Red Alert for Winter Season ‘Tripledemic:’ Flu, RSV, and COVID-19 Cases are Rising in Turkey and Europe - Vitrosens Biotechnology - Human and Animal Health Rapid Test Kits

Red Alert for Winter Season ‘Tripledemic:’ Flu, RSV, and COVID-19 Cases are Rising in Turkey and Europe

14/02/2024

As winter tightens its grip on the Northern Hemisphere, a concerning phenomenon is unfolding across Turkey and Europe – a ‘Tripledemic.’ The simultaneous surge in flu, Respiratory Syncytial Virus (RSV), and COVID-19 cases is posing a significant challenge to public health systems. In this blog, we will delve into the reasons behind this winter health crisis and explore the potential impact on communities.

Red Alert for Winter Season ‘Tripledemic Flu RSV and COVID 19 Cases are Rising in Turkey and Europee
Red Alert for Winter Season ‘Tripledemic’ Flu, RSV, and COVID-19 Cases are Rising in Turkey and Europe

What is Tripledemic?

The ‘Tripledemic’ refers to the concurrent prevalence of three respiratory viruses—flu, RSV, and COVID-19—during the winter season. Winter has always been associated with an uptick in respiratory infections, but the co-circulation of influenza, RSV, and the ongoing COVID-19 pandemic has created a perfect storm. The convergence of these viruses is straining healthcare infrastructure, leading to increased hospitalizations and a surge in demand for medical resources.

What is Tripledemic
What is Tripledemic?

Overlapping Symptoms and Diagnostic Challenges:

One of the challenges posed by the ‘Tripledemic’ is the similarity in symptoms among the three respiratory illnesses. Fever, cough, and difficulty breathing are common manifestations, making it difficult to differentiate between the viruses without proper diagnostic testing. This overlap complicates both diagnosis and treatment, potentially delaying timely interventions.

Symptoms of RSV COVID 19 and Flu.
Symptoms of RSV, COVID-19 and Flu.

Risk Groups of Tripledemic:

The elderly, young children, and individuals with underlying health conditions are particularly vulnerable to the triple threat of flu, RSV, and COVID-19. The increased risk of severe illness in these populations necessitates heightened vigilance and targeted preventive measures. Vaccination campaigns and public health initiatives become crucial tools in mitigating the impact on vulnerable communities.

Children are the major risk group for RSV.
Children are the major risk group for RSV.

Prevention of Tripledemic:

Vaccination remains a cornerstone in the battle against the ‘Tripledemic.’ Governments and health authorities are emphasizing the importance of getting vaccinated against influenza, RSV, and COVID-19. A robust vaccination strategy not only protects individuals but also contributes to community immunity, reducing the overall burden on healthcare systems.

Vaccination is the most powerful weapon in the battle against the Tripledemic.
Vaccination is the most powerful weapon in the battle against the Tripledemic.

Also, as the winter ‘Tripledemic’ unfolds, adherence to public health measures becomes paramount. Wearing masks, practicing good hand hygiene, and maintaining physical distancing are essential in reducing the transmission of respiratory viruses. Individuals must also take personal responsibility for their health, seeking timely medical attention if symptomatic and staying informed about the latest public health guidelines.

Flu, RSV, and COVID-19 Cases are Rising in Turkey and Europe

The escalating cases of influenza (flu), Respiratory Syncytial Virus (RSV), and COVID-19 in Turkey and Europe have raised concerns, signaling the onset of a challenging period often referred to as a ‘Tripledemic.’ As winter tightens its grip, the co-circulation of these three respiratory viruses poses significant health risks and strains healthcare systems.

Flu Resurgence:

According to the ECDC Communicable Disease Threats Report, by the end of week 1 in January 2024, rates of influenza-like illness (ILI) and/or acute respiratory infection (ARI) in the community continue to increase across most EU/EEA countries. Seasonal influenza, predominantly influenza type A, particularly the A(H1)pdm09 viruses, is circulating at higher levels than SARS-CoV-2 and RSV. The resurgence of the flu, known for its typical symptoms like fever, cough, and body aches, has been observed, contributing to the Tripledemic scenario.

