All the hospitalizations and infections caused by the new variant of coronavirus, the main focus has shifted mainly on omicron and the chances are the world has forgoan about an old infection, the flu. The virus causing influenza is kicking and alive and the Centers for Disease Control and Prevention (CDC) have reported 30,000 cases of influenza since October 2021(1).

Right from the start of the coronavirus pandemic, public health experts and doctors have been worried about a “twindemic” in which hospitals might overflow with dual cases of flu and coronavirus. But 2022 has brought with it a new concern, “flurona”. An unvaccinated pregnant woman was brought to a hospital in Israel infected with both viruses and since then a number of such cases have been reported in the United States as well especially in teenagers and children.

WHAT IS “FLURONA”?

The term “flurona” is coined to refer to a condition in which a single individual is infected with both coronavirus and influenza virus simultaneously. Co-infection or the condition in which two or more organisms infect someone at once is considered to be relatively common. People infected with HIV also contract tuberculosis whereas, in prior influenza pandemics, a major cause of death has been bacterial co-infections.

Therefore, it is not surprising to find co-infection in patients suffering from coronavirus (2).

What we need to know are the prevalence of flurona and its symptoms. Are the risks greater when an individual catches both viruses at the same time?

SYMPTOMS OF FLURONA

Bothe coronavirus and flu present with common symptoms, Getting tested is recommended to determine the exact cause of illness, According to CDC, the common

symptoms of flu include fever, sore throat, body or muscle aches, cough, stuffy or runny nose, tiredness, headaches, sometimes diarrhea or vomiting (3). Similarly, coronavirus infection also presents with chills or fever, difficulty in breathing, tiredness, diarrhea, body aches, cough, sore throat, vomiting or nausea, loss of smell or taste, or headache

(4), The identical symptoms are presented by both the viruses making diagnosis difficult based on these signs.

THE PREVALENCE OF FLURONA

A recent systematic review carried out at Alborz University of Medical Sciences in Karaj, Iran reported the identification of 15 case reports of co-infection of coronavirus and influenza, and additional eleven studies also worked to estimate the prevalence of such co-infection, these studies included data from Japan, Iran, China, France, USA, Switzerland, Italy, and Brazil demonstrating the widespread occurrence of such co-infections. Although good quality data is not enough to conclude firmly, the review estimated that 1.2% of coronavirus patients might be co-infected with the influenza virus as well (5).

However, the difficulty still lies in knowing that a person is infected with both viruses because unless specifically tested for both, doctors would not know that someone has been infected with coronavirus and influenza. Such testing is only possible when someone gets hospitalized and even then due to raised concern for coronavirus, one might not get tested for influenza.

IS FLURONA A REASON FOR CONCERN?

Scientist agree upon the Let that two organisms can cause infections in a single person

simultaneously. A single infection weakens the body and the ease of access increases for another infection. With coronavirus infection, strep throat has been seen a lot lately.

While scientists agree upon co-infection of influenza and coronavirus simultaneously, it is still early to define how much sickness flurona can cause. The simultaneous infection of corcvirus and influenza affects the same group that include immunocompromised, obese, elderly, and those with other concomitant conditions such as heart disease,

diabetes, or lung disease. Since the cases of coronavirus are increasing, keeping a check on usual influenza cases can help determine the flurona risk in the community (6).

Although a lot of uncertainty is present related to flurona but the following the usual

guidelines to avoid spread of virus like social distancing and use of face mask can reduce the spread of coronavirus and influenza at the same time. However, a great emphasis is put on getting vaccinated against both viruses as best way of defense. Since people are

more concerned about getting protection against coronavirus infection, the vaccination against influenza is forgotten by a great many people. Moreover, the vaccine fatigue is also understandable.

Getting vaccinated against only one virus does not offer a complete protection because

both influenza and coronavirus belong to different classes of virus and does not relate to one another in any way. Therefore, getting vaccinated against both the coronavirus and influenza becomes of utmost importance. Nevertheless, the likelihood of developing severe symptoms decreases significantly when a person gets both coronavirus and influenza vaccines even though a person gets infected with coronavirus and flu. As per

CDC, getting vaccinated against both coronavirus and influenza at the same time is safe (7).

WHAT SHOULD BE COURSE OF ACTION IN CASE SYMPTOMS DEVELOP?

In the case a person develops symptoms from either of the two infections such as cough, sore throat, shortness of breath, fever, headache, stuffy or ninny nose, or body pain, the first instinct is to get tested to coronavirus in the present times. But in actual, the current times demand to be tested for both influenza and coronavirus. Management of milder symptoms can be done even at home with help of over-the-counter medicines and anti-pyretic. For severe type of infections oral therapies are available for treatment of both influenza and coronavirus such as anti-viral medications including oseltamivir.

If someone finds himself with this combination of respiratory diseases, one must ensure to isolate himself to avoid passing on the flurona on to family and friends.

THE BOTTOM LINE

The term “flurona” may be new and gaining rapid popularity but the co-infection of coronavirus and influenza are not. Increase spread of both the viruses have raised concerns in healthcare community as risk of hospitalization increases in co-infection with both viruses concurrently. Though with the spread of coronavirus, taking precautions against influenza has taken a back seat but it is important to get protection against influenza along with Covid-19.

Sources

CDC. Upcoming 2020-2021 Influenza Season [Internet]. Centers for Disease Control and Prevention. 2021 [cited 2022 Feb 6]. Available from: https://wmv.cdc.govifluiseasonifaq-flu-season-2020-2021.htM

  1. Lansbury L, Lim B, Baskaran V, Lim WS. Co-infections in people with COVID-19: a systematic review and meta-analysis. J Infect. 2020 Aug;81(2):266-75.
  2. Flu Symptoms & Complications [Internet]. Centers for Disease Control and

Prevention. 2021 [cited 2022 Feb 6]. Available from:
https://www.cdc.govifluisymptomsisymptoms.htm

  1. Coronavirus Disease 2019 (COVID-19) — Symptoms [Internet]. Centers for Disease Control and Prevention. 2021 [cited 2022 Feb 7]. Available from: https://www.cde.govicoronavirusi2o19-ncovisymptoms-testingisymptoms.html
  2. Dadashi M, Khaleghnejad 5, Abedi Elkhichi P, Goudarzi M, Goudarzi H, Taghavi et al. COVID-19 and Influenza Co-infection: A Systematic Review and Meta-Analysis. Front Med [Internet]. 2021 [cited 2022 Feb 6];8. Available from: https://vnvw.frontiersin.orgiarticle/10.3389/fmed.2021.68469
  3. Cassata C. What Is ‘Flurona; and How Serious Can It Be? [Internet]. Healthline. 2022 [cited 2022 Feb 7]. Available from: https://ymnAr.healthline.comihealth­news/what-is-flurona-and-how-serious-can-it-be
  4. Frequently Asked Questions about COVID-19 Vaccination [Internet]. Centers for Disease Control and Prevention. 2022 [cited 2022 Feb 7]. Available from: https://www.cdc.govicoronavirus/2019-ncovivaccinesifaq.html

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