Flu Levels Are High or Very High Across Much of the U.S.

Flu Levels Are High or Very High Across Much of the U.S.

Flu is currently sweeping through the United States, making many Americans miserable with sneezing, congestion, cough, body aches, and fever.

The latest available data from the Centers for Disease Control and Prevention (CDC) shows that 44 states are experiencing high or very high levels of influenza.

The federal health agency estimates that, so far this season, there have been at least 20 million illnesses, 250,000 hospitalizations, and 11,000 deaths from flu.
The virus is becoming notably widespread among children, leading to temporary school closures in many states, including Georgia, Iowa, Missouri, Ohio, Oklahoma, Tennessee, Texas, and Virginia.

“Flu cases are traditionally expected to rise after children return to school from the holidays in January, which may explain the current spike in cases,” says Asif Noor, MD, a specialist in pediatric infectious disease at NYU Langone Health in New York City.

Is the Flu Actually Worse This Year?

While the virus may be hitting people hard right now, and the flu season is far from over, indications suggest that this year should not be any worse than the last, when the CDC recorded about 40 million illnesses for the 2023–24 season.

“The flu activity we’re having now seems to be on par with what we had during flu seasons prior to the COVID-19 pandemic, which kind of erased people’s memory of what flu seasons are like,” says Amesh Adalja, MD, an infectious disease physician and senior scholar at the Johns Hopkins Center for Health Security in Baltimore.

Lower Vaccination Rates May Be a Factor

Dr. Adalja says that a lower vaccination rate may be a contributing factor in driving up respiratory infections and serious illness.

“Influenza vaccine rates have slipped since COVID-19, as vaccine hesitancy spilled from COVID into other vaccines, including influenza,” says Adalja, who is also a spokesperson for the Infectious Diseases Society of America.

About 44 percent of American adults ages 18 and older have received a flu vaccine this season, according to the CDC. For the flu season last year, about 45 percent of adults got the shot.

For the 2020-21 season, however, the rate was above 50 percent.
Low vaccination uptake among children may explain the widespread flu activity in schools. According to the latest available numbers from January 25, coverage among children ages 6 months to less than 18 years is at 44.5 percent — that’s down from 49.1 percent at the same time last year, and a significant drop from 58.3 percent at the end of January 2020.

What’s the Difference Between Influenza A and Influenza B?

Seasonal influenza vaccines are formulated each year to protect against the main groups of type A and type B flu viruses, based on surveillance data from the World Health Organization.

The A and B viruses are very similar, but they have slight differences in their protein structure. Influenza A usually accounts for more flu cases and causes more severe illness than type B flu. Dr. Noor estimates that currently 98 percent of flu illnesses are due to the A strain and 2 percent are due to the B strain.

Predicting which strains and subtypes will actually be circulating can be challenging, and minor mutations can occur within the flu A and flu B strains that can make a vaccine less effective.

How Effective Is the Flu Vaccine This Year?

While the vaccine for this season will prevent severe infection, it wasn’t the best match for the currently circulating strains, says Saahir Khan, MD, PhD, an infectious disease specialist with Keck Medicine of USC in Los Angeles.

“The typical range of flu vaccine effectiveness is about 40 to 60 percent,” says Dr. Khan. “This year’s flu shot is on the lower end of that range — so probably closer to 40 percent.”

Because flu season can extend into May or even June in some cases, there’s still plenty of time to get a flu shot, and it’s still well worthwhile.

“It’s not too late to get vaccinated. We are seeing a lot of influenza nationally, so there’s definitely still time,” says Luis Ostrosky, MD, chief of infectious diseases at UTHealth in Houston. “Even if this season’s vaccine is slightly less effective than in other years, it will still lower the severity of illness, lower hospitalizations and death, and avoid other possible effects from the flu, such as stroke and heart attack.”

Know the Symptoms of Flu, and Treat Them Early On

If you can identify signs of flu, you can start care early on and potentially reduce the duration and severity of the illness. Common symptoms are:

  • Aching muscles, especially in your back, arms, and legs
  • Fever of 100.4 degrees F or higher
  • Chills and sweats
  • Headache
  • Cough
  • Runny or stuffy nose
  • Sore throat
  • Fatigue and weakness

Khan adds that anecdotally he’s hearing of more patients this season reporting stomach symptoms as part of their influenza.

The problem with many respiratory illnesses, however, is that they share similar symptoms, so they are hard to tell apart. “The common cold is usually mild with just a runny nose, but anything that is coupled with fever and cough might be COVID, RSV, or the flu,” says Dr. Ostrosky.

The only way to know for sure if you have the flu is through testing, and now home tests can tell you within minutes if you have the virus. New combination COVID-flu tests may be even more helpful, as they can quickly differentiate between influenza A, influenza B, and COVID-19 — all from a single nasal swab.

Most people who get the flu will recover with plenty of rest and hydration, within a few days to less than two weeks. Some over-the-counter medications such as ibuprofen or acetaminophen can temporarily relieve symptoms.

Prescription antiviral medications can actually fight the virus and block it from replicating and infecting more cells. These drugs can shorten the duration and severity of illness if treatment is started when symptoms are just beginning. The four available prescription drugs for flu are:

  • oseltamivir phosphate (Tamiflu)
  • zanamivir (Relenza)
  • peramivir (Rapivab)
  • baloxavir marboxil (Xofluza)

“You can discuss these options with your doctor, but these medications are probably more of a priority for people who are more vulnerable,” says Khan.

Avoiding Flu and Preventing Spread

Although some regions in the United States are experiencing higher flu rates than others, no one area is really safe from getting the illness. Adalja notes that a number of factors may account for the amount of flu activity in a state, including the level of social activity, the amount of travel in a geographic area, the density of a region, and colder weather that may force people to cluster indoors.

To prevent the spread of flu and protect yourself, Noor advises following basic precautionary measures. “Masking and hand-washing are the two most effective methods of preventing and spreading infection,” he says, in addition to staying home when sick and steering clear of people with symptoms.

“Although people have moved away from using masks, masks protect people from getting sick, particularly in crowded places, and they prevent the spread of infection to other people.”

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