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This Is The Worst Flu Season In 15 Years. Here's Why—and How To Protect Yourself.

Seasonal flu cases have hit a 15-year high this year—filling hospitals, shutting down schools, and leading to an estimated 19,000 flu-related deaths so far in the United States. These deaths even topped winter COVID-19-related deaths for the first time since the pandemic began five years ago.

While flu cases surge, RSV, norovirus, and COVID-19 infections have also remained high, "putting a significant strain on hospitals—particularly as patients compete for the same resources such as intensive care unit beds and healthcare personnel," says Jason Nagata, a pediatrician at University of California, San Francisco Benioff Children's Hospital. "Hospitals are struggling to keep up with the demand, and some have been forced to set up temporary triage tents."

Moreover, this flu season most closely resembles the 2019-2020 season, which saw peaks in December, February, and March. If a similar peak happens next month of this year, there could be even more devastation.

(Got a cold? Here's how your immune system is fighting it.)

Here's what's contributing to this year's remarkably high flu rates—plus what you can do to protect yourself and your family.

What's behind the 15-year high flu rates?

"It's not always clear why flu seasons vary so much in severity," says William Schaffner, an infectious disease specialist at Vanderbilt University School of Medicine, but there are likely several factors contributing to this year's significantly high numbers.

One component Schaffner points to is this year's unusually cold winter "driving people indoors, thereby increasing close contact and making it easy for the virus to spread." Similar to RSV and COVID-19, influenza is transmitted through tiny respiratory droplets that are released when an infected person breathes, talks, coughs, or sneezes.

The U.S. Is also likely still experiencing an "immunity gap" resulting from less exposure to the flu and other viruses during the pandemic due to COVID-19-related preventative measures, says Nagata. Precautions like social distancing and face mask use, while critical in preventing the spread of the coronavirus, led to fewer influenza cases during the pandemic and therefore fewer antibody development in individuals to protect against subsequent flu seasons like the one occurring now.

Colored scanning electron micrograph (SEM) of H1N1 influenza (flu) virus particles (pink) budding from lung cells. H1N1 is a subtype of the influenza A virus, a family of viruses capable of infecting multiple species, and the most virulent human pathogen of the three influenza types (A, B and C).

Micrograph by Science Photo Library

This flu season has also been "highly unpredictable," Nagata explains, with multiple waves of flu infections and both H1N1 and H3N2 strains circulating at the same time. The virus normally only sees one peak per season and has a strong predominance of one strain over another, so multiple peaks and two strains sharing the same stage is unusual.

One preliminary report indicates that such unpredictability may have made this year's flu shots a poorer match with the virus than in previous years—but there isn't enough data yet to know if that's actually the case, explains Jason Newland, chief of infectious diseases at Nationwide Children's Hospital in Ohio. "We do know that even in mismatched years or where the effectiveness isn't as good, we still get some protection against severe disease," he says.

In US, Experts Are Increasingly Worried About A Bird Flu Epidemic Spreading To Humans

A year ago, a strain of avian flu was discovered in dairy cattle in the United States, but authorities have failed to take strong measures to contain it. These mistakes and omissions are now taking their toll. Virus experts say conditions are right for a dangerous jump to humans.

Cramped barns provide ideal conditions for the rapid spread of bird flu viruses.

Andres Kudacki / AP

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Five years after the emergence of COVID-19, it appears that its lessons have not been fully learned. It is possible that we are watching a «made in USA» pandemic unfold in real time. Strains of the H5N1 bird flu virus have been spreading widely in the United States for the past three years, resulting in the deaths of more than 153 million farm-raised birds. In February 2024, the virus unexpectedly appeared in dairy cows. Since that time, a total of 973 farms nationwide have reported infections (as of Feb. 25, 2025). The latest bad news came in January, when, for the first time, a person died from an H5N1 infection in the United States.

Public health experts, veterinarians, and virologists are increasingly concerned. In another five years, prominent Frankfurt virologist Sandra Ciesek recently predicted, people will no longer be talking about COVID-19, but rather about bird flu.

Previous influenza pandemics have killed millions of people. For example, the Spanish flu that circulated between 1918 and 1920 claimed up to 50 million lives. That's why experts are genuinely worried – and are not just looking for a new reason to sound an alarm.

