Q&A: How is winter sickness affecting Kentucky?

LEXINGTON, Ky. (Jan. 31, 2025) — This winter, low temperatures have impacted the state of Kentucky. One of the biggest concerns statewide is the rise in the number of reported respiratory infection cases in adults and children. As families gather indoors to escape the cold weather, the chances of spreading infectious viruses are increasing.

Medical physicians are encouraging people to take action to prevent the spread of the current waves of influenza, COVID or other respiratory infections.

UK HealthCare experts recently answered questions from local media members and the community about the latest wave of winter sickness.

Nick Van Sickels, M.D., medical director for UK HealthCare Infection Prevention and Control, discussed the respiratory viruses currently impacting hospitals and clinics in Lexington.

Lindsay Ragsdale, M.D., the chief medical officer for Kentucky Children’s Hospital, shared her insights on how these illnesses are affecting the younger population, from newborns to adolescents.

To understand more about the multiple viruses that people must be on the lookout for and how to protect against them, dive into the Q&A with Van Sickels and Ragsdale below.

UKNow: What respiratory illnesses are we currently seeing and what do people need to know about them?

Van Sickels: Just like most winters, we've had an increase in respiratory and gastrointestinal (GI) viruses this season. That is to be expected, but what makes this winter a little bit different is that first, Kentucky has consistently had a higher level of infections this season. Secondly, we have seen an uptick in GI illnesses across the nation — specifically norovirus. GI viruses tend to spread a bit easier in the winter, as we gather, share meals and spend more time inside. Norovirus has been the predominate virus and we are tracking these infections across our facilities at the University of Kentucky. Our infection control program also monitors daily rates of influenza, respiratory syncytial virus (RSV) and COVID and reports these numbers out to key stakeholders so we can take action during heightened levels of infections.

Ragsdale: It’s been a busy winter season with infections. We've seen the same thing in the children’s hospital. We’ve seen a change in the past few years during our triple-demic, where we saw respiratory viruses starting early in the fall, and luckily this year we’re starting to get back to a normal winter season where we see the respiratory infections starting somewhere around the November mark.

We are seeing high volumes of kids with RSV, which is a common virus that affects children in the wintertime. Particularly it hits kids who have underlying lung disease, heart disease or prematurity, who are just more fragile and prone to having difficulty with this infection. Additionally, influenza is definitely on the rise, especially in children.

We’re seeing somewhere between 10 to 20 patients each day in the children’s hospital who need admission. That’s a significant amount. We are encouraging families and caregivers to talk to their pediatricians and their primary care doctors about vaccinations, which is the best tool we have to help prevent these infections.

Good handwashing, trying to stay home, keeping your kids home when they’re sick. It’s the best way that we can prevent these infections.

We do have another tool in our toolbox, which is an RSV antibody that boosts the immune system of brand-new newborns and infants in their first season of RSV. It helps protect them for that full first year of their lives, so we are encouraging families to investigate that.

We also have a vaccination for pregnant patients, and they can go to their OB and ask for it, so their brand-new infant is protected after delivery. This is a way that we can help our most fragile children, which is the newborn phase in the first year of life.

UKNow: How effective are the RSV vaccines on newborns?

Ragsdale: We have two tools to fight RSV; one is a vaccine for pregnant patients to protect the newborn during the first RSV season, the second is a monoclonal antibody for infants during their first RSV season in the fall/winter.

Vaccine: For the vaccine for pregnant patients, we have seen that that is particularly effective, but we are encouraging patients to talk to their OB provider about this protective vaccine. We are hoping our community considers vaccination as an effective and safe way to prevent newborns from getting infected.

Antibody: The antibody, which is a boost that we give directly to newborns, has proven to be 80-90% effective at preventing hospitalization for RSV. This antibody can be particularly important for infants with prematurity, lung disease, heart diseases or who are immunocompromised. We have seen an impact in children’s hospitals that, for patients who have had it, this helps with the severity of the infection if they do get RSV.

UKNow: When should both adults and caregivers of children seek medical attention for these illnesses?

