Flu Surges Nationwide, With Regional Hotspots Leading The Spike

Most people in the country know someone who currently has, or just had, the flu.

Flu season arrives with the holidays, as parties and travel kick into high gear and colder weather sets in across many states. Like last year, though, this flu season is shaping up to be a bad one. While levels aren’t at a peak right now, certain regions are currently getting hit hard (and cases are rising overall).

Here’s where flu cases are the worst right now and why this year is expected to have high cases of the virus:

“In general … if we look at the different wastewater monitoring systems, or if we look at the CDC’s influenza dashboard, we see that overall cases of influenza across the country are increasing,” said Elisabeth Marnik, the chief science officer at Those Nerdy Girls, an organization dedicated to sharing accurate health and science information.

But certain areas are harder hit than others right now, she added. According to the Centers for Disease Control’s data for the week ending with Dec. 6, New York, Colorado, New Jersey and Louisiana are all reporting high levels of flu. New York City, in particular, is reporting flu levels at “very high” — which is the highest category.

“When you have the kind of population density that New York and New Jersey have … you really run the risk of accelerated transmission,” said Dr. Daniel Varga, the chief physician officer at Hackensack Meridian Health in New Jersey. Hackensack Meridian Health’s emergency departments, urgent cares and physician offices are seeing a 30% test positivity for flu right now, Varga added, compared to about 2-3% for COVID and RSV.

Cases are currently moderate in Connecticut, Idaho, South Carolina, Georgia, Michigan, Texas, Massachusetts and Puerto Rico, according to the CDC data.

“It’s kind of dispersed throughout the country right now,” Marnik said.

Data show many kids are currently sick with the flu. Kids who get the flu at daycare or school then go to gatherings with cousins, aunts, uncles, grandparents, friends and neighbors and spread it on to them, causing a potential surge after the holidays.

Flu cases increased quickly this year, noted Dr. Neal Shipley, the medical director of Northwell Health-GoHealth Urgent Care in New York.

“We went from having almost no flu activity to, right after Thanksgiving … a pretty sharp uptick.” This also happened last flu season and in 2023.

It’s typical for respiratory illnesses like the flu to spike after holidays, which often involve lots of social gatherings and travel.

“I think we’re all concerned that over the winter break and Christmas holidays, people will again be traveling and staying indoors and mingling and sharing flu and COVID or RSV with their friends and neighbors,” Shipley said.

“The reality of this is we’ve got a solid six weeks left,” Varga noted. Cases will remain elevated and even increase again for a week or two after Christmas and New Year’s and start to slow down as we reach the end of January, he said.

While cases may not be as high as right after the holiday, flu season will linger well into the spring.

While other respiratory viruses may start off with a lingering tickle in your throat, the flu hits you fast and all at once.

“Within one or two days of exposure, most patients are going to have fever, chills, coughs, body ache, they’re going to feel pretty lousy,” Shipley said.

Kids may have these symptoms plus some GI issues like diarrhea or vomiting. Some of the symptoms can look like COVID-19 or RSV or a cold, but it’s important to know what you have. At-home tests are available at pharmacies, or you can go to the doctor to get tested.

There are anti-viral treatments available for flu (and COVID-19) for high-risk populations. These anti-viral medications work best if started early on in the course of your illness. “Get tested early so that if you do qualify for treatment, you can get the treatment, you’ll feel better faster, and you’ll make it less likely that you spread it to other people,” Shipley said.

If your symptoms become concerning — difficulty breathing, chest pains, an ongoing fever — don’t hesitate to get medical attention. “Flu, in particular, we know can cause complications. [It] can turn into bacterial pneumonia, can cause people to become really ill … there were 400,000 hospitalizations last year,” Shipley said.

Tens of thousands of people die from the flu every year, too, and states including Colorado and North Carolina have already reported pediatric flu deaths this flu season.

Certain groups of people including folks over 65, children under 4, folks with certain medical conditions like asthma and heart disease and pregnant people, are all at higher risk of complications from flu, Shipley said.

“Flu is a respiratory pathogen, so just like what we learned during like the height of COVID-19, masking is a really great strategy for people,” said Marnik.

This is especially true if you’ll be in crowded spaces like airports or trains. “Wearing a well-fitting N95 is a great way to protect yourself from getting sick,” Marnik said. It also helps protect those around you if you are coming down with flu (or another illness) and don’t know it yet, she said.

“And then if you’re in a crowded situation, maybe you can’t mask for some reason, then thinking about ventilation — can you open a window? Can you put an air filter in? Can you be in a space that’s less crowded?” Marnik said.

It’s also not too late to get your flu shot, which can protect you from severe consequences. “The current data shows that if you define vaccine effectiveness as preventing hospitalization in adults, the current vaccine is about 30 to 50% effective in preventing hospitalization, and in kids, it’s about 70 to 75% effective,” Shipley said. “So, that’s pretty good.”

Hand washing is also an important way to prevent getting sick. It’s also a good idea to disinfect high-touch surfaces (doorknobs, cell phones, remote controls, etc.) with an alcohol-based sanitizer. Getting enough sleep and sticking to your exercise regimen can also help you fight off illnesses.

“But because it’s an airborne pathogen, we really are thinking about what we’re breathing as being the primary way we could potentially get infected,” Marnik noted.

It’s doubly important to do all that you can to protect yourself and your loved ones from the flu this year, as it’s expected to be a pretty bad flu season (similar to last year).

“Last year was one of the worst flu seasons on record for pediatric deaths, and there’s some concern that this season could be as equally bad, if not worse than last year,” Marnik said.

A lot of this is because of a new mutation in the flu virus, which is behind the increased cases in other countries like Japan and the United Kingdom, and also here in the U.S.

The mutated strain is known as H3N2 and “it’s changed a lot from prior versions of the flu,” said Marnik. “And when that happens, that means that our immune system doesn’t recognize it as well, so then more people are likely to get sick because they can’t fight it off as well.”

If you know someone with the flu right now, they likely have this mutation. “It’s really this H3N2 strain that’s about 85-86% of our cases that we’re seeing now,” Shipley said.

Beyond the mutation, Varga said it “won’t surprise me at all when folks do the final debrief of the flu season to find that vaccine hesitancy was a big contribution to this — a little bit earlier, a little bit more severe, a little bit faster rise.”

Once again, it’s not too late to get your flu shot and it can protect you from hospitalization and even death. Vaccination can also help reduce the spread to others.

“Influenza can be a really bad disease … people across the age spectrum tend to die every year from influenza,” Varga said. “You don’t take influenza lightly.”