There's been an alarming increase of respiratory and gastrointestinal viruses in the United States lately, causing anxiety about a so-called "quad-demic". According to surveillance reports, influenza, COVID-19, RSV and norovirus are at very high levels everywhere. While the surge aligns with patterns typical for this season, several epidemiologists view simultaneous infections of such proportions to pose risks not only to individual healthcare but public health.

The incidence of the quad-demic should vary with seasonal patterns, vaccination rates, and public health interventions. Each virus alone is relatively easy to manage; however, the effect of all together could lead to overburdening of health care facilities and increase risks for those at higher risk. Continuing surveillance, early testing, and proactive prevention measures will play an important role in the control of these infections going forward.

While the term "quad-demic" sounds daunting, it must be taken into perspective. For years, we have had all these viruses together, and we have the capabilities to mitigate some of the risk. Vaccination, proper hygiene and using common sense helps individuals get through the season unscathed. Is the quad-demic a permanent fixture or just another seasonal wave? Let's break this down.

What is the Quad-demic?

Typically, flu, COVID-19, and RSV have been the primary culprits behind seasonal respiratory infections. However, norovirus, a highly contagious stomach bug, has emerged as a fourth significant player, inducing fears of a more severe and widespread viral outbreak. According to the Centers for Disease Control and Prevention (CDC), the U.S. recorded nearly 500 norovirus outbreaks between August and December 2023, a substantial rise from the previous year’s numbers.

While the term "quad-demic" may sound ominous, the seriousness and consequences of such infections should be weighed in light of the U.S. healthcare system's experience with managing viral surges since the start of the COVID-19 pandemic.

1. Influenza (Flu)

Flu continues to be one of the most common and alarming seasonal illnesses. In the period spanning from 2023 to 2024, there were approximately 40 million cases of flu, and thousands of hospitalizations along with reported 47 deaths have been reported this season. Flu symptoms include fever, chills, cough, sore throat, muscle pain, and fatigue, with most recovering within a week or two but risky factors for severe illness effects occur in young children, elderly, and people with chronic conditions.

2. Covid-19

Despite its reduction from the first pandemic peak, COVID-19 is still rampant. The CDC estimates that alone between October and December 2023, there were between 2.7 and 5 million cases in the U.S. Hospitalization has increased by cities such as Los Angeles, Chicago, and New York. Symptoms are closely similar to the flu, fever, cough, and fatigue but uniquely presents in some cases as loss of taste and smell.

3. RSV

RSV is the most common cause of lower respiratory infections in infants, older adults, and immunocompromised individuals. While RSV peaked late in 2023 and early 2024, it continues to be a threat because it can lead to bronchiolitis and pneumonia. It is very similar to the common cold, presenting with symptoms such as congestion, runny nose, coughing, and fever, which can make it difficult to differentiate from flu or COVID-19 without testing.

4. Norovirus

Norovirus, also called the "stomach flu," is a highly contagious infection of the gastrointestinal tract, not a respiratory virus. It transmits quickly from contaminated food and water and contact with contaminated surfaces, causing such symptoms as diarrhea, vomiting, nausea, and stomach pain. Cases have shot up, the CDC said Monday, with reports of outbreaks surging compared with last year.

Is There a Challenge In Diagnosis Due to Overlapping Symptoms?

The greatest challenge during the quad-demic is how the four viruses are alike and thus make identification very hard with no testing applied. Most cases present symptoms common to all viruses: fever, tiredness, body pains, and respiratory, which includes coughing and congestions for influenza, COVID-19, and RSV; the other would be norovirus symptoms as nausea and vomiting can appear even in extreme influenza and COVID-19. This overlap increases the risk of misdiagnosis and delayed treatment, hence the need for early testing and proper medical guidance.

Also Read: Is US Preparing For A Quad- demic 2025?

Effective Prevention Strategies That Work

The best defense against these viruses is a combination of vaccines, hygiene, and lifestyle precautions. While lifestyle modifications are highlighted as part of the constant need to eat healthy, ensure daily movement and drinking adequate amount of fluids. There is a sure short two preventive strategies that are effective:

Vaccination

• Flu vaccine: Annual flu shots reduce the severity of infection, allergic flare ups and hospitalizations.
• COVID-19 vaccine: Though COVID-19 cases have declined, vaccination remains critical in preventing severe outcomes.
• RSV vaccine: Available for those aged 60 years and older, especially those with underlying conditions.
• Norovirus vaccine: No vaccine is yet available, but mRNA vaccine research is in progress.

Hygiene and Sanitation

• Washing hands frequently with soap and water for at least 20 seconds, especially after public exposure.
• Disinfect frequently touched surfaces regularly, use sanitiser when outside.
• Avoid close contact with infected people and wear masks.