Acute Respiratory Infection incidinces 2023 2024 in Germany
Acute Respiratory Infection incidinces, 2023-2024, in Germany.

Test positivity for seasonal influenza among Severe Acute Respiratory Infection (SARI) cases increased to 41% in week 1, 2024, and country-specific test positivity rates among Severe Acute Respiratory Infection (SARI) cases have varied, reaching 71% in the 5-14 years age group in some countries with the majority of infections being typed as influenza A.

RSV Impact:

RSV activity peaked around week 50 in 2023, affecting predominantly children aged 0–4 years. As of week 1 in 2024, a decline in RSV detections has been reported, as per the ECDC report. This respiratory virus, characterized by symptoms such as runny nose, cough, and wheezing, remains a significant concern, especially in younger age groups. However, the ECDC underscores that data for weeks 51 in 2023 to week 1 in 2024 must be interpreted with caution due to decreased testing and reporting during the holiday period.

COVID-19 Challenges:

The trajectory of COVID-19 cases has exhibited fluctuations. According to the ECDC, SARS-CoV-2 transmission surged until week 49 in 2023, followed by a decline. The dominating lineage, BA.2.86, is rapidly increasing in EU/EEA countries, particularly affecting individuals aged 65 and above. For instance, Belgium reported a proportion of 75.6%, whereas Denmark’s proportion was 91.2%. Variants like XBB.1.5 displayed diverse prevalence levels, ranging from 7.4% to 47.2% across EU/EEA countries.

Forecasts of COVID 19 cases in Belgium to 2023 2024
Forecasts of COVID-19 cases in Belgium, to 2023-2024.

The symptoms of COVID-19, including fever, shortness of breath, and loss of taste or smell, continue to contribute to the overall respiratory health challenges. The ECDC advises continued monitoring and adaptation of strategies to the evolving situation.

Tripledemic Rates Increases in The USA

The tripledemic wave is not only sweeping across Europe but also making its presence felt in the United States. According to the CDC Report, In the United States, the Tripledemic scenario persists with elevated respiratory illness activity, though a slight decrease is noted this week. Emergency department visits for influenza, COVID-19, and RSV remain high, potentially influenced by holiday-related healthcare-seeking behavior.

Percentage of total emergency department vissit each week for COVID 19 the flu and RSV in USA according to the CDC.
Percentage of total emergency department vissit each week for COVID-19, the flu and RSV in USA, according to the CDC.

As of January 12th, 2024, COVID-19 test positivity is stable at 12.7%, while influenza positivity decreased to 14.0%, and RSV remains stable at 9.9%. Wastewater viral activity for COVID-19 is very high nationwide, with all regions experiencing increasing levels. The CDC underscores ongoing vigilance and a comprehensive public health response, emphasizing vaccination and surveillance to manage the impact of this complex respiratory landscape.

Diagnosis Methods for Tripledemic:

The Tripledemic, characterized by the concurrent presence of influenza, Respiratory Syncytial Virus (RSV), and COVID-19, demands a nuanced diagnostic approach. Healthcare professionals employ diverse methods to efficiently differentiate between these respiratory illnesses.

Clinical Assessment:

  • Flu: It manifests through symptoms such as fever, cough, body aches, and fatigue.
  • RSV: Presentation includes symptoms like runny nose, cough, and wheezing, often affecting children.
  • COVID-19: Symptoms span from fever and cough to loss of taste or smell and shortness of breath.

PCR Testing:

  • A gold standard for COVID-19, Polymerase Chain Reaction (PCR) tests amplify and detect viral genetic material, ensuring accuracy.
  • PCR assays are employed for specific identification of influenza and RSV.

