If you or a family member has the flu or other respiratory infection, Dr. Tina Ardon, a Mayo Clinic family medicine physician, says there are ways to manage most respiratory infection symptoms at home.

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"Most upper respiratory infections can be managed at home," says Dr. Ardon.

That can start by staying hydrated, which is important part of the body's recovery process.

"If we are feeling sick and we're not drinking enough — maybe we have a high fever or throwing up, we have diarrhea — we are at risk of dehydration. And that may need more urgent evaluation, perhaps in the ER settings," says Dr. Ardon. 

Cough is a very common symptom of upper respiratory infections and is usually the last symptom to leave. When it comes to cough, time is the best treatment.

"For the most part, cough will resolve on its own, but some patients may benefit from using things like honey at home as long as you're over the age of 1."

She says if a cough lasts more than two weeks, that's when you should contact your healthcare team.

The other thing you can do for your body when you're sick can sometimes be the hardest.

"Take the time to rest. That's one way to help your body recover faster," says Dr. Ardon. "I often find people have a hard time turning things off to be able to rest and recover. So that really is probably key for most patients to recover fastest."

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H5N1 bird flu, also known as avian influenza, continues to spread, with reports of a third human case from an unknown exposure source. To date, 67 cases have been confirmed, and one death has been reported in the U.S.

"Most of the people are interacting with infected birds and animals, and there have been several cases where we don't have a specific history of that individual interacting with an animal or a bird that might be infected," says  Dr. Matthew Binnicker, director of the Clinical Virology Laboratory at Mayo Clinic. "And that's why we're cautious and somewhat concerned because the question arises, how did those several individuals become infected?"

There are no reports of the virus spreading from person to person, and the public health risk remains low. 

Watch: Dr. Matthew Binnicker provides update on H5N1 bird flu outbreak

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Avian influenza spreads as migratory birds carrying the virus travel between hemispheres. Wild birds can transmit the virus to poultry, farm animals and backyard flocks through respiratory secretions, droppings or shared water. Dr. Binnicker says most cases of infection in humans are from animals to humans at dairy and poultry farms.

"Right now, the primary means of transmission is from individuals interacting with an infected bird or an animal like a dairy cow, handling a sick or dead bird, and then self-inoculating the virus into your eyes, nose or mouth, or working with a dairy cow and becoming infected during the process of collecting milk. We have not seen documented human-to-human transmission of H5N1 yet," he says.

Precautions

U.S. dairy and poultry workers are encouraged to take precautions to prevent infections.

"It's really important for those who work in bird facilities or on farms where there are dairy cattle when interacting with the animals or debris from the animals that those individuals wear a mask, eye protection and gloves. Many individuals who have been affected following exposure to dairy cattle are coming down with conjunctivitis because the virus is being introduced into the eyes. There are receptors that the virus binds to in the eyes, so wearing eye protection is also important," says Dr. Binnicker.

How to protect yourself from bird flu at home:

• Cook poultry, meat and eggs to their recommended internal temperatures.
• Use only pasteurized dairy products.
• Practice good hand hygiene, especially when handling food.
• Use separate utensils for raw and cooked meat to avoid cross-contamination.

Dr. Binnicker says the U.S. is seeing the most infections due to increased testing and screening, but the virus is likely prevalent in many countries. Health officials are concerned about the potential for a large outbreak in humans. 

"We've seen now for years this growing outbreak among birds and animals and in mammals, with millions of poultry being affected in the U.S. and worldwide. We're seeing a growing number of human cases. Fortunately, those cases have been mild so far, but what we know about influenza is that the more it infects animals and humans, the better the chance it has to change and mutate. And it's a numbers game. The more times that happens, the greater the probability that a virus will arise that can transmit effectively between one person and another and cause severe disease," says Dr. Binnicker.

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You may have heard recent news reports about a surge in cases of human metapneumovirus, or HMPV, in the Northern Hemisphere, especially in China. But Dr. Matthew Binnicker, director of the Clinical Virology Laboratory at Mayo Clinic, says people shouldn't be concerned.

"In the late winter, early spring, it can account for 5% to 10% of all the respiratory infections that we diagnose in the United States. So it's definitely out there," says Dr. Binnicker.

Watch: Dr. Matthew Binnicker discusses human metapneumovirus (HMPV)

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HMPV is a respiratory illness that generally causes mild symptoms similar to the common cold that usually last just a few days.

