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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.
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.
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.
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.
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.
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.
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?
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:
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.
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Three British Airways cabin members were taken to the hospital after they ate marijuana-laced sweets handed to them by a passenger during a flight from London Heathrow to Los Angeles.
The staffers were unaware that the sweets contained up to 300mg of THC, the main psychoactive compound in weed a produces the psychoactive effect.
The affected members are said to have had 'out-of-body experiences' after unknowingly consuming the weed-laced gummies. The airline has now launched an investigation to find the passenger who gave the crew member the marijuana edibles.
"It is a godsend in this case the sweets in question were not shared out among the crew until they had arrived in the US," one source told The Sun.
"They were consumed in the crew bus after touchdown, and tired staff gratefully gobbled them up. Almost immediately BA staff realized something was wrong.
"By the time the group had reached the crew hotel, three staff members who had numerous sweets began suffering 'out-of-body' experiences. They felt totally out of control and became panicked and scared."
As a result, the entire crew had to be grounded in LA and a new team was out in place to operate the return service. The affected members were flown back on a separate service days later as passengers.
THC is essentially the compound that causes the euphoric “high” associated with cannabis. It’s commonly consumed through smoking cannabis, edibles, tinctures, and capsules. THC also offers medical benefits but is more likely to cause psychoactive side effects.
Known for helping with nausea, appetite stimulation, chronic pain, and insomnia, this FDA-approved edible is used in synthetic forms (like dronabinol) for treating chemotherapy-induced nausea and appetite loss in conditions like AIDS.
THC can cause temporary effects like dry mouth, red eyes and increased heart rate. Long-term use, especially in adolescents, may be linked to psychiatric issues such as anxiety or low motivation.
While CBD is not intoxicating but has mild psychoactive properties, such as promoting relaxation, THC, however, directly binds to brain receptors, causing euphoria or a “high.
Furthermore, THC disrupts normal brain function, affecting memory, learning, and attention, especially in developing adolescent brains. It can cause acute panic, anxiety, and, in some cases, induce psychosis.
Along with this, it impairs coordination, slows reaction time, and alters judgment, directly contributing to motor-vehicle accidents.
Frequent use of marijuana has been previously linked to a higher risk of developing schizophrenia or other psychoses in people who are predisposed to these conditions.
According to the American Health Association, smoking cannabis also causes respiratory issues such as lung irritation and coughing as well as increases heart rate and blood pressure, which can raise the risk of heart attacks or strokes.
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Erythritol sweetener, commonly found in most of the food we consume, whether it is a protein bar or energy drink could be linked to stroke risk. While it is considered as a safer alternative to sugar as a natural sweetener, a study from the University of Colorado suggests it could damage cells in the blood-brain barrier.
The blood-brain barrier is brain's security system that keeps the harmful substance off the limits, while letting in nutrients. Research also suggests that it would lead to serious consequences for heart health and stroke risk.
In the latest study, researchers exposed cells that form the blood–brain barrier to erythritol levels typically seen after consuming a soft drink sweetened with the compound. What followed was a cascade of cellular damage that could leave the brain more vulnerable to blood clots, one of the leading causes of stroke.
The researchers found that erythritol triggered intense oxidative stress, overwhelming cells with unstable molecules known as free radicals. At the same time, it weakened the body’s natural antioxidant defences. This double hit impaired normal cell function and, in some cases, led to cell death.
Damage to blood–brain barrier cells is particularly concerning because this barrier plays a crucial role in protecting the brain from harmful substances circulating in the bloodstream. When its integrity is compromised, the risk of neurological injury rises sharply.
Even more troubling was erythritol’s effect on how blood vessels regulate blood flow. Healthy blood vessels constantly adjust their width—expanding when organs need more oxygen and nutrients, and narrowing when demand is lower.
This process depends on a delicate balance between two molecules: nitric oxide, which relaxes blood vessels, and endothelin-1, which causes them to constrict. The study found that erythritol disrupted this balance by reducing nitric oxide production while increasing endothelin-1 levels.
