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Flu hospitalizations rise nearly 30% as US enters holiday season

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Susana Sanchez, a nurse practitioner, administers a flu shot to Loisy Barrera at a CVS Pharmacy and MinuteClinic in Miami, Florida.

Joe Raedle | Getty Images

Flu hospitalizations are up nearly 30% in a week as the spread of respiratory disease remains high in most of the United States

More than 11,200 people were hospitalized with the flu in the week ending Nov. 19, compared with about 8,700 patients admitted the previous week, according to data from the Department of Health and Human Services.

The flu hit unusually hard and early this season, putting pressure on emergency services across the country. Flu activity normally resumes after Thanksgiving, but hospitalizations had already reached their highest level in a decade in early November.

Scientists and public health experts fear flu hospitalizations will rise even further after millions of people traveled to see family and friends for Thanksgiving. Christmas is also weeks away, giving the flu another opportunity to spread widely.

About 11 in every 100,000 people have been hospitalized with the flu since early October, the highest level in a decade. More than 6.2 million people have become ill, 53,000 have been hospitalized and 2,900 have died this season, according to data from the Centers for Disease Control and Prevention.

“The fact that we’re already at this high level before the holiday season makes me nervous,” said Scott Hensley, a microbiologist and influenza expert at the Penn Institute for Immunology.

Hensley said the flu hit harder earlier this year because population immunity is likely at its lowest level in recent history. The flu barely circulated for two years due to masking and social distancing measures put in place during Covid, he said. Therefore, large swaths of the population has not received an immune boost against infection, so they may be more vulnerable to the flu this year than in previous seasons.

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The elderly and children under five are the most vulnerable, with hospitalization rates about double the national average. A variant of the flu that is more severe for older people is also dominant right now, meaning the United States could have a tough season. More than 60% of flu samples tested by public health labs were positive for the influenza A(H3N2) strain, according to the CDC.

“It’s a well-described phenomenon. H3N2 has a more severe impact on older people, so more hospitalizations, ICU admissions and deaths,” said Dr. William Schaffner, an infectious disease expert at Vanderbilt University.

Flu shots aren’t usually as effective against H3N2, although there’s hope this season might turn out to be different. The majority of flu viruses tested are similar to the strains included in this year’s vaccine, according to the CDC.

Vaccine efficacy data have yet to be published, but injections normally work best when matched well with circulating variants. Influenza vaccine effectiveness has varied widely from 19% to 60% in past seasons, depending on the match between injections and circulating strains.

“From what we can see, it looks like the vaccines are a very good fit with what’s been circulating,” Hensley said. “If there’s a time to get vaccinated, this is the year to do it,” he said.

Influenza activity was highest in the Southeast in recent weeks, but most of the country is now experiencing high levels of illness, according to the CDC.

Influenza activity is moderate to low in Alaska, Arizona, Delaware, Hawaii, Iowa, Maine, Massachusetts, Michigan, Montana, New Hampshire, Pennsylvania, North Dakota, Rhode Island, Vermont, Wisconsin, South Dakota and Wyoming.

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