It’s a muscle condition most often seen in children during or shortly after common viral infections, especially influenza (the flu). While the condition can be alarming for parents, medical experts say it is usually temporary and treatable with proper care.

Mustafa Bakir, MD, a pediatric infectious disease specialist with OSF HealthCare, says viral myositis typically appears a few days after the onset of a viral illness.

What is viral myositis?

Viral myositis refers to inflammation of the muscles caused by a viral infection. A specific and more common form in children is known as benign acute childhood myositis (BACM).

“Benign acute childhood myositis (BACM) is more likely to be seen with influenza,” Dr. Bakir says.

In these cases, the virus can trigger muscle inflammation after the initial respiratory symptoms begin to improve.

“Viral myositis, oftentimes, starts with influenza and then begins to cause damage in the person's muscles, also known as muscle inflammation.”

Common symptoms and who is affected

Viral myositis most often affects the calf muscles and can significantly impact how a child walks.

“Calves are almost exclusively affected by viral myositis, as well as gait (walking pattern).”

Children may complain of sudden leg pain, stiffness or difficulty walking, sometimes refusing to walk altogether. The condition is most seen in younger kids.

“This is likely a benign condition, but it takes about three to seven days to heal. It's mostly seen in school-aged children between 4 and 7 years of age,” Dr. Bakir says. “Usually, it presents with this pain and gait problems. Patients usually are out of school for those days.”

Treatment and recovery

In most cases, viral myositis resolves on its own within about a week. Supportive care at home is often sufficient, with a strong focus on hydration and pain control.

“Fluid support is important to prevent kidney damage. Anti-inflammatory medications like ibuprofen both decrease the pain and inflammation,” Dr. Bakir says.

Encouraging children to drink water and electrolyte-containing fluids is especially important during recovery.

When to seek emergency care

While viral myositis is usually mild, some symptoms require urgent medical evaluation. Severe pain, inability to walk or extreme muscle tenderness may signal a more serious condition.

“We must differentiate severe myositis from benign acute childhood myositis. If the patient has very severe pain and can't walk, they must be seen in the emergency department,” Dr. Bakir says. “The physician will decide if this is serious, and if the patient needs to be admitted.”

In rare cases, viral infections can lead to rhabdomyolysis, a severe breakdown of muscle tissue that can affect the kidneys.

“Those patients who refuse to walk and have very tender muscles with severe pain should be seen in the ED,” Dr. Bakir says. “Because we must differentiate those acute conditions from the more severe muscle involvement. This is rarely seen with influenza and other viral infections. We call it rhabdomyolysis.”

Dr. Bakir notes that kidney failure can occur in extreme cases and must be treated in the hospital.

“Because of the breakdown of muscle cells, the kidney canals may become blocked,” Dr. Bakir says.

Rising flu cases and prevention concerns

Dr. Bakir also points to a noticeable increase in influenza cases among children since the COVID-19 pandemic ended.

“Children under five years of age are more likely to have influenza compared to the other ages,” Dr. Bakir says. “There is a significant increase in childhood influenza since the end of the COVID-19 era.”

Low vaccination rates remain a major concern.

“Why can't we decrease the flu numbers? Because, especially in Illinois, the reported coverage of the influenza vaccine is only 24.4%. This is not optimal and sufficient to predict epidemics and complications in this community,” Dr. Bakir says.

Bottom line

Dr. Bakir emphasizes the importance of recognizing warning signs – such as severe pain or refusal to walk – that may signal the need for emergency care. As flu activity continues to rise, prevention efforts, including vaccination and early medical evaluation, remain key to reducing complications in children.

Video Interview Clips

Bathrooms are filled with germ-breeding objects, and your toilet isn’t the sole culprit. 

Showers, toothbrushes, soap dispensers and any surface can be added to the germy list, according to Kaylin Heinz, an infection preventionist RN with OSF HealthCare. Heinz offers some cleaning tips for the different areas of your bathroom.

Shower Cleaning tips 

"When you're cleaning, go from top to bottom," Heinz says. “If you start cleaning your tub and then you clean your shower walls, you're going to have to re-clean the tub. When you're getting out of the shower, think about the moisture that's there. That's where the bacteria and fungus are going to grow, so you're going to want to get rid of that moisture if you can.”

