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.

From H. pylori and parasitic infections to metabolic and lifestyle-related conditions, the global burden of gastrointestinal (GI) diseases is changing, said experts at the World Congress of Gastroenterology (WCOG) 2026 in New Delhi today.

Being held in India for the first time, the four-day Congress brings together around 3,000 delegates from 61 countries to discuss the changing burden of gastrointestinal and liver diseases, early diagnosis, prevention and treatment.

Speaking at a media roundtable, Dr Govind Makharia, Professor, Department of Gastroenterology and Human Nutrition Unit, AIIMS New Delhi, stated that "the GI disease burden is changing in both its scale and clinical profile. Alongside infections such as H. pylori and parasitic diseases, metabolic and lifestyle-related conditions are becoming increasingly important".

He stressed the need for making timely diagnosis critical, whether for liver disease, colorectal cancer, celiac disease or IBD.

H. pylori And Cancer Risk

Notably, infections like H. pylori have become a major driver of cancer. A recent Lancet study found that five infections, including H. pylori and HPV, contribute to about 1 in 8 cancers worldwide.

Speaking to HealthandMe, Dr Garg said H. pylori is a very important bacterial infection that resides in the stomach.

“It is very common in India; about 40-60% of people might be affected by this. It has been shown that H. pylori infection can cause swelling in the stomach, can cause ulcers in the stomach, and in some cases may also cause gastric or stomach cancer. It has been classified as a carcinogen,” he said.

However, he stressed that H. pylori infection does not mean a person will develop cancer.

“So, it is not that anybody who is infected with this will develop cancer. This is very, very important for people to understand otherwise, there will be a lot of scare,” he cautioned.

On whether everyone with H. pylori should be treated, Garg said the answer depends on the context.

“In some countries, they are testing and treating; in others we are not advocating routine testing and treating because the other factors which lead to cancer are not fully known in that case.”

Also read: Fatty Liver, Chronic Gut Diseases And Worm Infections: India’s Changing Disease Burden

MASLD And Liver Disease

The experts also discussed colorectal cancers, MASLD and liver disease and stressed the need to strengthen screening, risk stratification, newer pharmacological approaches and identifying patients at risk of hepatocellular carcinoma.

“Gastrointestinal diseases may present differently across populations, but many of the challenges are shared. Earlier diagnosis, access to evidence-based treatment and stronger prevention strategies remain important priorities,” said Professor Carolina Olano, Professor and Director, Department of Gastroenterology, Universidad de la República, Uruguay, and President, World Gastroenterology Organisation.

Alongside these clinical priorities, WCOG 2026 is also highlighting simple measures for better digestive and liver health, including safe food and clean water, a balanced diet, regular exercise and avoiding alcohol.

How Can You Boost Your Digestive and Liver Health

Beyond diagnosis and treatment, the experts also highlighted simple measures that can support digestive and liver health.

1. Wash it. Cook it. Keep it safe.

2. Eat a balanced diet.

3. Eat smart, not large.

4. Eat slowly.

5. Make yoghurt your daily gut friend.

6. Drink water and eat whole fruits, not just fruit juice.

7. Think twice before eating processed, fatty or sugary foods.

8. Your liver is better without alcohol.

9. Exercise daily for better health and long-term wellness.

10. Sharing is caring — but not all the time.

The four-day Congress is jointly organized by the Indian Society of Gastroenterology and the World Gastroenterology Organization under the theme “Transforming Gastrointestinal Health, Preserving Nature.”

A recent Delhi High Court ruling has highlighted reproductive autonomy of women with disabilities. The court dismissed a plea seeking to let a woman with cerebral palsy undergo hysterectomy (uterus removal) solely because she was unable to manage her menstrual cycles independently.

The court stated that “disability can never be the only ground to deny reproductive autonomy”. At the same time, it also said that such surgeries can only be considered if medical experts determine that it is in the person's best interests and would protect their welfare and dignity.

Also Read: We Are Exposed To 93% Of Plastic Chemicals Through Food Packaging, Toys & Clothes: What Are The Health Risks

Delhi HC On Disability And Reproductive Autonomy

The Delhi High Court was hearing a plea from the parents of a differently-abled woman suffering from cerebral palsy with spastic moderate hemiparesis with moderate mental retardation. They had approached the court seeking to let the woman undergo a surgery for removal of the uterus.

According to the petition, the woman was born in March 2005 and had cerebral palsy with spastic moderate hemiparesis and moderate mental retardation.

Her parents argued that her disability was permanent and that she was unable to give consent for the procedure. They also cited difficulties in managing her during menstruation. The court, however, dismissed the plea for the surgery.

Justice Amit Mahajan, instead, directed authorities to constitute an independent multidisciplinary medical board to evaluate whether hysterectomy was medically appropriate. The board was asked to make a decision within four weeks.

The court's stance was that disability by itself cannot justify removing a person's reproductive organs.

The judge said, “It is apposite to mention that disability in itself can never be the only ground to deny reproductive autonomy or approve removal of reproductive organ and thus, such a route of surgical intervention can be adopted if medical evaluations suggest that the same would be in the best interest of the petitioner for protection of her welfare and dignity.”

The court also clarified that allowing the medical board to examine the situation was not the same as approving the hysterectomy.

“The same may not be construed as carte blanche or approval of the surgery, since the opinion on the surgery has to be formed by domain experts, that is, medical experts,” the judge said.

Also read: Trying to Conceive After an Abortion? Key Physical and Emotional Factors to Consider

What Is A Hysterectomy?

Hysterectomy is a surgical procedure to remove the uterus. Depending on medical reasons, other reproductive organs like the cervix, fallopian tubes or ovaries may also be removed.

After the uterus removal, a woman can no longer become pregnant and will no longer have menstrual periods. It is therefore a major, irreversible procedure that warrants careful consideration.

