Where is flu surging in the US? Some hospitals are overwhelmed in states with high rates

Flu activity is still spiking across the United States as the country faces a winter wave of respiratory illness. The post-holiday surge in influenza cases and hospitalizations is straining hospitals, leading to overflowing emergency rooms and prompting some facilities to limit patient visitors.

The 2024–2025 flu season — which has sickened an estimated 20 million Americans so far — is in full swing. However, there’s more to come before the season peaks, according to experts.

As of Jan. 31, seasonal flu activity remains elevated and continues to increase across the country, the U.S. Centers for Disease Control and Prevention said in its latest FluView weekly surveillance report for the week ending on Jan. 25.

Last week, the flu test positivity rate jumped to over 29%, up from 18% in mid-January.

At least 41 states and Washington, D.C., are currently reporting high or very high levels of influenza-like illness activity, per the CDC‘s most recent data.

“We are right now in the middle of a nationwide epidemic of seasonal influenza that is filling emergency rooms,” Dr. William Schaffner, professor of infectious diseases at Vanderbilt University School of Medicine, tells TODAY.com.

The majority of the cases in the U.S. are being caused by influenza A, primarily the H3N2 and H1N1 strains, according to the CDC. Flu A tends to be more aggressive in adults and hit earlier than flu B, but flu B can surge later in the season.

The increased flu activity comes as the country also sees high levels of norovirus and COVID-19, as well as surges in respiratory syncytial virus or RSV — which some have dubbed a “quad-demic.” While it’s expected to see these four viruses surge in the winter, the spike in respiratory illness is keeping doctors and hospitals very busy.

Seasonal influenza is a common and highly contagious respiratory illness. In the U.S., flu activity tends to peak between December and February, per the CDC. However, the 2025-2025 year’s flu season started late and has yet to peak, experts say.

The 2025 flu season

Last year’s flu season peaked in late December, but this year’s season got off to a slower start. Influenza activity started increasing dramatically in early December, says Schaffner, and has “taken off” since.

So far, the CDC estimates there have been at least 20 million illnesses, 250,000 hospitalizations and 11,000 deaths from influenza this season. This includes 47 pediatric deaths, 16 of which were reported last week.

Currently, there are multiple indicators of high flu activity in the U.S., including positive laboratory tests, outpatient and emergency department visits, and hospitalizations, a CDC spokesperson tells TODAY.com. “Mortality associated with influenza is also increasing,” the spokesperson adds.

As of Jan. 31, emergency department visits for influenza are “very high” nationally, according to the CDC. Flu-related hospitalizations started spiking after the holidays and continue to increase, especially among people ages 65 and older.

Wastewater surveillance is also showing very high levels of flu activity across the U.S. According to WastewaterSCAN, which monitors viruses through municipal water systems, influenza A is in the “high” category nationwide as of Jan. 26. Flu B remains in the “low” category, but positive detections are rising, a spokesperson for WastewaterSCAN tells TODAY.com.

The latest CDC FluView data show that flu activity dipped during the first two weeks of January. However, a spokesperson for the CDC said this decrease could’ve been “due to changes in healthcare seeking or reporting during the holidays rather than an indication that influenza activity has peaked.”

“We have a really long way to go with this flu season,” Dr. David Janz, director of medical critical care service at University Medical Center in New Orleans, tells TODAY.com. “We aren’t even halfway up (last year’s) curve of influenza hospitalizations. … We’re maybe 25%.”

It’s unclear how the rest of flu season will pan out, and it’s too soon to tell how its severity will compare to past seasons, experts say.

“We’re in the midst of influenza and it’s bad, but whether it’s different than previous years, we won’t know that for months,” Dr. Jason Newland, the Division Chief of Infectious Diseases at Nationwide Children’s Hospital, tells TODAY.com.

“The current levels of influenza activity are within the range of what has been seen at this time during past seasons,” the CDC spokesperson says.

The 2023-2024 flu season was “moderately severe,” and caused an estimated 40 million illnesses and 28,000 deaths, per the CDC. “Last year, we had over 200 pediatric deaths from flu, that was a really bad year,” says Newland.

Where is flu surging in U.S.?

The following U.S. states reported “very high” influenza-like illness activity during the week ending Jan. 25, according to the latest CDC data:

The District of Columbia and New York City are also reporting very high levels of influenza activity, according to the latest CDC data.

Some hospitals feel strained as flu cases rise

Every winter, hospitals fill up around this time of year due to respiratory illnesses, and this year is no exception.

