Phyllis Wilcox
This year’s flu and cold season could be a bad one. During the holidays, emergency rooms and urgent care facilities saw increasing numbers of patients with respiratory infections.
Although last week’s new hospitalization admissions (a metric used by the Centers for Disease Control to measure the severity of disease transmission) for COVID-19 were down, mortality rates are up. There’s also RSV, the flu, and a new variant of COVID-19 to contend with–what some are calling a “tripledemic” or “tridemic.”
According to Dr. Jose Luis Perez, Chief Medical Officer at South Central Family Health Center in Los Angeles, “There are more than a hundred different viruses that cause upper respiratory infections. Those include COVID19, RSV and the influenza virus.”
Most people tend to think of the influenza virus as being the same as having a cold according to Perez who shared, medically, this is incorrect.
“It is not the same, having the flu is being specifically infected with the influenza virus.” In popular culture the term is used interchangeably, he noted, adding, “But make sure we understand that having the flu, medically, is not the same thing.”
It can be difficult to tell which respiratory infection an individual patient may be dealing with because all have some symptoms in common. “Most of these viruses cause upper respiratory infections. Those include the nose, the throat, the eyes along with what we in medicine call constitutional symptoms such as fever and muscle aches. All three viruses can cause lower respiratory infections and that includes infections of the bronchial tree and lungs which can lead to bronchitis and pneumonia,” stated Perez.
Causation
Most of these viruses occur ‘more frequently’ when people are in enclosed spaces breathing the same air and coming into contact with surfaces touched by an infected person. An uninfected person will then touch these areas and touch their own faces or breathe the air around the infected person and the virus enters the body through the nose or the mouth.
“So how do we get these viruses? All three viruses invade the human body by coming in contact with bodily fluids from an infected individual. All occur more frequently during the winter time when people are forced to be more indoors due to inclement weather and during celebrations,” according to Perez. It’s very difficult to tell which virus is infecting the patient based on symptoms alone but in general a cold may require fluids, bed rest and medicine for pain and fever.
Who’s Most at Risk
Anyone can contract an upper respiratory infection however some infections are lower respiratory infections and cause bronchitis or pneumonia. RSV can present with some of the same symptoms but also shortness of breath and an increasing respiratory rate especially in children, wheezing and respiratory retractions can also occur. According to Perez, retractions occur in small children with difficulty breathing, who use their intercostal muscles to move their chest up and down. Young children under six months and the elderly over sixty five are most at risk of RSV.
COVID-19
According to Dr Perez, in addition to coughing, a sore throat, runny nose, and fever you should be aware of tiredness, muscle aches, shortness of breath and the one symptom that is particular to COVID-19 is a loss of the sense of taste or smell. The people who are most at risk are, “Those who suffer from lung diseases like asthma, COPD, and obesity,” Perez stated. “We know now more firmly that obesity does impair our ability to breathe normally. So obesity is a risk factor, especially with developing more severe Covid disease.” Other people of particular concern are those who are immunosuppressed, have cancer and are undergoing treatment or have HIV.
RSV
According to Dr. Manisha Newaska, a Pediatric Pulmonologist at Stanford Children’s Health, a typical RSV season in the U.S. and North America is October through March, however since the COVID pandemic, it’s a little more variable.
RSV presents as a cold in older children, however the symptoms tend to be more severe.
According to Newaska, the signs of infection in younger children can be ‘loss of appetite, irritability and trouble breathing or ‘breathing very fast.’ or ‘retractions’ in small children is a sign of ‘low oxygen levels’. If you notice these symptoms, children should go immediately to the hospital or emergency room.’
Protecting yourself
To protect yourself from respiratory viruses, wear a mask when in situations where you are in public and watch how close you are to others. When in doors ventilation is important, open doors or windows, wash your hands, if someone is coughing or sneezing be aware of the potential of infection. If you are ill or immunocompromised, vaccinations, masking, hand washing and limiting contact with others who may be infected is also recommended.