Weekend flu check-in
Preliminary influenza data from select states (full reports Tuesday)
Due to the Thanksgiving holiday, most respiratory virus data will not be available until next week, so my regular reports will come out on Tuesday. However, several states published their surveillance updates last week, which offers an early look at current trends. I’ve pulled together a sneak peek based on data through the week ending November 22 and focusing primarily on influenza activity.
Overview
Influenza activity has been rising steadily throughout the month of November. It remains low compared to what is typically seen this time of year, but activity is picking up for most of the country. I expect continued increases through the holiday season. RSV activity is rising as well, particularly in young children. COVID-19 activity remains low and stable.
South:
In Alabama, visits to the emergency department for any respiratory illness has increased to 1.5%, an increase from 0.8% at the beginning of November. Most of that increase is driven by influenza.
Kentucky is not seeing notable increases yet.
In North Carolina, the percentage of ED visits that are for influenza is now 1.5%, up from 0.7% at the beginning of the month. Covid-19 activity is stable.
In Tennessee, flu activity is beginning to rise, particularly in children, but is still fairly low. Covid-19 is rising, but only in the 0-4 age group, which could foreshadow wider circulation in the weeks ahead.
In Virginia, flu activity remains low but is rising sharply in children.

Northeast:
In Massachusetts, influenza activity is low but rising, particularly in Plymouth County. Children are seeing the most rapid increases.
In New Jersey, 0.8% of visits to the emergency department were for influenza. 4% of visits to the outpatient doctor were for influenza-like illness. This number has been increasing steadily but remains below the threshold that marks the beginning of flu season.
New York City is seeing a rapid increase in flu activity. The percent of visits to the emergency department for influenza has risen from 0.2% at the beginning of the month to 1.6% most recently. School-aged children have the highest activity. COVID-19 activity is low and stable.
West:
Influenza activity in Colorado is picking up quickly. As seen in the chart below, 1.8% of visits to the emergency department were for influenza, a substantial increase from 0.2% at the beginning of the month. Test positivity has also increased dramatically from 3% to almost 13%.
Flu activity is low and stable in Washington.
Flu activity is low but rising in Arizona. 0.5% of visits to the emergency department were for flu, up from 0.1% at the beginning of the month.
Midwest:
Influenza activity is low in Illinois but rising particularly among young children. 1.6% of visits to the emergency department among children ages 0 to 4 were for influenza, up from 0.3% at the beginning of the month. Test positivity is also increasing.
Flu activity is very low and stable in Kansas.
Influenza activity is low but rising in Minnesota. 0.7% of visits to the emergency department were for influenza-like illness, up from 0.2% at the beginning of the month. Test positivity is rising as well.
Canada
In Canada, flu activity is rising quickly. Test positivity has increased from 1.9% at the beginning of the month to 8.1%. Prairies and Ontario are seeing particularly rapid intensifications. Hospitalizations for influenza are rising as well, including in children. RSV activity is rising, though much more slowly. On the bright side, COVID-19 activity is down.






Thanks for the data. Hope you and your family had a nice Thanksgiving.
We are outside of NYC and our 7 y.o. has had some flu-like illness for at least 5 days. Tested negative on home flu/covid tests. High fever off and on for 4+ days, congestion, now cough. No body aches reported. It’s a beast of a virus - stay well everyone!