In early January, influenza hospitalizations reached a record high of 10.2 per 100,000 — this is the highest peak weekly rate observed during all flu seasons since 2010, according to the CDC.

Hospital bed occupancy for influenza has doubled in the last month, rising from 1.7% during the week ending Dec. 28 to 3.4% during the week ending Jan. 25, per the latest data from the CDC’s National Healthcare Safety Network.

The sudden surge in flu cases, along with other respiratory viruses, is overwhelming some hospitals.

Tennessee is one of several states currently experiencing the highest levels of flu activity in the U.S.

“My hospital is jammed,” says Schaffner, who is based in Nashville. “We have people on stretchers, on gurneys in the emergency room waiting to be admitted, and this is true across the country.”

California is also being hit hard. San Diego in particular is seeing a steady rise in flu cases and hospitalizations, Dr. Francesca Torriani, an infectious disease specialist at UC San Diego Health, tells TODAY.com. Compared to this time last year, flu-related emergency department visits are nearly double that of last year in San Diego County, she says.

Also in San Diego, Sharp Chula Vista Medical Center has deployed a temporary tent outside their emergency department to triage and treat low-risk patients in response to high volumes of patients with flu symptoms. The hospital is seeing about 15-20 flu patients per day in the tent, which helps open the availability of beds in the ER for other health concerns, Sharp HealthCare tells TODAY.com.

Louisiana is another influenza hot spot. Janz, who works with LCMC hospitals in south Louisiana, says the number of patients hospitalized and in the ICU with influenza has jumped by about 30% since December.

“We’re able to deal with that influx pretty well,” says Janz. However, he notes that the surges in flu-like illnesses can quickly strain hospitals already busy with other patients.

In South Carolina, three major hospital systems have tightened visitor restrictions due to increased influenza, NBC affiliate WYFF4 reported. Last week, Spartanburg Regional Healthcare System, Prisma Health and Bon Secours St. Francis began restricting children under 16 and anyone with flu symptoms from visiting hospitalized patients as a safety measure.

Flu is also surging in the Midwest, especially in Ohio. Amid a backdrop of increased RSV and COVID-19 activity, “our hospitals get really busy,” says Newland, who works in Columbus. However, according to Newland, this year’s flu season is less of an outlier and more of a return to the pre-pandemic normal.

Although older adults are driving most hospitalizations, flu is hitting people of all ages. In Oregon, another state seeing very high flu activity, two children have died from flu in recent weeks, NBC affiliate KGW8 previously reported.

As flu activity continues, experts warn that ER wait times and bed availability may be affected. “We’ve got a lot of work left to do for this season, and it still puts all these hospitals at risk,” says Janz.

Influenza symptoms

Flu symptoms can range from mild to severe. Common flu symptoms include:

“People are going to feel bad for a few days, but it’s something that usually people can ride out at home,” says Janz.

Some people are at higher risk of developing severe illness or complications due to influenza. According to the CDC, these include but are not limited to:

• People with weakened immune systems

• People with underlying chronic health conditions

Flu treatment

Most people will recover from flu without treatment, the experts note. Supportive care such as rest, fluids and over-the-counter medication can help manage symptoms.

The CDC recommends staying home for at least 24 hours until after your fever is gone, except to seek medical attention.

Flu can be treated with antiviral drugs, such as Tamiflu, which are especially important for people at higher risk of severe illness, the CDC says. These require a prescription and are most effective when taken within 48 hours after symptoms begin.

If you are in a high-risk group, feel very sick or have any concerns about flu season, contact your doctor. “They can walk you through when to go and when to not to go in,” says Newland.

In some cases, going to the emergency room may be necessary.

“If people start having difficulty breathing, or if people start getting confused or having really high fevers, or they’re unable to eat or drink for days … I would recommend people seek health care,” says Janz.

How to protect against flu

It’s not too late to get your annual flu shot, the experts say. The influenza vaccine can help protect against flu and its complications, which is especially important for high-risk individuals. It’s recommended by the CDC for everyone ages 6 months and older.

The flu shots for the 2024-2025 season include three flu viruses: two flu A strains (H1N1 and H3N2) and one influenza B strain. Flu B can surge later in the flu season, so the flu shot can offer continued protection for months, TODAY.com previously reported.

In addition to getting your flu shot, you can protect yourself and others by taking the following steps:

• Wear a mask in crowded, indoor spaces.

This article was originally published on TODAY.com