When Is Hysterectomy Medically Necessary?

Difficulty in managing menstruation due to a disability is not automatically the same thing as a medical indication for hysterectomy. Hysterectomy may be recommended for certain serious medical conditions when other treatments are ineffective or inappropriate.

Dr. Renu Raina Sehgal, Chairperson - Department of Obstetrics & Gynaecology, Artemis Hospital, Gurugram, told HealthandMe, “Hysterectomy is not indicated for disability alone. It may be considered if a woman has heavy bleeding, pain, fibroids, cancer and another problem with her uterus.”

Doctors also believe that women with disabilities may have difficilty in managing heavy periods and other symptoms difficult.

Dr. Anagha Chhatrapati, Senior Consultant Gynaecologist, Gleneagles Hospital, told HealthandMe, “For a woman with severe physical or cognitive disability, managing recurrent heavy periods may be particularly difficult, but less invasive options should generally be considered first. The decision should be individualised, medically justified, and made with the woman’s informed consent, wherever she has decision-making capacity.”

Also read: Rare Pregnancy Infections Linked To 3-Fold Higher Autism Risk: What Is TORCH?

Experts On The Court's Ruling

Delhi High Court’s ruling focuses on medical necessity and reproductive autonomy for disabled women. People with disabilities may require additional support to manage menstruation and reproductive needs. But the need for assistance does not, by itself, mean that an irreversible reproductive surgery is appropriate.

Dr. Raina Sehgal said, “Removal of the uterus cannot be done solely on the wishes of the patient or caregivers. There must be a valid medical indication and in cases involving mental illness and severe debilitating conditions, approval of an appropriate medical board may also be required. Disability may affect care needs but should never automatically determine hysterectomy.”

Alternatives For Disabled Women Besides Hysterectomy

The doctors also explain that women with disability have several alternatives to an irreversible surgery.

Dr. Raina Sehgal said, “Alternatives may include menstrual management with hormonal medications, a hormonal intrauterine device, pain management, management of underlying conditions and endometrial ablation in selected women. Practical support, accessible menstrual products as well as caregiver support could help.”

Dr. Chhatrapati said that the choice should be individualised based on the woman’s medical needs, preferences, and overall wellbeing.

Risks Of Hysterectomy

It is important to consider alternatives to hysterectomy as it is not only irreversible but also has some risks.

Dr. Chhatrapati said, “Hysterectomy can lead to bleeding, infection, blood clots and injury to nearby organs such as the bladder or bowel. Recovery can take several weeks, depending on the type of surgery and the woman’s overall health. It also permanently ends the ability to carry a pregnancy and, if the ovaries are removed, can cause surgical menopause.”

Cholera deaths increased by 30% in 2025, reaching their highest level since 1999, according to a new report by the World Health Organization (WHO).

In 2025, 47 countries reported 451,499 cholera cases and 7,870 deaths to WHO. The actual global burden is likely substantially higher, as many cases go unreported.

“The rise in cholera deaths is a reminder of the challenge ahead,” said Dr Chikwe Ihekweazu, Executive Director of WHO's Health Emergencies Program.

“No one should be dying from cholera today when we have the tools to prevent and treat this disease,” he added.

7 Countries Account For 90% Of Global Cholera Toll

Seven countries accounted for around 90% of reported cholera cases and deaths globally in 2025:

• Angola
• Bangladesh
• The Democratic Republic of the Congo
• Nigeria
• South Sudan
• Sudan
• Yemen

The WHO African Region recorded the largest burden, with cases rising 34% and deaths 58% from 2024.

Further, the WHO stated that more than one in five reported cholera deaths occurred outside health facilities, showing that many patients are still not reaching care in time.

Among patients treated in health facilities, the global fatality rate remained below 1%, the threshold for adequate care. However, it exceeded 1% in 12 countries.

The WHO called for targeted investments in safe water, sanitation and hygiene, along with stronger surveillance, vaccination and access to quality care, to reverse the trend.

The WHO report also covered bacterial meningitis and plague.

Vaccination Behind Declining Bacterial Meningitis Cases

Read More: Kent Meningitis Outbreak: Scientists Find Genetic Changes Behind Severe Disease

The African meningitis belt, stretching from Senegal to Ethiopia, continues to face a substantial burden. In 2025, 24 of 26 countries reported 21,526 suspected cases and 971 deaths, a fatality rate of 4.5%.

However, among countries reporting data for both years, cases declined 5.9% from the previous year.

Since the meningococcal A conjugate vaccine was introduced in 2010, serogroup A cases have fallen by more than 99% among vaccinated populations.

In 2025, Niger became the first country to conduct a nationwide campaign with the broader Men5CV/MMCV vaccine.

Plague Cases Reported In 10 Countries

Between 2019 and 2025, 10 countries reported suspected human plague cases to WHO, with six reporting confirmed cases.

A total of 3,847 suspected cases and 423 deaths were reported, giving a case fatality rate of 11%.

Most cases came from the Democratic Republic of the Congo and Madagascar, where plague remains endemic in some areas.

What Is Cholera?

Cholera is an acute diarrheal disease caused by Vibrio cholerae bacteria and spreads through food or water contaminated with feces.

It is preventable and treatable but can be fatal when severe dehydration is not treated quickly. Global production of oral cholera vaccines more than doubled from around 30 million doses in 2022 to approximately 80 million in 2025.

What Is Meningitis?

Meningitis is inflammation of the tissues surrounding the brain and spinal cord. Bacterial meningitis is the most serious type and can be life-threatening.

What Is Plague?

Plague is a bacterial disease that usually spreads among animals through fleas but can also infect humans. Surveillance of rodents and other animal populations and rapid outbreak response remain important for preventing transmission.