In late March, my second grader tested positive for flu A. Over the course of about a week and a half, many of his classmates and his teacher were also hit with the virus. And we’re not alone; it feels like the flu is all over the place! Just when we thought we were through with that virus (you know the one), there seems to be another wave of sickness is sweeping the nation. Is it just our collective imagination? If no, why is everyone getting the flu right now?
Do more people have the flu this year than usual?
Pediatrician Dr. Natasha Burgert tells Romper that she is seeing “lots of influenza A, gastroenteritis, and RSV” at her private practice in Kansas City. “Typically May is a quiet month in the pediatrician's office,” she explains. “But this year, we are unusually busy due to all the illnesses.”
The Centers for Disease Control and Prevention (CDC) reported an uptick in late-season flu cases on March 18. According to the report, it was “an unusual time for flu activity to be increasing.” The report also noted that flu cases had declined from December to mid-January (the typical season peak) before rising again. As of May 6, cases were back in decline, but still cumulatively higher than previous seasons. “CDC estimates that, so far this season, there have been at least 5.7 million flu illnesses, 59,000 hospitalizations, and 3,600 deaths from flu,” states their website. The majority of circulating cases are caused by H3N2 virus, more commonly known as flu A.
Put simply, Dr. Michael Chang, a pediatric infectious disease specialist at UT Health Houston and Children's Memorial Hermann, tells Romper, “Influenza cases have not necessarily increased recently, but they have persisted in higher numbers well beyond the ‘normal’ respiratory flu season.”
The good news is that while current hospitalization rates for respiratory flu cases are higher than the end-of-season rates for the 2020-2021 season, per the CDC, they are lower than the four seasons that preceded the start of the Covid pandemic.
Is the stomach flu going around?
Here’s the thing, the “stomach flu” and influenza are not the same. “Although the influenza virus has been associated with symptoms of vomiting or diarrhea, the more common complaints tend to be fever, chills, and respiratory symptoms like cough, congestion, and shortness of breath,” Dr. Claire Boogaard, a pediatrician at Children's National Hospital, tells Romper. Chang adds that with influenza, any gastrointestinal issues typically arise after respiratory symptoms are present.
So, what exactly is the “stomach flu” if it’s not influenza? “In most cases when someone has a ‘stomach flu’ they have something called gastroenteritis, which is really just a fancy way of saying inflammation of the stomach and intestines,” Chang says. “In most cases gastroenteritis is caused by viral infections, though many bacteria like E. coli and Salmonella can cause enteritis (intestinal inflammation) and lead to similar symptoms.”
Symptoms of gastroenteritis can include nausea, abdominal pain, cramping, vomiting, watery diarrhea, fatigue, low-grade fever, and general malaise. “With respect to stomach bug illnesses, CDC definitely showed a recent surge in norovirus cases, but we don’t have complete data for the whole country,” Chang explains. “However, I’ve definitely been hearing of more families and patients complaining of GI illnesses spreading through their families in the last few weeks — primarily vomiting and watery diarrhea.”
Why is everyone getting sick right now?
It may not be a coincidence that as Covid restrictions have eased around the country, viruses like influenza and norovirus have seemingly spread like wildfire. “Decreased infection control is the main reason we are seeing an uptick,” Burgert explains.
“Pre-Covid, there was a rhythm, almost a calendar to common viruses,” Dr. Susan V. Lipton, chief of the Division of Pediatric Infectious Diseases at Sinai Hospital of Baltimore tells Romper. “They could surprise us with some early seasons or late, and occasional ones where they were on the wrong ‘schedule,’” she continues. And like with what is currently happening, “no viruses always follow the rules about what they are supposed to look like and do.”
Lipton says that “masking and attention to other hygiene is going out the window and very political,” which she says is the central cause of more viral illnesses circulating concurrently. Additionally, Lipton explains that children “have not developed immunity to the normally spaced-out viral illnesses they go through when it's not a pandemic and people aren't masking,” and some viruses are “breaking through now on susceptible people.”
Preventing the spread of the flu & other viruses
You can probably recite viral spread prevention strategies in your sleep by now, but to keep everyone in your home healthy, experts say that these measures are worth repeating once again.
- Stay home if you don’t feel well. And if you manage people at work, encourage them to do the same. “The key to preventing spread is really to avoid contact with other people when you have symptoms (whether respiratory or GI) up through 72 hours after recovery,” says Chang.
- Wash your hands. “The virus that causes the stomach bug is not killed with typical hand sanitizer, so don't count on that for protection,” Burgert says. “A good scrub with soap and water is what you need.”
- Be mindful of others. “If you are high risk of poor outcomes from infection (immunocompromised or living with someone who is immunocompromised), you can consider continuing social distancing and masking as that decreases risk of exposure,” Boogaard says.
- Get tested for Covid. (Yes, this is still a thing.) Remember that nausea and vomiting can be symptoms of Covid. “Test if you were exposed before you expose others, ideally around day three after exposure or at the first sign of symptoms,” says Lipton.
- Stay up-to-date with vaccines. Whether it’s your flu shot, Covid vaccine, or standard childhood vaccinations, Lipton’s advice for preventing viral spread is to “be vaccinated (when available for age), stay informed, and plan for potential changes.”
Dr. Claire Boogaard, pediatrician, Children's National Hospital
Natasha Burgert, MD, FAAP, pediatrician in South Overland Park, KS
Dr. Michael Chang, pediatric infectious disease specialist, UT Health Houston and Children's Memorial Hermann
Susan V. Lipton, MD, MPH, Chief, Division of Pediatric Infectious Diseases, Sinai Hospital of Baltimore and Chief, Section on Infectious Diseases, Maryland American Academy of Pediatrics