Do You Need To Wear A Mask All The Time?

While debates on masked wear continue on, experts on mask-wear affirm that this does not only have a historical precedent but works towards reducing airborne viruses spreading within the environments. Hospitals, though, ensure masking in key sections of themselves. Publicized mask-wear remains a discretion, though massing indoors still goes a longer way in cases like peak flu seasons.

If you notice the symptoms of these viruses, then it's best to be confined at home and avoid having face-to-face interaction with others and seek immediate attention from your physician if your condition worsens. Quarantining for some days can decrease the spread of infection.

As we move into the first half of 2025 and beyond, staying informed and proactive is the best strategy for maintaining health and avoiding unnecessary panic. The key takeaway? Stay vigilant, but don’t be alarmed—these viruses are here, but so are the means to fight them.

One in seven stroke patients in India are young adults aged below 45 years, with hypertension leading as the major risk factor, according to a study by the Indian Council of Medical Research (ICMR).

The study, published in the International Journal of Stroke, showed that two in five patients arrived in the hospital after 24 hours of onset of symptoms, highlighting the need for improving awareness about the first hour (golden hour) in stroke care.

“The findings highlight the gaps in acute stroke care, including delayed hospital arrival, limited access to advanced treatments, and inadequate follow-up services,” said Prashant Mathur, Director, ICMR—National Centre for Disease Informatics and Research, Bengaluru, in the paper.

“Stroke continues to pose a major public health burden, with poor outcomes. The study shall contribute to the development of evidence-based comprehensive strategies for stroke prevention, effective management, and improved treatment outcomes,” he added.

What Stroke Patterns Did The Study Find?

The team included 34,792 stroke cases from 30 Hospital-Based Stroke Registries (HBSRs) across India, recorded between 2020 and 2022.

About 64 percent of the stroke patients were males, and 36.6 percent were females.

Stroke in the younger age group (aged below 45 years) constituted 13.8 percent of the total cases. More than 70 per cent of the participants were residents from rural areas.

Hypertension (74.5 percent) was the most common risk factor, followed by smokeless tobacco use (28.5 percent) and diabetes mellitus (27.3 percent).

Ischemic stroke accounted for 60 percent of cases. Only 20.1 percent were presented within 4.5 hours of symptom onset, while 37.8 percent of cases presented after 24 hours.

The commonest symptoms at onset included motor impairment (74.8 percent), followed by speech disturbance (51.2 percent), dysphagia (30.4 percent), and impaired consciousness (25.6 percent).

The study also highlighted substantial disparities in stroke care services. Time-sensitive therapies like thrombolysis were given in 4.6 percent of cases, while thrombectomy was administered in 0.7 percent of ischemic strokes.

At three months, 27.8 percent of patients had died, while nearly 30 percent suffered significant disability, and 1.1 percent had a recurrent stroke. This highlighted the need for improving comprehensive stroke care across India.

Burden Of Stroke In India

Stroke remains one of the leading global health burdens, causing significant deaths and disability worldwide, including in India. Compared to Western countries, stroke also tends to occur at a younger age and is associated with a higher case fatality rate in the country.

The Global Burden of Disease Study 2021 identified hypertension, air pollution, tobacco smoking, high cholesterol, increased salt intake, and diabetes as the leading risk factors of stroke.

Incidence of stroke is increasing significantly in low- and middle-income countries (LMICs), especially in India, due to population growth, aging, and greater exposure to risk factors.

The estimated stroke incidence in India ranged from 108 to 172 per 100,000 population, and 1-month case fatality varied from 18 percent to 42 percent.

As per data from the ICMR-NCDIR, India has a crude stroke incidence rate of 138.1 per 100,000 population and an age-standardized case fatality rate of 30 per 100,000 population.

Amid changing climatic conditions that are soaring temperatures and leading to over 200,000 deaths annually in South Asia, the World Health Organization (WHO) today announced two health initiatives that will prevent the impacts of extreme heat and save lives in the region.

Extreme heat in South Asia, including in India, is rapidly threatening human health and can potentially also cause economic instability in the subcontinent.

The two initiatives -- the South Asia Climate–Health Desk and the South Asia Scientific Research Consortium -- were announced at the ongoing Mumbai Climate Week in collaboration with several global and regional partners.

The initiatives, with an investment of $11.5 million by the Rockefeller Foundation and Wellcome, aim to connect climate science to health action to prevent heat-related deaths and illnesses.

“Few regions feel the impacts of extreme heat as sharply as South Asia, and I welcome the clear determination to respond. We all know that every death primarily due to excess heat can be prevented, and heat health action plans are saving lives,” said Celeste Saulo, Secretary-General at the World Meteorological Organization (WMO) Climate and Health Joint Programme.

“By uniting science, government leadership and support, and community action, countries here are proving that this challenge can be met,” Saulo added.

