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.

President Donald Trump said he takes a higher dose of aspirin than his doctors recommend, blaming it for the bruises on his hands that have again drawn attention to his health. The remarks came during an interview with The Wall Street Journal published on Thursday.

“They tell you aspirin is good for thinning the blood, and I don’t want thick blood running through my heart,” Trump, 79, said. “I want thin blood flowing through my heart. Does that make sense?”

“I Want Thin Blood,” Trump Explains Why He Ignores Doctors’ Advice

Trump said his doctors prefer that he take a smaller dose, but he has chosen otherwise. “They’d rather I take the smaller one. I take the larger one. I’ve done it for years,” he said, adding that bruising is a known side effect, as per CNN

Bruising, Makeup, and Bandages Renew Questions About Trump’s Health

The interview marked one of Trump’s most detailed discussions with journalists about his health in recent years. Scrutiny has grown as questions persist about his age, stamina, and how transparent the White House has been about his medical condition.

Bruising on Trump’s right hand has been visible for months. CNN previously reported that it existed before his return to the White House. The issue drew more attention after Trump appeared to conceal the marks with makeup or bandages and often shielded his hand from cameras. Observers have also pointed to swelling in his legs and moments where he appeared to doze during public events.

Trump’s Doctor Confirms President Takes 325 mg of Aspirin Daily

Trump’s physician, Dr. Sean Barbabella, told the Journal that the president takes 325 milligrams of aspirin each day. According to the Mayo Clinic, low-dose aspirin therapy typically ranges from 75 to 100 milligrams, with 81 milligrams being the most commonly advised dose. The clinic notes that aspirin therapy can fall anywhere between 75 and 325 milligrams daily.

What Is Aspirin Used For?

Aspirin is widely used to thin the blood and reduce clot formation, lowering the risk of heart attack and stroke. However, it also increases the risk of bleeding. In recent years, medical guidelines have moved away from recommending daily aspirin for many adults, as the potential harms often outweigh the benefits. Some experts advise discontinuing aspirin entirely in people in their 70s.

Dr. Jonathan Reiner, a professor at George Washington University’s School of Medicine and Health Sciences and former cardiologist to Vice President Dick Cheney, said the explanation offered by Trump and his team raises further questions.

“It’s uncommon to see that kind of bruising with one aspirin a day,” Reiner said. “The question becomes whether the president is taking medications that have not been disclosed by the White House.”

White House Says Trump Is in “Exceptional Health”

Barbabella said on Thursday that Trump remains in excellent condition. In a statement to CNN, he said the president’s medical evaluations and lab results show strong metabolic health and that his cardiovascular condition is comparable to someone 14 years younger. “Overall, the President remains in exceptional health and fully capable of carrying out his duties as Commander in Chief,” Barbabella said.

Bruising Also Seen on Trump’s Left Hand During Recent Events

At several public appearances last week, Trump appeared with light discoloration or bruising on the back of his left hand as well, in addition to the more persistent bruising on his right hand. As per CNN, the White House has previously attributed the right-hand bruising to frequent handshaking combined with aspirin use, which can make bruises more likely to appear.

Why Daily High-Dose Aspirin Is Rarely Recommended

Reiner said that while 325 milligrams is not considered an extreme dose, there is no clear medical reason to take that amount every day. He explained that people with acute injuries, such as a sprained ankle, may be prescribed 325 milligrams every four hours, which would be considered a high dose.

“Aspirin has been studied at many doses,” Reiner said, as per NBC News. “Eighty-one milligrams offers the best balance between reducing clot risk and limiting bleeding. A higher dose increases bleeding risk without improving effectiveness. That’s why we don’t use it.”

He added that the broader concern is a lack of transparency. “All of this highlights how opaque the White House has been about the president’s health.”

Trump Clarifies October Medical Scan Was a CT, Not an MRI

During the interview, as per CNN, Trump also discussed a medical scan he underwent in October. At the time, he told reporters it was an MRI but declined to provide details, directing questions to his doctors.

