Winter has settled in. Cold, damp or storm-ridden weather means people are hanging out indoors. And, based on our research, indoor air quality leaves a lot to be desired. This week’s “Outbreak Update-1” reveals that influenza is surging in many areas of the country along with stomach flu and RSV (respiratory syncytial virus. I hate to add that WastewaterSCAN suggests that COVID-19 is also trending upwards. The bottom line: there are lots of viruses out there now and it is only going to get worse over coming weeks.
The People’s Pharmacy Outbreak Update-1
As of Friday, December 11, 2025
- Subclade K Influenza is rising nationwide. Flu activity continues climbing, though the CDC is a couple of weeks behind. Canada is being hit hard and we are hearing that New York State is suffering along with Louisiana and Colorado. Other states trending upward include Iowa, Idaho, Michigan and Missouri. But the truth is that our flu reporting system is behind this year. Recent emergency-department and laboratory data show increasing positivity and rising hospitalizations in many states.
- Norovirus is resurging, ahead of schedule. The so-called “winter vomiting disease” is already showing a surge: norovirus cases have reportedly doubled over the past few months, with outbreaks now increasing across multiple states. We are reading about Texas, Massachusetts, Virginia, Alabama, Connecticut, Florida, Louisiana, Michigan and Indiana. Cruise ships are being hit really hard.
- RSV is gaining traction — especially among very young children. RSV activity is slowly rising, with emergency-department visits and hospitalizations increasing in some regions (notably in the South, Southeast, upper Midwest, northeast and Mid-Atlantic).
- Measles in South Carolina — hundreds quarantined. Measles used to be rare. 2024 saw 285 confirmed cases. 2025 is different! We are approaching 2,000 confirmed cases across 43 states…the highest total in 30 years. South Carolina now has 114 confirmed cases over the last few weeks and more than 250 people have been quarantined.
- Multiple infections circulating concurrently — a “quadruple-threat” season shaping up. Because flu, RSV, COVID-19 and norovirus are all on the upswing, some pediatric wards and hospitals are already seeing more simultaneous admissions for different respiratory and gastrointestinal viruses
- Bottom line: flu, COVID and norovirus seem the most active now; RSV is rising and likely to grow more significant as winter deepens. Measles — while still present — does not appear to be a major nationwide surge at this moment, though there has been a serious outbreak in South Carolina. The actual measles number could be substantially higher, though, since many kids are not being tested and some younger doctors, nurse practitioners and physicians’ associates may not recognize this condition because it supposedly disappeared years ago.
Why This Season Might Be Trickier Than Usual: Outbreak Update-1
This year’s influenza vaccine is already out of date. That’s because the variant taking over the country is Subclade K type A (H3N2). No one knows how well the vaccines that are being administered will work against this mutated flu virus. But as I have written previously, the flu season was bad in the southern hemisphere and that was before the virus mutated.
There are whispers that norovirus has also mutated. The variant called GII.17 is now taking over from the GII.4 strain. You can a lot more about norovirus at this link.
COVID-19 has not disappeared. I know that you do not want to hear that, but the truth is that this virus is likely to be with us for a very long time. It has become less virulent over time, but people are still being hospitalized because of SARS-CoV-2. Some are dying. Since no one is actually tracking COVID anymore, we have no way of knowing precisely how many cases were occurred last month.
What You Can Do:
- Get vaccinated — for RSV if eligible in your area and age group. Respiratory syncytial virus can be serious for infants, older people and those with compromised immune systems. That would include anyone taking one of the newer biological agents for conditions such as eczema, psoriasis, psoriatic arthritis, rheumatoid arthritis or inflammatory bowel disorders such as Crohn’s disease. the RSV vaccine is roughly 80% effective in preventing visits to the emergency room or hospitalizations in vulnerable populations.
- Practice basic hygiene & sanitation — Norovirus is nasty! Just a few particles of this virus can cause horrific vomiting and diarrhea. Frequent hand-washing (especially after using the bathroom or before eating), thorough cleaning of shared surfaces (especially during and after gatherings) and isolation of sick individuals until symptoms resolve are basic precautions. Wear a mask when using public restrooms since particles of norovirus could easily be circulating in the air and you do not want to breathe them in!
- Pay attention to local wastewater and public-health dashboards — if your town or county participates, a rising “viral activity level” can be an early warning. Encourage friends and family to check their state or county’s health-department site. Here is a link to WastewaterScan.
- Be prepared for overlapping illnesses — respiratory (flu/RSV/COVID) and gastrointestinal (norovirus) viruses may circulate simultaneously, putting pressure on families, schools, childcare centers, and hospitals.
What to Watch Next — What We’ll Be Tracking for You with our Outbreak Update
Are you interested in our Outbreak Updates? This week we brought you Outbreak Update-1. Would you like to continue to receive Outbreak Updates over the coming weeks? We need your help if we are to do so.
How Can You Help With Outbreak Updates?
- First, please let us know if this information is worthwhile. We can only continue this initiative if enough people are interested. Let us know in the comment section below.
- Tell us if you have been sick recently. If you know of friends or family members who have been ill, we need to know that too. Please let us know your geographic area so we can track reader response, location and severity of illness.
- If you know what you or your friends came down with, please let us know. We are especially interested in results of over-the-counter flu and COVID tests. But if you get a diagnosis from a healthcare professional, please let us know what that was.
What We Will Be Tracking:
- Weekly updates from the national wastewater surveillance program and participating state dashboards.
- CDC updates from FluView.
- Reports of school, daycare, or nursing-home outbreaks — especially if norovirus appears along with flu or RSV.
- Hospitalization and emergency-department admission trends, especially for children (with RSV) or older adults (with flu).
- Possible unusual flu-strain or animal-origin flu signals: because wastewater can detect non-human influenza A (e.g. from livestock or avian sources), public-health labs are increasingly monitoring for subtypes. CDC+1
Thank you for supporting our work. Your job, should you accept our challenge, is to:
- Let us know in the comment section below if you are interested in Outbreak Updates.
- Share Personal experience with infections this winter.
- Provide updates from your friends and family.
- Offer reports from your community regarding school closings or other outbreaks due to infection.
You may find our eGuide to Colds, Coughs & the Flu of interest at this link.
