US Flu Season Arrives Weeks Early as CDC Counts 2.6 Million Illnesses and Seven States Hit High Activity
The 2026-27 flu season is off to an unusually early start in the United States, and it is intensifying fast. The Centers for Disease Control and Prevention reported Friday that seven states were already seeing high flu activity last week, up from just two the week before, and that more than 3 percent of doctors’ office visits were for flu-like illness — the level that signals the season is truly under way.
The CDC estimates that at least 2.6 million illnesses, 36,000 hospitalizations and 2,100 deaths have already been tied to flu infections this season. Two more children died of flu this week, bringing the pediatric death toll to five.
Seven states at high activity, with Louisiana hit hardest
Flu activity is concentrated in the South and West. The states now in the high or very high category are California, Louisiana, Oregon, South Carolina, Tennessee, Texas and Washington, according to the CDC’s FluView report. Activity is moderate in Colorado, Florida, Hawaii, Idaho, Massachusetts, New Jersey, New Mexico, New York state and Puerto Rico.
Louisiana is seeing the worst of it so far. The early-season activity is higher than what is usually seen at this point of the year, although the CDC cautioned that it is not yet clear the season will be worse than others overall.
“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,” said Dr. Fred Lopez, an infectious diseases specialist at the LSU Health Sciences Center in New Orleans. “If you haven’t been vaccinated, you should get vaccinated now.”
Outpatient visits for influenza-like illness reached 3.2 percent, above the 2.9 percent national baseline, according to a summary of the CDC report by the Center for Infectious Disease Research and Policy. Flu test positivity rose to 11.3 percent, up from 9.1 percent a week earlier, driven mostly by influenza A.
A shifting H1N1 strain is driving the surge
This season is being driven by H1N1, not the H3N2 strains that headlined some recent winters. In the CDC’s week 43 surveillance report, 97.7 percent of subtyped influenza A samples from public health laboratories were A(H1N1)pdm09, most of them in a subclade called D.3.1.1.
The variant carries mutations with the potential to partly slip through the immune system’s defenses. Data so far suggest, however, that the current vaccine “can recognize” the circulating virus and work against it, said Andrew Pekosz, a Johns Hopkins University immunology expert, during a recent media briefing. Health officials will not know for months exactly how effective this year’s vaccine is, but “right now there is no cause for concern,” he said.
One warning sign stands out: the flu hospitalization rate in mid-October was the highest seen that early in an autumn in more than 15 years, noted Dr. Anna Durbin of Johns Hopkins University. Experts at the Johns Hopkins Bloomberg School of Public Health pointed to nearly 5,000 lab-confirmed flu hospitalizations in the week ending October 17, the highest mid-October rate since the 2010-2011 season. Hospitals reported 8,396 lab-confirmed flu admissions in the week ending October 31, up 38 percent from about 6,100 the week before.
Why this matters
The timing could hardly be worse. Doctors expect accelerated spread of flu and other respiratory viruses as people travel and gather later this month for Thanksgiving, when families mix across generations.
“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.
Related Articles
Flu is not the only respiratory threat circulating. The World Health Organization has warned of respiratory illnesses surging in Gaza as winter floods hit displaced families, and in the United States measles continues to spread — the country has lost its measles elimination status after 5,412 cases across 45 states this year, with 10 deaths reported, according to ABC News. A second child died in Wisconsin’s measles outbreak as state cases reached 649.
Latest developments
The CDC’s preliminary severity assessment still rates the flu season as low across all age groups, and the agency stressed that “an earlier increase in activity does not necessarily lead to a higher seasonal peak or greater overall severity.” It also said it expects this respiratory season to look much like last year’s.
The CDC’s FluSight forecasts project that weekly flu hospital admissions for the week ending November 21 could range from 6,900 to 30,100, a wide band that reflects how much uncertainty remains. The next FluView report, covering the week ending November 7, will show whether admissions are tracking toward the low or high end of that forecast.
Last winter’s flu season surged in late December and was especially intense in some parts of the country. At the time, New York City health officials called it the most intense season in 20 years. The season faded by late March, but the CDC later estimated there had been at least 32 million illnesses, 380,000 hospitalizations and 24,000 deaths that season.
Frequently asked questions
How early is this flu season?
Weeks ahead of the usual calendar. Seven states were already at high flu activity in the week ending November 7, up from two the week before, and flu-like illness accounted for more than 3 percent of doctors’ office visits — above the national baseline of 2.9 percent.
Which flu strain is circulating?
Mostly influenza A(H1N1)pdm09, which made up 97.7 percent of subtyped influenza A samples in the CDC’s week 43 report. Most of those viruses belong to a subclade called D.3.1.1, which carries mutations that may partly evade existing immunity.
Is it too late to get a flu shot?
No. Health officials say now is the time to get vaccinated, before the season peaks and before Thanksgiving travel and gatherings. People should not get vaccinated while suffering significant symptoms, but those who already had a flu infection this fall should still get a shot, because the vaccine protects against three kinds of flu virus and more than one strain can circulate in a season.
How bad could this season get?
That is still uncertain. The CDC’s FluSight forecast projects 6,900 to 30,100 new flu hospital admissions in the week ending November 21. The agency rates overall severity as low so far and says an early rise does not automatically mean a higher peak or a more severe season overall.
The early surge is a clear signal, though: with seven states already at high activity and hospital admissions climbing fast, the weeks before Thanksgiving are the moment to get vaccinated, not after the peak arrives.
Sources: Associated Press via MedicalXpress; CIDRAP summary via QUE.com; MedicalDaily; CDC FluView.