Speaking to the Journal, Trump clarified that the scan was a CT. “It wasn’t an MRI,” he said. “It was less than that. It was a scan.” Barbabella said the CT scan was done “to definitively rule out any cardiovascular issues.” Last month, he released a memo stating that imaging of Trump’s cardiovascular and abdominal systems showed “perfectly normal” results.

In 2018, however, Trump underwent a coronary CT scan that revealed plaque buildup in his arteries, indicating moderate heart disease.

White House press secretary Karoline Leavitt defended the administration’s disclosures, saying the president’s doctors have always confirmed he received advanced imaging. She added that Trump himself has shared additional details and described him as “the most transparent and open president in history,” while criticizing former President Joe Biden.

Trump Addresses Leg Swelling Linked to Chronic Venous Insufficiency

Trump also spoke about swelling in his lower legs, which the White House announced in July was caused by chronic venous insufficiency, a common condition among older adults. Trump said he tried compression socks but stopped using them. “I didn’t like them,” he told the Journal.

He also suggested he has little interest in regular exercise. “I just don’t like it. It’s boring,” Trump said. “Walking or running on a treadmill for hours, that’s not for me.” The Journal questioned Trump about moments where he appeared to fall asleep during public appearances. During a Cabinet meeting last month, Trump closed his eyes for several seconds at a time. A similar moment occurred during a November 6 event in the Oval Office.

Trump denied falling asleep. “I just close my eyes. It’s very relaxing to me,” he said. “Sometimes they take a picture when I’m blinking, and that’s what people see.”

President Downplays Hearing Concerns

Asked about his hearing, Trump said he only struggles when many people are talking at once and dismissed broader concerns. Before and after the election, Trump repeatedly questioned Biden’s fitness to serve, even suggesting Biden was unaware of documents signed in his name using an autopen. Biden has denied the claim.

Biden later exited the 2024 presidential race following a widely criticized debate performance that intensified concerns about his health and ability to remain in office.

Nimesulide (over 100 mg), a commonly used non-steroidal anti-inflammatory drug (NSAID) which is prescribed for pain and inflammation is now banned in India. This is to safeguard public health.

What Exactly Happened? The Centre has prohibited the manufacture, sale and distribution of oral formulations of nimesulide which contains more than 100mg, with immediate effect, across the country.

As per the government notification, oral formulations of nimesulide that contains more than 100 mg have been banned as such high-dose could be risky for human health. The order states that safer alternatives to this drug is available in market, and thus in public interest, the continued availability of this drug at such high dosage is not justified.

The ban is issued under the Section 26A of the Drugs and Cosmetics Act, 1940. This section empowers the Centre to restrict or prohibit drugs that pose a risk to patients. The government also consulted the Drugs Technical Advisory Board (DTAB), which is also country's apex advisory body on technical matters related to drugs and cosmetics.

Why Did Government Ban Nimesulide?

The drug had long been under regulatory and medical scrutiny. The major concern is the liver toxicity, which is one of the side effects of this high-dose drug. In fact the World Health Organization (WHO) has no included nimesulide in its Model List of Essential Medicines, all due to the global caution around it. Several other countries too have either restricted or completely withdrew the drug.

The Ministry of Health and Family Welfare in a notification said that the Central government is "satisfied that the use of all oral formulations containing Nimesulide above 100 mg in immediate release dosage form is likely to involve risk to human beings and that safer alternatives to the said drug are available".

The restriction on certain nimesulide formulations follows recommendations made by the Indian Council of Medical Research (ICMR) after reviewing the drug’s effects in adults. These recommendations were accepted by an expert committee under the apex drug regulator. Nimesulide is known to cause liver toxicity in some cases.

ICMR had also advised that nimesulide be used only as a second-line treatment when other medicines fail or cannot be prescribed. It recommended against its use in pregnant or lactating women, those planning pregnancy, and patients with liver or kidney impairment. The drug should also not be used alongside other medicines that are toxic to the liver or kidneys. Nimesulide is already banned for children under 12 years of age.

The committee has further asked ICMR to review the impact of the drug across different age groups, including adolescents and older adults.

