"This is a tragic reminder that the 2022-23 flu season is already an active one. As we approach the holidays, I strongly recommend that persons 6 months of age and older get a flu shot," said DPH Commissioner Manisha Juthani, MD.

Commissioner Juthani added that as of Nov. 26, there were about 6,000 flu cases reported in the state and 102 hospitalizations. Flu season occurs between October and May; however, the highest levels of influenza are traditionally seen between December and March. Symptoms include fever, cough, sore throat, muscle aches, chills, congestion, and fatigue.

"We have not had a flu season this early over the last four years," Juthani said at a press conference on Nov. 28. "And it is continuing to trend up. We can only expect that [cases] will get higher," adding, "I am still of the belief that COVID will surge. This is the first season we've had with all these viruses competing with each other. My guess is that we will still see a COVID peak, maybe in January or February."

The CT Department of Public Health says that spreading respiratory viruses like the flu, COVID-19, and respiratory syncytial virus (RSV) can be prevented through handwashing, remaining home when sick, disinfecting surfaces, and masking if you have any respiratory symptoms. At this time, the Department recommends that all Connecticut residents should also ensure that they have received their annual flu shot and are up to date on COVID-19 vaccines, including recommended boosters.

According to a CT Mirror report, the state has already been weathering a flood of RSV cases among kids. Leaders at children's hospitals worry the rising flu cases will worsen the crowded situation in intensive care units and emergency departments.

"For the last six weeks, we have been over capacity, which means we've had an average of 15 to 20 children who require admission, but they haven't been able to be brought up to one of our inpatient beds," said Dr. Juan Salazar, physician-in-chief at Connecticut Children's Medical Center, in a CT Mirror interview this month. "So they're remaining in our emergency department bays, awaiting a bed to open to be able to move them upstairs."

"One of the things that is challenging from a pediatric perspective is that we don't have a very deep bench of providers … we may have people, for example, who are in the National Guard or other places who could be brought in for adult care. But unfortunately, a lot of the people who have that type of skill set are already working in our pediatric hospitals. So that is a little bit of a challenge," Commissioner Juthani said.

"The spread of respiratory viruses like the flu, COVID-19, and respiratory syncytial virus (RSV) can be prevented through proper respiratory virus etiquette. These practices include handwashing, remaining home when sick, disinfecting surfaces and masking if you have any respiratory symptoms. Flu and COVID-19 vaccines are the best way to protect yourself and your family. Both vaccines are effective at preventing severe illness, hospitalization, and death."

But what is RSV?

According to the Centers for Disease Control and Prevention, Respiratory syncytial virus, or RSV, is a common respiratory virus that usually causes mild, cold-like symptoms. Most people recover in a week or two, but RSV can be severe, especially for infants and older adults. RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia (infection of the lungs) in children younger than one year of age in the United States.

People infected with RSV usually show symptoms within 4 to 6 days after getting infected. Symptoms of RSV infection usually include

• Runny nose
• Decrease in appetite
• Coughing
• Sneezing
• Fever
• Wheezing

These symptoms usually appear in stages and not all at once. In very young infants with RSV, the only symptoms may be irritability, decreased activity, and breathing difficulties.

Almost all children will have had an RSV infection by their second birthday.

RSV can spread when

• An infected person coughs or sneezes
• You get virus droplets from a cough or sneeze in your eyes, nose, or mouth.
• You have direct contact with the virus, like kissing a child's face with RSV.
• You touch a surface with the virus, like a doorknob, and then touch your face before washing your hands.
• People infected with RSV are usually contagious for 3 to 8 days and may become contagious a day or two before showing signs of illness. However, some infants, and people with weakened immune systems, can continue to spread the virus even after they stop showing symptoms for as long as four weeks. Children are often exposed to and infected with RSV outside the home, such as in school or childcare centers. They can then transmit the virus to other members of the family.
• RSV can survive on hard surfaces such as tables and crib rails for many hours. It typically lives on soft surfaces such as tissues and hands for a shorter time.

Care

Most RSV infections go away on their own in a week or two.

There is no specific treatment for RSV infection, though researchers are working to develop vaccines and antivirals (medicines that fight viruses).

How can you relieve symptoms?

• Manage fever and pain with over-the-counter fever reducers and pain relievers, such as acetaminophen or ibuprofen. (Never give aspirin to children.)
• Drink enough fluids. It is essential for people with RSV infection to drink enough fluids to prevent dehydration (loss of body fluids).
• Talk to your healthcare provider before giving your child nonprescription cold medicines. Some medicines contain ingredients that are not good for children.

RSV can cause more severe health problems

RSV can also cause more severe infections, such as bronchiolitis, an inflammation of the small airways in the lung, and pneumonia, an infection of the lungs. It is the most common cause of bronchiolitis and pneumonia in children younger than one year of age.

Healthy adults and infants infected with RSV do not usually need hospitalization. But some people with RSV infection, especially older adults and infants younger than six months, may need to be hospitalized if they have trouble breathing or are dehydrated. In the most severe cases, a person may require additional oxygen, IV fluids (if they can't eat or drink enough), or intubation (have a breathing tube inserted through the mouth and down to the airway) with mechanical ventilation (a machine to help a person breathe). In most of these cases, hospitalization only lasts a few days.

People at High Risk for Severe RSV Infection

Most people who get an RSV infection will have a mild illness and recover in a week or two. Some people, however, are more likely to develop severe RSV infection and may need to be hospitalized. Examples of severe infections include bronchiolitis (inflammation of the small airways in the lung) and pneumonia. RSV can also make chronic health problems worse. For example, people with asthma may experience asthma attacks because of RSV infection, and people with congestive heart failure may experience more severe symptoms triggered by RSV.

How can RSV be Prevented?

There are steps you can take to help prevent the spread of RSV. Specifically, if you have cold-like symptoms, you should

• Cover your coughs and sneezes with a tissue or your upper shirt sleeve, not your hands
• Wash your hands often with soap and water for at least 20 seconds
• Avoid close contact, such as kissing, shaking hands, and sharing cups and eating utensils, with others
• Clean frequently touched surfaces such as doorknobs and mobile devices

Residents can receive their flu vaccine from their health care provider, a retail pharmacy, or by visiting www.vaccines.gov to find a flu vaccination clinic.

The DPH and the Connecticut Immunization Coalition are partnering with local health departments throughout the state on numerous flu vaccine clinics for children and adults. The entire schedule of local health flu clinics can be accessed at www.ct.gov/dph/fluclinics.