The moisture buildup isn’t limited to linens, Heinz says. She recommends wiping down any moisture seen in the shower before getting out. Use a Squeegee, towel or paper towel to dry the area.

Normally, you should clean your shower at least once a week. If many people use the shower on a daily basis, or if someone is sick, Heinz says it is best to clean it every day.

Charles Gerba, PhD, a microbiology professor at the University of Arizona, told Reader’s Digest that bathmats and other fabrics are some of the dirtiest items, because people step on them with dirty shoes, and they stay wet and damp the longest.

Bathtubs’ path to bacterial and fungal infections

If you have a cut on your body, you can introduce bacteria or fungus to the area during a shower. 

"You can get athlete's foot or a staph infection just through the tub and not cleaning," Heinz says. She adds the film on the bottom of the shower or bathtub is a clear sign of where bacteria is living. Make sure to scrub the area, clean it and let it dry completely. If you notice discoloration in your shower or bathtub, Heinz recommends cleaning it immediately.  

Bathroom cleaning tips

"Your toilet can aerosolize and throw germs up onto surfaces within about five feet," Heinz says. “With flat surfaces, it can collect dust or other things that are in the air, so make sure you're wiping those down frequently. At least weekly, if not daily.”

Heinz recommends cleaning areas of your bathroom twice. The first time is for cleaning, the second time is for disinfecting. And don’t forget about the soap dispenser! Heinz says since this is one of the first places people reach to clean their hands, it’s one of the dirtiest places in the bathroom.

The Centers for Disease Control and Prevention (CDC) recommends the surface you’re wiping stays wet the entire time of contact to make sure germs are killed. You should clean surfaces with water and soap and scrub them before sanitizing or disinfecting them.

According to the CDC, “Cleaning removes most germs, dirt and impurities from surfaces. Clean with water, soap and scrubbing. Sanitizing reduces germs to levels public health codes or regulations consider safe. Sanitizing is done with weaker bleach solutions or sanitizing sprays. Clean surfaces before you sanitize them. Disinfecting kills most germs on surfaces and objects. Disinfecting is done with stronger bleach solutions or chemicals.”

Don't mix multiple chemicals

"With any products that you're going to be using, I'd make sure you're looking at the warning labels. I would definitely not mix chemicals," Heinz says. “If you are going to use one chemical and then use another, I'd make sure that you're rinsing thoroughly, making sure it dries, and then you can use the next product.”

If you’re diluting a chemical-based product, the CDC says to only use water at room temperature. Adding that an extra safety precaution is to wear eye and skin protection (like gloves) and store chemicals out of children’s reach.

Don’t forget your toothbrush!

Does your toothbrush hang out on the bathroom counter? You might want to rethink that.

"If you keep your toothbrush on the counter, it likely has fecal matter on it. So, put your toothbrush away or switch it often and clean it,” Heinz says.

Stop the spread | Toilet style

Here’s a habit change you can consider. Instead of flushing the toilet and just walking away, close the lid before you flush and keep the germs inside.

"Make sure when you're flushing the toilet, go ahead and close the lid. That's going to minimize the number of germs that are spraying all over your bathroom and aerosolizing," Heinz says.

Heinz adds another fun fact about the dirtiness of toilets – the minerals in the water. She says the minerals in toilet water can get stuck to the toilet bowl, which can also be a breeding ground for germs.

Video Interview Clips

All the talk each fall centers on colds, flu and RSV.  But one viral infection to pay close attention to is hand, foot and mouth disease (HFMD).

HFMD typically impacts young children, but adults and older children can get it, too. It causes painful red blisters in the mouth and throat, and on the hands, feet, and diaper area. HFMD is most common in children who are in child care because young children need frequent diaper changes and help using the bathroom. They also tend to put their hands in their mouths.

“Hand, foot and mouth disease is a pretty classic viral infection that’s most commonly affected in the younger age group under the age of five," says Asma Khan, DO, a pediatrician for OSF HealthCare. "The symptoms you typically see are mouth lesions, usually on the tongue or the cheeks. You also have a rash on the body, most often it's clustered on your hands and feet. Sometimes it can be a full body rash, and occasionally fevers and just feeling a little down and irritable.”

Other symptoms include sore throat, fussiness in infants and toddlers and a loss of appetite.