"Typically, individuals will progressively feel worse with a runny nose, maybe a sore throat, some slight body aches, perhaps a cough. The symptoms are not typically as severe as other respiratory viruses like RSV or especially influenza," says Dr. Binnicker.

He says, like many other respiratory viruses, HMPV spreads from an infected person or through contact with a contaminated surface, and he emphasizes the importance of proper hand-washing and covering your cough.

"Human metapneumovirus is transmitted in a similar way to other respiratory viruses, like the flu and COVID and RSV, mainly through respiratory droplets that are produced while an individual coughs or sneezes. It can also be spread through what we call contaminated fomites. So if an infected individual coughs into their hand and then touches a door handle, another person could come along, touch that door handle, and then self-inoculate the virus into their eyes, nose or mouth. And that's a potential way of transmitting the virus as well," says Dr. Binnicker.

He adds that there is no approved antiviral medication to treat HMPV.

"If you would happen to go in and see your family physician with a few days history of a sore throat and a cough and a runny nose, and you were ultimately diagnosed with human metapneumovirus, they wouldn't be able to prescribe you a medication or an antiviral. They would typically just recommend supportive care. So if there's medication that you can take to reduce any body aches or reduce a fever, and staying well hydrated," says Dr. Binnicker. "Really, it all comes down to supportive care, rather than a specific drug to target the virus."

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It's a post-holiday surge. The Centers for Disease Control and Prevention (CDC) reports the number of people seeking care for acute respiratory illness is at a high level.

The latest nationwide numbers show that emergency department visits for flu, RSV and COVID-19 are all increasing. RSV, in particular, is very high in many areas, especially among young children.

Dr. Matthew Binnicker, director of the Clinical Virology Laboratory at Mayo Clinic, says the surge is not unexpected. "We are in what's called respiratory virus season right now, which basically runs between the beginning of November and the end of February. We typically see increasing rates of viral infections like influenza or respiratory syncytial virus (RSV), and, since 2020, COVID-19."

Dr. Binnicker says the symptoms of all three of those viruses can overlap, especially early on, so you probably wouldn't know which virus is causing your illness based on how you're feeling. That’s why he stresses the importance of testing. "My recommendation and guidance has been: If you start to feel ill, if you have a sore throat, cough, fever, maybe some body aches, and you have a COVID-19 antigen test at home, take that. If it's positive, you have COVID-19, and you could call your doctor if you have risk factors. And they may think about putting you on an antiviral," he says. 

Watch: Dr. Matthew Binnicker discusses acute respiratory illness

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If the COVID-19 antigen test is negative, Dr. Binnicker says you still might want to make an appointment with your healthcare team because "they can order up a test that looks for all three of those viruses. They'll get a swab, they'll send it to the lab, and they'll be able to do a molecular or PCR test that will test for COVID-19, RSV, influenza A and influenza B — all in the same test — and be able to tell you if you're infected with one of those viruses."

He says that's a good step because therapies can be considered now for COVID-19, influenza and even RSV in some populations.

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If you've been bit by a stomach bug lately, you're not alone.

Noroviruses are usually more widespread in the fall and winter, but you can get sick from the virus any time of the year. The Centers for Disease Control and Prevention (CDC) says norovirus is the leading cause of vomiting and diarrhea from acute gastroenteritis in the U.S.

Norovirus infection, sometimes referred to as stomach flu, is unrelated to the flu caused by the influenza virus. Dr. Nipunie Rajapakse, a pediatric infectious diseases physician with the Mayo Clinic Children's Center, says it's a virus that causes gastroenteritis.

"Norovirus is a type of virus that causes gastroenteritis or stomach flu. Usually, it presents with symptoms like vomiting and diarrhea. Most healthy people will have recovery over a few days. But for people with a weakened immune system, for example, their symptoms can last longer than that," she says.

Watch: Dr. Nipunie Rajapakse explains norovirus and how to avoid it

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Dehydration is a concern, especially for young children, older adults, and those with other health issues or who are pregnant. Those symptoms can include decreased urination, dry throat and mouth, and feeling dizzy when standing up.  

Transmission

"Norovirus is spread through contact with the virus. People sick with norovirus shed the virus in high amounts in their vomit and stool, so coming into contact with the virus is how you get sick. This can be through direct contact or through contaminated food, or you can pick it up from a surface. That's why hand-washing is important and the best way to prevent getting sick with norovirus," says Dr. Rajapakse.

