Mike Snider
Flu is ramping up across the country just as millions prepare to hit the road for holiday celebrations.
While influenza activity across the U.S. isn’t currently at abnormal levels, travelers may want to take some precautions to avoid illness – and prevent spreading it.
More than half of the states in the U.S. – especially those in the South – have reported high or very high flu activity as of the week ending Dec. 9, according to the Centers for Disease Control and Prevention.
Flu activity escalates from Thanksgiving on “because there’s gatherings and that’s when we see a peak,” said Dr. Francesca Torriani, program director of the infection prevention, clinical epidemiology and tuberculosis control units at the University of California San Diego Health.
In the western part of the U.S. flu “really peaks off the 25th of December, and then (goes) up in the new year, in general … and then we have a second peak in February,” she said.
Typical ways the flu spreads: you inhale droplets in the air after someone who’s sick coughs, sneezes or even talks, the CDC says. You can also get sick by touching something with the flu virus on it and then transferring it to your mouth, nose or eyes.
So far this year’s flu activity is something between last year’s “very aggressive” flu season and pre-pandemic flu seasons, said Dr. Michael Mina, chief science officer at Miami-based telehealth company eMed. Last year’s flu season spiked as people who’d been masking and staying at home went back to “pre-pandemic levels of in-person engagement,” he said. As a result, the flu virus “spread more rapidly and more robustly,” Mina said.
This year, holiday travelers are heading out into a population that’s been reluctant to get vaccines against viruses. The CDC last week issued a health advisory to medical caregivers saying that low vaccination rates against influenza, COVID-19, and RSV (respiratory syncytial virus) “could lead to more severe disease and increased healthcare capacity strain in the coming weeks.”
Across the U.S. visits to health care providers for respiratory illnesses rose 4.4% in the week ending Dec. 9, according to the CDC. Positive lab tests for influenza rose 10% over the previous week; overall, labs have processed more than 810,000 tests since Oct. 1, 2023, with more than 36,360 being positive for the flu, the CDC says.
“We’re definitely seeing activity (and) it is widespread,” Torriani said. With cases of RSV and COVID-19 also on the rise, “we are having a viral respiratory fest.”
What are some flu symptoms?
People who get the flu may have any or all of these symptoms, the CDC says: fever or feeling feverish – not everyone who has the flu will have a fever – chills, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches, and fatigue.
Vomiting and diarrhea may also accompany the flu, however, children are more likely to have those symptoms than adults.
About 8% of the U.S. population will get sick with the flu each year. Usually they get a mild to severe illness. However, about 21,000 died from the flu during the 2022-2023 season, the CDC says.
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States in the US with the most flu activity
Here are the latest findings of flu activity from the CDC’s Influenza-like Illness Activity Level Indicator (ILINet):
- Very high flu activity levels (5 states): Alabama, Mississippi, Louisiana, New Mexico and South Carolina.
- High flu activity (12 states): New York City, Arizona, California, Colorado, Florida, Georgia, Nevada, New Jersey, North Carolina, Tennessee, Texas, Virginia, and Wyoming.
- Moderate flu activity (9 states): Arkansas, Connecticut, Illinois, Indiana, Kentucky, Maryland, Massachusetts, North Dakota, Ohio.
- Low flu activity (14 states): Alaska, Idaho, Iowa, Kansas, Missouri, Nebraska, New Hampshire, New York, Oklahoma, Pennsylvania, Rhode Island, Utah, Washington, and Wisconsin.
- Minimal flu activity (10 states): Delaware, Hawaii, Maine, Michigan, Minnesota, Montana, Oregon, South Dakota, Vermont, West Virginia, and Puerto Rico.
How to protect yourself from flu and viruses during the holidays
With 115.2 million Americans expected to travel over the Christmas and New Year’s holidays, there’s a likelihood that some of them will be sick. Here are some tips for travelers and those gathering with them:
- Mask up. In crowded places such as airports, train stations and shopping malls, wear a mask.
- Increase ventilation at home. If it’s not too cold, crack a few windows to increase the low of air through the home – a preventive measure found to decrease the likelihood of spreading COVID-19 and other viruses, according to the CDC. You can also turn on exhaust fans in bathrooms or above the stove. Have ceiling fans and have other fans running, but pointed away from people.
- Test to see if you actually are sick before the gathering. Consider who will be at your gathering, suggests eMed’s Dr. Mina. “Is your 92-year-old grandma going to be at the Christmas dinner table with you? Or how about your diabetic cousin with three different comorbidities? If so, then it might be a good idea to try to ask people to test the morning before getting together or, at a minimum, ask those who have symptoms of a respiratory infection to test for COVID-Influenza,” said Mina, who worked with the National Institutes of Health on The Home Test to Treat program, which provides free COVID-Flu home tests for those who are uninsured or get government health care.
- Remember other COVID-19 practices. In addition to masking, “wash your hands frequently, practice social distancing … (and) stay home when sick,” said Dr. Purvi Parikh, an allergist and immunologist with Allergy & Asthma Network.
Many of these tips are similar to how we were expected to act coming out of the COVID-19 lockdown. “We learned some lessons during the pandemic about what we can do to not be miserable,” Torriani said.
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Is it too late to get a flu vaccine?
No. While it takes about two weeks for the vaccine to provide full protective effects, remember the flu season can go into March, says Dr. Wesley Self, professor of emergency medicine at Vanderbilt University Medical Center. He collaborated with several other medical experts and the CDC on a study, released earlier this month, which found flu shots given during last year’s flu season reduced the risk of hospitalization by 37% overall.
“Given what we see currently, we would likely expect flu activity to continue increasing into January and possibly February, which would be similar to last year,” he told USA TODAY.
Vaccines at the Blue Shield of California Promise Health Plans’ Community Resource Center on Oct. 28, 2022, in Lakewood, Calif.
Are fewer people getting vaccinations?
Yes. Pharmacies and medical offices had administered 7.7 million fewer flu shots as of Nov. 25, compared to the same period in 2022, according to the CDC. Overall, about 32.2 million doses were given in pharmacies and 18.9 million in medical offices, the CDC says.
And it’s not just flu vaccination rates that are down. People aren’t getting shots to fend off COVID-19 and RSV at the levels health care providers would prefer, either. “We are seeing a very low uptake in vaccinations this year and that is worrisome,” Torriani said.
- Flu vaccination rates: About 69.3% of adults 65 and older, 42.2% of adults 18 and older, and 43.3% of children have gotten a flu shot, the CDC says.
- COVID-19 vaccination rates: The CDC says about 37.4% of adults 66 and older, 18.3% of adults 18 and older, and 7.8% of children have gotten the updated vaccine.
- RSV vaccination rates: About 17% of adults 60 and older have gotten an RSV vaccination, the CDC says.
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