We have been tracking influenza since before there were cases in North America this year. That’s because we pay careful attention to what happened in the Southern Hemisphere: Australia, New Zealand, South Africa and Chile. This early warning system alerted us to a potentially bad flu season, and that was before the new subclade K variant reared its ugly head. This week, we have a personal story to share. We have a relative who works in one of the country’s premier hospitals. We have been asking about influenza outbreaks for this FLU WATCH outbreak update. Until this week we heard nothing unusual. But our healthcare pro worked in the emergency department this week and reported that the ER was filled with flu cases!
FLU WATCH for 12/26/2025:
First, we cannot rely upon the usual Friday FluView from the CDC. It would normally be updated on 12/26/25, but because of the holidays, we will not get an official CDC “Influenza Surveillance Report” until December 30, 2025. Because of this lag at a critical time of the year, we are forging ahead with an Outbreak Update and just focusing on influenza.
Our secret healthcare sleuth gave us a snapshot of the influenza outbreak at one emergency room at one hospital in the southeast. What’s happening elsewhere?
Flu Watch for Other States:
The CDC’s outdated map shows that flu activity is very high in New York, Colorado, Louisiana, Rhode Island and New Jersey. It’s high in Massachusetts, Delaware, Maryland, Michigan, North Carolina, South Carolina, Georgia, New Mexico, Idaho and Puerto Rico. Keep in mind, though, the data for the CDC’s map is at least two to three weeks out of data.
Just because your state is not on that list does not mean you are protected. We suspect that all states are now experiencing a surge in subclade K cases of the A/H3N2 influenza virus.
We monitor news from around the country. A hospital in Cincinnati is reporting an “uptick” in upper respiratory tract infections.
A pediatrician at the University of Michigan in Ann Arbor was quoted on NBC News:
“Flu, flu, flu. So much flu…we are inundated.”
The New York Times, Dec. 26, 2025:
An article published on 12/26/25 in the NYT reveals a scary story for New York City!
“Preliminary data from hospitals across the city indicates that more patients went to emergency rooms complaining of flulike symptoms — such as fever and a cough — in the week ending Dec. 20 than during any other week in the past decade.
“New York City’s syndromic surveillance system, which collects information about every patient who visits an emergency room, reported 9,857 visits for ‘influenza-like illness’ last week. That was higher than in the worst weeks of the 2017-18 or 2024-25 flu seasons, both ranked as ‘high severity’ by the Centers for Disease Control and Prevention.”
Walgreen’s Respiratory Illness Index:
According to this pharmacy chain, the Respiratory Index is an interactive online tool that:
“tracks flu and COVID-19 activity nationwide using prescription, testing and over the counter (OTC) product purchase data from Walgreens locations nationwide.”
Looking at the map it looks like the entire country is lighting up. The only states where respiratory illnesses seem low are Washington, Oregon and Arizona. I tend to believe a data source that takes into account OTC product purchase data. If people are buying lots of cough, cold and flu medicine to ease their symptoms, that may be a more accurate reflection of what is happening than the CDC’s delayed metrics.
WasteWater Scan Poop Patrol:
One of the most innovative advances in pathogen monitoring comes from WastewaterSCAN.
These folks collect samples from:
“participating sewage treatment plants in nearly 150 locations across 40 states, serving more than 39 million people.”
I find this data compelling. The most recent update from these intrepid researchers shows a dramatic uptick in influenza cases. It lists most states as “High” for influenza A and “Low” for influenza B. Here is a link to the WastewaterSCAN Dashboard. Although influenza B is “low” in this sewage detection system, it is showing up in more than 30 states.
Flu Watch Recommendations:
If you are really sick, get to an emergency room. Yes, there will be lots of other sick people there, but a healthcare professional needs to listen to y0ur lungs and check you out for anything so serious it requires hospitalization.
All the public health authorities are recommending a flu shot. And yes, I got one several weeks ago. I am not going to say it’s too late, but by now you are pushing your luck if you think it will magically protect you from this year’s influenza A strain.
The subclade K variant may make it more difficult for the vaccine to do its job effectively. Even when the shot is a very good match against circulating viruses, effectiveness is only about 60%. Most years it averages around 40%. That’s not great. If I were a betting person, and I am not, I would estimate that this year’s vaccine is going to turn out to be less than 40% effective at preventing influenza.
There are antiviral meds that might shorten the duration and severity of the flu. But you need to know if you have a bad cold or influenza. The flu drugs will do nothing for the common cold. That’s why the home tests are so useful. You can read more about meds like Tamiflu or Xofluza and OTC flu tests at this link.
Final Words From This Week’s Flu Watch:
Stay home if you’re sick, avoid crowded indoor spaces when possible, practice good hand hygiene, and consider wearing a well-fitted mask such as an N95 if you must be around others. Influenza isn’t acting alone this season; other respiratory viruses like RSV, COVID-19, and norovirus are also circulating, making vigilance and preventive measures even more important during holiday gatherings.
Consider prophylactic use of the OTC allergy nasal spray azelastine (Astepro). You can read why we are using this product when we go out in public at this link.
Please let us know if you or someone you know has become sick in the comment section below. You can help us maintain our surveillance of influenza and other pathogens by sharing this story. Thank you for helping us keep your friends and neighbors informed about the flu this winter. It is your dedication to this website and newsletter that allows us to keep reporting health stories that matter to you.
