• Respiratory viruses are responsible for thousands of illnesses every year in Montana. In addition to the virus that causes COVID-19, the influenza virus and respiratory syncytial virus (RSV) are common viruses that circulate annually. Parvovirus B19 (Fifth Disease), adenovirus, rhinovirus, and parainfluenza are also common viruses that circulate annually. 

• COVID-19, influenza (flu), and RSV are common circulating respiratory conditions in Montana. They are caused by different viruses and are different diseases: SARS-CoV-2 (COVID-19), influenza viruses (flu), and respiratory syncytial virus (RSV).
• These viruses spread between people when someone who is sick coughs, sneezes, or does other things to cause droplets containing the virus to be expelled.
• These viruses spread year-round, but activity tends to peak in the fall, winter, and spring months (e.g., October-May).

• Symptoms of COVID-19, flu, RSV, and other respiratory illnesses are similar and may include a fever, cough, sore throat, runny or stuffy nose, headache, body aches, and low energy.
• If you are experiencing any of these symptoms, consult with your medical provider. Your provider may recommend that you get tested to confirm a diagnosis.
• If you are experiencing an emergency warning sign (such as trouble breathing or chest pain), seek medical care immediately.

• Testing is an important tool to help protect yourself and others from COVID-19, influenza, and RSV infections. 
• Testing for respiratory viruses can help you decide what to do next, like seeking treatment to reduce your risk of severe illness or taking steps to lower your chances of spreading viruses to others. 
• COVID-19 tests are available over the counter and from community testing sites. To find no-cost COVID-19 testing near you, visit Search for No-Cost Covid-19 Testing.
• A healthcare provider can help advise you on getting tested for flu, RSV, or other respiratory viruses.

Stay Home and Away from Others (Isolate)

• You may return to your normal daily tasks when you are experiencing an improvement in symptoms and have been fever-free for at least 24 hours without the use of a fever-reducing medication (e.g., Tylenol).

Seek Health Care for Testing and/or Treatment

• Treatments for COVID-19 and the flu can help lessen symptoms and shorten the time that you are sick. They may also reduce the risk of complications, including those that can result in hospitalization. For individuals at risk for severe illness, early treatment can result in a milder illness.

Use Additional Precautions for 5 Days After Returning to Normal Activities

• Practice good hygiene
  • Hygiene (practices that improve cleanliness) is a core prevention strategy to lower risk from respiratory viruses.
  • Practice good hygiene by covering your coughs and sneezes, washing or sanitizing your hands often, and cleaning frequently touched surfaces.
• Take steps for cleaner air
  • Respiratory viruses can spread in the air between people. By bringing in fresh outside air, purifying indoor air, or gathering outdoors, you can improve air quality and possibly lower your risk of contracting a respiratory virus.
• Maintain physical distance
  • Infectious droplets and particles build up in the air closer to the person who is releasing them. Putting physical distance between yourself and others can help lower the risk of spreading respiratory viruses.
• Wear a mask
  • Wearing a mask can help lower the risk of spreading respiratory viruses. When worn by a person who is currently sick or is beginning to feel better after being sick, masks reduce the spread of the virus to others by preventing respiratory droplets from circulating in the air. 

• COVID-19 Vaccine Recommendations for the 2024-2025 Respiratory Season:
  • The CDC recommends that everyone ages 6 months and older receive an updated 2024-2025 COVID-19 vaccine.
    • SARS-CoV-2 (the virus that causes COVID-19) changes frequently, and protection from previous COVID-19 vaccines declines over time.
    • Some children 6 months to 4 years of age may need one or more additional doses of COVID-19 vaccine to be considered up-to-date.
    • Persons who are moderately or severely immunocompromised may need one or more additional doses of COVID-19 vaccine to be up-to-date.
    • Receiving an updated 2024-2025 COVID-19 vaccine can restore and enhance protection against the virus variants currently responsible for causing infections.
  • COVID-19 vaccination can help reduce the chances of suffering the effects of Long COVID.
  • Updated COVID-19 vaccines will be available from Moderna, Novavax, and PFizer.

• Flu Vaccine Recommendations for the 2024-2025 Respiratory Season:
  • The CDC recommends that everyone 6 months and older, with rare exceptions, receive an updated 2024-2025 Influenza (flu) vaccine. Updated flu vaccines will be trivalent and will protect against flu A H1N1, flu A H3N2, and flu B/Victoria lineage.
  • September and October remain the best times for most people to get vaccinated, but flu vaccination is recommended as long as influenza viruses are circulating.
    • Pregnant women who are in their third trimester can get a flu vaccine in July or August to protect their babies from flu after birth, when they are too young to get vaccinated.
    • Some children 6 months to 8 years old need two doses of flu vaccine, including children getting vaccinated for the first time, those who have only previously received one dose of flu vaccine, and whose flu vaccination history is unknown. For those children, it is recommended they get the first dose as soon as vaccine is available, because the second dose needs to be given at least 4 weeks after the first.
    • Vaccination in July or August can be considered for children who have health care visits during those months if there might not be another opportunity to vaccinate them.
    • For adults (especially those 65 years old and older) and pregnant women in the first and second trimester, vaccination in July and August should be avoided unless it won’t be possible to vaccinate in September or October.

