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COVID-19 and flu co-infection isn't common, but doctors say more cases could be coming

The first case of COVID-19 and flu co-infection was just detected in Israel. Here’s what you need to know and how experts say it's possible to get both at once.

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Ever since the pandemic began, public health experts have warned about the possibility of getting COVID-19 and the flu at once. With flu cases jumping up across the country after a very mild season last year, doctors are warning that so-called “flurona” can happen — and Israel just had its first documented case, which may be the first in the world.

Israeli health officials recently announced that the patient was an unvaccinated pregnant woman who had both the flu and COVID-19 (likely omicron variant) at once, per the Times of Israel. The woman had mild symptoms and was released from the hospital on Thursday.

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Flu cases are steadily increasing across the U.S. — 4,514 new cases were diagnosed the week of Dec. 18, according to the Centers for Disease Control and Prevention — and that raises the risk that flurona can happen here, according to Thomas Russo, M.D., professor and chief of infectious disease at the University at Buffalo in New York.

But what is flurona, exactly, and what should you do if you suspect that you have it? Here’s what you need to know.

What is flurona?

Flurona is a play on words that basically jams “flu” and “coronavirus” together. While there have been reports that the Israeli patient is the first documented case of flurona in the world, infectious disease expert Amesh A. Adalja, M.D., a senior scholar at the Johns Hopkins Center for Health Security, said that these co-infections were more common when the pandemic began because the flu was circulating more widely.

Still, flurona cases aren’t common here — yet. “I’m concerned about this because we had a practically non-existent flu season last year, and the flu is circulating this year,” Russo said. “Each virus is potentially lethal. The combination could be quite bad.”

Adalja agrees, noting that there isn’t a lot of data on how people do with flurona given that it doesn’t happen often. “It’s unclear what the severity may be,” he said.

How can you get flurona?

Both the flu and COVID-19 are most commonly spread via infected droplets, per the CDC, and people can simply be exposed to both viruses at the same time or around the same time, Russo said. This means you could contract COVID-19 one day and the flu the next and develop flurona.

Here’s the thing: These two viruses won’t necessarily “outcompete” each other to protect you from one when you have the other. “They utilize different receptors in your body,” Russo explained. As a result, you can get the full flu and COVID-19 experience — at the same time — when you have flurona.

What are the symptoms of flurona?

Flurona won’t cause new symptoms that you wouldn’t get with one illness or the other, Russo said. So, you could experience any of the symptoms of either condition at once.

For the COVID-19 portion of the illness, that means you could experience the following, per the CDC, which include omicron variant symptoms:

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

For the flu part of flurona, the CDC says you could have any of the following symptoms:

  • Fever or feeling feverish
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Muscle or body aches
  • Headaches
  • Fatigue
  • Vomiting and diarrhea (this is more common in children than adults)

How is flurona treated?

There is no specific treatment for flurona. “The treatment is for the individual viruses,” Adalja said. So, you might be prescribed oseltamivir (Tamiflu) if it’s been within 48 hours since you developed symptoms. And, if you qualify for Pfizer's Paxlovid and Merck's molnupiravir antiviral COVID-19 pills, your doctor may give them to you or another COVID-19 treatment like monoclonal antibodies or remdesivir, Russo said.

It’s pretty much impossible to know on your own if you have flurona, Russo said, adding that it can also be tricky for your doctor to tell without testing you for both illnesses. So, if you feel sick with symptoms of either COVID-19 or the flu, it’s important to get tested and get the appropriate treatment from there.