses which spread via droplets, norovirus is spread via contact, such as touching contaminated surfaces or eating contaminated food.

The CDC reported that norovirus has been more common this season, with at least 495 outbreaks as of mid-December, about 36% higher than the previous year.

Severe year for flu

The CDC reported on Jan. 15 that the number of weekly flu hospital admissions continues to rise across the country, and that in the last week, 20 children have died from influenza-associated conditions.

Nationally, influenza test positivity increased to 18.8%, COVID-19 test positivity remained stable at 6.6%, RSV test positivity decreased to 8.9% and viral activity levels for both influenza and COVID-19 are at high levels, according to the CDC.

“Influenza predictions suggest that emergency department visits will remain at a high to very high level for the next two weeks,” the federal agency reported.

Which virus do I have?

So how do you know which respiratory virus rallied your immune system?

Sharon Hospital’s Marshall noted that symptoms for the “big three” — flu, RSV and COVID-19 — are similar, as are their courses of infection and complications.

The only way to positively determine which bug has invaded your cells is to get tested.

“If you are ill and seek treatment, you can test for these viruses individually or there is even a single swab test for flu, RSV and COVID,” he explained.

Marshall stressed the importance of getting vaccinated.

“Both the updated influenza and COVID vaccines are recommended, and it’s not too late for a flu vaccine.”

Flu, COVID-19 and RSV are all more dangerous to older adults and very young children, along with people with chronic illnesses and co-morbidities, including those who are immunocompromised, noted the Sharon Hospital physician.

Vaccines, he said, have been shown to reduce ICU admissions by 25%, and deaths by 30%. “And even if people who get the vaccine still get COVID, it reduces their risk of severe disease.”

Health officials’ recommended treatment for most of these infections includes resting, staying home when sick, getting adequate nutrition, washing your hands and drinking plenty of fluids. The CDC recommends that people in the community with COVID-19, influenza or RSV should remain home until fever free for 24 hours without the use of fever-reducing medications and symptoms are improving.

Marshall also noted that there are several antiviral treatments available for at-risk people, including Paxlovid for COVID-19 and Tamiflu for influenza.

HMPV threat?

In recent weeks reports of a wave of hospitalizations from another respiratory illness known as human metapneumovirus, or HMPV, which is sweeping across China, has stoked fears of a new global pandemic.

The virus causes symptoms similar to COVID-19, including fever, persistent cough and congestion — and in severe cases leads to pneumonia.

Marshall noted that HMPV has been around for years and most people have encountered this virus in childhood. At this time, he said, he does not see it as an imminent threat.

“I don’t believe what is happening in China represents the early signs of a new pandemic.”