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.

Indian drugmaker Dr Reddy's Laboratories is now gearing up to launch its generic semglutide injection in the country in March under the brand name Obeda, reported the news wire agency Reuters. Patent protection for semglutide expires in India in March 2025. This has triggered a rush among Indian drugmakers to come up with lower-cost versions.

Semaglutide is the active ingredient in Danish drugmaker Novo Nordisk's Ozempic and Wegovy, popularly known as the weight loss drugs, but also effective for diabetes and used primarily for that.

Indian Drugmakers Rush For Generic Weight Loss Drugs

Hyderabad-based Dr Reddy's already applied for trademark with the brand name Obeda and a logo, reported Reuters, based on a government filing. In an email response to Reuters, Dr Reddy's spokesperson said, "As semaglutide is yet to be officially launched, it would not be appropriate to refer to or publish any name as the brand name at this stage."

Other companies like Sun Pharma, Zydus Lifesciences, and Nacto Pharma too are entering the rat race of launching multiple generic versions to make the treatment more affordable for patients with obesity and weight-related health risks.

Sun Pharma also announced the plans for "day-one" launches of generic prefilled pens.

Will Launching Generic Weight Loss Drugs Make It Cheaper To Buy?

Until the patent is expired, the semaglutide therapies are owned by the original company. In India, semaglutide injections like Ozempic and Wegovy are soled at a high cost that has limited accessibility to many patients.

Industry analysts, as reported by NDTV, expect that one generic semaglutide enters the market from March 21, 2026, prices could be cut roughly by 50 per cent as compared to the prices it started with. This means Wegovy which was previously sold for around Rs. 10,000 per month could fall somewhere between Rs 3,500 to Rs. 4,000 per month for starter doses.

Dr Reddy's Laboratories have positioned their generic brands competitively, and could potentially offer discounts of up to 50 to 60 per cent in early competition.

How Does Semaglutide Work?

Semaglutide works as a GLP-1 receptor agonist that mimics the GLP-1 hormone to regulate appetite and blood sugar. It slows gastric emptying and makes you feel fuller longer. It also signals the brain to reduce hunger and cravings, and triggers the pancreas to release insulin when blood sugar is high.

Read: Wegovy And Ozempic Will Cost Less In 2027, Novo Nordisk Slashes Weight Loss Drugs Prices By Half

They work by increasing insulin release in a glucose-dependent manner, decreasing the liver's production of glucagon, and slowing down the emptying of the stomach, which helps lower blood sugar levels after a meal. They also act on the brain to suppress appetite and increase feelings of fullness, leading to reduced calorie intake.

In people with type 2 diabetes, notes Harvard Health, the body's cells are resistant to the effects of insulin and body does not produce enough insulin, or both. This is when GLP-1 agonists stimulate pancreas to release insulin and suppress the release of another hormone called glucagon.

These drugs also act in the brain to reduce hunger and act on the stomach to delay emptying, so you feel full for a longer time. These effects can lead to weight loss, which can be an important part of managing diabetes.

Scientists for the first time ever developed antibodies that could block Epstein Barr virus or EBV. This is a pathogen that is estimated to infect 95 per cent of the global population. The Epstein Barr virus is also linked with multiple types of cancer, neurodegenerative diseases and other chronic health conditions.

Antibodies for Epstein Barr Virus: How Does It Work?

Scientists used mice with human antibody genes. The team then developed new genetically human monoclonal antibodies that would prevent two key antigens on the surface of the Epstein Barr virus from binding to entering human immune cells.

The findings are published in Cell Reports Medicine. The study shows how the newly identified monoclonal antibodies successfully block infection in mice with human immune systems when they had EBV.

Scientists View On The Antibodies That Block Epstein Barr Virus

"Finding human antibodies that block Epstein Barr virus from infecting our immune cells has been particularly challenging because, unlike other viruses, EBV finds a way to bind to nearly every one of our B cells," explained Andrew McGuire, Ph.D., a biochemist and cellular biologist in the Vaccine and Infectious Disease Division at Fred Hutch. "We decided to use new technologies to try to fill this knowledge gap and we ended up taking a critical step toward blocking one of the world's most common viruses."

What Was the Challenge In The Creation Of Antibodies To Block Epstein Barr Virus?

The key challenge was to pursue human monoclonal antibodies that could actually halt the Epstein Barr virus infection without triggering an anti-drug response to the antibodies themselves. This is a common response among patients who are treated with antibodies raised in other animals.

The researchers targeted two antigens namely: gp350, which helps EBV bind to cell receptors. The second antigen was gp42 that allows EBV to enter and infect human antibody genes. This has led to the monoclonal antibodies to work against gp350 and eight gp42.

"Not only did we identify important antibodies against Epstein Barr virus, but we also validated an innovative a new approach for discovering protective antibodies against other pathogens," noted Crystal Chhan, a pathobiology Ph.D. student in the McGuire Lab. "As an early-career scientist, it was an exciting finding and has helped me appreciate how science often leads to unexpected discoveries."

Read: Chronic Epstein-Bar Virus: Can A Common Viral Infection Cause Fatal Brain Damage?

What Is Epstein Bar Virus (EBV)?

EBV is a highly contagious virus that can pass through bodily fluid contact. It is the cause of one of the most common infections, mononucleosis or mono. Once you get this virus, it stays in your body, inactive and in a dormant state until it becomes reactivated.