There are two main viruses that cause HFMD – coxsackie and enterovirus. There is usually a three to five day incubation period, when patients are infected and spreading the virus, before the initial onset of symptoms. The virus is spread through saliva, stool and respiratory droplets such as sneezing and coughing.

“There are very few complications with hand, foot and mouth disease, it’s usually more of a milder course," says Dr. Khan. "You may feel rundown for about seven to 10 days. On occasion if we have a more virulent strain of the virus, you can have more serious complications and those can be meningitis, encephalitis, or myocarditis but that has been rare. Sometimes there's a late strain of enterovirus that can be more related with those complications.”

According to Dr. Khan, the treatment is usually supportive care at home.

“It’s treating them comfortably with Tylenol and Motrin to help keep their pain down because those mouth lesions tend to be the one that’s most painful," says Dr. Khan. "The rash on the body typically is not. So we want to keep them continuing to eat and drink and then we want to make sure we really push fluids so if they're having a lot of pain in their mouth. They may not want to eat but as long as we can get them to drink and stay hydrated that’s the number one key.”

Dr. Khan adds that if your child has a high fever or shows no gradual improvement after a few days, it’s time to call your physician. 

HFMD typically occurs in the summer and fall seasons, but Dr. Khan says outbreaks can also develop in the winter. HFMD is similar to herpangina, another viral illness that is often seen in children ages three to 10. The difference between the two illnesses is that HFMD can form on the hands, feet and inside of the mouth while herpangina only forms in the mouth and throat.  

To prevent the spread of HFMD, Dr. Khan encourages parents to keep kids home from school and daycare while they have a fever or open blisters on the skin and in the mouth. Everyone in your home should wash their hands, especially after using the bathroom or changing a diaper, and before preparing food. Toys and surfaces should also be cleaned with a disinfectant as often as possible.

When is it safe for my child to return to school or child care? That is the biggest question Dr. Khan is asked by parents.

“The big criteria is fever. No child should be going to school with a fever. The fever should be gone for 24 hours," says Dr. Khan. "The rash itself is not clearly an indication to stay out of school, because a rash may take a good week or so to fully resolve, and the infectivity rate after that first week is really gone down. You don't necessarily have to keep a child out of school just because a rash has not resolved in a few days.”

For more information about HFMD, visit OSF HealthCare. 

 

Interview Clips 

“It’s important for parents and caregivers to know the signs of labored breathing, also known as respiratory distress,” says Kelsey Grimes, DO, outpatient pediatrician at OSF HealthCare. “This understanding can help them know when it's time for their children to receive immediate medical attention.”

When to seek help

OSF HealthCare has multiple options to use if your child is in respiratory distress.

“During work-time hours, you can call your outpatient pediatrician's office, or primary care provider's office, and try to get a same-day appointment,” Dr. Grimes says. “In that, OSF also has a pediatric nurse triage line where a nurse can provide guidance or recommendations based on the symptoms you tell them. In the evenings, we have the pediatric after hours clinic (2806 Knoxville Ave. Peoria, Illinois), which is a good option.”

Additionally, OSF has multiple OSF OnCall Urgent Care and OSF PromptCare locations. But oftentimes if you're concerned about breathing for your child, the OSF HealthCare Children's Hospital of Illinois pediatric emergency department or calling 9-1-1 is the right first step.”

Why labored breathing happens

“If your child has labored breathing, oftentimes in the pediatric population, the most common cause is a viral infection. With viral infections you get a lot of inflammation, mucus, snot, phlegm – all of that,” Dr. Grimes says. “Kids' airways are smaller. So, inflammation, even on the mild side, makes those airways even smaller. Then when they're plugged up with mucus, or phlegm, they are going to really struggle to breathe.”

Children with significant breathing difficulty may need oxygen support to help them recover. This can be done using high-flow oxygen therapy (HFOT), which delivers air and oxygen down into their respiratory tract. In these cases, hospitalization is required.

At home, nasal saline and suction may be recommended, as well as controlling fevers with Tylenol or Motrin.

Rhinovirus, RSV (respiratory syncytial virus) and influenza, among other virus strains, are common culprits that can cause labored breathing. When treated properly, symptoms should begin to improve after three to four days. However, if symptoms worsen, it could indicate an underlying bacterial infection. This may require antibiotics or even hospitalization, depending on the child’s age and severity of illness.

