As holiday season gets underway, here’s how to protect yourself and your family from respiratory viruses

ANY PATIENT. THEY THINK IT WILL HELP. YOU KNOW, WE USED TO CALL IT COLD AND FLU SEASON, RIGHT? WELL, NOW IT’S MORE LIKE COLD FLU, COVID, RSV, SOMETHING ELSE. SEASON. HOW LONG DO THESE GERMS LAST, THOUGH? RIGHT. THAT’S THE QUESTION. AND WHEN ARE YOU MOST CONTAGIOUS? SO HERE ARE THE ANSWERS. DR. TODD ELLERIN, CHIEF OF INFECTIOUS DISEASES AT SOUTH SHORE HEALTH, TO HELP US OUT HERE. HOW ARE YOU DOING, DR. ELLERIN? HEY, DR. GREAT TO SEE YOU. SO, ALL RIGHT. SO LET’S START WITH THE FIRST ONE. LET’S START WITH THE COLD AND THE FLU. WELL, THERE’S THAT. THE FIRST TWO, THESE ARE THE OLD SCHOOL GERMS, RIGHT? NEARLY EVERYONE HAS HAD ONE OR THE OTHER OR BOTH AT THE SAME TIME AT SOME POINT. BUT SOMETIMES SYMPTOMS LINGER EVEN LONGER. DOES THAT MEAN THEY’RE CONTAGIOUS FOR A LONG TIME, TOO? USUALLY NOT. WHEN WE TALK ABOUT RUN OF THE MILL FLU, THAT’S INFLUENZA. USUALLY YOU’RE CONTAGIOUS. FOR THE FIRST FEW DAYS, MUCH MORE. YOU KNOW, THE AMOUNT OF VIRUS COMES UP AND IT COMES DOWN. WE THINK THAT YOU GENERALLY ARE MORE CONTAGIOUS WHEN YOU HAVE HIGH FEVERS AS WELL. AGAIN, SOME PEOPLE IT MAY LAST LONGER IF YOU’RE IMMUNOCOMPROMISED, BUT GENERALLY SPEAKING, FIRST FEW DAYS, THAT’S WHY WE GET KIDS BACK TO SCHOOL. YOU HEAR THAT? AS LONG AS YOU DON’T HAVE A FEVER FOR 24 HOURS OFF TYLENOL OR IBUPROFEN, YOU CAN GO BACK TO SCHOOL. AND THAT’S GENERALLY, I THINK, GOOD RECOMMENDATIONS, RIGHT? OKAY. THE NEXT BIG ONE IS COVID. AND YOU KNOW, COMPARED TO COLD AND FLU, IT’S RELATIVELY A NEW VIRUS. WE’RE STILL LEARNING ABOUT IT. BUT IF SOMEONE IS INFECTED AND DEVELOPS SYMPTOMS, IS HOW LONG SHOULD THEY EXPECT TO FEEL SICK AND WHEN ARE THEY MOST LIKELY TO MAKE OTHERS SICK? RIGHT. AND JESSICA, I THINK IT’S VERY SIMILAR TO INFLUENZA. USUALLY IN THOSE FIRST FIVE DAYS OR SO, YOU’RE MORE CONTAGIOUS. THAT’S THE REASON THAT YOU KNOW, WE’RE TOLD TO ISOLATE FOR AT LEAST FIVE DAYS BEFORE YOU CAN GO OUT. YOU COULD BE CONTAGIOUS A LITTLE BIT BEYOND THAT. THAT’S WHY YOU’RE SUPPOSED TO MASK UP UNTIL DAY TEN AGAIN. BUT YOU’RE PROBABLY LESS CONTAGIOUS AT THAT POINT AS FAR AS HOW PATIENTS DO YOU KNOW THIS IN 1 IN 1 FAMILY, YOU CAN HAVE SOMEONE WHO’S ASYMPTOMATIC, NO SYMPTOMS, AND ANOTHER PERSON THAT HAS VERY MILD SYMPTOMS. YOU’RE BETTER IN A FEW DAYS AND ANOTHER PERSON THAT ENDS UP IN THE HOSPITAL OR FIGHTING FOR THEIR LIFE. USUALLY THOSE ARE THE MORE, YOU KNOW, PATIENTS WITH COMORBIDITIES, IMMUNOCOMPROMISED, THOSE ARE REALLY THE ONES YOU WANT TO GET VACCINATED. REMEMBER, YOU CAN VACCINATE ANYONE OVER SIX MONTHS. SAME WITH THE FLU. AND SO SO DOCTOR T, THE FIRST STEP YOU’VE BEEN DEALING WITH RSV FOR A LONG TIME, RIGHT? THAT’S TRUE. RIGHT? WE HAVE SO MANY PEOPLE HADN’T HEARD OF IT REALLY UNTIL THE BIG SURGE LAST FALL. SO THE SAME QUESTIONS APPLY. SICK FOR HOW LONG AND WHEN ARE PATIENTS MOST CONTAGIOUS? AGAIN, SIMILAR TO FLU AND COVID, YOU’RE MORE CONTAGIOUS EARLY ON THOSE FIRST FEW DAYS. MAYBE YOU MIGHT BE CONTAGIOUS A LITTLE BIT LONGER THAN INFLUENZA. BUT GENERALLY, AGAIN, THAT FIRST WEEK MORE CONTAGIOUS THAN THE SECOND WEEK. USUALLY THE CONTAGION HAS GONE AWAY. THESE CAN ALL GIVE SIMILAR SYMPTOMS. THAT’S WHAT’S IMPORTANT. AND REMEMBER, RSV, WHAT I WANT TO SAY ABOUT IT IS WHILE WE ONLY THINK OF IT FOR THE INFANTS AND THE YOUNG ONES, YOU CAN ALSO GET IT IN THE OLDER POPULATION. AND WE NOW HAVE TWO VACCINES THAT CAN BE GIVEN FOR 60 AND OLDER. AND ONE OF THOSE VACCINES YOU CAN GIVE TO PREGNANT WOMEN BETWEEN 32 AND 36 WEEKS. WE ALSO HAVE A MONOCLONAL RSV ANTIBODY FOR YOUNG KIDS UNDER SEVEN MONTHS IF THEY’RE ABOUT TO BE DELIVERED AND ARE FACING THE RSV SEASON. SO GENERALLY, SEPTEMBER AND INTO THE WINTER AND SO THAT’S GOOD NEWS. VERY GOOD NEWS, GREAT REMINDERS.