According to the Frontiers in Immunology, Chronic active Epstein-Barr virus (CAEBV) disease is a very uncommon problem where people's bodies can't fight off the EBV virus. It keeps getting worse, with a lot of the virus's DNA in their blood and the virus attacking their organs with infected blood cells.

People with this disease often have fevers, swollen glands, a big spleen, liver problems caused by EBV, or low blood counts. Over time, their body's ability to fight off infections gets weaker. If they don't get treatment, they can die from other infections, a problem where the body attacks its own blood cells, organ failure, or cancers linked to EBV.

The only treatment that has been proven to work for this disease is a stem cell transplant (a procedure to replace damaged blood cells with healthy ones). Right now, scientists are trying to figure out why this disease happens. They are looking at problems with the body's defense system (immune defects) and changes in people's genes that might be linked to the disease. A new study as also revealed that EBV may also cause us brain damage due to a disease called encephalitis.

Symptoms Of Epstein-Bar Virus

EBV infections do not cause symptoms especially for children, teens and adults are more likely to experience symptoms like fever, feeling tired or fatigued headache, sore throat, swollen lymph nodes in your neck and arm, enlarged spleen or swollen liver, body aches and skin rash. The symptoms of this usually last for two to four weeks. Things are a bit different with Chronic EBV. In rare cases of EBV, it can lead to a chronic condition called active EBV (CAEVB) some symptoms include, swollen and tender lymph nodes, fever, enlarged liver, fatigue, sore throat, headache, muscle pain joint stiffness, anemia and liver failure.

Meghalaya's Health Minister Wailadmiki Shylla has raised alarm over the rising HIV cases in the state, noting that 10,293 infected residents were receiving antiretroviral treatment.

Along with this, Shylla noted that nearly 750 people have died due to the condition in the past decade with East Khasi Hills district reporting 435 of those cases. Coming in second is West Jaintia Hills with 123 cases, East Jaintia Hills with 90 cases, Ri Bhoi with 51 cases and Eastern West Khasi Hills reporting 16.

Nine deaths in West Garo Hills, eight in West Khasi Hills, seven in South West Khasi Hills, three in South Garo Hills, two in South West Garo Hills, and one in North Garo Hills have also been recorded.

During a question hour in an assembly session on February 25, the official said: "It is very unfortunate, but Meghalaya is having the highest cases in India".

He also highlighted the confidentiality clauses in the HIV and AIDS Prevention and Control Act, 2017 as well as existing social stigma as major challenges in addressing the rampant spread of the issue. “Early detection and intervention get complicated because testing requires consent and treatment cannot be forced,” he said.

“The State government has sanctioned a ₹25-crore intervention program for the next five years to address the alarming rise in HIV/AIDS cases,” Shylla declared as well as assured that the Department has been intensifying awareness campaigns to improve testing and treatment.

The global challenge of HIV/AIDS remains one of the most pressing public health issues today. According to the latest data from UNAIDS, around 38.4 million people worldwide are living with HIV/AIDS.

As of 2024–2025, India has approximately 2.5 million to 2.56 million people living with HIV (PLHIV), marking the third-largest HIV epidemic globally, underlining the need for not only medical intervention but also comprehensive awareness, education, and social change.

What Is HIV?

HIV is the virus responsible for attacking the body’s immune system, specifically targeting CD4 cells, which are crucial for the body’s defense against infections. As HIV progresses, it destroys these cells, weakening the immune system over time. If left untreated, this continuous damage can lead to AIDS.

HIV is highly contagious and can be transmitted through the exchange of bodily fluids such as blood, semen, vaginal fluids, and breast milk. It is primarily spread through unprotected sexual contact, sharing needles, from mother to child during childbirth or breastfeeding.

Without treatment, HIV progresses through three stages:

- Acute HIV Infection: This stage occurs shortly after transmission and may include symptoms like fever, fatigue, and swollen lymph nodes.

- Chronic HIV Infection: Often asymptomatic or mildly symptomatic, the virus continues to damage the immune system but at a slower rate.

- AIDS: This is the final stage, marked by severe immune damage and the presence of infections that take advantage of the compromised immune defenses.

The disease is diagnosed through blood tests or oral swabs that detect the presence of the virus or antibodies produced by the immune system in response to the virus. Early detection of HIV is crucial, as it allows for timely intervention and treatment, which can prevent the virus from progressing to AIDS.

For HIV, the primary treatment goal is to suppress the virus to undetectable levels, thus maintaining a strong immune system and preventing further transmission of the virus. People living with HIV can often live long, healthy lives if they adhere to antiretroviral therapy (ART).

What's Happening In Mizoram?

Mizoram Health Minister Lalrinpuii has expressed serious concern about rising HIV cases, as data shows that cases in the state are 13 times higher than the national average.

Calling it a "collective disgrace", Lalrinpuii said: “About 70 per cent of HIV transmissions in Mizoram occur through sexual contact. While the national prevalence rate stands at a mere 0.2 per cent, Mizoram’s rate has climbed to 2.74 per cent. This is a matter of shame for Mizo society.”

Speaking at an event organised for International Condom Day in Aizawl on February 13, she noted that a majority of that sexual contact remains the primary route of HIV infections in the state, accounting for 70 per cent of all cases.

The minister noted that the spread is largely driven by infidelity and a lack of preventive measures, which she argued contradicted the moral and religious values of the Mizo society.

She urged the people of the state to remain faithful to their partners. “To protect the future of Mizoram, our youth must remain vigilant,” Lalrinpuii added.