Rapid Antigen Tests:

  • These tests deliver immediate results, crucial for timely identification of suspected cases.
  • However, they are less sensitive than PCR tests, particularly in cases with lower viral loads.

Viral Cultures:

  • Cultures assist in isolating and identifying the specific virus causing respiratory symptoms.
  • This method enables tailored treatment strategies based on the identified viral strain.

Imaging Studies:

  • Chest X-rays reveal pneumonia or respiratory distress in cases of flu and RSV.
  • Chest CT scans in COVID-19 cases show characteristic lung abnormalities, enhancing diagnostic precision.

Managing the Tripledemic necessitates a multi-faceted diagnostic approach, considering symptoms, laboratory results, imaging studies. Healthcare professionals adapt their strategies based on the evolving clinical landscape to ensure accurate diagnosis and appropriate management of these complex respiratory challenges.

The Most Effective and Commonly Used Test Kits for Tripledemic

Rapid test kits play a crucial role in swiftly identifying suspected cases during outbreaks like Tripledemic, providing a significant advantage in outbreak management. Their quick results and rapid turnaround times are particularly valuable for making timely decisions and interventions.They emerge as a critical tool in alleviating outbreak impacts and controlling their spread. Here are the most valuable diagnostic tools for tripledemic;

The SARS-CoV-2 Rapid Antigen Test Kit employs colloidal labels for detecting SARS-CoV-2 antigens in nasopharyngeal, nasal, and oropharyngeal specimens. It offers ease of use and reading, requiring no additional lab equipment. The kit includes variant detection capabilities for various strains, including B.1.1.7 (Alpha), B.1.351 (Beta), E484K mutation, B1.617.2 (Delta), P.1 (Gamma), C.37 (Lambda), B.1.1.529 (Omicron). With early phase detection, it proves to be a convenient and portable solution.

The SARS-CoV-2 & FLU A/B Antigen Combo Test Kit is designed for in vitro differentiative detection of SARS-CoV-2 & FLU A/B antigens in human nasopharyngeal and nasal swab samples. With its user-friendly design, the kit offers ease of use and reading without the need for additional lab equipment. It serves as a 2-in-1 test for Influenza and SARS-CoV-2, incorporating variant detection for strains such as B.1.1.7 (Alpha), B.1.351 (Beta), E484K mutation, B1.617.2 (Delta), P.1 (Gamma), C.37 (Lambda), B.1.1.529 (Omicron). Providing early phase detection, it is suitable for rapidly screening a large number of people.

Test procedure of the SARS CoV 2 FLU AB Antigen Combo Test Kit
Test procedure of the SARS-CoV-2 & FLU AB Antigen Combo Test Kit

The SARS-CoV-2 + Flu A/B + RSV Combo Rapid Test Kit is designed for in vitro qualitative and differentiative detection of SARS-CoV-2, FLU A/B, and RSV antigens in nasopharyngeal swab samples, utilizing a lateral flow sandwich assay. With its 3-in-1 testing capability for SARS-CoV-2, FLU A/B, and RSV, the kit aids in differentiating respiratory diseases, providing fast and accurate results. The test procedure is easy, facilitating early diagnosis.

The Influenza A/B Rapid Test Kit is a single-test solution designed to identify both Influenza A and B viral nucleoprotein antigens in human nasopharyngeal samples. Offering a 2-in-1 test for both influenza A and B, the kit utilizes nasopharyngeal swabs, ensuring ease of performance. Results are available within 15 minutes, utilizing a safe, efficient, and accurate testing methodology.

The RSV Rapid Test Kit is designed for in vitro qualitative identification of the RSV nucleocapsid antigen in nasopharyngeal swab samples, employing a lateral flow sandwich assay. With usability for early diagnosis, the kit offers a simple sampling process, ensuring safe and reliable performance. Results are available within 15 minutes, showcasing a high level of sensitivity and accuracy.