Risk factors

The CDC says that around half of food-related sickness outbreaks caused by norovirus are linked to restaurants or food-related environments. This happens when infected food workers and staff touch food or when it is contaminated.

Dr. Rajapakse says food that is contaminated with norovirus usually looks, smells and tastes normal so it can be difficult to tell it is contaminated.

Norovirus can quickly spread, especially in confined spaces, such as day care centers, nursing homes, schools and cruise ships. These viruses are tough to eliminate since they can endure high and low temperatures and most disinfectants.

"One of the common places that we see norovirus outbreaks occur is in close confined settings, like cruise ships, for example, where you have a lot of people eating from the same places and living in close proximity to each other," says Dr. Rajapakse. "Even one case of norovirus on a cruise ship can spread quickly to others there. That's why it's crucial to make sure that you're washing your hands well, especially before you eat."

Preventing norovirus infection

Antibiotics won't help because it's a viral infection, not bacterial. The best protection is prevention.

Tips to prevent the spread of norovirus:

• Wash hands with soap and water for at least 20 seconds.
• Avoid food and water that might be contaminated.
• Clean fruits and vegetables before eating.
• Cook seafood thoroughly.
• If you're sick, stay home and avoid others.
• Avoid preparing food for others if you are sick with vomiting/diarrhea.
• Disinfect surfaces and counters that may be contaminated.

And use caution when traveling. The CDC tracks outbreaks of norovirus and other diseases. You can learn more on their website. 

The CDC says outbreaks from norovirus are usually more common in the winter months. In countries above the equator, outbreaks are most common from November to April, while they are most common from May to September in countries below the equator. 

Related post:

• Mayo Clinic Minute: What to do when sick with norovirus or ‘stomach flu’

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According to the Centers for Disease Control and Prevention, respiratory infections like colds, flu and RSV are rising across the U.S. 

When you get sick, it’s helpful to understand how to manage your symptoms effectively, especially if you’re at higher risk for complications. Dr. Tina Ardon, a family medicine physician at Mayo Clinic, offers tips for managing common viral illnesses and when to seek medical care.

Recognizing symptoms

Flu symptoms include sore throat, runny or stuffy nose, fever, body aches and fatigue. These symptoms may overlap with other illnesses, like the common cold, but key differences exist. Colds generally develop gradually, while flu symptoms typically appear suddenly within two or three days of exposure to the virus.

Managing your symptoms

Start using over-the-counter medications such as pain relievers or cough suppressants to alleviate your symptoms. Staying hydrated is essential; drink plenty of water, broth or warm tea to nourish your body. Using a humidifier or taking a steamy shower can help ease congestion and make breathing easier.

Your body needs time to heal, so rest is crucial. "If you can, I highly recommend you stay home from school and work so your immune system can recover," says Dr. Ardon.

Try the following to help manage symptoms:

• Stay hydrated: Drink water, juice, or warm lemon water with honey to ease congestion and prevent dehydration. Avoid alcohol, coffee, and caffeinated drinks.
• Use warm liquids: Sip chicken soup, tea or warm apple juice to help with congestion.
• Try honey: Honey can soothe coughs in adults and children over 1 year old. Add it to warm tea or lemon water.
• Rest: Let your body recover with plenty of rest.
• Add moisture: Use a cool-mist humidifier or vaporizer to relieve stuffiness. Clean and refill daily.

Planning ahead 

For people at higher risk of flu complications—such as older adults or those who are pregnant or have chronic conditions or weakened immune systems—consider discussing a care plan with your doctor before getting sick. “If you’re at higher risk, we may recommend closer monitoring or additional care,” says Dr. Ardon.

High-risk patients diagnosed with the flu might be prescribed antiviral medications. These prescription drugs, available as pills, liquids, inhaled powders, or intravenous solutions, target the flu virus directly and require a medical prescription.

It’s important to note that flu antivirals differ from antibiotics, which treat bacterial infections, and antiviral treatments for other illnesses like COVID-19. Flu-specific antivirals won’t work for COVID-19 and vice versa.

When to seek medical attention

While most respiratory illnesses resolve on their own, you should seek medical care if your symptoms worsen or if you experience any of the following:

• Trouble breathing
• Chest pain
• Dizziness or confusion
• Severe dehydration or weakness

For children, also watch for:

• Fast breathing or blue lips
• No tears when crying or no urination
• Symptoms that improve but then return or worsen

Dr. Ardon says recovering from a respiratory virus can be managed at home for most people. "Knowing when to get help can make all the difference," she says.

