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ASMA KHALID, HOST:

As the weather cools down, health officials are gearing up for the season of sickness. It's that time for gathering indoors and spreading respiratory viruses. NPR's Pien Huang reports on what's brewing in the viral stew.

PIEN HUANG, BYLINE: There's the big three, to start - flu, RSV and COVID. Those are the ones health officials like the CDC's Dr. Demetre Daskalakis are talking about the most.

DEMETRE DASKALAKIS: These are the three that really cause the most sort of utilization of the health care system and the most severe disease.

HUANG: Last year a survey by the health policy nonprofit KFF showed that 40% of households were hit with at least one of these three viruses. But Marlene Wolfe, an epidemiologist at Emory University, says there's more in the respiratory viral stew.

MARLENE WOLFE: There's always something else. There's always something else in the mix, right?

HUANG: Things like rhinoviruses and non-COVID coronaviruses, both causes of the common cold. There are parainfluenzas, which can cause croup and pneumonia in children, and an enterovirus, which caused a national outbreak 10 years ago. And then there's human metapneumovirus.

WOLFE: That's a pretty new virus, actually, that was identified in the early 2000s - looks quite similar to RSV a lot of the time in clinical presentation.

HUANG: Wolfe says data from wastewater shows that human metapneumovirus actually circulated a lot last winter. It could have been the fourth virus added to the tripledemic (ph) mix. A lot of these viruses have the same cold and flu-like symptoms - coughing, sneezing, fevers, chills.

WOLFE: Now, most people who are infected with all of these viruses will recover and be completely fine, right? But it's important for us to understand what is circulating so that we can know how to use the interventions that are available to us.

HUANG: Wolfe leads WastewaterSCAN, a program that provides a granular, real-time look at pathogens. It's still early in the season. So far, data shows there are mid levels of COVID going around and low levels of everything else. To Dr. Daskalakis from CDC, that means it's a good time to get protected.

DASKALAKIS: We have a new updated COVID vaccine. We have updated flu vaccines.

HUANG: For older people and pregnant people, there are vaccines for RSV and preventive shots for newborns. The CDC expects this virus season to be similar to the last, better than the height of the pandemic but worse than the years before it. They say hospitals could be in trouble if these viruses all surge at once, and they're hoping that preventive vaccines can help keep those levels down. Pien Huang, NPR News.

(SOUNDBITE OF MINUTEMEN'S "COHESION") Transcript provided by NPR, Copyright NPR.

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