Many Americans gathered with friends and family over the holidays. That meant hugs and togetherness. There have also been sporting events. College basketball is a big deal where we live. Duke and UNC (University of North Carolina) are famous rivals. Basketball arenas are filled with screaming fans. Oh, and let’s not forget that the Super Bowl is coming! Friends and family will be gathering to cheer on their favorite team! If we are in the middle of a sexdemic, a lot of people are likely to be catching something over the next couple of weeks.
What’s a Sexdemic?
Are you sick? What about your friends or family? If not, consider yourself fortunate. Epidemiologists and public health officials are reporting a quademic. That is four viral infections spreading simultaneously: influenza, COVID, RSV (respiratory syncytial virus) and norovirus. But we disagree. We think we are in the middle of a sexdemic, ie, six simultaneous infections! It might even be more!
If you thought “sexdemic” had something to do with sex, you are wrong. We are talking Latin here friend. “Quad” means four. “Sex” means six in Latin. So, a sexdemic means six different circulating infections!
What Infections Comprise the Sexdemic?
It’s a little more challenging than usual to track such infections because the CDC is operating under communication restrictions. However, the data that are available indicate that influenza A, RSV and COVID-19 are all out there this winter. Norovirus appears to be more active than it has been for several years.
Wait, there’s more! To reach a sexdemic situation, you have to count colds! Remember, there are over 160 rhinoviruses, a bunch of coronaviruses (not counting COVID-19), adenoviruses and enteroviruses. There is also Mycoplasma pneumoniae (walking pneumonia) circulating. So, if you count cold viruses and Mycoplasma pneumoniae you are already at a sexdemic.
But wait, there’s more! According to WastewaterScan (which monitors pathogens in sewage) Human Metapneumovirus (HMPV) is also out there. You can read more about HMPV at this link!
But wait, there’s more! Whooping cough (pertussis) is also up this year. Because I had whooping cough as a kid I can attest to the nasty nature of this Bordetella bacteria. Learn more about whooping cough at this link.
Will you catch flu, COVID, norovirus (stomach “flu”), RSV (respiratory syncytial virus), a cold or whooping cough? Are you already suffering or are you contagious but don’t know it? How long will you spread your germs around?
What’s Out There Right Now?
The CDC is slow to report the spread of nasty stuff. As I write this, the most up-to-date information comes from CDC’s “Fluview” 2024-2025 Influenza Season Week 3 ending Jan. 18, 2025. And that information is always a week or so behind what’s happening on any given date. As you can see, the CDC data are not current! I won’t editorialize, but without current data we are shooting blind.
Nevertheless, the CDC says flu is trending up:
“• Seasonal influenza activity continues to increase across the country.”
Not surprising, right? It looks like influenza a (H1N1) and influenza a (H3N2) are the most prevalent strains. How good are the vaccines? We won’t know until much later in the season, but do not expect perfect protection. Even in a “good” year, the flu vaccines only work about 40% of the time.
We have tabulated influenza vaccine effectiveness going back to 2004-2005. You can check out the CDC’s stats at this link. Some years the flu shot is a bit better than 20% effective in preventing infection. Other years it may be as much as 50% or so. We rarely see it topping 60%. So you can catch flu even after vaccination. That suggests exercising prudence to keep from putting yourself at risk might be wise.
What Else Is Circulating?
We like to check WastewaterScan for the most recent outbreaks. And yes, this is just what it sounds like. It is possible to detect a lot of different pathogens in sewage. So what’s up and what’s down?
- COVID is “High”
- RSV is also “High”
- Influenza A is “High”
- Influenza B and human metapneumovirus are both low…so a little good news here
- Norovirus is “High”
You do not want to deal with a nasty respiratory infection or a GI bug! If your family doesn’t catch flu, possibly because you got an influenza vaccine, have been cautious or had good luck, that still doesn’t mean you are home free. The next several weeks will be the most dangerous.
There are a lot of infectious agents just ready to enter your body through your nose, mouth or hands. Most people have stopped worrying about COVID on the grounds that: 1) it’s no big deal, 2) they have already caught it once or twice or thrice and survived or 3) you gotta live your life regardless of what’s lurking in the air. But ask someone who has long COVID what that’s like and you might get a very different answer. Keep in mind that whenever you catch COVID you have a chance of suffering the lingering complications of long COVID.