With Thanksgiving just days away, people across the United States are finalizing travel plans or racing through grocery stores in search of the perfect turkey, but there's another plan to consider ahead of the holiday season: how to stay healthy and avoid the mix of seasonal viruses in circulation.Flu cases continue to pick up in most parts of the country, particularly the South and the West, according to data from the U.S. Centers for Disease Control and Prevention.COVID-19 and respiratory syncytial virus are also spreading as many Americans hit the road and take to the skies this week, noted Dr. Peter Chin-Hong, an infectious disease specialist at the University of California at San Francisco — and they'll be touching common surfaces that may be contaminated and sharing air with infected people."A lot of people are going to be traveling at record numbers for Thanksgiving and the holiday period," he said. "That means that risk is going to be mixed in from all around the country."While navigating a sea of strangers may seem intimidating for the health-conscious, experts say there are a number of familiar precautions you can take to keep from catching an illness from fellow travelers or out-of-town visitors this year.'Don't let your guard down'Some Americans have continued to wear masks well into 2023, but many cast the practice aside as local jurisdictions eased COVID-19 guidelines. However, Chin-Hong said that wearing a mask on public transport and at the airport is still one of the best things you can do to prevent the spread of disease."I know we think about masking as something that people do when they don't want to get , but if you have mild symptoms, wearing a mask is actually going to prevent other people from getting what you have, even if it's a common cold," he said.Masking is also key in areas with limited ventilation and airflow, such as the stuffy jet bridges that passengers stand in while waiting to board a flight. Chin-Hong adds that masks should also be worn on flights, even if there is good ventilation, as an added layer of protection from people who are coughing and sneezing.When it comes to Thanksgiving dinner or meeting up with old friends, try to avoid gathering in crowded spaces, Chin-Hong recommends."The hole-in-the-wall bar is going to be a little bit riskier," he said. "But if you sit by the window, that's going to be less risky."Handwashing is also a good habit to practice during the holidays, Chin-Hong said. If soap and water aren't available, a hand sanitizer with at least 60% alcohol can kill many germs, according to the CDC. It's also a good rule of thumb to avoid touching your eyes, nose and mouth to avoid spreading germs.In theory, Chin-Hong said, the only way to make sure you don't pick up a virus while traveling for the holidays is to not travel at all, but that's not a reality for most Americans. About 55 million people are expected to travel between the Wednesday before Thanksgiving and the Sunday after the holiday, AAA forecasts. Nearly 3 million people are expected to hit airports nationwide on the Sunday after Thanksgiving alone, according to the Transportation Security Administration. Not everyone will be flying, however. A majority of Americans — more than 49 million — will be driving to their destinations. Chin-Hong said some people may see this as a safer alternative to milling about an airport or sitting on an airplane, but a car is still an enclosed space."People let their guard down because they know somebody, but of course, the virus doesn't care if you're related to the person," he said. "I got COVID last Thanksgiving, and it was from a relative. They were visiting, and I let my guard down. I didn't think of them as a stranger on the street."Chin-Hong said many Americans have become nonchalant about circulating viruses. In fact, about three-quarters of adults say they are "not too worried" or "not at all worried" about getting COVID-19 over the holidays, according to a new survey from KFF, and two-thirds say they are not worried about spreading the virus to people close to them.If you're worried