Twindemic

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Twindemic and tripledemic (or tridemic) are terms used during the COVID-19 pandemic, referring to the possibility of a severe flu season happening alongside an increase in cases of COVID-19 during the fall and winter of 2020 and 2021, [1] [2] [3] [4] [5] as well as respiratory syncytial virus in the winter of 2022. A consequence of a twindemic may be a mixture of two different infections in the same person at the same time. [6] The term twindemic is a portmanteau of "twin" and "pandemic". [3]

Contents

History

The term was used by an August 2020 article from The New York Times written by Jan Hoffman. [1] [2] [3] In the article, Hoffman credited Dr. L.J. Tan of the Immunization Action Coalition as an "early promoter" of the possibility of a twindemic. [3] After the publication of The Times' article, several media outlets began to report on the possibility of a twindemic. [3] Health experts responded to the threat of a possible twindemic by encouraging more people to get the flu vaccine. [1] [2]

A twindemic did not occur during the flu season in late 2020 due to cases of the seasonal flu being at historic lows in the United States and globally. [7] These low amount of flu cases were attributed to measures put in place to prevent COVID-19 from spreading, including face masks, social distancing, and hand washing. [7]

Health experts renewed concerns of a possible twindemic happening during the fall and winter of 2021 due to loosening restrictions. [4] [5] In April 2022, Apoorva Mandavilli of The New York Times speculated that a twindemic has not occurred because "exposure to one respiratory virus may put the body's immune defenses on high alert, barring other intruders from gaining entry into the airways. This biological phenomenon, called viral interference, may cap the amount of respiratory virus circulating in a region at any given time." [8] In the United States, flu cases, hospitalizations and deaths were up from the previous flu season, but were still lower than the pre-pandemic average. [8]

"Flurona"

In January 2022, Israel reported, for the first time, a mixture of COVID-19 and influenza infections, colloquially known as "flurona". [9] [10] [11] [12] In Brazil, four cases of the double infection have been identified, including a 16-year-old male from Rio de Janeiro. In Fortaleza of Ceará state, two children, including a one-year-old child tested positive without complications, and also a 52-year-old man who did not need hospitalization. [13] In São Paulo, the Secretariat of Health announced that its state had 110 cases in 2021. [14]

Flurona infections have also been reported in the United States, the Philippines, Hungary and Romania. [11]

Related Research Articles

<span class="mw-page-title-main">Pandemic</span> Widespread, often global, epidemic of severe infectious disease

A pandemic is an epidemic of an infectious disease that has spread across a large region, for instance multiple continents or worldwide, affecting a substantial number of individuals. Widespread endemic diseases with a stable number of infected individuals such as recurrences of seasonal influenza are generally excluded as they occur simultaneously in large regions of the globe rather than being spread worldwide.

<span class="mw-page-title-main">Epidemic</span> Rapid spread of disease affecting a large number of people in a short time

An epidemic is the rapid spread of disease to a large number of hosts in a given population within a short period of time. For example, in meningococcal infections, an attack rate in excess of 15 cases per 100,000 people for two consecutive weeks is considered an epidemic.

<span class="mw-page-title-main">Spanish flu</span> 1918–1920 global influenza pandemic caused by the H1N1 influenza A virus

The 1918–1920 flu pandemic, also known as the Great Influenza epidemic or by the common misnomer Spanish flu, was an exceptionally deadly global influenza pandemic caused by the H1N1 influenza A virus. The earliest documented case was March 1918 in the state of Kansas in the United States, with further cases recorded in France, Germany and the United Kingdom in April. Two years later, nearly a third of the global population, or an estimated 500 million people, had been infected in four successive waves. Estimates of deaths range from 17 million to 50 million, and possibly as high as 100 million, making it one of the deadliest pandemics in history.

<span class="mw-page-title-main">Avian influenza</span> Influenza caused by viruses adapted to birds

Avian influenza, also known as avian flu, is a bird flu caused by the influenza A virus, which can infect people. It is similar to other types of animal flu in that it is caused by a virus strain that has adapted to a specific host. The type with the greatest risk is highly pathogenic avian influenza (HPAI).

<span class="mw-page-title-main">Influenza A virus subtype H5N1</span> Subtype of influenza A virus

Influenza A virus subtype H5N1 (A/H5N1) is a subtype of the influenza A virus which can cause illness in humans and many other species. A bird-adapted strain of H5N1, called HPAI A(H5N1) for highly pathogenic avian influenza virus of type A of subtype H5N1, is the highly pathogenic causative agent of H5N1 flu, commonly known as avian influenza. It is enzootic in many bird populations, especially in Southeast Asia. One strain of HPAI A(H5N1) is spreading globally after first appearing in Asia. It is epizootic and panzootic, killing tens of millions of birds and spurring the culling of hundreds of millions of others to stem its spread. Many references to "bird flu" and H5N1 in the popular media refer to this strain.

The Hong Kong flu, also known as the 1968 flu pandemic, was a flu pandemic whose outbreak in 1968 and 1969 killed between one and four million people globally. It is among the deadliest pandemics in history, and was caused by an H3N2 strain of the influenza A virus. The virus was descended from H2N2 through antigenic shift, a genetic process in which genes from multiple subtypes are reassorted to form a new virus.

