It is possible to get multiple infections at once. Researchers have found cases of people testing positive for both Covid-19 and the flu since the beginning of the pandemic. While respiratory syncytial virus infections are not as common in adults as they are in children and seniors, it is also possible for someone to have Covid and R.S.V. — or any other viral infection, for that matter.
“But it’s not as common as we thought it might be,” said Dr. Michael Chang, a pediatric infectious disease specialist at Memorial Hermann Health System in Houston.
Social distancing and masking during the first two years of the pandemic may have protected people from getting co-infections with other respiratory viruses, Dr. Chang said. And even as R.S.V. and flu cases are reaching record highs this year, in surges that have been labeled a “tripledemic,” these viruses are not peaking at the same time in the same parts of the country.
“If it feels like everyone you know has been sick since the beginning of September, it’s because we’ve had different viruses peak one right after the other,” said Dr. Dana Mazo, an infectious diseases specialist and clinical associate professor of medicine at NYU Langone Health. “In September, we had a lot of rhinovirus and enterovirus, which cause the common cold. At the beginning of October, we saw R.S.V. surge and then flu is sort of peaking right now.” That pattern has varied in different regions of the country.
If you are unlucky enough to get two respiratory infections at once, that doesn’t necessarily mean you will be doubly sick. Your innate immune system, which serves as the body’s first line of defense, is not particularly discerning against different pathogens. So when you get infected with a virus, the innate immune response is already revved up, and could help the body detect and fight off another pathogen. As a result, the second infection may be slightly less severe, or it may resolve a bit sooner.
But because every person’s immune response varies based on their genetics, the kinds of pathogens they’ve been exposed to before and the types of medications they may be using, scientists don’t yet know for sure if everyone experiences that immune benefit. According to Dr. Chang, there’s just as much a chance that one infection will make you more vulnerable to another pathogen. R.S.V., for example, can increase the risk of secondary bacterial infections, such as ear infections, particularly in young children.
Certain other groups may also be more susceptible to co-infection. Pregnant women, people above 65 and those who are immunocompromised are already at high risk for Covid-19, the flu and R.S.V. They may be even more likely to have severe disease if doubly infected. And data shows that people who are opposed to getting one vaccine also tend to refuse others — a trend that has been accelerating because of Covid vaccine misinformation earlier in the pandemic. People who are not vaccinated for Covid or the flu are at higher risk of getting both viruses, Dr. Chang said.
You may not know you have a co-infection unless you get tested for more than one virus. Respiratory infections often have incredibly similar symptoms. And unless you need treatment in a hospital, doctors said that infection management would be the same regardless of what you infection have: rest at home and recover with plenty of fluids and a few over-the-counter medicines. But if your symptoms are serious, or you have trouble breathing, you should talk to a health care provider and see if you are eligible for antiviral treatment.
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