Protecting kids from germs

“Regular hand hygiene and making sure when we touch surfaces (doorknobs, countertops, etc.) that we're not rubbing our eyes or mouth after,” Dr. Grimes says. “Don't share drinks or bites of food. Do anything you can do to try and prevent germ exposure. It’s hard, because a lot of these kids are in day care, preschool and kindergarten. So, there are no boundaries, and the kids are up close and personal there. You try your best for good hygiene, but in the end, they are probably going to be exposed.”

Signs of respiratory distress

Dr. Grimes says the most important thing to watch out for is how fast your child is breathing. Respiratory distress can cause a child to breathe much faster, or sometimes slower, than normal.

Retraction breathing, or the visible “sucking in” of the skin between or below the ribs, is another red flag.

“This happens because the muscle underlying the skin is really contracting, working hard to get that air in and back out,” Dr. Grimes explains.

Retraction breathing can happen under the rib cage (subcostal), between the ribs (intercostal), above the collarbones (supraclavicular) or at the base of the neck (tracheal tugging). Flaring nostrils are also a warning sign.

Other concerning symptoms include:

• Drooling in children who are past the teething stage
• Blue discoloration around the mouth
• Head bobbing with each breath (an emergency sign)
• Sitting forward and extending the neck in a “sniffing position” to ease breathing
• Wheezing when breathing out
• Grunting when exhaling
• Lethargic behavior (confused, drowsy)

Care and comfort at home

For viral infections, medical teams focus on supportive care, especially fever control.

For babies 2 months old or younger, any high or low temperature warrants an emergency department visit. Do not give Tylenol at this age.

Once babies are over 2 months old, Tylenol may be given in the appropriate dose based on weight, always under guidance from your pediatrician. Once over 6 months of age, babies can receive Motrin, as their kidneys are more developed. Both medications can be given every six hours as needed.

“When kids are having fevers, signs of labored breathing increase as well,” Dr. Grimes notes.

Hydration is also extremely important. “Really make sure to push fluids when your kids are sick. Hydration is key in recovery.”

Parents can help clear their child’s airway by using nasal saline followed by gentle suction. Humidifiers can help loosen mucus, and standing in a steamy bathroom with the shower running hot can offer short-term relief.

The bottom line

Labored breathing can be a sign of serious illness, and early action is the best protection. Parents and caregivers who recognize the warning signs and know when to call their pediatrician or seek emergency care, can help ensure their child receives timely, life-saving support.

Making sure your child receives the recommended childhood vaccines is another way to ensure your child is protected against respiratory illness.

Video Interview Clips

The respiratory viral infection, although thought eliminated in the U.S. in 2000, has reemerged, especially among unvaccinated individuals. As of early April 2025, the Centers for Disease Control and Prevention (CDC) has reported more than 600 confirmed cases of measles.

Measles is extremely contagious

"The key to measles is how highly infectious it is. Each person that has measles will infect between 12 and 18 people in an unvaccinated situation," says Doug Kasper, MD, an infectious disease specialist with OSF HealthCare. "The key for controlling measles is widespread vaccine use."

For reference, each influenza patient, on average, will infect one to two others.

The measles vaccine is normally offered once a child has reached one year of age. It's a two-shot series, which came on the market in 1963. Dr. Kasper says this gives medical experts decades of data that show a correlation between people receiving the vaccine, and close to zero circulation of the virus in the United States.

The states with measles outbreaks are in unvaccinated people, and no breakthrough cases (in those who have received the vaccine) have been reported, Dr. Kasper adds.

The long-term risks for unvaccinated measles patients 

"There is emerging information that vaccination not only protects an individual from not becoming ill or having less severity of illness with a viral exposure, whether that's measles, chicken pox, influenza or COVID-19, but that there are long-term risks from viral infections that we do not appreciate in the moment," Dr. Kasper says. "Some of these have been associated with memory loss or dementia as somebody ages. Some of these are associated with organ disease like hepatitis or kidney disease."

Subacute Sclerosing Panencephalitis (SSPE)

SSPE is a rare, deadly degenerative disease of the central nervous system that can happen seven to 10 years after a measles infection. Young children, pregnant women and immunocompromised people are the most at-risk for SSPE. One to three out of every 1,000 children who become infected with measles will die from respiratory and neurologic complications, the CDC says.

