A ‘quad-demic’ hit NC this winter, and now a 5th virus is spreading. How to stay safe
North Carolina is in the midst of a “quad-demic,” meaning at least four viruses are spreading this winter. Those who are susceptible to getting sick could experience some severe symptoms.
Due to the spike, hospitals throughout the state including Duke Health, UNC Health and WakeMed enacted visitor restrictions to contain the spread, The News & Observer reported.
A fifth virus is also starting to circulate, and it’s brutal.
We talked to Dr. David Weber, an infectious disease specialist at the UNC School of Medicine, to learn which illnesses are spreading across North Carolina and how to best protect ourselves against them.
Viruses going around North Carolina
COVID-19, flu, RSV and walking pneumonia continue to spread across the state, Weber said, but some viruses are circulating faster than others.
“We’re seeing substantial increases in influenza and RSV,” Weber said, adding there has also been a “small bump” in COVID-19 cases.
Walking pneumonia cases are going down, but doctors are still seeing more cases this year than expected.
There has also been an uptick in cases of norovirus (or “winter vomiting disease”), since it’s more common in the winter, Weber said.
What’s norovirus?
Norovirus is a very contagious gastrointestinal illness that is the leading cause of vomiting, diarrhea and foodborne illness in the U.S. Anyone can get infected with norovirus, but children younger than 5 years old, older adults and people with weakened immune systems are more likely to develop severe infections. (Info: CDC)
Simple definitions for the other viruses circulating North Carolina:
▪ COVID-19: A contagious and easily spreadable respiratory illness caused by a virus. Anyone infected can spread it, even if they don’t have symptoms. Over 1 million people in the U.S. have died from it, and its complications include “long COVID,” which is a chronic condition that can cause permanent disability. (Info: CDC)
▪ Influenza (flu): A contagious and spreadable respiratory illness caused by influenza viruses that infect the nose, throat and lungs. The illness can be mild to severe. (Info: CDC)
▪ Respiratory syncytial virus (RSV): A common respiratory virus that causes mild symptoms in most people, but it’s the leading cause of infant hospitalization in the U.S. It infects the nose, throat and lungs and can be difficult to tell apart from the common cold. (Info: CDC)
▪ Walking pneumonia: A contagious respiratory illness caused by a bacteria. Most infections are mild, although the cough may last for several weeks (and people might not stay in bed when they have it, coining it “walking pneumonia”), but it can cause serious lung infections and require hospitalization. (Info: CDC)
Have flu cases peaked in NC?
No, flu cases have not yet peaked in North Carolina, Weber said.
“We can peak as early as November, and as late as April or May, but we tend to peak late January to mid February, so the numbers are still going up,” said Weber.
Who’s most at risk of catching these winter viruses?
Young children are the most at risk of all four of these respiratory illnesses, and older adults are also at risk, but the general population should be cautious of all of them.
The same can be said for norovirus. Anyone who consumes raw shellfish is at risk of contracting norovirus, according to the CDC.
How to avoid COVID, flu & RSV
There are quite a few ways we can protect ourselves, according to the CDC. Make sure you:
▪ Wear masks: All of these respiratory illnesses can be spread through airborne virus or bacteria particles. Be sure to wear them especially when you’re indoors in large crowds, since we’re seeing case counts increase this time of year.
▪ Get vaccinated: Most people 6 months and older are recommended to get a flu shot and the most recent COVID shot. RSV vaccines are mostly recommended for adults 75 and older and very young children. There’s also a high-dose flu vaccine for older adults. (There’s no vaccine for walking pneumonia or norovirus.) Pregnant people are especially encouraged to get vaccinated to protect themselves and the fetus, Weber said.
▪ Take early therapies: There are simple and effective oral antiviral therapies for flu and COVID, but you need to start them early, Weber stressed. You only have 48 hours from the earliest symptoms for flu cases and five days for COVID cases. (Oral antibiotics can treat walking pneumonia. And while there’s no therapy for RSV, there is a vaccine for older adults and pregnant people.)
▪ Stay safe the old-fashioned way: Cover your nose and mouth when you sneeze, wash your hands with soapy water (or use alcohol-based sanitizer if you can’t), open windows to promote airflow and stay home and secluded when you’re feeling under the weather.
How to avoid norovirus
Here are some tips from the CDC on how to protect yourself against norovirus:
Wash your hands well and often.
Cook shellfish thoroughly, and wash fruits and vegetables.
Clean and disinfect contaminated surfaces.
Wash laundry in hot water.
Stay home when sick for two days (48 hours) after symptoms stop.
Is it too late get a flu, COVID vaccine?
No, it’s not too late to get a flu or COVID vaccine, Weber said.
“It’s not too late to get shots, because it takes three weeks to build immunity” to virus after getting them, Weber said.
An estimated 44% of adults in North Carolina have received their flu shot this season, according to the latest CDC data available.
Where to get a COVID or flu vaccine in NC
Visit covid19.ncdhhs.gov/vaccines and enter your zip code find a vaccine near you. In general, you can also check out:
▪ Pharmacies: Walk in or schedule appointments at national pharmacies like CVS and Walgreens. You can also inquire with local neighborhood pharmacies.
▪ Grocery and big box stores: Walk in or schedule appointments at stores like Walmart, Target, Harris Teeter and Publix.
▪ Your healthcare provider: Of course, you can contact your doctor for an appointment.
The News & Observer’s Kimberly Tutuska contributed to this story.
This story was originally published January 7, 2025 at 3:48 PM with the headline "A ‘quad-demic’ hit NC this winter, and now a 5th virus is spreading. How to stay safe."