<span class="mw-page-title-main">Influenza A virus subtype H1N1</span> Subtype of Influenza A virus

In virology, influenza A virus subtype H1N1 (A/H1N1) is a subtype of influenza A virus. Major outbreaks of H1N1 strains in humans include the 1918 Spanish flu pandemic, the 1977 Russian flu pandemic and the 2009 swine flu pandemic. It is an orthomyxovirus that contains the glycoproteins hemagglutinin (H) and neuraminidase (N), antigens whose subtypes are used to classify the strains of the virus as H1N1, H1N2 etc. Hemagglutinin causes red blood cells to clump together and binds the virus to the infected cell. Neuraminidase is a type of glycoside hydrolase enzyme which helps to move the virus particles through the infected cell and assist in budding from the host cells.

<span class="mw-page-title-main">Influenza pandemic</span> Pandemic involving influenza

An influenza pandemic is an epidemic of an influenza virus that spreads across a large region and infects a large proportion of the population. There have been six major influenza epidemics in the last 140 years, with the 1918 flu pandemic being the most severe; this is estimated to have been responsible for the deaths of 50–100 million people. The most recent, the 2009 swine flu pandemic, resulted in under 300,000 deaths and is considered relatively mild. These pandemics occur irregularly.

<span class="mw-page-title-main">Canine influenza</span>

Canine influenza is influenza occurring in canine animals. Canine influenza is caused by varieties of influenzavirus A, such as equine influenza virus H3N8, which was discovered to cause disease in canines in 2004. Because of the lack of previous exposure to this virus, dogs have no natural immunity to it. Therefore, the disease is rapidly transmitted between individual dogs. Canine influenza may be endemic in some regional dog populations of the United States. It is a disease with a high morbidity but a low incidence of death.

<span class="mw-page-title-main">2009 swine flu pandemic timeline</span>

This article covers the chronology of the 2009 novel influenza A (H1N1) pandemic. Flag icons denote the first announcements of confirmed cases by the respective nation-states, their first deaths, and relevant sessions and announcements of the World Health Organization (WHO), the European Union , and the U.S. Centers for Disease Control (CDC).

<span class="mw-page-title-main">Pandemic H1N1/09 virus</span> Virus responsible for the 2009 swine flu pandemic

The pandemic H1N1/09 virus is a swine origin influenza A virus subtype H1N1 strain that was responsible for the 2009 swine flu pandemic. This strain is often called swine flu by the public media. For other names, see the Nomenclature section below.

During the 1972–1973 flu season in the Northern Hemisphere, a new variant of influenza, dubbed the 'London flu' by the press in the United States, was responsible for epidemics in many countries. 'London flu' was caused by a variant of influenza A/H3N2 that was first isolated in India in mid-1971 but only identified as a distinct strain in England in January, 1972.

<span class="mw-page-title-main">1889–1890 pandemic</span> Global pandemic

The 1889–1890 pandemic, often referred to as the "Asiatic flu" or "Russian flu", was a worldwide respiratory viral pandemic. It was the last great pandemic of the 19th century, and is among the deadliest pandemics in history. The pandemic killed about 1 million people out of a world population of about 1.5 billion. The most reported effects of the pandemic took place from October 1889 to December 1890, with recurrences in March to June 1891, November 1891 to June 1892, the northern winter of 1893–1894, and early 1895.

<span class="mw-page-title-main">Influenza A virus subtype H7N9</span> Subtype of the influenza A virus

Influenza A virus subtype H7N9 (A/H7N9) is a bird flu strain of the species Influenza virus A. Avian influenza A H7 viruses normally circulate amongst avian populations with some variants known to occasionally infect humans. An H7N9 virus was first reported to have infected humans in March 2013, in China. Cases continued to be reported throughout April and then dropped to only a few cases during the summer months. At the closing of the year, 144 cases had been reported of which 46 had died. It is known that influenza tends to strike during the winter months, and the second wave, which began in October, was fanned by a surge in poultry production timed for Lunar New Year feasts that began at the end of January. January 2014 brought a spike in reports of illness with 96 confirmed reports of disease and 19 deaths. As of April 11, 2014, the outbreak's overall total was 419, including 7 in Hong Kong, and the unofficial number of deaths was 127.

<span class="mw-page-title-main">Neil Ferguson (epidemiologist)</span> British epidemiologist and researcher

Neil Morris Ferguson is a British epidemiologist and professor of mathematical biology, who specialises in the patterns of spread of infectious disease in humans and animals. He is the director of the Jameel Institute, and of the MRC Centre for Global Infectious Disease Analysis, and head of the Department of Infectious Disease Epidemiology in the School of Public Health and Vice-Dean for Academic Development in the Faculty of Medicine, all at Imperial College London.

<span class="mw-page-title-main">1957–1958 influenza pandemic</span> Pandemic of influenza virus (H2N2)

The 1957–1958 Asian flu pandemic was a global pandemic of influenza A virus subtype H2N2 that originated in Guizhou in Southern China. The number of excess deaths caused by the pandemic is estimated to be 1–4 million around the world, making it one of the deadliest pandemics in history. A decade later, a reassorted viral strain H3N2 further caused the Hong Kong flu pandemic (1968–1969).