Ragsdale: If you’re seeing your child having difficulty breathing, that’s one of those signs that make us worry. If we see their nostrils flare and their muscles working overtime to breathe, we would consider those hazard signs where we would want rapid attention in our emergency department or acute care visits. Another sign to watch for is dehydration, if an infant or child is struggling to drink or eat enough, we would want them to be seen. We see infants and children with dehydration stop making wet diapers and not making tears when crying. Parents can monitor their child’s urine output and how much they are drinking and eating.

I do think that if you’re starting to see early signs, that’s the time to talk to your primary care doctor. There are sick visits and urgent care treatment options available. For RSV, we are seeing some of these cases respond to more inhalers this year, which is something new for this virus. So, it’s something that your primary care doctor can look into and start on the early end.

Van Sickels: For the adult population, I typically try to preventatively counsel about these respiratory infections to people who have chronic underlying medical conditions such as heart disease, lung disease and liver or kidney disease. Any chronic health issue where you have to take multiple medications or see several specialists is a population I want to prioritize for vaccination. This being said, thousands die unnecessarily from the flu each year. We can help ourselves and each other by getting flu and COVID vaccines — regardless of our underlying health conditions. For those over 60 and for pregnant adults, talking to your doctor about the RSV vaccine is also recommended.

In addition to getting annual flu, COVID and, if indicated, RSV vaccines, we would encourage those with chronic medical conditions to reach out to their primary care provider early if they are feeling ill. While the three viruses — and common colds — have somewhat similar symptoms, treatment is most beneficial when started early. I encourage people to seek urgent medical attention if they are having high fevers, are unable to stay hydrated due to vomiting or diarrhea, or if they are not breathing well. For those who have chronic lung disease and may not breathe well on a regular basis, but they know their baseline, if you’re worse than your baseline, it’s worth it to come in.

However, if you start to feel worried for any reason, call your primary care doctor to discuss options for your care. We are often able to offer telehealth for those with mobility concerns, or who are worried about exposing others to their illnesses. When diagnosed early, we can offer treatment for flu and COVID which could reduce your risk of hospitalization and time to feeling better.

UKNow: When do you foresee the end of the respiratory virus season with our activity being so high?

Van Sickels: It is tough to say when it is going to end, but certainly some numbers look to be at their peak with certain infections trending down. I’m hopeful that over the next couple of months, we will see a consistent downtrend of COVID, flu and RSV, but we will have to monitor the data, which unfortunately has a lag. It takes us one to two weeks to get all the reporting together.

UKNow: Is there anything that you would like the public to know about these viruses?

Ragsdale: Prevention is the key. Getting your vaccines, washing your hands and just keeping yourself informed of any updates on this matter can help us make a huge change in how the numbers are looking now. Talk to your primary care doctor and ask for information that is real and factual in order to find prevention techniques that we can utilize as a community.

UKNow: What is norovirus and how can we treat it?

Ragsdale: We are seeing norovirus in all of our populations: pediatric and adult. It acts like a GI illness presenting symptoms like a lot of vomiting and diarrhea and it is contagious. If anyone in the household has the norovirus, I would recommend good hand washing and sanitizing any public space shared among the family members. If you can isolate the one infected person, that is also helpful but not always easy to do when you're sharing a space. As this virus can come with GI symptoms, make sure to monitor children to keep them hydrated and bring them in to be seen if anything changes. We are encouraging everyone to put into action any recommendations given to protect each other from this virus.

Van Sickels: In addition to what Dr. Ragsdale said, norovirus can live on surfaces for a long time. Heavy-touch surfaces, such as counter tops and doorknobs are where the virus can latch on to and should be cleaned with a bleach-type cleanser when someone is sick in the home.  

Hand hygiene is also essential, as norovirus does not respond to alcohol-based cleansers. We advise that if someone is sick in the house with a GI illness, to wash hands with soap and water for 20 seconds as opposed to using alcohol-based hand sanitizers. Unfortunately, there is no treatment for norovirus at this time. The key is to stay hydrated through the use of electrolyte-based solutions you find at your local grocery or drugstore.