SSPE symptoms happen over four stages.

-          Stage 1: Personality changes, mood swings or depression. There may also be fever and headaches, this stage can last up to six months

-          Stage 2: Muscle spasms and uncontrolled movement problems. Loss of vision, dementia and seizures can occur

-          Stage 3: Twisting movements and rigidity. Sometimes death

-          Stage 4: Serious brain damage, including areas of the brain that control breathing, heart rate and blood pressure, leading to coma and death

Immune amnesia

Another long-term impact of measles is known as immune amnesia. The American Society for Microbiology (ASM) calls immune amnesia “one of the most unique and most dangerous features of measles pathogenesis.” The extremely rare condition causes people’s immune systems to “forget” how to fight off infections and makes the person more susceptible. The ASM determined it normally takes two to three years after a measles infection for protective immunity to return.

A measles outbreak was declared in Northeast Illinois in early 2024 and declared “over” by the Illinois Department of Public Health (IDPH) in June. The expectation of statewide health experts is that measles will return to Illinois in the coming months. This is mainly due to heavy travel through Chicago airports and summer festivals. County health departments have now been tasked with keeping an eye on their measles vaccine rates and identifying areas where vaccine rates are low. 

Peoria County's measles vaccine rate is quite high, around 95%. But outlying communities in central Illinois have lower vaccine rates, normally more rural counties. Health experts at Michigan Medicine call the Great Lake State “ripe for a measles outbreak,” as only 66% of toddlers receive the recommended childhood immunizations.

Measles symptoms 

"Measles typically presents with a high fever, typically much higher than what we'd see with seasonal colds or influenza. Fevers can be 104 or 105 degrees Fahrenheit," Dr. Kasper says. "That's followed by a runny nose and a characteristic rash. This typically develops on the head and then spreads down the rest of the body."

“We don’t want to go back”

"Measles at its peak, in the 1950s before the vaccine, led to a significant number of hospitalizations in young children. Around 50,000 hospitalizations were estimated per year and about 500 deaths," Dr. Kasper says. "We don't want to go back to that scenario in any capacity, where we have a large number of unvaccinated people. The outcomes could be too severe." 

Immunocompromised people like those who have received an organ transplant, cancer patients or those on long-term therapies that could impact their immune system, are at high risk for measles. 

Why vaccines are so important right now

Summer travel along with large crowds at places like airports and theme parks, will likely bring more measles cases to the United States. 

"This time, as good as any time, is to make sure somebody is updated on their vaccinations. If somebody isn't sure if they were vaccinated as a child, they should talk to their primary care provider about testing or receiving the vaccine. If someone is immunocompromised and they might be at a higher risk for measles through travel in areas that have exposure, they should talk to their primary care provider about the vaccine," Dr. Kasper says. "If someone has young children or is at an age where vaccine is recommended, we wholly recommend for them to discuss with their provider to remain up to date on their vaccine series."

Vaccine hesitancy continues to be a topic of discussion, one that Dr. Kasper recommends patients openly discuss with their medical provider. 

Natural immunity is not a viable option with measles. The highly infectious nature of the virus, along with the severity of symptoms and potential for long-term complications, make it an illness people need to try and avoid entirely. 

To choose a primary care provider, visit the OSF HealthCare website.

Video Interview Clips

Showers, toothbrushes, soap dispensers and any surface can be added to the germy list, according to Kaylin Heinz, an infection preventionist nurse at OSF HealthCare. 

Heinz offers some cleaning tips for the different areas of your bathroom. 

Moisture from your bath or shower leads to the buildup of bacteria and fungi, while also being a prime spot for viruses to live and grow. 

Linen items like towels and bathmats are known as some of the dirtiest items, since people step on them with dirty shoes, and they stay wet and damp the longest. 

Heinz says if you have a cut on your body, like on your feet, you can introduce bacteria or fungus to the area during a shower. This can lead to athlete's foot or a staph infection. 

She gives additional guidance on how to clean your shower.