Like Russian roulette

At present, the conditions are again right in the United States for a virus that normally affects animals to mutate into a virus that can easily infect humans, what scientists call a zoonosis. Influenza viruses are notoriously unstable, changing their genes quickly and easily. Such changes can be small, within an individual gene. However, flu viruses are also known for their ability to exchange entire segments of their genetic material with each other if two viruses infect the same animal or person at the same time.

Such changes give the viruses the chance to adapt to new hosts. And especially if viruses jump back and forth between different animal species such as birds and mammals, multiplying millions of times with each infection, then chances increase that a mutation will occur that allows the virus to efficiently infect human cells. It's a kind of Russian roulette.

In 1918, viruses were the winners. Scientists have found evidence that the pandemic started with an avian influenza virus that first circulated widely in waterfowl. It then jumped to pigs and horses. Numerous genetic changes led to the emergence of a strain that could efficiently infect humans, and could easily be passed on from person to person. The data suggest, ironically, that this mutation emerged first in the United States. Soldiers then brought the deadly cargo to Europe at the end of World War I.

From a public health perspective, the top priority is to give viruses with the potential to jump from animals to humans as few opportunities to mutate as possible. In other words, to allow little reproduction and no circulation in mammals. But today, the exact opposite is happening in the United States. In recent months, U.S. Farmers and authorities at all levels have done exactly what China was accused of doing in 2020: reacting too late, providing too little information and launching half-baked attempts at containment. This has created a situation conducive to the emergence of a pandemic virus.

Parallels to Wuhan in 2019

«The dynamics, the extent and also the infections of so many mammals make the outbreak in the United States unique,» says Martin Beer, veterinarian specialist for microbiology and virology, in an interview. Beer is head of the Institute for Diagnostic Virology at the Friedrich Loeffler Institute, on the island of Riems in northeast Germany.

The start of the epidemic in cows is very reminiscent of the situation in Wuhan in November 2019. There, it took weeks to identify the pathogen that was causing a new type of pneumonia. Despite this experience, farmers and authorities in the United States took their time tracking down the cause of an initially unexplained disease.

In February 2024, a few cows on a farm in Texas were barely producing any milk, and the milk they did produce was thick and yellowish. The animals became apathetic and developed a fever. It took more than five weeks to identify H5N1 influenza as the cause, in large part because cows were previously considered to be resistant to bird flu viruses. It wasn't until cats on the farm died with suspicious symptoms that researchers thought to test for bird flu.

It is still unclear exactly how and when H5N1 first infected dairy cows. Genetic analyses have shown that it probably jumped from wild birds to dairy cows only once before December 2024. One theory is that milking machines might have been accidentally contaminated with bird droppings containing the virus. To enter a cell, viruses attach themselves to receptors – proteins on the cell surface that act like docking stations, allowing a virus to bind. Udder cells have receptors that are similar to those in bird cells, so it might have been relatively easy for H5N1 viruses to enter there and continue to multiply happily in the udder.

Early in February 2025, a new report caused a stir. The U.S. Department of Agriculture (USDA) announced that a slightly different strain of H5N1 had again spread from wild birds to dairy farms. This variant has evidently been circulating in wild birds and farm-raised poultry for months. It's an extremely unlucky development.

The udders of dairy cows offer an ideal environment for the rapid multiplication of bird flu viruses. In the United States, H5N1 influenza has been detected on more than 960 dairy farms.

Matthew Ludak / WAPO / Getty

Lax controls allowed spread

However, the spread of H5N1 in cattle has mostly occurred from cow to cow and farm to farm. This is due to the lax and uncoordinated handling of sick dairy cows by both farmers and the authorities. This was exacerbated by a second mistake: Instead of immediately sealing off affected regions, animals were transported to distant farms as part of the standard practice of raising young milking cows at one location before selling them to dairies. The virus went along, spreading to distant states.

A third rule for suppressing an emerging virus has also been consistently disregarded in the United States. None of the affected farms have been subject to a thorough epidemiological investigation. Which animals were affected, and in what order? Were there infections that did not show any symptoms? How long were the cows contagious? Have nonlactating animals also been infected?