Not a Sexdemic but a Tripledemic:
Comparing COVID-19 to Influenza and/or RSV
How many times have we heard that COVID is no worse than the flu, so don’t sweat it? A study published in JAMA Internal Medicine, Jan. 27, 2025, says that thinking is wrong. This was a retrospective cohort study involving patients in the US Veterans Health Administration. During the 2022-2023 season there were 68,581 veterans who came down with RSV, flu or COVID-19. During the 2023-2024 season there were 72,939 vets who fulfilled the eligibility criteria.
Here is what they discovered:
“Among more than 141 000 nonhospitalized US veterans included in this cohort study, who were diagnosed with COVID-19, influenza, or RSV, and concurrently tested for all 3 viruses during the 2022 to 2023 or 2023 to 2024 respiratory illness seasons, COVID-19 was by far the most common diagnosis, and 30-day risk of hospitalization was lowest among persons with RSV. Hospitalization risk was similar between COVID-19 and influenza, but ICU admissions were more likely among persons with COVID-19.”
Just Maintain a Healthy Immune System, Tripledemic or Sexdemic!
A great many visitors to this website maintain that all you have to do is maintain a healthy immune system. They make it sound easy: eat healthy food, take supplements, exercise and don’t worry. We wish it were so simple. Don’t get me wrong. I am all for building up your immune system…but it’s not as easy as wishing it to be so.
For one thing, there are tens of millions of Americans who are taking medications for inflammatory conditions such as psoriasis, arthritis, lupus or diabetes. Roughly 9 million people get prescriptions for prednisone each year. Many more take another type of corticosteroid for asthma, COPD or a different inflammatory problem. Such drugs dampen immunity.
Commercials on TV for many of the new monoclonal antibodies to treat everything from eczema to psoriatic arthritis mention that the meds often dampen immune reactivity. Let’s not forget the millions of cancer patients who have compromised immune systems because of life-saving immunotherapy. Finally, there are a lot of people who are especially vulnerable to infection for reasons that are not entirely understood. Please, let’s not blame the victims.
Air Quality Is Rarely Tested:
Used air filters from a public establishment
The photo above was taken at a fancy hotel that will remain nameless. If you look at these air filters you can see immediately that they are not in the greatest shape. Even if a pharmacy, bank or restaurant uses MERV 13 or HEPA air filters, they have to change these high efficiency filters frequently to really protect the public. That doesn’t always happen.
Airborne Pathogens:
There are lots of other respiratory infections lurking all around you: RSV (respiratory syncytial virus), strep, walking pneumonia (Mycoplasma pneumoniae) and pertussis (whooping cough), for instance. Let’s not forget the “common” cold. It is actually caused by any one of hundreds of other viruses: rhinoviruses, adenoviruses and coronaviruses. There is also human metapneumovirus (our family caught HMPV two years ago and it was nasty!).
Whooping cough is also bad news. This year cases are up about five fold compared to last year. That makes this bacterial lung infection scarier than it has been in a decade. More about my personal story with pertussis momentarily.
The Anti-Vaccine Movement is Growing!
We have often written about disappointing results of influenza vaccines. Here are just a few articles where we have complained about flu shots:
What Should You Know About Vaccine Effectiveness?
Should You Be Rushing To Get Your Flu Shot?
We try to keep an open mind about vaccines, reporting on both the benefits and the risks. The VAERs (Vaccine Adverse Event Reporting System) leaves a lot to be desired. This FDA/CDC initiative is supposed to be an early warning system to alert health professionals to unforeseen vaccine complications. How the data are analyzed and reported, however, is not as scientific as most people would like.
We Are NOT Anti-Vaccine!
I caught polio when I was two years old. That was a long time ago, before there was a polio vaccine.
Doctors had nothing to offer patients with polio when I was a child. Kids were dying all around me in the polio ward at Children’s Hospital of Philadelphia (CHOP). Others were in iron lungs. I was immobilized in traction with ropes and pulleys to stretch my paralyzed legs. I was often surrounded by alien beings in white coats and masks. There was not a lot of comfort or love in that polio ward.
Parents no longer have to watch children die from polio. Kids are not locked into iron lung machines to breathe. They do not have to wear braces on their legs to walk. Maybe you can tell that I am not an impartial observer when it comes to vaccines.
I worry that far too many Americans have become anti-vaxxers. Has that raised our risk of catching horrible infections like polio or whooping cough (pertussis)?
If You Don’t Catch Flu, What About Whooping Cough (Pertussis)?
