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The CDC is warning of elevated levels of non-COVID respiratory illnesses in recent weeks -- including rising cases of influenza, respiratory syncytial virus (RSV), and rhinovirus.

The surge stands in contrast to the lower activity of these viruses seen during the past couple of pandemic years, as a result of the various mitigation measures for COVID-19.

While COVID cases have "leveled off" in the last few weeks, it is "not gone," and now many children are being exposed to other respiratory viruses for the first time, said José R. Romero, MD, director of the National Center for Immunization and Respiratory Diseases, during a call with reporters on Friday.

With regard to the potential harms to expect this flu season, Dawn O'Connell, the HHS Assistant Secretary for Preparedness and Response, was careful not to cause alarm.

"What we know right now is that we are seeing an early season. As far as how severe the season will be ... right now we're not seeing anything that would lead us to believe that it is more severe," she said.

Influenza-Like Illnesses

The CDC is carefully tracking the percentage of visits to outpatient sites and emergency departments related to "influenza-like illnesses," symptoms of which include "fever plus cold or sore throat," Romero explained, pointing out that cases in the U.S. are high for this time of year.

"In fact, we're seeing the highest influenza hospitalization rates going back a decade," he added, and the CDC has reported the of the 2022-2023 season.

In the southeastern part of the country, almost 20% of respiratory specimens have tested positive for influenza. Most have been positive for influenza A (H3N2), which has been associated with more severe disease in young children and older adults.

In the mid-Atlantic and Midwest, the CDC has seen a "growing proportion of H1N1 virus" and "early signs of influenza causing severe illness," particularly in young children and older adults, as well as higher flu-related hospitalizations reported to the Influenza Hospitalization Surveillance Network for both groups, and for people of all ages, compared with the same time last year and previous years.

RSV

Most children experience a mild version of RSV before the age of 2 years. The virus typically leads to a cold, but in children younger than 1 year, RSV is the most common cause of bronchiolitis and pneumonia, Romero said. He noted that children ages 4 years and younger are the most likely to be hospitalized, and that it can also be serious in older adults.

Symptoms tend to appear 4 to 6 days after exposure, and for older children, adolescents, and adults, the virus tends to last 1 to 2 weeks, he explained.

RSV activity has continued to increase across the country, except for the South and South Central states, according to the . Preliminary data also suggest a decline in RSV cases in Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming.

In some areas, "it seems like RSV is trending downward and influenza is beginning to increase or surge," Romero said. However, all of the data suggest RSV activity is "significantly higher" than last year.

Prevention, Treatment, Warning Signs

Romero flagged the following "emergency warning signs" for infants and young children, urging parents or caregivers to immediately seek medical attention if these signs emerge:

• Fast breathing
• Trouble breathing
• Bluish lips or face
• Chest pain
• Muscle pain
• Dehydration

Other warning signs may include a lack of alertness or engagement, refusing to walk, or crying "excessively" when picked up.

Vaccines for COVID-19 and influenza are safe and effective, and "protect against severe complications," Romero noted. With the holidays approaching, he stressed that vaccination is "your best protection against infection."

In addition to vaccinations, Romero recommended practicing "cough hygiene," staying away from people who are sick, frequent handwashing, and using alcohol-based hand sanitizers.

"People may also choose to wear a well-fitting mask as an added precaution," he said.

For influenza and COVID-19, antiviral drugs are available and work best when started early, he added.

Following the call, the CDC released a highlighting ways to test for, treat, and prevent respiratory illnesses.

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