Doctors’ visits for influenza-like illness have reached levels not seen in nearly three decades, the Centers for Disease Control and Prevention reports, and cases appear likely to climb further in the coming weeks. For the week ending Dec. 27, roughly 8.2% of outpatient visits nationwide were for flu-like symptoms — the highest share recorded since the CDC began tracking these visits in 1997. This season has produced more than 11 million illnesses, about 120,000 hospitalizations and at least 5,000 deaths, including nine children. Forty-five states now report high to very high flu activity; only Montana, South Dakota, Vermont and West Virginia report lower spread, and Nevada’s data is listed as insufficient.
Key takeaways
- CDC: For week ending Dec. 27, 8.2% of outpatient visits were for influenza-like illness (highest since 1997).
- Scale of impact: More than 11 million estimated illnesses and about 120,000 hospitalizations this season.
- Reported deaths: At least 5,000 fatalities this season, including nine pediatric deaths so far.
- Geography: 45 states show high or very high flu activity; Montana, South Dakota, Vermont and West Virginia show lower levels; Nevada data insufficient.
- Pediatric context: Last season there were 289 pediatric influenza deaths, the highest on record since tracking began.
- Clinical strain: Hospitals report higher admission rates, more patients with low oxygen levels, and frequent coinfections with viruses like COVID-19 or RSV.
Background
The U.S. flu season normally begins in the fall and peaks between December and February, but timing and intensity vary by year. Public-health authorities monitor outpatient visits for influenza-like illness (ILI) as an early indicator of community spread; the CDC has published these weekly metrics since 1997. Seasonal influenza can place sustained pressure on emergency departments and inpatient capacity, especially when severe disease overlaps with other respiratory viruses. Vaccination, antiviral treatment and public health guidance have been the main levers to reduce severity and spread, though uptake and policy differ across jurisdictions.
Last season’s pediatric toll — 289 deaths reported by the CDC after an additional late report — was the deadliest for children since tracking began and eclipsed deaths recorded during the 2009 H1N1 pandemic. That recent history shapes concern among clinicians and pediatric specialists this winter, even as the current season’s patterns evolve. Public and private healthcare stakeholders, including hospitals and health departments, are balancing surge response with routine care amid staffing challenges and seasonal demand.
Main event
The CDC’s week-of-Christmas data show a nationwide uptick: nearly one in 12 outpatient visits were for ILI during the week ending Dec. 27. Because those data predate much holiday travel and family gatherings, epidemiologists warn the full effect of holiday-associated spread may not yet be visible. Krista Kniss, an epidemiologist in the CDC’s influenza division, said it is premature to assume the season has peaked and that trends “are not yet settled.”
Emergency departments in major centers are feeling the load. Dr. Nick Cozzi, EMS director at Rush University Medical Center in Chicago, reported large numbers of patients with cough, congestion, shortness of breath, gastrointestinal symptoms and profound body aches. He noted that many patients present with coinfections (for example, COVID-19 or RSV plus influenza) and that a higher-than-normal proportion require hospital admission for oxygen support.
At Johns Hopkins Children’s Center in Baltimore, pediatric flu hospitalizations more than doubled in a recent two-week period compared with the prior two weeks, according to Dr. Emily Boss, director of pediatric otolaryngology. She emphasized that the rise began about a month earlier than last season, though peak timing and overall burden remain uncertain. Clinicians describe a mix of typical influenza presentations and more severe respiratory compromise in older or medically vulnerable patients.
Analysis & implications
Health systems face near-term strain: rising inpatient admissions, increased oxygen and ventilatory support needs, and staff stretched by higher patient volumes and respiratory illness among healthcare workers. When influenza co-circulates with COVID-19 and RSV, diagnostic complexity and resource demand increase because testing, cohorting and treatment decisions become more complicated. Hospitals may need to reallocate beds, adjust elective procedures and expand surge staffing to maintain capacity.
The public-health implications include potential impacts on school attendance, workplace productivity and long-term health for patients who suffer severe influenza complications. Pediatric risk is an acute concern given last season’s 289 child deaths and the comparatively small number of pediatric deaths so far this season (nine reported to date), which could change as the season progresses. Vaccine policy shifts also influence population protection and the short-term trajectory of illness.
Policy choices are already under debate. The Department of Health and Human Services announced an immediate change removing the flu vaccine from the official childhood immunization schedule; this decision departs from CDC guidance, which still advises vaccination for everyone 6 months and older with rare exceptions. Public-health experts warn that altering recommendations during a severe season may reduce vaccine uptake and complicate public messaging.
Comparison & data
| Metric | This season (so far) | Recent comparison |
|---|---|---|
| Estimated illnesses | More than 11,000,000 | Substantially elevated vs typical seasons |
| Hospitalizations | About 120,000 | High burden on hospitals |
| Reported deaths | At least 5,000 (9 pediatric) | Last season pediatric deaths: 289 |
| Outpatient visits for ILI | 8.2% (week ending Dec. 27) | Highest since 1997 tracking began |
The table summarizes official CDC tallies and recent season-to-season comparisons where available. These figures represent national estimates; local experience varies widely by state and county. Public-health authorities caution that weekly surveillance can lag behind real-time transmission, and reported hospitalizations and deaths are usually revised as additional cases are confirmed.
Reactions & quotes
Hospital leaders and clinicians described pressure at the bedside and uncertainty about near-term trends.
“We’re incredibly busy — many patients present with cough, shortness of breath and bone‑chilling body aches,”
Dr. Nick Cozzi, Rush University Medical Center (EMS director)
Coherent surge-management steps — testing, early antiviral treatment for eligible patients and oxygen support when needed — were cited as immediate priorities. Public-health officials emphasized that surveillance data through Dec. 27 may not yet reflect holiday-related spread.
“It’s still too soon to know what the holiday season’s impact will be; we are not anywhere close to being done,”
Krista Kniss, CDC influenza division (epidemiologist)
Professional societies raised concerns about vaccination policy changes that contradict longstanding CDC advice.
“Scaling back a flu recommendation amid a severe season risks undermining protection for children,”
Dr. Sean O’Leary, American Academy of Pediatrics (committee chair)
Unconfirmed
- The full quantitative effect of holiday travel and gatherings on case counts for late December and January is not yet confirmed by surveillance data.
- How the immediate HHS change to the childhood vaccine schedule will affect vaccine uptake and pediatric case counts this season remains uncertain.
- Forecasts for the season’s peak and total burden are preliminary and will depend on vaccine uptake, viral evolution and public behavior.
Bottom line
The U.S. is experiencing an early and wide-reaching influenza surge: outpatient ILI visits are at record highs for the modern tracking era, and hospitalization and death tallies show substantial national impact. Local conditions will vary; community-level transmission and hospital strain are concentrated in 45 states reporting high to very high activity.
Short-term priorities are clear: expand testing and early antiviral access for high-risk patients, reinforce oxygen and inpatient capacity where needed, and clarify vaccine messaging so clinicians and families can make informed choices. Surveillance through January will determine whether holiday-related spread produces a larger peak; public-health officials and hospitals are preparing for that possibility.
Sources
- NBC News (news report)
- Centers for Disease Control and Prevention — FluView (official surveillance)
- U.S. Department of Health and Human Services (official announcement)
- American Academy of Pediatrics (professional medical association)