Read: Cough Syrup Row: Death Toll Rise To 22 As 2 More Children Succumb

What Are The New Development On Drug Ban In India?

The Ministry also removed cough syrups from the list of over-the-counter medicines. While lozenges, pills or tablets for cough continue to remain on the list. This has come in the backdrop of 22 children who died in Madhya Pradesh after they consumed contaminated cough syrups.

Disclaimer: Health and Me's report is based on the notice issued in public knowledge and is not a substitute for prescribed drugs. Always consult your doctor before making changes in your medicines.

Indore water contamination is linked to fecal bacteria like E coli and Klebsiella, confirmed officials. These bacteria are known to cause severe vomiting and diarrhea. The death toll too have risen to 10, confirmed the local officials. Indore councillor Kamal Waghela said that two more persons died on Thursday night. The laboratory tests of the water supplied through the Narmada pipeline in Bhagirathpura, which is the epicentre of the outbreak confirmed E coli and Klebsiella bacteria to be the culprits.

Also Read: Australian Cricketer Damien Martyn in Hospital With Meningitis

What Happened In Indore That Led To Water Contamination?

The outbreak occurred due to lapses in civic infrastructure. Investigation revealed that a toilet constructed directly above a main drinking pipeline near a police outpost, without a mandatory safety tank resulted in the sewage mixing with drinking water.

Indore Municipal Corporation Commissioner Dilip Kumar said, “We have found that in case of the construction of the toilet, no safety tank was constructed beneath it. We are also probing the other lapses.”

What Is E. Coli - The Bacteria Found In Indore Contaminated Water?

Escherichia coli, or E.coli is a bacterium that lives in the human intestine and is one of the most common causes of foodborne illness.

The Centers for Disease Control and Prevention (CDC), these bacteria are commonly found in environment, food, water, and the intestines of people and animals. While most E.coli are harmless, some can make people sick with diarrhea, urinary tract infection, pneumonia, sepsis, and other illnesses.

E. Coli from Contaminated Water

WebMD writes that one can swallow E.coli from contaminated water, as in the case of Indore, a toilet was constructed directly above the main drinking water pipeline, without a mandatory safety tank, which may have led to the contamination. Studies have also shown that some E.coli could regrow even after chlorine treatment.

What Is Klebsiella - The Bacteria Found In Indore Contaminated Water?

CDC notes that Klebsiella is a type of gram-negative bacteria which is also found in human stool and can cause healthcare-associated infections or HAIs. They are also highly resistant to antibiotics and can also resist carbapenems, which is the last line of defense against multi-drug resistant bacterial infections.

Klebsiella can cause pneumonia, bloodstream infections, wound or surgical site infections and meningitis.

It can spread from person-to-person contact, which is one of the most common way of spreading. Other ways could also be from contact with contaminated water or soil, contact with contaminated equipment, for example, ventilators, breathing machines, or intravenous catheters. Klebsiella cannot spread through the air.

Also Read: Sewage Mixing With Drinking Water Kills 7 in Madhya Pradesh’s Indore, Over 100 Remain Hospitalized

What Actions Have Been Taken So Far In Indore?

As of now, the water supply Assistant Engineer (AE) has been suspended, and the sub-engineer relieved of duty. The Zonal Officer has also been suspended for failing to ensure proper coordination. “The zonal officer has been suspended because he should have seen overall coordination,” Commissioner Kumar said.

“We have found a few chambers that intersect the distribution line. We are getting them diverted,” Kumar also noted.

Authorities have stepped up efforts to contain the crisis and avert further casualties. District Magistrate Shivam Verma said the response has been extensive, with around 149 people currently hospitalised and survey teams conducting door-to-door checks. By 31 December, 2025, nearly 2,700 houses had already been covered.

The survey has been extended to other surrounding areas in Indore to check the water quality and to know whether the contamination has spread beyond Bhagirathpura, which was the initial epicentre. for precaution, ASHA workers and Auxiliary Nurse Midwives are also distributing oral rehydration solution (ORS) to residents.