“When you're cleaning, go from top to bottom. If you start cleaning your tub and then you clean your shower walls, you're going to have to re-clean the tub," Heinz says. "When you're getting out of the shower, think about the moisture that's there. That's where the bacteria and fungus are going to grow, so you're going to want to get rid of that moisture if you can.”

Heinz adds if there's any discoloration in the shower or tub, clean it immediately, as this is a sign of where bacteria is growing. 

Make sure to scrub the area, clean it and let it dry completely.

Health Highlights Video Version With Chyrons

Health Highlights Video Version Without Chyrons

Now, health professionals are warning the public about a number of health concerns that can come with sitting on the toilet too long and scrolling on your cell phone.

Leave the phone at the door

Many people have gotten into the habit of taking their phone into the bathroom with them and scrolling TikTok or Instagram while they do their business. Kaylin Heinz, an infection preventionist RN at OSF HealthCare, recommends making the mental decision to not even take your phone with you.

"With you sitting on your phone and looking through TikToks, everyone probably knows that with social media, you look at it for a minute, and next thing you know it's been 30 minutes or an hour. So, I think it's a good idea to just not bring your phone in. Or if you are, just keep it to a minimum," Heinz says.

She adds if your phone tags along to the toilet with you, wipe it down with disinfectant wipes.

Bacteria, fungi and viruses, oh my!

A simple flush doesn’t get rid of the nastiness that is common in the restroom. Especially with bathrooms that have showers and bathtubs in them, the moisture in the room can lead to bacteria, fungi and virus growth, not just inside the toilet, but on all bathroom surfaces. Heinz calls these surfaces a “breeding ground” for germs.

Heinz says it’s important to consider every step of the process, from entering the bathroom to flushing the toilet to washing your hands. Where can the germs be? Are you really cleaning your hands?

"With sitting and scrolling, you're sitting there for long periods. Your hands are probably dirty before you go to the bathroom, because you're typically not washing your hands before you go to the bathroom. Then when you're sitting on the toilet, you're probably setting your phone down on a surface area that has germs," Heinz says. “Then you'll wash your hands, which you'll typically think your hands are clean, but they're not. Then you wash your hands and pick up the phone that was on the surface with germs, and now your hands are dirty again. And you're picking up the germs, taking them elsewhere, and spreading them to other people.”

Save the toothbrushes!

Does your toothbrush hang out on the bathroom counter? You might want to rethink that.

"If you keep your toothbrush on the counter, it likely has fecal matter on it. So, I would definitely put your toothbrush away or switch it often and clean it,” Heinz says.

Stop the spread | Toilet style

Here’s a habit change you can consider. Instead of flushing the toilet and just walking away, close the lid before you flush and keep the germs inside.

"Definitely make sure when you're flushing the toilet, go ahead and close the lid. That's going to minimize the number of germs that are spraying all over your bathroom and aerosolizing," Heinz says.

Heinz adds another fun fact about the dirtiness of toilets -- the minerals in the water. She says the minerals in toilet water can get stuck to the toilet bowl, which can also be a breeding ground for germs.

Clean up, clean up, everybody do their share!

Heinz recommends cleaning your bathroom at least once a week. If someone is sick, she says to clean it once a day, including using disinfectant wipes on all surfaces.

If you’re sick with a virus, your urine and feces can have the virus in them, which keeps the virus living and growing in the toilet longer.

Heinz recommends researching different products and reading over the spray labels, as some can interact with dust or debris, causing them to go into the air. She says if you prefer using wipes but only have spray at the moment, spray a paper towel first and then wipe the surface. She suggests using products with bleach in them, but to never mix chemicals.

“If you’re uncertain about a product, consider spot testing it first, as some finishes can be damaged,” Heinz adds.

The Centers for Disease Control and Prevention (CDC) recommends the surface you’re wiping stays wet the entire time of contact to make sure germs are killed. You should clean surfaces with water and soap and scrub them before sanitizing or disinfecting them.

According to the CDC, “Cleaning removes most germs, dirt, and impurities from surfaces. Clean with water, soap and scrubbing. Sanitizing reduces germs to levels public health codes or regulations consider safe. Sanitizing is done with weaker bleach solutions or sanitizing sprays. Clean surfaces before you sanitize them. Disinfecting kills most germs on surfaces and objects. Disinfecting is done with stronger bleach solutions or chemicals.”

