Winter is Here: Hackensack Meridian Experts Share Insight & Tips About Respiratory Virus

Many refer to it as a "triple threat virus" as three major respiratory viruses, influenza, respiratory syncytial virus (RSV) and COVID-19 virus start to show growing trends in the winter months.   Cristina Cicogna, M.D., an infectious disease specialist and the Division Chief for the Center of Infectious Diseases at Hackensack University Medical Center, and Daniel Ruderfer, M.D., chief of Pediatric Infectious Diseases, K. Hovnanian Children's Hospital at Jersey Shore University Medical Center, provide their expertise on these viruses, offering advice on how to differentiate between them and how to stay protected.

Q: Which viruses are most prevalent during this time of year?   We are always concerned about the three major respiratory viruses that peak in the fall and winter: RSV, influenza, and, for the past five years, COVID-19. Some of the other less severe viruses that cause the common cold also tend to be more active at this time of the year.

Historically, we observe significant spikes in December and January. Lower temperatures favor stability of the virus outside our bodies and may also impair our defense mechanisms by drying up the airway passages and preventing our nose “microbrushes” from clearing mucus and viruses. As the cold weather prompts more indoor activities and crowding, it facilitates respiratory viruses transmission. 

Q: How can one tell which virus they may have?    It can be challenging to determine which virus one may be infected with as the signs and symptoms can overlap particularly for influenza and RSV. Symptoms of upper respiratory infections include coughing, sneezing, runny nose, watery eyes and sore throat. Distinguishing features of influenza are the abrupt onset of high fever with cough, body aches and headache while the common cold viruses tend to cause more gradual nasal symptoms and low or no fever. A loss of taste and smell is a distinctive symptom of COVID-19’s early strains, more recently people experience severe sore throats.

Diagnosing young children can be more difficult since they cannot articulate their symptoms. The initial signs in young children might be decreased activity and a reduced appetite. It is always important to monitor a child's temperature. If a fever in a child or an elderly person is accompanied by decreased activity, lethargy, or a refusal to eat, you should seek immediate medical attention.

Q: When is it time to see a doctor versus managing symptoms at home?   If you feel a significant change from your normal state of health and are concerned, it is best to see a doctor. You are the best judge of your own body, so don't hesitate to seek medical advice rather than waiting for a specific set of symptoms to appear or for someone else to suggest it.

For younger children less than 6 years old, the elderly and individuals who are immunocompromised or have pulmonary or cardiac conditions then immediate medical care is warranted. Symptoms to look for are high fever, difficulties breathing , changes in eating habits, confusion, or lethargy. 

Q: With the holidays approaching, what is your advice for preventing the spread of infection?    First and foremost, ensure you are up-to-date on all vaccinations recommended by the CDC. Vaccinations are vital for preventing or lessening the severity of an infection and reducing the likelihood of ICU admission, as we saw during the COVID-19 pandemic. Being vaccinated does not only protect you but also protects vulnerable individuals from getting secondarily infected.

Important measures for prevention of getting infected include frequent hand hygiene with soap and water or alcohol hand rub, avoid touching your eyes, nose or mouth with unwashed hands, and avoid close contact with people who are sick. Measures to protect others when you are sick include isolating from others, which means practicing social distancing, staying at home if you are sick, covering your coughs and sneezes with your elbow, if using your hand then immediately perform hand hygiene, clean and disinfect objects and surfaces.

If you have a diagnosed infection, it is best not to attend gatherings. To support your immune system, stay well-hydrated, eat a healthy diet, and engage in regular physical activity.

Q: What are the most common misconceptions about the cold, RSV, the flu, and COVID-19?    A misconception is that vaccines can cause the infection. Most frequently, we do not use live viruses in these vaccines. If you feel sick after a vaccination, it could be because you were infected with a different virus or strain, or you are in the window before the vaccine has become fully effective. Vaccines do not provide immediate immunity; it takes about 2 weeks to build optimal protection.  For more information, visit HMH's infectious diseases page.