about spreading a virus, Chin-Hong said that testing — whether for COVID-19, the flu or RSV — is a good option that should be utilized more often, especially if you're headed to visit young, elderly or at-risk relatives, such as those with compromised immune systems or pregnant people."It's hard to go by symptoms alone," he said. "Getting a test is an important way to distinguish what's happening, particularly for flu and COVID. It's important for those at risk, because you can get early therapy that can shorten the course or prevent hospitalization."Vaccines are availableFor the first time, there are vaccines available to protect against COVID-19, influenza and RSV, and now is the time for everyone eligible to get vaccinated, experts stress.Everyone 6 months and older should get COVID-19 and flu shots, the CDC recommends. Both are available now at retail pharmacy chains like CVS and Walgreens, and you can even get them at the same time.Ideally, Chin-Hong said, very young children should have gotten their flu shot last month. Even if parents have not received their own flu shot, at the very least, they should get their child vaccinated."Kids actually have a very high rate of doing poorly with flu," he said.RSV is another dangerous virus for young children and infants. Nirsevimab, marketed as Beyfortus, is a long-acting monoclonal antibody injection to protect infants against severe illness related to RSV.Although doses are in short supply, the CDC announced Thursday that more than 77,000 additional doses will be distributed "immediately" to doctor's offices and hospitals.For people 60 and older, there are also two vaccines for RSV, and the CDC is encouraging people to get them as soon as possible. The vaccines are also available at pharmacy chains and other retailers, and at local health clinics.Staying up to date on vaccinations can help take a load off hospitals, many of which were overwhelmed with RSV, flu and COVID-19 last year, Chin-Hong said.Make sure you have cold and flu medications like acetaminophen and ibuprofen, "particularly for kids," he said, because many of those medications were in short supply due to overwhelming demand last winter.'It's good to be humble'In most parts of the country, seasonal flu activity is increasing once again after taking a backseat during the COVID-19 pandemic. According to the CDC, flu-like activity was high in Puerto Rico and several Southern U.S. states for the week ending Nov. 11, with Louisiana reporting very high flu activity. During this week, 3.5% of health care visits were due to respiratory illness that included fever plus a cough or sore throat.Meanwhile, Western states like Alaska, New Mexico, California and Texas are seeing more cases, according to CDC data.More than a third of U.S. adults and nearly a third of children have gotten their flu shot this year, the CDC said. By comparison, about 14% of adults and 5% of children have gotten the new COVID-19 vaccine, and about 14% of older adults 60 and up have gotten the new RSV vaccine.Overall, outpatient visits for flu-like illness are lower than they were at this time last year but higher than in the previous four seasons. COVID-19 hospital admissions, emergency department visits, and test positivity are all trending down, CDC data shows. For the week ending Nov. 11, the percentage of COVID-related emergency department visits was 1.4%, or just over 16,200 people – similar to rates seen throughout this month and last month.The last time we saw a "significant" spike in flu activity was about a year ago, Chin-Hong notes, "so a lot of immunity has gone away, whereas we've had successive waves of COVID," in the past year, he said.Even though COVID-19 is trending down at the moment, it's still a virus to keep in mind, since it continues to cause serious illness and death, Chin-Hong said, noting that he expects to see another spike in the new year."There are things that we can't always predict, and I think it's good to be humble about all of these viruses and how they work and when they peak," he said.CNN's Deidre McPhillips contributed to this report.

