Travel Health Update With On Call’s Chief Medical Officer: What You Should Know About Common Respiratory Illnesses

Respiratory illnesses such as a cold, COVID-19, RSV, and the flu are common, but even more so in the colder months of the year, when more time is spent indoors.

On Call’s Chief Medical Officer, Dr. Michelle Nathan, says, “The CDC is currently monitoring respiratory illness around the world, and some countries have reported elevated levels of respiratory illness activity. Respiratory illnesses are not something that should be taken lightly, but luckily, we’re in a position where there are much better tools available to us to prevent—or minimize the effects of—respiratory illnesses.”

For purposes of this post, Dr. Nathan focuses on three common respiratory illnesses that are on many travelers’ radars right now: RSV, flu, and the JN.1coronavirus variant. Additionally, she shares some healthy habits for avoiding respiratory illnesses before, during and, after travel.

Let’s begin with the coronavirus. What should people know about the JN.1 subvariant? How is different from other variants?

Dr. Nathan: the JN.1 variant is a new omicron variant and is the main cause of COVID-19 infections now. The variant has some mutations that allow it to avoid immunity and it can be transmitted easily and quickly. The good news is that the symptoms from the JN.1 variant are similar to the earlier omicron variants, and it does not seem to cause more severe disease.  The new vaccines still protect against severe disease, and antivirals are still able to treat infection from JN.1.

What is the main difference (in symptoms) between flu, COVID, and RSV?

Dr. Nathan: Flu symptoms usually occur suddenly and include fever, cough, sore throat, runny nose, muscle/body aches, headaches, and fatigue.  Children may also have vomiting and diarrhea.

Common cold symptoms tend to be milder than flu symptoms and tend to come on more gradually.  Common colds are more likely to have a stuffy nose, sore throat, and sneezing.COVID-19 has a wide range of symptoms, but most people have fever or chills, cough, fatigue, runny nose, and fatigue.  Loss of taste and smell are being seen less with the JN.1 variant and some people are reporting more gastrointestinal symptoms like diarrhea and stomach upset. RSV usually causes mild cold-like symptoms including runny nose, decreased appetite, cough, sneezing fever, or wheezing.  Severe illness causes shortness of breath, low oxygen levels, inflammation of the airway (bronchiolitis), and pneumonia.

If a person is experiencing symptoms – aside from taking a COVID-19 test, how can a person know which respiratory illness they have?

Dr. Nathan: Taking a test is the only way to know which illness you have.  There are several home COVID tests on the market, and there are home flu test kits.  In the US, there is an approved home test for RSV, flu, and COVID-19, but the test swab needs to be mailed in the manufacturer and results aren’t available for a few days.

Are there any populations that more susceptible to contracting respiratory illnesses?

Dr. Nathan: In general, children, older adults, and people with underlying lung conditions are more susceptible to getting respiratory infections.  Some lifestyle factors like smoking, secondhand smoke, lack of sleep, and stress make it easier to get respiratory infections.  Finally, we see outbreaks that happen in groups, even for people that aren’t susceptible.  For travelers, these can be tour groups, cruise ships, hotels, and/or mass gatherings.

Are there any populations who are at higher risk for severe illness if they contract any of these illnesses?

Dr. Nathan: Influenza can be serious for children under the age of 2, adults over age 65, adults with chronic health conditions (asthma, heart disease, stroke, diabetes), and during pregnancy.

RSV can be serious for infants up to 12 months of age, older adults, and adults with chronic medical conditions (heart disease, lung disease, and weakened immune systems).

COVID can be serious for older adults and people with lung disease (asthma, COPD), heart disease, diabetes, obesity, and weakened immune systems.  Other risk factors include kidney disease, liver disease, cancer, blood disorders like sickle cell anemia and thalassemia, and disabilities like intellectual and developmental delays.

Let’s talk about vaccines. There is so much confusing information out there! What are the current recommendations for all three illnesses?

Dr. Nathan: Simply put, I always say, get vaccinated!  Remember that it is possible to get infected with multiple viruses at one time, so being vaccinated is the best protection against severe disease. For COVID, we recommend having the most recent vaccine since it has antibodies that recognize JN.1 and protect against severe disease. COVID vaccinations are recommended for everyone over 6 months of age.

For influenza, this year’s vaccines have protection against 4 influenza viruses and are recommended for everyone over 6 months of age.

RSV vaccination is recommended for adults over age 60 and for pregnant individuals from week 32 to week 36 of pregnancy.

What are the best ways travelers can take to avoid these infections while traveling?

Dr. Nathan: The biggest thing travelers can do is get vaccinated.  Other things that help are frequent hand washing/sanitizing, avoiding contact with people who are sick, avoiding touching your eyes, mouth, and nose, and wearing a mask in indoor spaces if you are in an area with high infection rates.

If someone gets sick overseas with any of these illnesses, how do they know if they should seek medical care?

Dr. Nathan: Most mild to moderate symptoms don’t need medical care and can be managed at home with rest, fluids, and medicine for fever reduction.  You should seek care if you have shortness of breath, chest pain, confusion, repeated vomiting, or if you are not urinating.  People who are at risk for more severe COVID-19 or flu should seek care when they first get symptoms. These patients may be put on medications that can decrease the risk of getting severe disease.


Want to learn more?
From 24/7 emergency medical transportation, referrals for medical facilities abroad, and even prescription assistance, On Call can provide medical assistance support to travelers anywhere in the world.  Contact us today to learn more.


About On Call International:
When traveling, every problem is unique–a medical crisis, a political threat, even a common mishap such as a missed flight. But every solution starts with customized care that ensures travelers are safe and protected. That’s why for over 25 years, On Call International has provided fully-customized travel risk management and global emergency assistance services protecting millions of travelers, their families, and their organizations.