Video Interview Clips

In a health advisory sent to long-term care (LTC) facilities, farm bureaus and local health departments, the IDPH reports large commercial poultry flocks in central and southern Illinois have recently tested positive for the H5N1 virus. Farm owners are now in the process of “de-populating” the birds.

Several counties in northern Illinois have reported events where many ducks and geese have died, referred to as “die-offs.” The reason LTCs received the notice is because many are located on retention ponds that attract waterfowl and wild birds.

No human cases have been reported in Illinois yet. But health officials continue to warn those who interact with potentially infected animals that if they don’t wear the proper personal protective equipment (PPE), they are at higher risk of developing the novel influenza A virus due to H5N1.

Doug Kasper, MD, an infectious disease specialist with OSF HealthCare, says bird flu has really hurt local American farms.

"Avian flu is a different strain of Influenza A. It's a strain that has been circulating in bird and cattle populations for over two years. It has been devastating to those populations, like poultry and dairy farms across the country," Dr. Kasper says. "What was unique was that in the calendar year 2024, was the first confirmed testing where the spread from an animal to a human occurred of this specific strain of influenza."

In early January, the Louisiana Department of Health reported the first-ever human bird flu death in the United States. The patient was reported to be over 65 years of age and had underlying medical conditions. The patient contracted H5N1 after exposure to sick and dead birds in a backyard flock.

Currently bird flu is only transmitted from animal to animal or animal to person. There have been no reported cases to have transmitted from human to human, but Dr. Kasper says there is always a concern about that possibility.

"Whenever there is an animal strain of infection that's not typically found in humans, we worry about the impact of if it were to cross over," Dr. Kasper says. "We've seen this with other infections throughout history. Even within COVID-19, there was the initial thought that it was an animal strain of infection."

The current flu vaccine does not protect against avian influenza, Dr. Kasper says.

"Each year the influenza vaccine, which is made up of three or four strains of influenza virus, is reexamined and matched up to a variety of factors to try and predict which strains will be most prevalent the next year," Dr. Kasper says. "Right now, avian flu cases in humans are so low that it doesn't warrant a different strain that would be much more likely to be found." 

IDPH’s guidance to LTCs is to have residents tested for the flu if they are suspected of having acute respiratory illness. Don’t touch dead or sick birds, only trained staff in appropriate PPE should handle with caution.

"The average person who does not interact with poultry or dairy farms is at very low risk of avian flu," Dr. Kasper says. 

There is concern that bird flu could enter the food production and distribution across America. This is why the United States Department of Agriculture (USDA) is closely monitoring dairy and poultry farms, to try and limit any possible contamination of dairy, meat or poultry products. 

The bird flu continues to be rarely seen in humans, as only 67 cases (as of January 15) have been reported by the Centers for Disease Control and Prevention. Most cases have been mild, Dr. Kasper says.

Video Interview Clips

Feeling tired all the time no matter what you do? Is it making it difficult to enjoy life? You might want to talk to your health care provider about chronic fatigue syndrome. Experts say it’s a tough ailment to live with and a tough one for science to grasp, but there are ways to ease the symptoms.

“It is challenging, for sure,” says Aminat Ogun, MD, a family medicine physician at OSF HealthCare. “Feeling that intense fatigue day to day for normal activities that other people can tolerate.”

Symptoms and diagnosis

Dr. Ogun says there’s no known, specific cause for chronic fatigue syndrome. But it’s associated with other health issues: viral infections like Epstein-Barr, coronavirus and retroviruses; Lyme disease; depression and sleep disruption. Dr. Ogun says the disorder impacts women more than men and is most often seen in ages 30 to 50.

There’s no test to diagnose chronic fatigue syndrome, so providers will look at five symptoms:

• Persistent fatigue
   
• Malaise (feeling discomfort or ill) after exerting yourself

“If you’ve done any mental or physical activity and you have that sudden onset of feeling fatigued and very tired,” Dr. Ogun explains.

• Feeling unrefreshed after sleeping
   
• Memory and concentration problems
   
• Orthostatic intolerance. This is a disorder where your blood pressure rises when you stand up.

“If you’ve had six months of these symptoms with moderate to severe intensity at least half of the time,” you’d likely be diagnosed with chronic fatigue syndrome, Dr. Ogun says. “It’s through history taking. When you see your primary care provider, they ask questions. That’s how it’s diagnosed.”