By the way, I also caught whooping cough as a child. It was a killer in those days and it freaked my parents out, especially since my bout with polio was so traumatic for the family. But I was lucky. I did survive, though I still have PTSD when entering a hospital.
If I catch an upper respiratory tract infection, my cough still sounds like a whoop. I suspect permanent damage was done when I had pertussis as a child.
Sadly, many parents are no longer vaccinating their children against whooping cough and measles. Doctors call this vaccination hesitancy. As a result, childhood diseases that we thought had been pretty much eliminated are starting to recur.
Whooping Cough Is Popping Up Around the US:
As I write this in early 2025, I am sorry to report that whooping cough cases are widespread. The Denver Gazette reported on Jan. 28, 2025 a whooping cough outbreak was confirmed at a Colorado Springs middle school. On Jan. 29, 2025, cases of pertussis were reported in Springfield, Mo. On Jan. 30, 2025, cases of pertussis were confirmed at a Rutherford County, Tenn. school district. Prior to these recent cases, public health officials have reported whooping cough in Pennsylvania, Michigan, New York, Minnesota, Ohio, Indiana, Illinois, Wisconsin, Washington and California.
Bordetella pertussis is highly contagious. It’s hard to diagnose. When someone has a bad cough it could be a bad cold, RSV, pertussis, mycoplasma, COVID or influenza. In other words…a SEXDEMIC!
Babies are extremely vulnerable to whooping cough. About one half of the youngest children who catch this bug will end up in the hospital. Older children and adults can also get very sick from pertussis. Symptoms can linger for months.
Did You Catch Flu or Something Else?
It is not surprising that a lot of people are suffering with upper respiratory tract infections. Family get-togethers, parties and sporting events make spreading germs easy. When your team is winning it’s hard not to cheer, scream and shout! Participating in these activities is good for our emotional health, but it may also offer a great opportunity for pathogens to spread.
How Long Are You Contagious?
There are no perfect rules when it comes to upper respiratory tract infections. People can spread COVID before they have any symptoms. That is also true for cold viruses. Of course when you are sneezing and coughing you are highly contagious. But many people remain “toxic” for a long time, even after they are starting to feel better. A lot depends upon the immune system.
Remember when public health officials maintained that droplets containing COVID particles would fall to the floor within about six feet? That was total nonsense. We now know that viruses can float through the air over far greater distances. That’s why we wish people would just stay home if they 1) think they are coming down with something or 2) are recovering from an infection. It would be nice if employers encouraged such behavior and offered paid sick days.
If you catch the flu, chances are good that you will be spreading viral particles for up to a week. Norovirus causes intense gastrointestinal symptoms. Fewer than 100 particles can make you as sick as a dog. When people are suffering vomiting and diarrhea they can shed billions of virus particles.
Some individuals remain contagious for as long as two weeks. More than you ever wanted to know about this infectious disease is available at this link. No matter how great your immune system, if you are exposed to this pathogen, you will become very ill. Kids with whooping cough can spread bacteria for about three weeks, unless they take an appropriate antibiotic.
Should You Test?
People uncertain whether they have influenza or COVID-19 might consider using the Lucira home test. FlowFlex Plus, iHealth and CorDx TyFast also offer combination COVID-19 and flu tests.
[The People’s Pharmacy is reader supported. When you buy through links in this post, we may earn a small affiliate commission (at no cost to you).]
Respiratory syncytial virus is also widespread. In most people, this infection causes coughs, sneezes, fever and wheezing. But for babies and elderly people, RSV can be deadly.
Doctors also report that they are seeing more strep infections. This bacterial infection is best known for causing sore throats rather than coughs or congestion. However, if left untreated, it might lead to complications. A prompt antibiotic prescription should speed healing from a strep infection. There are now at-home strep throat tests that allow parents to determine if a child or adult has caught this bacterial infection.
Final Words on the Sexdemic:
We hope you do not catch flu or any other infection this winter. If you do catch a cold or influenza, you may find our eGuide to Colds, Coughs & the Flu of some value. You’ll find it under the Health eGuides tab. If you have caught an upper respiratory tract infection, please share your experience in the comment section below. Let us know how you made out.
Citations
- Bajema, K.L., et al, "Severity and Long-Term Mortality of COVID-19, Influenza, and Respiratory Syncytial Virus," JAMA Internal Medicine, Jan. 27, 2025, doi: 10.1001/jamainternmed.2024.7452
