CHICAGO — Children’s Hospitals across the country, including the Chicago area, are bracing for a “tripledemic” threat of serious respiratory illnesses.

Experts fear the RSV, flu and Covid-19 viruses could all collide, and hospitals will be overwhelmed with patients.

Several children’s hospitals around the nation are already at or near capacity due to an early surge of RSV (Respiratory Syncytial Virus), a common respiratory virus that occurs every year.

“We haven’t seen much of it in the last two years because we’ve all been masked, with Covid,” said Dr. Julie Holland, Vice President of Pediatric Primary Care for Chicagoland Children’s Health Alliance. “It is most severe in the youngest kids, infants under one, premature infants, infants with heart and lung disease and it also causes a lot of disease in the elderly, but for the rest of us, we just get a cold. But the younger kids can get quite sick with it.”

These children will have symptoms such as wheezing, respiratory distress or need oxygen, according to Holland, whereas children between the ages of 5 and 13 will have milder cases.

There currently is no vaccine for RSV, but Holland said premature infants and kids with serious heart and lung issues can receive an injection of a medication called Synagis once a month.

“So, for the rest of all of us the best protection is to try and stay away from other people who are sick, washing our hands frequently, trying not to touch our faces, all the same kinds of things we’ve been doing to prevent Covid for the last few years.”

The tripledemic that is causing nationwide concern consists of three different respiratory infections.

Influenza, which is seen every winter but has started early this year; RSV, an upper respiratory infection which causes wheezing, coughing and breathing problems in very young children; and Covid-19 the contagious respiratory virus that caused the pandemic.

“The concern is that people might get all three together because we’re seeing RSV now. Flu is coming and is in a lot of states already. And Covid has been on the decline the last few months but we’re starting to see the numbers start to pick up in certain places, especially like in New England or in certain states in the West,” said Holland. “So, the concern is that if you get one, two or three of these viruses at the same time people are going to get quite ill.”

While the flu and Covid-19 have vaccines, RSV does not, and Holland has the following recommendation.

“Everybody six months and older should be getting their flu and covid vaccines on schedule. RSV as I mentioned before does not have a vaccine so the only real preventative measures are trying to avoid sick people and washing your hands and those kinds of environmental control measures,” she said. “But there certainly have been prior years where we’ve seen flu and RSV together, and people who get both tend to get sicker. And certainly, there’s been some covid and flu, especially in adults in the last several years, and those people have gotten sicker as well. So, they’re not good viruses that you would want to get at the same time.  You wouldn’t want to get any of them but having them at the same time is going to increase people’s risk for hospitalization or winding up in the ICU. So, anything we can do to prevent any three of those viruses is a good thing.”

Holland said with RSV and the flu, “the younger you are, the sicker you get.”

RSV tends to be most severe in children who are one year old or younger and Holland says they’re also more likely to wind up in the hospital, especially premature babies and children with medical issues.

Children under the age of five are at higher risk for flu, especially those under the age of two; however Covid-19 is the one virus out of the three that doesn’t cause severe reactions in most kids.

The symptoms for all three viruses are similar but there are some differences.

“With RSV, especially in little kids, we tend to see runny nose, cough, and wheezing. So, chests that are moving up and down quite a bit more than you would normally expect to see a chest moving during breathing, or a very rapid respiratory rate. And that’s the typical thing we tend to see RSV along with a lot of nasal secretion. There’s a lot of overlap between these symptoms, so you just can’t tell by just looking at someone. Flu is more commonly seen with a really high fever for five or six days, and body aches, chills and a cough, not quite as much the runny nose,” said Holland. “And Covid as we all know can present with any respiratory symptom, runny nose, cough, sore throat, all of the above. It tends to be a little less distinct with its symptoms unless for example you lost your sense of taste or smell. “

Holland said the best way to really find out what you have is to get your child or yourself tested.

While you can find Covid tests over the counter and in stores, she suggests you go to your pediatrician’s office, an urgent care or a testing facility to get tested for RSV or the flu.

“There’s a chance all of these could come together during the holidays. We see covid rising in certain areas, we know flu is spreading rapidly in the southern states and it’s just a question of when it will get here. It could easily be here by Thanksgiving which would be a bit early for a flu season. And RSV, we’re in major RSV season now, but because this is very early for RSV and a bit unusual, we’re not exactly sure how long it could last,” said Holland.

“So, people need to be smart and cautious. If your child is sick or you’re sick don’t go to school or work and spread it around. Stay home. Take care of yourself, take care of your family members. And people are just going to have to think about Thanksgiving and Christmas and all the other holidays in December and January if they have family members who are at high risk for these diseases, they may want to reconsider their plans.”

You can learn more about RSV and the tripledemic in the video above.