Flu Season Starts Early: 7 States at High Activity, Up From 2 a Week Earlier, CDC Says

The U.S. flu season has started early, and it is picking up speed.

The Centers for Disease Control and Prevention said in its Friday update that seven states reported high flu activity last week. The week before, it was two. More than 3% of doctor's office visits last week were for flu-like illness.

Where it is hitting

The surge began in the South and West. The CDC lists California, Louisiana, Oregon, South Carolina, Tennessee, Texas and Washington as high-activity states. Louisiana is seeing the worst of it so far.

That is not a surprise to Dr. Fred Lopez, an infectious diseases specialist at the LSU Health Sciences Center in New Orleans. Louisiana is often among the first states to surge, he said, at least partly because of low vaccination rates, high poverty rates and obstacles to getting care.

"Flu season is taking off and it's taking off in a direction that's only likely to increase in the next month or two," Lopez said.

The numbers so far

The CDC estimates at least 2.6 million illnesses, 36,000 hospitalizations and 2,100 deaths this season are tied to flu.

Dr. Anna Durbin of Johns Hopkins University said at a recent media briefing that the flu hospitalization rate in mid-October was the highest seen that early in an autumn in more than 15 years.

The CDC says early-season activity is higher than what is usually seen at this point of the year. The agency also says it is not clear that means this season will be worse than others.

An early start is not a forecast. Flu seasons can come in fast and fade, or build slowly and peak hard.

Last winter as a yardstick

Last winter's season surged in late December. New York City health officials called it the most intense in 20 years. It was basically over by late March.

The CDC later estimated that season caused at least 32 million illnesses, 380,000 hospitalizations and 24,000 deaths. This year's totals are a small fraction of that so far, but the clock started earlier.

Thanksgiving is the next test

Doctors expect flu and other respiratory viruses to spread faster as people travel and gather later this month for Thanksgiving.

"As we prepare to gather with family and friends over the upcoming holidays, getting vaccinated is especially important," said Dr. Nicole Iovine, a University of Florida-affiliated infectious disease specialist, in an emailed statement this week.

Lopez's advice was blunt: "If you haven't been vaccinated, you should get vaccinated now."

The timing rules are simple. People with significant symptoms right now should wait, because the immune system is already busy. Anyone who has already had an infection this fall should still get the shot, Lopez said. The vaccine covers three kinds of flu virus, and more than one strain often circulates in a season.

The vaccine match

Most of the illnesses so far this fall are caused by a version of an A H1N1 flu bug with mutations that could more easily slip through the immune system's defenses. Andrew Pekosz, a Johns Hopkins University immunology expert, said at a recent media briefing that data so far suggests the current vaccine "can recognize" the circulating virus and work against it. Health officials will not know for months exactly how effective this year's vaccine is, but Pekosz said "right now there is no cause for concern."

The guidance dispute

Fox News Radio framed the surge as a clash between vaccine hesitancy and a disbanded federal advisory panel that, in its telling, leaves Americans without official guidance. The outlet gave no further detail on which panel it meant or what guidance is missing.

That is a separate argument from the CDC's numbers, and the agency's update does not address it. Whether to get a flu shot remains an individual decision, and the CDC's data show where the virus is moving, not how many people have chosen to skip the vaccine.

What comes next

The CDC's next weekly update will show whether the count of high-activity states keeps climbing from seven. Lopez expects activity to keep rising over the next month or two. Data from the Thanksgiving period will be the first read on how much holiday travel adds to it.