The Triplepidemic; Separating Truth from Fiction

Authors

  • Zmareye Sajid Northwest School of Medicine Peshawar Pakistan
  • Shahmir Arif Northwest School of Medicine, Peshawar Pakistan

DOI:

https://doi.org/10.59736/IJP.23.04.1044

Keywords:

Triplepidemic, Two spike W trend, Respiratory, Particulate matter, Surveillance

Abstract

Every fall and winter, a "tripledemic" convergence of respiratory viruses such as influenza, COVID-19, and RSV causes thousands of hospitalizations and deaths. The associated pathogens, which drive this seasonal crisis, comprise respiratory syncytial virus (RSV), human metapneumovirus (HMPV), coronavirus, enterovirus/rhinovirus, influenza virus (A and B being the cause of seasonal flu epidemics), parainfluenza virus, adenovirus, and human bocavirus (1).

It is this simultaneous surge of RSV, COVID-19 and Influenza that defines the tripledemic’s unique danger and with rising rates being attributed to air pollution and emerging viruses; it is important to identify relevant public health measures to address the combined threat.

Pakistan is currently ranked as the fifth most populous country with a population of 221 million, supplemented by a very high birth rate of 27 per 1,000. Viral illnesses affect 200 million children and elderly annually (1), displaying a typical "two-spike W-trend", however, healthy young adults can also be affected (2). Children under 5 years of age are more vulnerable to ARIs, reportedly responsible for a 16% incremental increase in the last decade, particularly in Pakistan, where respiratory infections account for 20% to 30% of all deaths (1). The tripledemic season significantly exacerbates this baseline burden.

References

Naz R, Gul A, Javed U, Urooj A, Amin S, Fatima Z. Etiology of acute viral respiratory infections common in Pakistan: A review. Rev Med Virol. 2019; 29:e2024. doi: 10.1002/rmv.2024

Martini M, Gazzaniga V, Bragazzi NL, Barberis I. The Spanish Influenza Pandemic: a lesson from history 100 years after 1918. J Prev Med Hyg. 2019 Mar 29;60(1):E64-E67. doi: 10.15167/24214248/jpmh2019.60.1.1205.

Naveed Siddiqui A, Musharaf I, Gulumbe BH. The JN.1 variant of COVID-19: immune evasion, transmissibility, and implications for global health. Therapeutic Advances in Infectious Disease. 2025;12. doi:10.1177/20499361251314763

Coccia M. Preparedness of countries to face covid-19 pandemic crisis: Strategic positioning and underlying structural factors to support strategies of prevention of pandemic threats. Environmental Research. 2022 Jan;203(111678):10-16. doi:

1016/j.envres.2021.111678

Arshad Y, Rana MS, Ikram A, Salman M, Aamir UB, Zaidi SS, Alam MM, Sharif S, Shaukat S, Khurshid A, Hakim R. Molecular detection and genetic characterization of human metapneumovirus strains circulating in Islamabad, Pakistan. Scientific reports. 2022 Feb 18;12(1):2790. doi: 10.1038/s41598-022-06537-5

Anderer S. CDC Eases Isolation Guidance for Respiratory Viruses. JAMA. 2024 Apr 2;331(13):1081-81. doi: 10.1001/jama.2024.2069

Tang S, Ji L, Bishwajit G, Guo S. Uptake of COVID-19 and influenza vaccines in relation to preexisting chronic conditions in the European countries. BMC geriatrics. 2024 Jan 12;24(1):56. doi: 10.1186/s12877-023-04623-5

Downloads

Published

2025-12-31

Issue

Section

Editorial

How to Cite

1.
Sajid Z, Arif S. The Triplepidemic; Separating Truth from Fiction. Int J Pathol [Internet]. 2025 Dec. 31 [cited 2025 Dec. 31];23(4):203-5. Available from: https://jpathology.com/index.php/OJS/article/view/1044