Latest / Culture Positive: An Infection Prevention Podcast / Flu, COVID, RSV, Oh My!
Transcript
- Ally: Welcome to Culture Positive, an infection prevention podcast where healthcare, public health, and real life meet. I'm Allie, and by day I work in infection prevention at an academic hospital, bringing my background in epidemiology and public health into everyday practice. Each week, We'll dive into healthcare stories, public health conversations, workplace realities, and the human side of this work. This is a space for curiosity, honesty, and hopefully some inspiration. I'm glad you're here. I am a total fall girly. I love the cooler weather, being able to throw on a sweater and jeans, the holidays, the food. I just love this time of year. Fall is great except for one thing. It means respiratory season is here. It's funny because you can almost tell when fall is approaching. By how people react to the idea of respiratory season. Nobody wants to be the first person to say it out loud. It's almost like if you say the words respiratory season, you're gonna jinx yourself and suddenly start seeing flu A and rhinovirus patients popping up positive everywhere. Well, folks, I hate to say it, but respiratory season is here. And it's actually getting off to quite a start. If you work in a hospital or another healthcare setting, you may have already noticed an increase in respiratory illnesses, particularly flu A. And here's the thing, we're still at the beginning of the season, so there's likely more to come. So what exactly are infection prevention dust monitoring during a respiratory season? What does it actually look like when you're managing a respiratory outbreak? And what can you do to protect yourself and your loved ones? Flu, COVID, and RSV. my. Let's get into it. So, what exactly is this ominous respiratory season I keep referring to? When does it start? Which illnesses are we talking about? And why does it keep infection preventionists so busy this time of year? Respiratory virus activity typically increases in the fall and winter, although timing and severity can vary from year to year. For those of us working in healthcare, this means preparing for an increase in respiratory illnesses, keeping an eye on data. Reviewing isolation precautions and helping prevent transmission within our facilities. The CDC's outlook for the 2026-2027 season projects that combined peak hospitalizations for COVID, influenza, and RSV could be similar to last season. And while flu and COVID vaccines have been updated for this season, respiratory viruses are still something we need to take seriously. I recently got my flu and COVID vaccines, and I hope you will too. Vaccination is an important way to help protect yourself and those around you, especially people who are at higher risk of severe illnesses. Now let's break down the big three: influenza, RSV, and COVID-19. Let's start with the flu. Millions of people in the US get influenza each year. Influenza, or the flu, is a contagious respiratory illness caused by influenza virus. Like the common cold, you can catch it by breathing in the virus after someone sneezes or coughs. Flu is an infection that requires isolation if a patient is positive for flu in the hospital. Droplet isolation includes visitors, staff members, and care teams wearing a mask in order to protect themselves and mitigate the transmission to others. This becomes particularly important in the respiratory season and can become crucial in a possible outbreak investigation. We can touch more on that later. flu symptoms usually come on suddenly. Generally people feel feverish and achy for three to five days. Other symptoms like coughing can last up to six weeks. People are most contagious during their first three days of getting the flu. If you have the flu, you may have some or all of the following symptoms. Fever chills, cough, sore throat, runny nose, muscle or body ache, headaches, fatigue. Vomiting and diarrhea. As I mentioned, I already got my flu vaccine. Several flu vaccine options are available. In addition to the standard injectable vaccine, a live weakened virus nasal spray vaccine is available for people ages 2 through 49. It can be self-administered or given by a caregiver, though it isn't recommended for people with certain health conditions. On to another infection, RSV. This is an infection of the lungs and respiratory tract that causes cold-like symptoms. Anyone can get RSV, but severe disease causing hospitalization is more common in infants and toddlers, as well as people over the age of 75. Symptoms are not surprising with runny nose, cough, fever, sneezing, wheezing, and a decrease in appetite being reported. can lead to severe infection in infants and premature infants, older adults, and people with heart and lung disease, with weakened immune systems, and people who live in nursing homes or long-term care facilities. in severe cases, symptoms can progress to cause pneumonia or broncholitis. For RSV patients, they will be put on droplet contact isolation due to the nature of transmission. Droplets from a cough or sneeze that contain the virus get in your eyes, nose, or mouth, or if you have direct contact with someone with RSV, like kissing the face of a child with RSV. Something relatively new since 2023 that is very exciting is a vaccine for RSV. A single dose for the RSV vaccine is recommended for all adults over the age of 75. Adults 50 to 74 at higher risk for severe RSV disease, we're thinking chronic lung disease or cardiovascular disease. Another group that may be recommended to get the vaccine are pregnant individuals, especially if they're between 32 and 36 weeks, from September to January. The idea of this being some immunity being shared with the baby if they are being born during the time frame of traditional respiratory season. whose mothers didn't receive the vaccine during pregnancy, and some high-risk older babies may be recommended an injection of an antibody against RSV. And to wrap up a respiratory illness review, COVID-19. COVID-19 is a contagious disease caused by SARS-CoV-2 virus. Like other illnesses that affect the respiratory system, It is spread through droplets that are exhaled or expelled by an infected person and enter another person's body, landing in their eyes, nose, or mouth. COVID-19 can spread from someone with minimal symptoms. People most at risk for severe symptoms include adults age 65 or older, people with certain chronical medical conditions, once again thinking lung disease or heart disease, and those who have a compromised immune system. COVID 19 symptoms usually appear 2 to 14 days after exposure and can range from mild to severe, including fever or chills. Shortness of breath, difficulty breathing, fatigue, body aches, nausea or vomiting. Since the emergence, COVID-19 has required airborne isolation, which requires special PPE if you're in the hospital. Instead of a surgical mask, you will see care teams wearing N95s as their protection. for this respiratory season, we are already