Local emergency rooms are seeing a rise in flu and respiratory syncytial virus cases at the same time, an uncommon trend.

Respiratory syncytial virus, better known as RSV, tends to peak when the flu season starts to trend down.

That’s not the case this year — the viruses are peaking simultaneously.

Jon Gonella, a physician assistant at MedStar Health, said no one was caught off guard.

“We’re not surprised to see them,” said Gonella. “We fully expect to see them.”

To avoid that flu fever or RSV cough, Gonella said it’s best to go back to the basics.

“Good hand hygiene,” he said. “I know we talk about it a lot. But it really does make a difference.”

The CDC also recommends getting vaccinated and staying home when you feel sick.

While the flu and RSV see an upward tick in cases, there’s one respiratory illness that hasn’t shown up as much this year.

“Not a lot of COVID,” Gonella said.

The Centers for Disease Control ranked COVID-19 as “very low” nationwide and “growing” in the D.C. area.