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.

The Union Minister of Health and Family Welfare, JP Nadda, today launched two key national initiatives -- the Strategy for Artificial Intelligence in Healthcare for India (SAHI) and the Benchmarking Open Data Platform for Health AI (BODH) to boost the role of AI in the country's healthcare ecosystem.

The initiatives, launched at the India AI Summit at Bharat Mandapam, in the national capital, are aimed at promoting safe, transparent, and accountable AI in healthcare. It will also help strengthen the digital health ecosystem for equitable healthcare access.

What is SAHI and BODH?

SAHI is a national guidance framework to enable the safe, ethical, evidence-based, and inclusive adoption of AI across India’s healthcare system.

It aims to provide strategic direction on governance, data stewardship, validation, deployment, and monitoring of AI solutions, while supporting States and institutions in responsible adoption aligned with public health priorities.

"SAHI is not merely a technology strategy but a governance framework, policy compass, and national roadmap for the responsible use of AI in healthcare,” said Nadda.

He stated that SAHI will guide India in leveraging AI in a manner that is ethical, transparent, accountable, and people-centric. Nadda also emphasized that SAHI provides a structured framework for collaboration, ensuring that innovation flourishes while public interest remains paramount.

The second initiative, BODH, was developed by the Indian Institute of Technology Kanpur in collaboration with the National Health Authority. It is a privacy-preserving benchmarking platform that enables rigorous evaluation of AI models using diverse, real-world health data without sharing underlying datasets.

As a digital public good under the Ayushman Bharat Digital Mission, it is designed to strengthen trust, transparency, and quality assurance in Health AI deployment.

"The collaboration between Government and academia has led to the development of BODH -- the Benchmarking Open Data Platform for Health AI -- which provides a structured mechanism for testing and validating AI solutions before deployment at scale,” said Nadda.

Nadda reiterated that AI solutions must be rigorously evaluated for performance, reliability, and real-world readiness. Together, SAHI and BODH represent India’s commitment to building a trustworthy, inclusive, and globally competitive health AI ecosystem grounded in innovation, responsibility, and public trust.

AI An Indispensable Enabler to Viksit Bharat

Earlier, delivering the keynote address at a session themed “Innovation to Impact: AI as a Public Health Game-Changer”, at the Summit, Anupriya Patel, Union Minister of State for Health and Family Welfare, highlighted AI as an "All-Inclusive Intelligence".

She also emphasized AI's potential in addressing "health inequities across the country".

Patel called technology -- particularly AI "an indispensable enabler" in India's race towards the vision of a Viksit Bharat by 2047.

She highlighted the potential role of AI on India’s vast and diverse population, the rural–urban divide, and the dual burden of communicable and non-communicable diseases, which present unique challenges.

She also noted that AI has been integrated across the entire continuum of healthcare -- from disease surveillance and prevention to diagnosis and treatment.

While the national capital is seeing a significant rise in H3N2 Influenza A cases, experts explained that it's not just the common cold and people must not try to self-medicate.

Speaking to Health And Me, multiple experts stressed the need to treat the virus properly, as its symptoms can last longer and potentially lead to pneumonia.

What Is The H3N2 Virus?

H3N2 is a subtype of the Influenza A virus that causes seasonal flu. The symptoms are often stronger and more persistent, with many patients reporting prolonged fatigue, cough, breathing difficulty, and slower recovery.

It is highly contagious, spreading via respiratory droplets (coughing/sneezing) and contaminated surfaces. The symptoms usually last 5–7 days, with treatment focusing on rest and symptom management.

Dr. Mohit Saran, Consultant - Internal Medicine and Diabetologist, Manipal Hospital, Gurugram, told this publication: “H3N2 is not just a common cold. While symptoms may not appear instantly, they can lead to high fever, constant cough, body pain, and breathing issues. In some people, this can also increase the risk of pneumonia or the need for hospitalization if not managed early.”

The experts attributed the surge in the disease to factors such as changing weather, fluctuating temperatures and reduced immunity.

Who Is At The Highest Risk For H3N2?

Children, youngsters, senior citizens, pregnant women and people with low immunity or with conditions such as asthma, diabetes, or heart problems are more vulnerable to H3N2. Health care professionals and people who are exposed to crowded places may also be affected by this disease.

Dr. Atul Gogia, Head of Infectious Diseases, Sir Ganga Ram Hospital, told Health and Me that the H3N2 virus "predominantly affects elderly people and those who have comorbid illnesses".

"We need to be especially careful because this illness predominantly affects individuals with comorbid conditions, the elderly, and those who are more vulnerable to developing complications that may require hospitalization,” he said.

Why Does H3N2 Last Longer Than The Common Flu?

Symptoms of H3N2 infection can last for two to three weeks, with a lingering dry cough and fatigue being common.

The virus often affects the lower respiratory tract, leading to more intense coughing and breathing discomfort. Young children, older adults, and individuals with chronic health conditions are at higher risk of complications.

