What is typically a one-two punch, early-winter viruses followed by late-winter influenza, may be emerging in the region as simultaneous rises in respiratory infections and flu. Both hit young children hard. Sudden weather changes and other factors make a child more vulnerable. "Being exposed to secondhand smoke, thirdhand smoke [clinging to furniture], predisposes them to more severe respiratory illnesses and even more ear infections," said Denise Salerno, a member of a large Temple practice.