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Flurona: Yes, you can get COVID-19 and flu at the same time

What to know about 'flurona', the co-infection of influenza and COVID-19.

INDIANAPOLIS — First came "delmicron," now comes "flurona" - an illness that potentially packs a double whammy for folks who get infected with both. 

This week, Israel confirmed its first case of a patient with the seasonal flu and COVID-19 at the same time. According to The Times of Israel, the double infection was found in an unvaccinated, pregnant woman at Rabin Medical Center in Petach Tikva. She tested positive for both viruses upon arrival, and was discharged shortly after.

The case has sparked conversation about the likelihood of co-infections, and about "flurona" as a whole. 

Flurona is a term that is used to describe an infection of COVID-19 and the flu together. It is a rare double infection in which a person catches both of the viruses, simultaneously.

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According to a U.S. Centers for Disease Control flu season FAQ posted in October, it is absolutely possible to "have flu, as well as other respiratory illnesses, and COVID-19 at the same time." 

Doctors say flu and COVID-19 infections have been present since the start of the pandemic, but can be more difficult to track. 

"Certainly, people can get both of the viruses together. When everyone was - or a majority of the people were - wearing masks, during that time, the cases of flu were less. And anytime they test - if they are positive for Covid, then they don't do the other tests. So, a lot of cases are not diagnosed that they have a co-infection," said Professor Suresh Mittal, Distinguished Professor with Purdue's Department of Comparative Biology.

In September, Indiana doctors raised concern about a possible 'twindemic' - where rising COVID-19 cases coincided with a rising number of flu cases and overwhelmed our health care system

Flurona is different than a twindemic, as it refers to a true co-infection of two viruses, as opposed to two sets of people with different viruses. 

Both COVID-19 and the flu are respiratory diseases which are spread through droplets, and when an infected person breathes, sneezes or coughs. 

Cough, runny nose, sore throat, fever, headache and fatigue are both common symptoms of influenza and COVID-19, according to the CDC

Both viruses can attack the lungs and lead to pneumonia. The flu has been around longer but COVID-19, Mittal said, is still the more hostile of the two.

"Coronavirus has more virulence compared to the lung infections and damage to lungs, and also the mortality rates," Mittal said.

When analyzed as separate viruses, scientists have a more clear understanding of the separate effects on the human body. However, scientists are still working to find out how a co-infection can affect the body. 

Early studies suggest undetected co-infections like influenza in COVID-19 patient are associated with increased hospitalization and mortality. 

In one 2021 study published in the Virology Journal, scientists found Influenza A H1N1 was one of the most commonly detected pathogens in 48 COVID-19 patients in Saudi Arabia. 

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Two-thirds of COVID-19 critically ill patients who died had a co-infection, and Influenza A H1N1 was the only pathogen for which a direct relationship with mortality was seen. 

They further hypothesized undetected co-infections in COVID-19 patients may have severe clinical implications associated with increased hospitalization, varied treatment approaches and mortality. 

Professor Mittal also said one study conducted in mice indicated the presence of influenza could make it easier for coronavirus to spread in the body. 

"It seems that one of the receptors, which coronavirus uses for virus entry - that receptor called ACE2 -  the number of that receptor on the cells, increased in response to influenza virus infection. And, with that, it become easier for coronavirus to replicate and infect those cells easier than they would normally do," he said. 

The best way to prevent both diseases remains to mask up, and get vaccinated. Remembering to get a flu shot in addition to a COVID-19 vaccine could be essential to preventing a double infection. 

Professor Mittal recommends getting the flu shot at the same time as a COVID-19 vaccine or booster. 

"I myself, I thought, why go twice? So, I got my annual flu shot, and also my coronavirus booster on the same day - on both arms," he said.

As COVID fatigue sets in across the country though, and many do not mask up in the way they used to, we could see more co-infections. 

"You don't see that many people wearing the mask. So, when the masks were there, at least the chances of getting flu was much less. But now, when we are not taking that much precaution, the chances of getting both are higher," Mittal said.