What Are The 2 Health Initiatives?

The South Asia Climate–Health Desk, implemented with the Indian Institute of Tropical Meteorology (IITM), India Meteorological Department (IMD), aims to improve how climate and weather information is translated into action to protect health.

It is one of the first units under the joint program to embrace research and development and operational domains in climate and health, and will also help develop more robust decision support tools, such as early warning and risk assessments.

The South Asia Scientific Research Consortium, under the Indian Institute of Science Education and Research (IISER) Pune, is expected to deepen the region’s scientific understanding of how heat affects different populations.

By developing tailored heat‑risk thresholds, this consortium aims to ultimately strengthen heat action planning, early warning systems, and preparedness efforts, helping communities and institutions better adapt to rising temperatures.

The Risks Of A Warming South Asia

UN Secretary-General António Guterres has called for urgent global action to address the growing risk of extreme heat worldwide, which takes a heavy toll on health in South Asia – the world’s most populous region.

According to WMO, Asia is warming nearly twice as fast as the global average, intensifying extreme weather and placing growing pressure on lives and livelihoods, health systems, economies, and ecosystems across the region, putting the most vulnerable and exposed communities at critical risk.

In India, pre-monsoon temperatures regularly rise above 50 degrees Celsius, with heat-related mortality exceeding 200,000 deaths per year.

Extreme heat also undermines economic stability and productivity.

In 2024 alone, heat exposure in India led to 247 billion potential labor hours lost. The Lancet Countdown reported that the reduced labor capacity led to an estimated $194 billion loss in income.

Haryana has significantly stepped up its HIV prevention and treatment efforts this year, screening more than 12.4 lakh people and expanding services across the state. Officials say the focus is not only on detection but also on reducing stigma and ensuring patients receive timely care.

Large scale testing across the state

Between April 2025 and January 2026, authorities tested 12,40,205 samples for HIV. Out of these, 5,877 people were found positive.

According to Additional Chief Secretary (Health) Sumita Misra, the state has been strengthening its response by making testing widely available and free. Haryana currently runs 104 integrated counselling and testing centres, including a mobile testing unit in Faridabad. These centres offer confidential screening so people can get tested without fear or hesitation.

A major focus has also been on preventing transmission from mother to child. During the same period, 5,65,830 pregnant women were screened. Among them, 613 tested positive and were immediately linked to treatment to reduce the risk of passing the infection to newborns.

Expanding treatment access

Alongside testing, treatment facilities have also grown. Haryana now operates 24 anti retroviral therapy centres in cities such as Rohtak, Gurugram, Faridabad, Karnal, Hisar, Ambala and Mewat. Thirteen of these centres were recently set up inside medical colleges to improve accessibility.

The state also runs five facility integrated ART centres and four link ART centres. At present, 40,851 patients are receiving HIV treatment across Haryana.

To support patients financially, the government introduced a monthly assistance scheme in December 2021. People living with HIV receive Rs 2,250 every month. So far, Rs 54.3 crore has been distributed under the programme.

Reaching vulnerable communities

The state is also tackling sexually transmitted infections through 31 dedicated clinics that provide free counselling, testing for syphilis, and treatment.

Beyond hospitals, outreach teams are working directly with high risk groups. Forty two targeted intervention projects run by Red Cross societies and NGOs engage with female sex workers, men who have sex with men, intravenous drug users, truck drivers, and migrant laborers.

For people dependent on opioids, Haryana operates 12 opioid substitution therapy centres and three satellite units. A total of 9,014 patients are registered and around 4,570 receive regular treatment.

Officials say several government departments are also involved in awareness programmes to educate communities and reduce stigma, which remains one of the biggest barriers to early testing and consistent treatment.

What IS HIV?

HIV- also referred as the human immunodeficiency disease, is a virus that attack cells of an individual’s immune system, and overtime makes the immune system weak, hence it loses its capability to fight against ordinary diseases, which in return increases the risk of catching up with infections and tumours. An individual is likely to develop AIDS in nearly 8 to 10 years, if HIV is left untreated. AIDS is considered as the final stage of HIV. This chronic disease can cause complications. Read to know more.

Symptoms for HIV

HIV symptoms can vary among individuals. The initial symptoms are Fever, sickness which is same as viral infections. Symptoms include:

• Fever
• Sore throat
• fatigue
• Swollen lymph nodes
• Headache
• Skin rash
• Pneumonia
• Nausea
• Vomiting
• Weight loss
• Weakness
• Skin rashes or bumps
• Night sweats
• Diarrhoea

Every person might experience the same symptoms, many individuals might go through some completely different set of symptoms. Since, the symptoms vary from person- to- person, many people can start noticing these symptoms at earliest stages and most of them aren’t even aware about any of this.