Flu cases continue to pick up in most parts of the country, particularly the South and the West, according to data from the U.S. Centers for Disease Control and Prevention.

COVID-19 and respiratory syncytial virus are also spreading as many Americans hit the road and take to the skies this week, noted Dr. Peter Chin-Hong, an infectious disease specialist at the University of California at San Francisco — and they'll be touching common surfaces that may be contaminated and sharing air with infected people.

"A lot of people are going to be traveling at record numbers for Thanksgiving and the holiday period," he said. "That means that risk is going to be mixed in from all around the country."

While navigating a sea of strangers may seem intimidating for the health-conscious, experts say there are a number of familiar precautions you can take to keep from catching an illness from fellow travelers or out-of-town visitors this year.

'Don't let your guard down'

Some Americans have continued to wear masks well into 2023, but many cast the practice aside as local jurisdictions eased COVID-19 guidelines. However, Chin-Hong said that wearing a mask on public transport and at the airport is still one of the best things you can do to prevent the spread of disease.

"I know we think about masking as something that people do when they don't want to get [sick], but if you have mild symptoms, wearing a mask is actually going to prevent other people from getting what you have, even if it's a common cold," he said.

Masking is also key in areas with limited ventilation and airflow, such as the stuffy jet bridges that passengers stand in while waiting to board a flight. Chin-Hong adds that masks should also be worn on flights, even if there is good ventilation, as an added layer of protection from people who are coughing and sneezing.

When it comes to Thanksgiving dinner or meeting up with old friends, try to avoid gathering in crowded spaces, Chin-Hong recommends.

"The hole-in-the-wall bar is going to be a little bit riskier," he said. "But if you sit by the window, that's going to be less risky."

Handwashing is also a good habit to practice during the holidays, Chin-Hong said. If soap and water aren't available, a hand sanitizer with at least 60% alcohol can kill many germs, according to the CDC. It's also a good rule of thumb to avoid touching your eyes, nose and mouth to avoid spreading germs.

In theory, Chin-Hong said, the only way to make sure you don't pick up a virus while traveling for the holidays is to not travel at all, but that's not a reality for most Americans. About 55 million people are expected to travel between the Wednesday before Thanksgiving and the Sunday after the holiday, AAA forecasts. Nearly 3 million people are expected to hit airports nationwide on the Sunday after Thanksgiving alone, according to the Transportation Security Administration.

Not everyone will be flying, however. A majority of Americans — more than 49 million — will be driving to their destinations. Chin-Hong said some people may see this as a safer alternative to milling about an airport or sitting on an airplane, but a car is still an enclosed space.

"People let their guard down because they know somebody, but of course, the virus doesn't care if you're related to the person," he said. "I got COVID last Thanksgiving, and it was from a relative. They were visiting, and I let my guard down. I didn't think of them as a stranger on the street."

