A recent report out of Israel that an unvaccinated pregnant woman had contracted both the flu and the coronavirus simultaneously — a phenomenon dubbed “flurona” — sent pandemic-weary people scurrying for more information.
Despite the concerns, flurona is not a recent development — nor is it a novel virus or disease. Rather, flurona is a coinfection of the flu and coronavirus. Similar cases have been reported since early 2020, when the pandemic first took hold.
So what do we know about flurona — and just how serious is it? Here’s a look below.
Why are these cases drawing widespread attention now?
Israeli authorities confirmed the country’s first case of an individual infected with both the seasonal flu and COVID-19 at the same time in December. The woman only developed mild symptoms and was released in “good condition,” the Times of Israel reported. The country has recorded a spike in flu cases in recent weeks, raising fears of a “twindemic” that was not realized last year.
Some outlets reported that it was the first such case of flurona globally — although multiple studies, including one out of Wuhan, China, where COVID-19 is believed to have originated, have concluded otherwise. The Atlantic reported on the “double-whammy” in November, noting an entire family in New York City had come down with COVID and the flu in February 2020.
Cases have been reported in several states throughout the United States, including in California, Texas, and Kansas. Other countries, among them Brazil, Hungary, and Spain have also confirmed instances of the coinfection.
Will flurona become more common this year?
The short answer is: We don’t know. But with flu activity picking up compared to last year, it’s possible we will see an increase of flurona.
Warnings of a potential twindemic — with experts fearing health systems could become overwhelmed along with the immune systems of individuals — never came to fruition last winter. Coronavirus safety protocols like social distancing and mask-wearing — and later, the arrival of vaccines — along with the virtual disappearance of the flu virus in early 2020, may have helped prevent the double infections.
The CDC expects both the flu virus and the coronavirus to spread throughout this winter. Flu activity in the United States is already increasing, following a period where it did not circulate as much as usual. Massachusetts recently recorded the highest activity of the flu since April 2020.
Coronavirus safety measures that were previously put in place to stem its spread, including stay-at-home orders and school closures, have also been relaxed nationwide, which may additionally “result in an increase in flu activity,” according to the CDC.
“These prevention measures likely contributed to reduced numbers of hospitalizations for both” the flu and coronavirus, according to the CDC. “Without these prevention measures in place, annual rates of COVID-19-associated hospitalizations would likely have been much higher than those for flu during typical flu seasons.”
Fewer people are also receiving their flu shot compared to previous years, and a sizable portion of the country is not yet fully vaccinated against the coronavirus, according to the CDC. This comes at a time when COVID cases are spiking nationwide, which has largely been attributed to the emergence of Omicron.
“The reason we haven’t talked about it much is that it’s not been clinically a challenge yet,” Dr. Jonathan D. Grein, an infectious disease physician and the director of hospital epidemiology at Cedars Sinai Medical Center, told the New York Times. “We anticipate that as flu becomes more prevalent, we will see more coinfections.”
Will you become more ill if you are infected with both?
Health experts are still studying how flurona affects people, according to the CDC. As a result of there being so few known cases, it’s unclear if people become sicker or if either illness potentially increases in severity during coinfection.
However, based on previous studies, coinfections do not necessarily mean an individual will experience a worse outcome than if they only had one illness. Previous research has indicated that in some scenarios, a viral infection may actually help to activate a strong immune response in the body, helping it to fight off or lessen the impact of a second infection later on.
What are the symptoms of flurona?
Both the flu and COVID-19 are contagious respiratory illnesses that share similar symptoms, despite being caused by different viruses. Those symptoms include fever, cough, shortness of breath, fatigue, and muscle pain or body aches, according to the CDC. Both illnesses can also result in complications, including pneumonia and respiratory failure.
Compared to the flu, the coronavirus can cause more serious illnesses in some people and appears to spread more easily, according to the CDC. It can also take longer for people to experience symptoms, and they can be contagious for a greater period of time. Most people who get the flu will recover on their own within two weeks.
Because the symptoms are so similar, testing is needed to confirm a diagnosis, according to the CDC. The treatment plan will depend on the patient’s circumstances.
Who is most at risk of developing the coinfection?
Those most susceptible to becoming infected with both COVID and the flu at the same time include children and the unvaccinated.
Researchers have found that coinfections with a number of respiratory viruses are “substantially more common” in children, especially those under the age of five. Children are viewed as “little germ factories” by those in the medical community because they tend to be exposed to more germs and get sick more often. However, children also tend to be more resilient than ill adults.
Those under the age of five are also not yet eligible to get vaccinated against the coronavirus, leaving them more vulnerable to infection. The number of hospitalizations among young children infected with COVID-19 rose to the highest levels since the beginning of the pandemic last week, according to the CDC.
For both COVID and the flu, those who are unvaccinated are far more likely to become seriously ill and develop an infection than those who are vaccinated. People who refuse to get vaccinated for coronavirus may also resist getting the flu vaccine and other vaccines, which makes them more susceptible to both illnesses.
Older adults, health care workers, pregnant people, and those with underlying health conditions are also more at risk from each virus, according to the World Health Organization.
What can you do to protect against flurona?
The most effective way to prevent yourself from developing either the flu or COVID-19 — and suffering the worst of their effects — is to get vaccinated. Both are airborne viruses, so public health experts also recommend social distancing and wearing a mask when the situation calls for it.
You can limit your exposure to the coronavirus by exercising caution about which activities you participate in, especially given the recent Omicron surge, and getting tested if you’re exposed to someone with the virus.