"H3N2 is considered more infectious because of its ability to mutate quickly and adapt to the human host. This high mutation rate allows the virus to evade the immune system more effectively and can lead to more severe outbreaks. It spreads easily through respiratory droplets, direct contact, and contaminated surfaces,” explained Dr. Manisha Arora, Director - Internal Medicine at the CK Birla Hospital(R), Delhi told HealthandMe

"Frequent changes in its surface proteins, a process known as antigenic drift, make it harder for the body to recognize and fight the virus, which can result in more hospitalizations and, in severe cases, increased mortality,”

How Can The Disease Be Prevented?

H3N2 can be prevented through regular handwashing, wearing masks in crowded places, avoiding close contact with people who are sick, and avoiding self-medicating. Flu vaccination, timely medical consultation for long-term fever, and adequate rest help reduce the risk and further spread of the condition.

The experts recommended that all adults above 18 consider annual flu vaccination ideally in August or September, unless they are currently experiencing flu-like symptoms.

Maintaining good hygiene, eating nutrient-rich foods, staying hydrated, and following healthy habits can help boost immunity.

Over 70 residents in Supertech Ecovillage-3, Royal Court Society and Himalaya Pride Society, Greater Noida have contracted food poisoning after they consumed a specific batch of buckwheat (kuttu) flour during Mahashivratri this weekend.

The widespread outbreak has caused panic and triggered a police investigation. As a result, officials sealed Prashant General Store, a retail shop in Royal Court Society and HD Spices, a primary warehouse in Chipiyana Buzurg village suspected of selling the spoiled batch.

Moreover, four people including the warehouse owner have now been detained by the Bisrakh police. Assistant Commissioner of Food, Noida, Sarvesh Kumar said lab tests are yet to confirm whether the infection was due to bacterial contamination, fungal toxins or adulteration.

This incident adds to a troubling trend of food and water contamination in the area, a topic that has recently reached discussions in Parliament. Improper storage allows toxic molds like aflatoxins to grow, triggering rapid-onset vomiting and dehydration, especially on the empty stomachs of fasters.

This "Buckwheat flour poisoning" occurs because the flour's high natural oil content makes it highly perishable; when stored in humid or warm conditions, these oils oxidize, creating a breeding ground for toxic molds and bacteria.

Why Is Buckwheat (Kuttu) Flour Harmful For Your Health?

Despite its reputation as a "pure" fasting food, buckwheat flour carries a hidden risk: its high natural oil content. Unlike refined grains, these healthy fats are highly unstable; when exposed to heat or moisture, they oxidize and turn rancid.

This transformation from a nutrient-dense staple to a source of food poisoning commonly occurs when households treat it like a non-perishable grocery item rather than the sensitive, short-lived ingredient it actually is.

The real danger of buckwheat flour lies in storage. Because buckwheat flour is used sporadically, it often sits in pantries in unsealed packets, warm cupboards or humid environments for months and becomes a silent breeding ground for dangerous molds and bacteria over time

The degradation is often hard to spot; a faint bitter aroma or slightly clumpy texture can easily be hidden by the strong spices and oils used in traditional fasting recipes.

Along with this, expired or damp buckwheat flour can harbor aflatoxins and other toxic compounds beneath the surface. Once ingested, these irritants attack the stomach lining, triggering a rapid physical "rejection," usually within just a few hours.

What Is Buckwheat-Caused Food Poisoning?

• Intense Nausea and Vomiting: Usually the first sign, as the body tries to expel the toxins.
• Acute Abdominal Pain: Sharp cramps or bloating in the stomach area.
• Fever and Chills: A sudden rise in body temperature as the immune system reacts.
• Diarrhea (Loose Motions): Frequent and watery stools.
• Extreme Weakness: Feeling dizzy, shaky, or completely drained of energy.
• Dehydration: Dry mouth and reduced urination due to fluid loss.

How To Safely Store Your Flour

• Buy Small, Buy Fresh: Purchase only the amount needed for the current fasting period. Avoid bulk buying buckwheat flour to store for the next season.
• Check the Date: Always look for the manufacturing date. If it’s more than two months old, it may already be turning rancid.
• Airtight & Cool: Transfer the flour to an airtight glass or metal container immediately. Store it in a cool, dry place, or better yet, refrigerate it to slow the oxidation of its natural oils.
• The "Sensory" Test: Before cooking, smell the flour. If it has a bitter, soapy, or musty aroma, throw it away. Fresh buckwheat flour should have a mild, nutty scent.
• Keep it Dry: Ensure your hands and measuring cups are completely dry before touching the flour, as moisture triggers fungal growth.
• Don't Mix Batches: Never mix new flour with old leftovers from a previous fast.

Who Is At The Highest Risk?

While anyone can get food poisoning, women, children and the elderly are at the highest risk. The practice of fasting can actually make the illness more dangerous. On an empty stomach, even a small amount of mold or bacteria can trigger an explosive physical response.

Furthermore, fasting usually involves lower water intake; once vomiting or diarrhea begins, the body loses its remaining fluid reserves instantly, leading to rapid, severe dehydration.