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Whether it's the annual flu shot, latest COVID-19 booster, or milestone shots that cover pneumonia, shingles or tetanus, staying up to date on immunizations is just one way to protect your health.

"It's worthwhile having that conversation with your primary care team because we might change depending on conditions that you have and potentially even the age at which you would receive that vaccine," says Dr. Presutti.

Adult vaccinations to update

Pneumonia can be life-threatening when fluid fills the lungs' air sacs. In general, a vaccination is recommended for all adults 65 and older.

Shingles, a reactivation of the virus that causes chickenpox, can cause a painful, blistering rash. Vaccination is recommended in adults over 50.

Tetanus is caused by a bacterial infection, often from a cut or wound. The Tdap vaccine is recommended every 10 years and also protects against diphtheria and pertussis – the latter known as whooping cough.

"If you're a new parent or a new grandparent, then you should be getting the pertussis update vaccine to decrease the risk of you actually communicating, or giving, pertussis to the newborn baby," says Dr. Presutti.

Related posts:

• Mayo Clinic Minute: Strategies to stay healthy during respiratory virus season
• Can you get COVID-19 and the flu at the same time? A Mayo Clinic expert weighs in
• Mayo Clinic Minute: Why vaccines are especially important for older people

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Taking a home antigen test for COVID-19 is a simple first step if you feel unwell or were exposed to the virus. 

But what about those COVID-19 tests you've stored away for the last year? Are they still good? Dr. Matthew Binnicker, director of the Clinical Virology Laboratory at Mayo Clinic, offers some guidance about COVID-19 testing.

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The flu, RSV and COVID-19 are caused by different viruses with similar early symptoms.

"Such as sore throat, some body aches, a cough, runny nose. And taking that COVID-19 antigen test is a good first step," says Dr. Binnicker.

If you have a stack of COVID-19 at-home tests, Dr. Binnicker says check the Food and Drug Administration's (FDA) website.

"I know there's been concern about some antigen tests expiring, and what you can do is you can go on to a website that's publicly available," he says.

Many COVID-19 tests have extended expiration dates, so they may still be usable.

He says prevention remains one of the most important tools.

"It's really important to get the updated COVID-19 vaccine that's based off of more recent strain to help reduce the chance that you can be infected and, most importantly, come down with a severe case," says Dr. Binnicker.

If your COVID-19 test comes back positive, Dr. Binnicker has this advice. 

"It's very likely that you've got COVID-19, and you should stay at home, stay away from others, and if you have to get out, wear a mask. That is a crucial step to help prevent transmission," he says. 

Not feeling well but your test came back negative? 

Dr. Binnicker says it's important to play it safe. "With the holiday season and interacting with family and friends, if there's anyone in the mix who's got a respiratory illness, cough, sore throat, runny nose, first, it's best that they just stay away from the gathering altogether," he says.

COVID-19 tests

Find out if your COVID-19 antigen test has an extended expiration date at this FDA website.

In the U.S., each household is eligible to order four free at-home tests. You can find the link for more information here.

Related posts:

• Mayo Clinic Minute: Reduce risk of respiratory infections
• Mayo Clinic Minute: 3 misconceptions about COVID-19 and flu vaccines

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Dr. Robert Jacobson, medical director of Mayo Clinic's Primary Care Immunization Program, says there are tools to help reduce the risk of becoming severely ill from these respiratory infections.

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"We're all at risk for getting the flu, and we can actually get (it) more than once a year. Every year, about 10% to 20% of us get the flu," says Dr. Jacobson.

Along with the flu, COVID-19 and RSV are among the most common respiratory illnesses. These viruses share similar symptoms, risks and prevention strategies.

Dr. Jacobson's No. 1 tip: Get vaccinated.

"This is specific protection your body can make to protect you and your loved ones," he says.

Along with vaccination, Dr. Jacobson stresses the importance of hand-washing.

"Especially before you eat, when you come home from work, when you come home from bringing your child from day care — both of you should go to the sink — wash your hands with soap and water after using a bathroom, before serving other people food, after being with a group of people, shaking hands with people, wash your hands," he says.