<span class="mw-page-title-main">Impact of the COVID-19 pandemic on other health issues</span> Health consequences of outbreak beyond the COVID-19 disease itself

The COVID-19 pandemic has had many impacts on global health beyond those caused by the COVID-19 disease itself. It has led to a reduction in hospital visits for other reasons. There have been 38 per cent fewer hospital visits for heart attack symptoms in the United States and 40 per cent fewer in Spain. The head of cardiology at the University of Arizona said, "My worry is some of these people are dying at home because they're too scared to go to the hospital." There is also concern that people with strokes and appendicitis are not seeking timely treatment. Shortages of medical supplies have impacted people with various conditions.

Viral interference, also known as superinfection resistance, is the inhibition of viral reproduction caused by previous exposure of cells to another virus. The exact mechanism for viral interference is unknown. Factors that have been implicated are the generation of interferons by infected cells, and the occupation or down-modulation of cellular receptors.

The 1989–1990 flu epidemic in the United Kingdom was an influenza epidemic of A(H3N2) type flu that occurred during the winter of 1989–1990. Although the outbreak was quite prolific in the United Kingdom, cases were reported in other parts of Europe and further afield, including France, Finland, Norway, Sweden, Switzerland and the Soviet Union. At its peak the epidemic saw an infection rate of between 534 and 600 people per 100,000, while various sources have attributed between 19,000 and 29,000 deaths to the outbreak.

<span class="mw-page-title-main">2022–2023 pediatric care crisis</span> Ongoing viral disease outbreak

In the waning months of 2022, the first northern hemisphere autumn with the nearly full relaxation of public health precautions related to the COVID-19 pandemic, hospitals in the United States and Canada began to see overwhelming numbers of pediatric care patients, primarily driven by a massive upswing in respiratory syncytial virus (RSV) cases, but also flu, rhinovirus, enterovirus, and SARS-CoV-2.

References

  1. 1 2 3 Hoffman, Jan (16 August 2020). "Fearing a 'Twindemic,' Health Experts Push Urgently for Flu Shots". The New York Times . ISSN   0362-4331 . Retrieved 6 March 2021.
  2. 1 2 3 Miller, Korin (18 August 2020). "Experts Warn of a Possible 'Twindemic'—Here's What That Means". Health.com . Retrieved 6 March 2021.
  3. 1 2 3 4 5 "twindemic". Dictionary.com . 2020. Retrieved 6 March 2021.
  4. 1 2 Rodriguez, Adrianna (25 August 2021). "Experts renew warnings of 'twindemic' as US enters flu season amid rising COVID-19 cases: 'We face the same threat this year'". USA Today . Retrieved 1 September 2021.
  5. 1 2 Scribner, Herb (30 August 2021). "Doctors warn this 'twindemic' will threaten everyone this fall and winter". Deseret News . Retrieved 1 September 2021.
  6. ↑ Khamsi, Roxanne (17 November 2021). "The Double-Whammy COVID-Flu". The Atlantic . Retrieved 5 January 2022.
  7. 1 2 Sepkowitz, Kent (7 February 2021). "Opinion: The mystery of the flu-Covid 'twindemic' that never happened". CNN . Retrieved 6 March 2021.
  8. 1 2 Mandavilli, Apoorva (8 April 2022). "Why a Coronavirus-Flu 'Twindemic' May Never Happen". The New York Times. ISSN   0362-4331 . Retrieved 30 April 2022.
  9. ↑ Dasgupta, Sravasti (1 January 2022). "Israel reports first case of 'flurona' – rare double infection of Covid and influenza - Doctors say it was diagnosed in young pregnant woman but suspect there are more cases in country". The Independent . Retrieved 1 January 2022.
  10. ↑ Nadeau, Barbie Latza (3 January 2022). "2022's Hottest New Illness: Flurona". The Daily Beast . Retrieved 3 January 2022.
  11. 1 2 Hassan, Jennifer (5 January 2022). "What is 'flurona'? Coronavirus and influenza co-infections reported as omicron surges. - Cases have been detected in countries including United States, Israel, Brazil, the Philippines and Hungary". The Washington Post . Retrieved 5 January 2022.
  12. ↑ Nierenberg, Amelia (7 January 2022). "Can You Get the Flu and Covid at the Same Time? - Yes, you can get "flurona." But it's probably not as bad as it sounds". The New York Times . Retrieved 7 January 2022.
  13. ↑ Rocha, Matheus (3 January 2022). "Rio e Ceará registram casos de 'flurona', coinfecção por Covid e influenza" (in Brazilian Portuguese). Folha da Manhã S.A. - Grupo Folha. Retrieved 4 January 2022.
  14. ↑ Baptista, Sara (4 January 2022). "Estado de São Paulo teve 110 casos de 'flurona' ao longo de 2021" (in Brazilian Portuguese). Universo Online . Retrieved 5 January 2022.
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