The result is blood vessels that stay constricted longer than they should, potentially restricting blood flow to the brain. This kind of dysfunction is a known warning sign for ischaemic stroke, the most common form of stroke caused by blocked blood vessels.
The most alarming finding in the study was how body's natural protect against blood clot is disturbed. Under normal circumstances, cells release a substance called tissue plasminogen activator, which is described as a natural 'clot buster', which helps dissolve clots before they become dangerous. However, erythritol could interfere with this protective mechanism and allow clots to persist and cause damage.
Several have shown that people with higher blood levels of erythritol face significantly increased risks of cardiovascular events. In one major study, individuals with the highest erythritol levels were nearly twice as likely to suffer a heart attack or stroke.
However, researchers caution that the experiments were conducted on isolated cells rather than full blood vessels. More advanced models that better replicate human physiology will be needed to confirm the findings.
Erythritol occupies a unique space in the sweetener world. Classified as a sugar alcohol rather than an artificial sweetener, it escaped recent World Health Organization guidance discouraging artificial sweeteners for weight control. Its sugar-like taste has also made it a favorite in “keto-friendly” and sugar-free foods.
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FDA refuses to review Moderna's flu vaccine: The U.S. Food and Drug Administration (FDA) has declined to begin reviewing Moderna’s application for its experimental flu vaccine. The company made the announcement on Tuesday. The decision marks another signal of stricter vaccine oversight under the Trump administration and has already rattled investor confidence, with Moderna’s stock falling nearly 7% in after-hours trading.
Read: CDC Vaccine Schedule: Coverage Falls From 17 to 11 Diseases For Children
Moderna said the FDA’s refusal came as a surprise and contradicted feedback the company had received earlier, before it submitted the application and launched phase three trials for the vaccine, known as mRNA-1010. The company has now requested a meeting with the agency to better understand what it described as an unclear “path forward.”
According to Moderna, the FDA did not flag any safety or efficacy concerns with the vaccine itself. Instead, the agency objected to the design of the clinical trial—despite having previously signed off on it. Moderna added that the setback would not affect its financial guidance for 2026.
The experimental flu shot had shown encouraging results in phase three trials last year, successfully meeting all primary trial endpoints. At the time, Moderna positioned the stand-alone flu vaccine as a critical step toward developing a combined influenza and COVID-19 vaccine, a key long-term goal for the company.
The decision comes amid sweeping changes to U.S. immunisation policy over the past year under Health and Human Services Secretary Robert F. Kennedy Jr., who has long expressed skepticism toward vaccines. Moderna on Tuesday pointed to the FDA’s top vaccine regulator, Vinay Prasad, who returned to the agency in August after being removed earlier.
Prasad currently heads the FDA’s Center for Biologics Evaluation and Research (CBER) and has publicly argued for tighter regulatory standards for vaccines. He has also drawn controversy for comments linking child deaths to COVID-19 vaccines.
In a letter dated February 3 and signed by Prasad, the FDA stated that its refusal to review Moderna’s application was solely due to concerns about the trial’s design. Specifically, the agency objected to Moderna’s choice of comparator, arguing that comparing the experimental shot to a standard, approved flu vaccine did not represent the “best available standard of care.”
As a result, the FDA concluded that the study did not qualify as an “adequate and well-controlled” trial under its regulatory definition.
Moderna has strongly disputed this interpretation, arguing that FDA rules do not require companies to use the most advanced or highest-dose vaccine as a comparator in clinical trials.
In a statement, Moderna CEO Stéphane Bancel said the decision undermines innovation and fails to advance shared public health goals. He emphasized that the trial design had been discussed and agreed upon with CBER before the study began.
Moderna now expects the earliest possible approval for its flu shot to come in late 2026 or 2027, pending regulatory reviews across the U.S., Europe, Canada, and Australia.
The FDA declined to comment, stating it does not discuss regulatory communications with individual companies, reported CNBC.
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