Treatment

Treatment for chronic fatigue symptoms can include medicine and lifestyle changes.

• A provider may recommend medication to help with the joint and muscle aches, nausea, headaches and depression that can come with chronic fatigue syndrome.
   
• Seeing a mental health professional
   
• Diet changes
   
• Graded exercise therapy. A provider will work with you to increase physical activity over time. This can help with overall energy.
   
• Improve sleep habits.

“Go away from screen time a couple hours before sleep. Don’t exercise right before sleep. That can also affect your sleep pattern,” Dr. Ogun lists as two examples.

Dr. Ogun says each treatment plan is different. Medical experts don’t know when, on average, chronic fatigue syndrome will go away. You may have to manage symptoms for the rest of your life. Dr. Ogun says you should stay in close contact with your primary care provider about your treatment plan.

Learn more

Read more about managing chronic fatigue syndrome on the OSF HealthCare website.

Interview clips

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Tis the tick season

During those times of the year when we’re feeling down and out, we hope a prescription from the doctor might do the trick to get us back on our feet.  

But that’s not always the case, especially when it comes to antibiotic resistance, says Michelle Brady, dean of Graduate Affairs and Research for Saint Anthony College of Nursing in Rockford, one of two colleges of nursing owned and supported by OSF HealthCare.

 “Antibiotic resistance is when bacteria no longer respond to the medications or antibiotics that we give you to treat an infection,” says Brady. “It's a change in the bacteria, not a change in us." According to Brady, there are 1.27 million death attributed to antibiotic resistance around the world.

The problems with antibiotic resistance include risk of longer illness or death, severe medication side effects, additional medical appointments and extended hospital stays.

One of the biggest issues is overuse of antibiotics. For example, you wouldn’t take antibiotics for a sore throat, which is a viral and not a bacterial illness.

Another problem is the misuse of antibiotics. If you forget to take one or more doses of your antibiotic or stop using the medicine too soon, bacteria can start to multiply, and mutated bacteria can quickly become resistant to medicine.

Antibiotic-resistant infections can affect anyone. There are, however, certain groups who face a higher risk of developing a problem including babies, people older than age 65, people with compromised immune systems and people who regularly use antibiotics.

Alissa Bartel is a nurse practitioner with OSF HealthCare. She says when people don’t feel well, obviously they want something to help them. She adds it’s important for providers to be well-educated and prepared to talk to patients about why antibiotics aren’t always good for them, why they don’t always treat the problem and possible alternatives.

“You really have to talk to patients at a level they can understand instead of using a bunch of jargon that can leave them frustrated,” says Bartel. “I make sure they know exactly what they're getting, what I recommend, what our follow-up plan would be and answer any questions they have.”

Health care organizations work with their providers to follow clinical guidelines related to infections. In addition, there are resources available to providers, so they know what common organisms are in the community and how those organisms respond to medications.

“In the last three to five years we have put more emphasis on health and wellness than we used to – good exercise, good sleep, good nutrition – all help you maintain a healthier, robust immune system,” Brady says. “I think we've done a really good job of making sure that each provider understands they have ownership in this and that starts with prescribing appropriately.

“But also taking the time to educate your patients as to why they think they need that antibiotic. Give them alternatives as to what they can do to feel better. It's more than just giving them a prescription. It's listening to them and listening to what their concerns are and helping them find a solution that may not be a prescription antibiotic.”

As winter approaches, physician offices are seeing more people experiencing respiratory infections, colds, flu, RSV and COVID symptoms. Unfortunately, antibiotics will not help treat those viral infections.

That’s why Bartel encourages patients to remember good hand hygiene, keep your hands away from your face and mouth and practice self-care to reduce your level of stress. It’s also important to stay up to date on vaccines for flu, COVID and RSV if you qualify.

“If your body is stressed and your chronic conditions are not well cared for, you are at greater risk of developing any of these infections, which can turn serious very quickly,” she says. “So stay up to date on your visits with your primary care provider, ask them questions and try to stay as healthy as possible to prevent illness without using antibiotics.”

To learn more about ways to prevent antibiotic resistance, visit OSF HealthCare.

Michelle Brady Interview Clips 

Alissa Bartel Interview Clips