• RSV Vaccination and Immunization Recommendations for the 2024-2025 Respiratory Season
  • RSV vaccine is not currently an annual vaccine, meaning older adults do not need to get a dose every RSV season. That means if you have already gotten an RSV vaccine, you do not need to get another one at this time.
  • The CDC recommends that everyone ages 75 and older and adults ages 60-74 who are at increased risk of severe RSV infection (e.g., adults with chronic heart or lung disease, certain other chronic medical conditions, and those who are residents of nursing homes or other long-term care facilities) receive an RSV vaccine.
  • Pregnant women should receive 1 dose of maternal RSV vaccine during weeks 32 through 36 of pregnancy, administered September through January. Pfizer Abrysvo is the only RSV vaccine recommended during pregnancy.
  • All infants aged 8 months and younger born during or entering their first RSV season should receive 1 dose of the monoclonal antibody product, nirsevimab.
  • All infants and children aged 8-19 months who are at risk for severe RSV disease and are entering their second RSV season should receive 1 dose of nirsevimab.

• More Information on Immunizations:
  • Immunizations are a core prevention strategy for reducing the total number of cases and overall risk of severe illness from respiratory illness.
  • Immunizations work in two different ways depending on the type you receive. One way immunizations work is by showing your immune system what the virus looks like so your body can develop antibodies to fight it. The other way immunizations work is by directly giving your body antibodies. Antibodies can help prevent infection. If you do become infected, antibodies help shorten the length of your illness and can reduce your risk of severe health outcomes like hospitalization and death.
  • Immunizations are especially important for individuals who are at risk of severe illness. This includes older adults, young children, people with weakened immune systems, people with disabilities, and pregnant women.
  • Talk with a healthcare provider to make sure you are up to date on your immunizations.

• COVID-19
  • There are several antiviral medications used to treat mild to moderate COVID-19 in people who have risk factors for severe illness.
    • Nirmatrelvir with Ritonavir (Paxlovid)
    • Remdesivir (Veklury)
    • Molnupiravir (Lagevrio)
  • COVID-19 treatments must be started within 5-7 days after you first develop symptoms to be most effective.

• Flu
  • There are several FDA-approved antiviral drugs recommended by the CDC to treat flu this season for people who are very sick with flu illness, and those with flu or suspected flu and who are at higher risk of serious flu complications (e.g., people with asthma, diabetes, or heart disease).
    • Oseltamivir phosphate (available as a generic version or under the trade name Tamiflu)
    • Zanamivir (Relenza)
    • Peramivir (Rapivab)
    • Baloxavir marboxil (Xofluza)
  • Flu treatments are most effective when started within 2 days of getting sick. However, starting them later can still be beneficial.

Schools can help prevent infections caused by common childhood respiratory or stomach viruses by using and encouraging everyday actions.

• Take steps for cleaner air
  • Move group activities outside when possible, including lunch, certain classes, and recess/social periods.
• Cleaning, sanitizing, and disinfecting
  • Schools should follow procedures for routine cleaning, sanitizing, and disinfecting.
  • Rarely, a school may need specialized or enhanced cleaning and disinfection for a particular infectious disease (e.g., norovirus). Schools should consult with their local or tribal health department to determine what cleaning and disinfection is needed in these instances.
  • When and How to Clean and Disinfect a Facility
• Hand washing
  • Teaching and reinforcing proper handwashing and hand hygiene can lower the risk of spreading diseases.
  • Schools can set routines and scheduled opportunities for handwashing throughout the day (e.g., coming inside after recess, before lunch, etc.). 
  • Schools should provide adequate handwashing supplies (e.g., soap, water, and paper towels). If soap and water are not available, an alcohol-based hand sanitizer with at least 60% alcohol should be provided.
    • Remember to store hand sanitizers up, away, and out of sight of younger children!
• Respiratory etiquette
  • Schools should reinforce the covering of the mouth and nose with a disposable tissue when someone needs to cough or sneeze. 
  • If tissues aren't available, students and staff should cover their mouth and nose with their elbow, not their hands.
  • Handwashing should be followed immediately after blowing the nose, coughing, or sneezing.
• Vaccinations
  • Vaccinations and immunizations are safe and effective tools that provide protection against COVID-19, influenza, and RSV.
  • All states, including Montana, have vaccination requirements for children attending schools and daycares.
  • Schools should provide information about recommended vaccines to staff, students, and families.
  • Schools can also consider making vaccinations available on-site by hosting school-located vaccination clinics.

• How to Get Your Flu, COVID-19, and RSV Vaccines This Year

• Resources for Adult Vaccination

• American Indians and Alaska Natives (AI/ANs) and Flu

• COVID-19 and Tribal Communities

• Respiratory Virus Vaccination for Pregnant Women

• Pregnancy and Vaccination

• COVID-19 Vaccination for Women Who Are Pregnant or Breastfeeding

• RSV Vaccination for Pregnant Women

Know that the emergency warning signs of respiratory virus complications can be different in children. Seek immediate medical care for any of the following:

• Fast breathing or trouble breathing

• Bluish lips or face

• Ribs that pull in with each breath

• Chest pain

• Severe muscle pain (for example, child refuses to walk)

• Dehydration (no urine for 8 hours, dry mouth, no tears when crying)

• Lack of alertness or interacting when awake

• Seizures

• Fever above 104 degrees Fahrenheit that is not controlled by fever-reducing medicine

• In children younger than 12 weeks, any fever

• Fever or cough that improves but then returns or worsens

• Parents Toolkit for Helping Children Fight Flu

• RSV Immunizations to Protect Infants

• Vaccines for Children Program

• Flu Vaccines are Important for Children

• 6 Things to Know About the COVID-19 Vaccine for Children

• RSV in Infants and Young Children

• Older Adults and Flu

• Older Adults and RSV

• Respiratory Virus Resources for People with Disabilities

• Flu and People with Disabilities

• Immunization and Vaccine Product Summaries for Fall and Winter Virus Season

• Long-Term Care Quick Start Guide: Preparing for Respiratory Virus Season

• Long-Term Care Facilities: Viral Respiratory Pathogens Toolkit

• Project Firstline: Infection Control Actions for Respiratory Viruses