BY MELISSA PATRICK
KENTUCKY HEALTH NEWS

As illness from the three respiratory viruses tracked by the state — influenza, COVID-19 and respiratory syncytial virus (RSV) — continue to increase in Kentucky, another one with a lingering cough that can last for months is spreading over much of the country, including the Bluegrass State.

“We have been seeing an unusually large number of patients who had typical viral upper-respiratory infections but have had a lingering cough that has lasted weeks to months,” Dr. Scott Braunstein, a double board-certified internal- and emergency-medicine physician and the national medical director of urgent-care chain Sollis Health told Julia Ries of HuffPost.

In the week ended Nov. 26, Kentucky reported 3,881 laboratory-confirmed cases of COVID-19, up from 2,998 the prior week, an increase of 29%. The state reported 703 laboratory-confirmed cases of the flu, up from 570 the prior week, an increase of 23%.

The Kentucky Department for Public Health’s latest weekly respiratory-illness report shows COVID-19 and RSV activity is high, influenza activity is increasing, and hospitalizations for RSV and flu are increasing.

In the week ended Nov. 26, emergency-department visits for respiratory illnesses in Kentucky increased again, to 4,061, an increase of 8% over the prior week, when the state reported 3,747 such visits. This number has gone up every week since the state started reporting the data Oct. 1.

Of the week’s cases, 1,737 were for flu, up from 1,524 the prior week; 1,426 were for COVID-19, up from 1,380; and 898 were for RSV, up from 843.

Among Kentucky children, emergency-room visits for respiratory illness also increased again, to 1,906, up from 1,794 the prior week. Of those, 934 were for flu, up from 880; 719 were for RSV, up from 710; and 253 were for COVID-19, up from 204.

Hospitalizations for respiratory illness in Kentucky increased to 577 in the week ended Nov. 26, up 12% from the prior week, when that number was 513.

Of those, hospitalizations for COVID-19 increased to 314, up from 295 the prior week; hospitalizations for RSV increased to 157, up from 137 the prior week; and hospitalizations for flu increased 30%, to 106, up from 81 the week prior.

Among children, hospitalizations for respiratory illness increased nearly 28% in the week ended Nov. 26, to 142. That’s up from 111 the prior week.

Of those, 98 were for RSV, up from 84; 24 were for flu, up from 20 the week prior; and 20 were for COVID-19, up from 7 the week prior.

A more recent report, by the Centers for Disease Control and Prevention for the week ended Dec. 2 shows that COVID-19 hospitalization rates in 12 Kentucky counties were above 20 hospitalizations per 100,000 people, which the CDC considers high.

Letcher County stood out with a rate of 74.2 hospitalizations per 100,000 residents. Other counties with the “high” designation were Pike, with a rate of 29.1 per 100,000; Lewis, 22.8; Boyd, Carter, Greenup, Lawrence and Martin, 21.7; and Daviess, Hancock, McLean and Ohio, 20.9. Another 24 counties (yellow on the CDC map) had rates between 10 and 20 per 100,000.

That thing that’s going around: “Dr. Janet O’Mahony, an internal medicine physician at Mercy Medical Center in Baltimore, said many of her patients have recently come into her practice with a nasty cough that’s lingered for two weeks or so,” Ries reports. “Some people have also had sinus congestion, a sore throat and post-nasal drip.”

O’Mahony told Ries, “This chest cold has a real junky and persistent cough,” and her patients aren’t responding to antibiotics, which suggests it’s “purely viral,” but they have tested negative for the flu and COVID-19. Experts think the illness is probably caused by one of many adenoviruses.

Braunstein, of Sollis Health, “said the persistent cough is most likely due to prolonged inflammation in the airways — even after the virus is gone, the body continues to produce mucus and have bronchospasms, which is when the muscles in the airways tighten and cause a cough,” Ries reports. “For some people, this inflammation can persist anywhere from two weeks to two months, he explained.

“As is the case with COVID, after 10 days, it’s believed people aren’t contagious anymore, Braunstein added. Some individuals may be infectious for longer. For example, people with weakened immune systems can shed adenoviruses for months, despite being asymptomatic.”

Wastewater warns: The Wall Street Journal reports that wastewater monitoring is warning about COVID-19 this holiday season, showing a national rise in the levels of the virus and a new variant, JN.1.

The CDC’s National Wastewater Surveillance System report shows that in the week ended Dec. 2, Kentucky’s wastewater activity level was 3.2, well under the national level of 7.7 and the regional level of 8.4.

Wastewater is used to detect traces of infectious diseases circulating in a community, even if people don’t have symptoms. These data can serve as early warning that infection may be increasing or decreasing in a community.

Deaths: Susan Dunlap, spokesperson for the health department, said respiratory-related deaths on the state’s weekly dashboard are reported according to the week they occur, which sometimes leads to a delay between the actual date of death and the submission to the department.

Since Oct. 1, the department has reported six deaths related to the flu, with one of those reported in the week ended Nov. 26. Since Oct. 1, the state has reported 80 deaths related to COVID-19, with no deaths reported in the week ended Nov. 26. All of the flu- and COVID- related deaths have been adults.

When it comes to COVID-19 deaths in Kentucky, Dunlap said, the health department “is reporting on average 13 to 16 new COVID-19 related deaths per week.”

Kentucky Health News is an independent news service of the Institute for Rural Journalism in the School of Journalism and Media at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.