All these questions could have been clarified with a reasonable expenditure of effort and resources. Tests for H5N1 were readily available last spring. «To date, there has been no such study – or else the data has not been published,» says Beer. As a result, it remains difficult to say exactly what happens at a dairy once the viruses arrive. «Precise epidemiological investigations are extremely important,» he says, especially now that scientists know that H5N1 has jumped from birds into dairy cows a second time. «They have to include a search for how the jump happened,» he adds.

At the beginning of the epidemic in cows, milk was not tested, although all the infected dairy cows suffered from mastitis, an inflammation of the udder. Such testing was carried out sporadically beginning only in early summer. It wasn't until December 2024 that the USDA launched a nationwide milk testing program. There is one glimmer of good news: According to laboratory tests, pasteurized milk is not dangerous. However, farmyard cats and mice have died, evidently as a result of exposure to contaminated raw milk.

All these errors have made targeted containment measures difficult or even impossible. «I'm really not a fan of the way the avian flu epidemic is being handled in the United States,» says University of Minnesota epidemiologist Michael Osterholm in an interview, sighing deeply. «The pandemic clock is ticking.»

A recent report by the Center for Strategic and International Studies think tank argues that these failures have in large part been attributable to authorities' fears of the dairy and agriculture-sector lobbies. The dairy industry is a billion-dollar business in the United States, the report notes. Authorities did not want to upset farmers, dairies and the sector's many other stakeholders by temporarily reducing their incomes or imposing restrictions, the authors write. In addition, they note, there has been disagreement from the very beginning about who was responsible.

The virus has been the primary beneficiary of this inaction. It took advantage of the opportunities provided to spread ever further. It also began a dangerous pingpong game between species. Over the summer, an H5N1 strain from dairy cows mysteriously found its way onto two poultry farms in Colorado. It also infected wild birds. In December 2024, house cats in several U.S. States died after eating food contaminated with H5N1. It's likely that poultry meat from infected animals had been processed to make the cat food, which was not cooked.

Genetic changes in the H5N1 virus

Humans, too, have become part of this pingpong game. As of Feb. 25, 70 people in the United States had been infected with H5N1 since the beginning of 2024. Within this group, 41 were infected by strains circulating among dairy cows and 24 with strains from poultry. The origin of the other infections is not known. Small-scale screening operations conducted on a few farms and among veterinarians suggest that the actual number of H5N1 infections in humans greatly exceeds the number of official reports.

These infections likely could have been prevented if farm employees had worn protective goggles and suits when milking cows, cleaning stables or disposing of dead chickens. However, according to reports from the United States, such safety gear has generally not been made available to farmworkers. So far, with the exception of one case, those infected have suffered only from mild respiratory illnesses and eye inflammation.

As expected, the viruses have changed genetically in recent months, making them better adapted to mammals. Studies have shown that the viruses infecting cows have mutated in such a way that they now multiply more rapidly in mammalian cells. In December, a research group from the National Institute of Allergy and Infectious Diseases in the U.S. Discovered that just one more change in the H5N1 strains infecting cows would be enough for the virus to bond with receptors on human cells.

In December, scientists found that viral strains from two people who had been infected via wild birds had mutated in a way that made them better adapted to human cells. One of the people died. It is not clear whether the strain behind the deadly infection was more aggressive, or whether the patient's health had been weakened by preexisting illnesses. Still, concern is growing – especially because the new strain recently discovered in dairy cows is the same one that caused the death.

In some regions of the United States, markets with live poultry have been banned due to the ongoing bird flu epidemic.

Lokman Vural Elibol/Anadolu/ Getty

No transmission between humans yet

One bright spot remains: So far in the U.S. There has been no documented transmission of the virus from person to person. Only if a virus manages to efficiently spread between people can it trigger a dangerous pandemic.

«We simply don't know whether the H5N1 viruses that are rampant in the United States can develop these fatal characteristics,» says Beer, the virus expert. But perhaps our luck will hold. So far, H5N1 viruses have been relatively slow to adapt to humans.

