‘Flurona’: when flu and COVID-19 collide

If you’ve heard the word “flurona” recently, but aren’t quite sure what it means, you’re not alone. Many people have expressed confusion about this mashup of the words “influenza” and “coronavirus.” 

Though it may sound like a brand new disease, flurona isn’t some strange mutant hybrid of these two viruses. It just describes a situation in which someone contracts both the flu and a COVID-19 infection at the same time.

To learn more about flurona, and what cancer patients in particular need to know, we reached out to Chief Infection Control Officer Roy Chemaly, M.D.

How long has flurona been around?

I believe the term itself was coined fairly recently in Israel, but there were a few cases of simultaneous flu/coronavirus infections reported as far back as January or February 2020 in China. That was the height of flu season at the time. So, it occurred very early on in the pandemic.

How many flurona cases have there been to date, and where has it been reported?

Here at MD Anderson, we haven’t seen any patients with it yet. But it’s been reported on virtually every continent now: Europe, Asia, the Americas, even Australia. Based on the published studies I’ve seen, I would say there have been at least 2,000 cases worldwide. But there are likely at least a few more than that. They just haven’t been documented.

Is getting more than one virus at the same time considered unusual?

No. Not at all. It doesn’t happen that often, and it depends on the season and the circulating viruses, of course, but the elderly and very young have been getting two and even three respiratory viral infections simultaneously for years and years.

The most common culprits are:

• influenza
• rhinoviruses, several of which cause the common cold
• respiratory syncytial virus (RSV)

These viral infections can happen in any combination, or even all at once. So, it’s not really a new phenomenon.

What are the symptoms of flurona? Are they any different from those of the individual diseases?

No. People with flurona can exhibit any combination of the symptoms that normally accompany each virus, including the ones that overlap, such as:

• fever
• headache
• body aches
• runny nose
• cough
• sore throat
• sinus congestion

So, there’s no specific set of symptoms that really points to someone having flurona.

How have people who’ve developed flurona fared? Were their symptoms or death rates any worse than those of people who only had one viral infection at a time?

We were really worried about that early on, which is why we campaigned so hard in 2020 and 2021 about getting vaccinated against both to prevent a “twindemic.”

If getting one upper respiratory virus was bad, we reasoned, then getting two must be worse. But when we put what limited data was available together, we found that there was really not much impact on mortality with two viruses among the general population. So, that was a welcome surprise.

And while some patients did have more severe symptoms, others had only mild ones. The same went for variables like the need for advanced care (e.g. a respirator), and how long it took people to recover. It really was a mixed bag.

What are the implications for cancer patients and the immunocompromised if they get both COVID-19 and the flu — or even two other viruses — at once?

There’s no data for that yet, so it’s really hard to say. We always worry about patients and survivors whose immune systems are suppressed, whether it’s due to steroids or cancer treatments. If someone is sick enough to be under our care, we never really know how they’re going to react if they get an infection on top of it.

The good news is that there’s not really much flu virus circulating right now. One reason is that people have been pretty good about wearing masks and social distancing. And if these behaviors can prevent exposure to one virus, then they can prevent exposure to others, too. But both COVID-19 and flu vaccinations have also played a part in reducing the number of simultaneous infections.

What can cancer patients and survivors do to protect themselves from the so-called flurona?

We have good treatments and prevention methods available for the flu. And we have some treatments and prevention methods available for the coronavirus. But vaccinations may not work as well in people who are immunocompromised. And the one monoclonal antibody we have that may work against the omicron variant is in very short supply.

So, I would say continue taking the same preventive measures you already have been:

• wear a mask
• practice physical distancing
• avoid large gatherings
• get vaccinated against both the flu and the coronavirus, and get additional doses or booster shots as soon as you can to better prevent COVID-19, as directed by your care team.

It’s always better to focus on prevention rather than to depend on “cures” — or effective treatments — to save the day.

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