seeing a steep increase in the community for flu A. And when we see an increase in the community, healthcare settings need to be prepared to treat those patients along with protecting those who are not currently sick with a respiratory illness. Now here's where this becomes particularly important for those of us working in infection prevention. When flus start circulating in the community, we aren't just thinking about the individual patient who comes into the hospital feeling not so hot. We're also thinking about everyone around that patient. Could they have exposed other patients? When were they admitted to the hospital? Were they in a shared room? Did they spend a lot of time in a waiting room? Are any other patients or healthcare workers developing similar symptoms? Did the patient have a recent visitor who was also not feeling well? One positive flu test doesn't automatically mean there's an outbreak. But when we start seeing cases that may be connected, that's when we need to pay attention, investigate what's happening, and work with our hospital teams to prevent further transmission. A flu investigation can create a lot of extra work for infection preventionists, the care team, ancillary teams, and honestly the patients themselves. Okay, I'm bringing up the R naught again. Essentially the reproduction number helps us understand how infectious a virus is estimating how many people one infected person might go on to infect. Per seasonal influenza, each infected person can typically transmit the virus to about one or two other people. Now think about that in a hospital, a school, or another congregate setting. If one or two people become sick with the flu, additional cases can follow, particularly when people are in close contact and prevention measures aren't in place. What starts as an isolated case can turn into a cluster of cases. or even an outbreak. that's why identifying your first known case, often called the index case, and figuring out how the flu might have spread are such important parts of an investigation. let's say you now have three patients who have tested positive for flu. what are some of the first questions I would ask? To start tracing this cluster. Are there rooms next to each other? Did any of these patients have the same nurses or doctors caring for them? Have any staff members who interacted with these patients reported feeling sick? And don't stop with the clinical care team. We also need to think about our environmental services colleagues and other staff who may have interacted with these patients or shared spaces. These are just some of the questions that can help us start connecting the dots and figuring out whether these cases might be related. Hopefully, you won't find yourself in a situation where you need to lead an investigation like this, but it can happen. And while investigating a cluster is important, we also want to prevent additional cases from occurring in the first place. So, what can we do to help prevent influenza or respiratory illnesses in general from spreading in the hospital? First, as always, hand hygiene. Making sure staff, healthcare teams, and visitors are practicing good hand hygiene is such an important part of infection prevention. Next, we need to make sure we're following appropriate masking and isolation precautions. In a healthcare setting, that means identifying patients with suspected or confirmed influenza, implementing the facility's recommended precautions. And making sure staff and visitors understand how to protect themselves and others. This oftentimes includes staff and visitors wearing surgical masks as their own personal protective equipment. And let's not forget environmental cleaning. While influenza transmission is primarily associated with respiratory particles, contaminated hands and surfaces can also play a role. Routine cleaning and disinfection are important. with particular attention to high-touch surfaces and shared spaces. Think about staff break rooms, shared computers, nursing stations, and other areas where people gather throughout the day. And finally, vaccination. When talking about flu, flu vaccination is an important way to reduce your risk and its complications. Many healthcare facilities also have influenza vaccination requirements for their staff, because protecting healthcare workers helps protect patients too. All of these strategies work together. We're not relying on one single intervention to stop transmission. We are using multiple layers of protection to keep patients. Healthcare workers and visitors safe. Now let's talk about what's making this particular respiratory season interesting. We're already hearing reports of flu activity picking up earlier than usual in parts of the United States. Some areas on the West Coast have seen levels of flu positivity that would be more typical later in the season, and activity appears to be spreading to other regions. Typically, we think of flu season ramping up as more into the holiday season, November through January. But viruses don't necessarily follow the calendar, and this is a good reminder that we can't rely on previous seasons to predict exactly what we'll see next. For infection preventionists, this matters because an early increase in community cases can mean earlier need to reinforce prevention strategies, monitor any healthcare-associated transmission, and prepare for potential outbreaks. So if you haven't already, the call to action is now to protect yourself, your family, your patients, and your colleagues. For our Huddle Corner, a section for some takeaways before signing off. Respiratory season is here, whether we like it or not. And while we can't prevent every infection, we can absolutely take steps to reduce transmission and protect the people around us. And vaccines. Please get your flu and COVID vaccines. Vaccines are an incredible prevention tool, helping protect you and the people around you from serious illness. Remember, Wash your hands, wear a mask when appropriate, and stay at home when you're not feeling well. This will help prevent spreading infections to others. Whether you're working on the front lines, supporting patients behind the scenes, or helping guide prevention efforts across a facility, we all play a role in keeping people safe. And if you take one thing away from today's episode, let it be this. Do your part to help prevent respiratory infections and please get your vaccines. Thank you for listening to Culture Positive. If you have any questions or ideas for an episode, please send me an email at CulturePositive Pod at gmail.com. You can also Thank you for listening to Culture Positive. If you have any questi Nope. find me on Instagram at CulturePositive Pod. Please like, share, and review the podcast wherever you listen. References for the episode can be found in the notes. Infection prevention is about more than policies and protocols. It's about people. Until next time, stay curious, stay compassionate, and keep building a culture that's truly positive.