The Bird Flu Could Be Way Worse Than We Know, According To Experts

On February 19, Tulane University reported that a new variant of the H5N1 strain of avian influenza, also known as bird flu, was found in cows and a dairy worker. But that's not the only bad news. Scientists have also detected bird flu in three veterinarians working with cattle, which may signal a change in the way the virus is spreading.

According to the university, three veterinarians working with cattle have tested positive for bird flu without presenting any symptoms. In a separate statement, the American Veterinary Medical Association said a study found that "Among 150 practitioners tested, three had evidence of recent infection with H5N1, including two who hadn't been exposed to animals confirmed or suspected to have H5N1 infections." One of those infected vets didn't even practice in a state with a confirmed H5N1 case.

Sarah Michaels, an infectious disease expert at Tulane University's Celia Scott Weatherhead School of Public Health and Tropical Medicine, says this study and others could indicate that the virus is far more widespread than we thought.

"It will be difficult to contain," Michaels said. "Recent screenings and the national milk testing program have shown that bird flu has spilled over from wild birds to cattle more than once. And this report of infections in three veterinarians highlights the importance of rapidly identifying infected dairy cattle, continued testing of bulk milk, and monitoring human infections among those at increased risk."

As for the new strain, it's known as the D1.1 variant, which Tulane explained had only been previously found in wild birds and some domestic poultry. However, now, it's not only been found in cattle but also in a Nevada dairy worker, marking the third known human case involving the variant. This follows two other high-profile cases with D1.1, including the death of a Louisiana farmer who contracted it from his backyard flock and a teenager in Canada who was hospitalized but later recovered. And now that that are two types of the virus out there, experts say it will be hard to both track and contain the spread.

"It's endemic in cows now. There is no way this is going to get contained," Seema Lakdawala, an influenza virologist and co-director of the Center for Transmission of Airborne Pathogens at Emory School of Medicine, shared with The Guardian.

Adding fuel to the fire is the absolutely rampant spread of the flu in humans this winter. The Centers for Disease Control and Prevention (CDC) reported that there have been "at least 33 million illnesses, 430,000 hospitalizations, and 19,000 deaths from flu so far this season," marking one of the worst flu seasons in over a decade.

"There's a lot of flu going around, and so the potential for the virus to reassort right now is high," Lakdawala additionally told The Guardian, noting there is the possibility of "reassortment" in animals.

While all this is really great, things could be worse than we know, as the Trump administration has halted communication with the World Health Organization, which is no longer receiving updates on either human flu or avian influenza. The administration has also halted the CDC's weekly report on bird flu.

Bird Flu Fast Facts

Current human cases in the U.S.: 70Deaths: 1States with confirmed cases in animals or humans: 13Sates with outbreaks in cattle: 16Number of birds affected in last 30 days: 18.91 million

"There's no way Americans can protect themselves from bird flu unless the Trump administration stops recklessly withholding the latest information on where and how it's spreading," Hannah Connor, deputy environmental health director at the Center for Biological Diversity, shared in a letter co-signed by 28 public interest groups. "The most effective way to slow an outbreak of this magnitude is to routinely keep us all well informed. The Trump administration's withholding of those details puts us at the mercy of the virus."

As for what you can do to protect yourself, Michaels noted that "Eggs and meat should be cooked thoroughly, and people should refrain from drinking raw milk." Emily Landon, an infectious diseases expert at the University of Chicago Medicine, echoed this sentiment in her own university's statement, noting that while the risk to humans remains is low, it's still important to stay vigilant. "The highest risk to most people would be through contaminated dairy products," Landon noted. So, for now, it's best to avoid raw milk and unpasteurized cheese. This also goes for your pets.

As always, you should avoid contact with infected animals and wash your hands frequently if you do come in contact with any farm animals. The CDC also noted if you do consume meat, you need to cook it at proper temperatures — including cooking poultry and eggs to an internal temperature of 165˚F — to effectively kill any viruses.

And all the experts agreed that if you haven't received a flu shot this year, you should consider getting one for yourself or the kids in your life.

"Many cases are among children, and fewer children are getting vaccinated against the flu compared to before the COVID-19 pandemic," Michaels added. "It's not too late to get a flu shot, and while it won't protect against bird flu, it does provide important protection against seasonal influenza.

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