Test procedure of the RSV Rapid Test Kit
Test procedure of the RSV Rapid Test Kit

The Respiratory ID-4 Genotyping qPCR Kit is designed for in vitro qualitative diagnosis of respiratory pathogens’ nucleic acids from various sources. This rapid RT-PCR test facilitates Real-Time PCR analysis for effective and timely results. Bacterial respiratory tract infections, which may follow a viral illness, are characterized by symptoms localized to a specific area. The kit targets viral agents such as Influenza A, Influenza B, SARS-CoV-2, and RSV.

Interpretation of results of the Respiratory Infection ID 4 Genotyping qPCR Kit sample result for positive and negative patient sample
Interpretation of results of the Respiratory Infection ID-4 Genotyping qPCR Kit sample result for positive and negative patient sample.

The Influenza A/B Detection qPCR Kit is specifically designed for the in vitro qualitative detection of Influenza A and B viral nucleic acids. This qPCR kit provides a reliable method for identifying and confirming the presence of Influenza A and B in various samples, aiding in timely and accurate diagnosis.

The Influenza A/B Rapid Antigen Test Kit (FIA) utilizes fluorescence immunoassay for the detection of influenza infection in human nasal and nasopharyngeal swab specimens, distinguishing between influenza virus types A and B. With advantages such as aiding in the auxiliary diagnosis of influenza virus, an easy-to-operate interface, accurate results, and maximized sensitivity, this kit proves valuable for efficient and reliable influenza detection.

The RSV Rapid Test Kit (FIA) utilizes the fluorescence immunoassay technique for the qualitative detection of Respiratory Syncytial Virus (RSV) antigens in nasopharyngeal swab samples. This kit provides fast, accurate, and reliable results, contributing to the efficient diagnosis of RSV infections.

Immunofluorescence Analyzer device helps to identify SARS CoV 2 antigens in samples with using immuno fluorescent assay technology. 1
Immunofluorescence Analyzer device, helps to identify SARS-CoV-2 antigens in samples with using immuno fluorescent assay technology.

The SARS-CoV-2 Rapid Antigen Test Kit (FIA) employs the immuno fluorescent assay technique for detecting SARS-CoV-2 antigens in collected nasopharyngeal samples. With advantages such as improved sensitivity, a cut-off index provided by a printer, accurate results, a user-friendly interface, fast results, and the ability to record test results, this kit offers efficient and reliable SARS-CoV-2 antigen detection.

REFERENCES

  1. Centers for Disease Control and Prevention. (2023b, September 13). Respiratory virus activity levels. Centers for Disease Control and Prevention. https://www.cdc.gov/respiratory-viruses/data-research/dashboard/activity-levels.html
  2. Week 2, 7 – 13 January 2024 this Week’s topics – european centre for … (n.d.-a). https://www.ecdc.europa.eu/sites/default/files/documents/communicable-disease-threats-report-week-2-2024.pdf
  3. Agca, H., Akalin, H., Saglik, I., Hacimustafaoglu, M., Celebi, S., & Ener, B. (2021). Changing epidemiology of influenza and other respiratory viruses in the first year of COVID-19 pandemic. Journal of infection and public health14(9), 1186-1190.
  4. Pınarbaşı, A. G. D. Ş., & Koçak, Ö. Ü. C. Trı̇pledemı̇c: COVID-19, İnfluenza ve RSV.
  5. Walsh, E. E., & Hall, C. B. (2015). Respiratory syncytial virus (RSV). Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases, 1948.
  6. Wu, D., Wu, T., Liu, Q., & Yang, Z. (2020). The SARS-CoV-2 outbreak: what we know. International journal of infectious diseases94, 44-48.
  7. MacMillan, C. (2023, January 12). “tripledemic:” what happens when flu, RSV, and covid-19 cases collide? Yale Medicine. https://www.yalemedicine.org/news/tripledemic-flu-rsv-and-covid-19

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Vitrosens Biotechnology is a high-tech company in Turkey founded for the development, manufacture, and delivery of in vitro diagnostic devices (IVD) to the world.
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