The United States is experiencing a challenging winter as four major illnesses circulate at high levels, creating what experts have dubbed a "quad-demic." COVID-19, Respiratory Syncytial Virus (RSV), influenza, and whooping cough (pertussis) are all affecting communities across the nation. Adding to the complexity, norovirus has emerged with more outbreaks than usual this season, further straining public health systems.
Public health officials report that these illnesses have shown varying patterns of spread. COVID-19 rates appear to have reached a plateau, providing some relief to healthcare systems. RSV has hit its peak for the season, while influenza activity remains elevated across most of the country. Many states report high or very high levels of flu cases, prompting health advisories and increased vaccination efforts. Meanwhile, whooping cough is returning to pre-pandemic patterns.
“It has a huge impact, not just on the individual who’s sick, but on the community,” – Geeta Sood, MD, ScM
Norovirus stands out as particularly concerning this winter, with data showing a record number of outbreaks. From August 1 to December 11, 2024, the U.S. recorded 495 norovirus outbreaks, over 100 more than during the same period in 2023. For the week ending December 5, 2024, there were 91 outbreaks, the highest on record since 2012.
“Norovirus is experiencing a relatively high year,” – Shira Doron, MD
The Centers for Disease Control and Prevention (CDC) reported that as of December 28, 2024, there were more than six times as many whooping cough cases compared to the same time in 2023. This resurgence aligns with pre-pandemic trends but highlights the need for continued vigilance and vaccination.
“These respiratory infections and norovirus are inevitable. Everyone’s going to come in contact with them. You can run, but you can’t hide from them,” – Shira Doron, MD
The bird flu remains rare in humans, with only 66 confirmed cases in the U.S., including one known death associated with the H5N1 virus. Most cases have been linked to direct exposure to infected animals, such as dairy herds or poultry farms. However, there are at least two cases with unknown sources of exposure, underscoring ongoing monitoring and research needs.
“We can’t assume that what China sees, we will see,” – Shira Doron, MD
Experts emphasize that while these viruses pose significant public health challenges, protective measures can mitigate risks. Vaccination remains a critical tool in preventing severe outcomes from influenza and whooping cough. Public health campaigns continue to stress the importance of hand hygiene and sanitation to curb norovirus spread.
“The best way to protect yourself is to be really healthy when you do get a cold.” – Shira Doron, MD
Norovirus is characterized by symptoms such as nausea, vomiting, and diarrhea. Dr. Shira Doron advises that managing these symptoms typically involves symptomatic treatment and ensuring adequate hydration.
“It is the most common cause of nausea, vomiting, and diarrhea, so you’re just going to generally manage it symptomatically and with hydration.” – Shira Doron, MD
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