Chin-Hong said many Americans have become nonchalant about circulating viruses. In fact, about three-quarters of adults say they are "not too worried" or "not at all worried" about getting COVID-19 over the holidays, according to a new survey from KFF, and two-thirds say they are not worried about spreading the virus to people close to them.

If you're worried about spreading a virus, Chin-Hong said that testing — whether for COVID-19, the flu or RSV — is a good option that should be utilized more often, especially if you're headed to visit young, elderly or at-risk relatives, such as those with compromised immune systems or pregnant people.

"It's hard to go by symptoms alone," he said. "Getting a test is an important way to distinguish what's happening, particularly for flu and COVID. It's important for those at risk, because you can get early therapy that can shorten the course [of the virus] or prevent hospitalization."

Vaccines are available

For the first time, there are vaccines available to protect against COVID-19, influenza and RSV, and now is the time for everyone eligible to get vaccinated, experts stress.

Everyone 6 months and older should get COVID-19 and flu shots, the CDC recommends. Both are available now at retail pharmacy chains like CVS and Walgreens, and you can even get them at the same time.

Ideally, Chin-Hong said, very young children should have gotten their flu shot last month. Even if parents have not received their own flu shot, at the very least, they should get their child vaccinated.

"Kids actually have a very high rate of doing poorly with flu," he said.

RSV is another dangerous virus for young children and infants. Nirsevimab, marketed as Beyfortus, is a long-acting monoclonal antibody injection to protect infants against severe illness related to RSV.

Although doses are in short supply, the CDC announced Thursday that more than 77,000 additional doses will be distributed "immediately" to doctor's offices and hospitals.

For people 60 and older, there are also two vaccines for RSV, and the CDC is encouraging people to get them as soon as possible. The vaccines are also available at pharmacy chains and other retailers, and at local health clinics.

Staying up to date on vaccinations can help take a load off hospitals, many of which were overwhelmed with RSV, flu and COVID-19 last year, Chin-Hong said.

Make sure you have cold and flu medications like acetaminophen and ibuprofen, "particularly for kids," he said, because many of those medications were in short supply due to overwhelming demand last winter.

'It's good to be humble'

In most parts of the country, seasonal flu activity is increasing once again after taking a backseat during the COVID-19 pandemic. According to the CDC, flu-like activity was high in Puerto Rico and several Southern U.S. states for the week ending Nov. 11, with Louisiana reporting very high flu activity. During this week, 3.5% of health care visits were due to respiratory illness that included fever plus a cough or sore throat.

Meanwhile, Western states like Alaska, New Mexico, California and Texas are seeing more cases, according to CDC data.

More than a third of U.S. adults and nearly a third of children have gotten their flu shot this year, the CDC said. By comparison, about 14% of adults and 5% of children have gotten the new COVID-19 vaccine, and about 14% of older adults 60 and up have gotten the new RSV vaccine.

Overall, outpatient visits for flu-like illness are lower than they were at this time last year but higher than in the previous four seasons. COVID-19 hospital admissions, emergency department visits, and test positivity are all trending down, CDC data shows. For the week ending Nov. 11, the percentage of COVID-related emergency department visits was 1.4%, or just over 16,200 people – similar to rates seen throughout this month and last month.

The last time we saw a "significant" spike in flu activity was about a year ago, Chin-Hong notes, "so a lot of immunity has gone away, whereas we've had successive waves of COVID," in the past year, he said.

Even though COVID-19 is trending down at the moment, it's still a virus to keep in mind, since it continues to cause serious illness and death, Chin-Hong said, noting that he expects to see another spike in the new year.

"There are things that we can't always predict, and I think it's good to be humble about all of these viruses and how they work and when they peak," he said.

CNN's Deidre McPhillips contributed to this report.

As holiday season gets underway, here’s how to protect yourself and your family from respiratory viruses

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'Don't let your guard down'

Vaccines are available

'It's good to be humble'

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