Wash your hands well and often with soap and water for at least 20 seconds. If soap and water aren't available, use an alcohol-based hand sanitizer with at least 60% alcohol. Make sure friends and family whom you're around regularly, especially kids, know the importance of hand-washing.

Tactics to avoid respiratory infections:

• Avoid touching your face. Keeping your hands away from your eyes, nose and mouth helps keep germs away from those places.
• Cover your coughs and sneezes. Cough or sneeze into a tissue or your elbow. Then wash your hands.
• Clean surfaces. Regularly clean often-touched surfaces to prevent the spread of infection from touching a surface with the virus on it and then your face.
• Avoid crowds. The flu spreads easily wherever people gather — in child care centers, schools, office buildings, auditoriums and on public transportation. By avoiding crowds during peak flu season, you lower your chances of infection.

And if you get sick, stay home to avoid spreading infection to others.

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Mpox, a disease caused by the monkeypox virus, is a global health concern, with outbreaks in Western and Central African countries spreading into other regions. Recently, health officials in the United Kingdom reported new cases of a mpox strain called clade Ib. The World Health Organization declared mpox a public health emergency of international concern in August.

Dr. Matthew Binnicker, director of the Clinical Virology Laboratory at Mayo Clinic, says there are two strains of the virus that cause mpox, clade I and clade II. Each has different subclades that can cause varying degrees of severity. Clade I generally causes more severe illness than clade II.

"We've known about mpox, but up until recently, the outbreaks have mainly been geographically isolated within the continent of Africa," says Dr. Binnicker. "In 2022, we saw a large worldwide outbreak of clade II monkeypox virus that was associated with a less severe form of mpox disease. But we still saw cases worldwide, including here in the U.S."

Watch: Dr. Matthew Binnicker discusses mpox

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Concern about clade I

It is clade I and its subclades that cause more concern for the global health community.

"The other clade of monkeypox virus (i.e., clade I) is more associated with severe disease and is causing a very large outbreak in the continent of Africa, and we've seen some sporadic cases of that more severe strain outside of Africa," Dr. Binnicker explains.

He says this is a much more severe form of infection compared to the 2022 outbreak.

"Clade Ib is causing this more recent outbreak in Africa and sporadically through other countries. The mortality rate of clade I infection can range between 3% and 10% of those who come down with the disease. It is a much more severe form of the infection than clade II infection, which caused the worldwide outbreak of 2022," says Dr. Binnicker.

Transmission

"There is some evidence that monkeypox clade Ib virus might be spreading more easily in younger populations, and health officials are closely monitoring," he says.

"In Africa, they're seeing more cases in young children, which implies that more routine contact may allow for spread of the virus. Whereas in the 2022 outbreak, it seemed like more intimate, close contact was required for the virus to spread."

Both clades of the virus can transmit or spread from direct contact with an infected animal, close or intimate contact with an infected person, or contact with contaminated objects like clothing, towels or bedding.

Symptoms of mpox

Monkeypox virus is in the same family as the virus that causes smallpox. It can cause flu-like symptoms such as fever, chills and swollen lymph nodes. It's most noted for its itchy, painful rash. Symptoms tend to start within three weeks after exposure to the virus.

"In most cases of mpox, people will develop lesions, a blister-like rash, near the site of infection. In certain patients, especially those with a compromised immune system, the presentation of their lesions can be throughout the body. In some cases, people can have what we call a disseminated disease, where the virus can infect a number of different organ systems, leading to hospitalization and, in some cases, death," says Dr. Binnicker.

Vaccination, prevention 

Nearly 900,000 doses of the mpox vaccine have been allocated for the region in Africa hit hardest by the mpox outbreak.

"They're really trying to get the mpox vaccine into Africa to increase the number of those vaccinated against it, to help drive down the number of infections there," he says. "There are also tests available for mpox, so we do have, to a limited degree, some tests within the U.S. and in other countries to diagnose cases."

Tips to protect yourself from mpox infection:

• Avoid close contact with people who have a rash that looks like mpox.
• Avoid handling clothes, sheets, blankets, or other materials that have been in contact with an animal or person with mpox.
• Talk to your healthcare team about whether mpox vaccination would be recommended for you.
• Isolate people who have mpox from healthy individuals.
• Wash your hands well with soap and water after any contact with an infected person or animal.
• Seek medical attention if you develop a flu-like illness and rash, especially after traveling to Africa or meeting a person who has been diagnosed with mpox.

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