Alabama is one of six states with the highest levels of influenza-like illnesses, and it has seen a 17% surge of emergency department visits related to respiratory illnesses within the past week.

Those numbers come ahead of the kids returning to school next week.

But public health officials say there is nothing unusual to what Alabama is facing. It’s flu season, they say, and the public needs to take precautions.

“It’s no different than the previous years,” said Dr. Kevin Michaels, the health officer with the Mobile County Public Health Department.

Dr. Wes Stubblefield, medical officer with the Alabama Department of Public Health, said he anticipates the current outbreak peaking in early February.

“If you look historically, RSV and flu peak in the first of the year in Alabama,” he said. “It has for many years. It’s lining up right now to track similar to where we were last year.”

The ADPH reports that about 8% of emergency room visits around the state are related to influenza, up from roughly 1% in early December. Nearly 10% of all emergency room visits throughout Alabama have been related to a respiratory illness, up from 9% a week ago.

COVID-19 cases are also slightly up from November, according to state data, but less than 1% of emergency department visits have been attributed to the virus. According to state data, COVID-19 cases peaked for the year on Aug. 19 at around 4% of emergency department visits.

The overwhelming majority of emergency room visits in Alabama are related to a host of ailments from chest pains to broken bones and automobile crashes, Stubblefield said.

The percentage of outpatient cases of Respiratory Syncytial Virus (RSV) are surging statewide since October. At DCH Regional Medical Center in Tuscaloosa, the number of outpatient cases spike within three months from six in October to 16 in November and 46 in December. At Northport Medical Center, the cases went from five in October to 28 in November and 44 in December. Fayette Medical Center’s numbers went from two in October to six in November and 12 in December.

Alabama’s influenza outbreak is similar to what other Southern states are experiencing. According to a U.S. Centers for Disease Control and Prevention map, Alabama is joined by Tennessee and Louisiana for having the highest levels of influenza-like illnesses. Mississippi, Georgia, South Carolina and Kentucky are also experiencing “very high” levels of outbreak.

The CDC map also shows influenza spreading to the Western states where Oregon and Idaho are in the same category as Alabama.

“When you look at that chart, you can see that respiratory illnesses are marching across the country,” Michaels said. “It’s a matter of time before you see as high of activity (in states with lower spread).”

The flu outbreak dropped significantly during the 2020-2021 flu season, as people stayed indoors and wore masks during the COVID-19 pandemic.

During the 2022-2023 season, the flu season peaked in late fall – October to November. Last year, the season returned to normalcy with flu numbers reaching the highest levels in January.

“We’re following the same trajectory as we were (last year) but we won’t peak till February,” Stubblefield said. “We’ve had a very low season up until the last couple of weeks in 2024.”

Stubblefield said he anticipates more illnesses to come.

“We will always see, after kids come back to school, a spread of respiratory pathogens,” he said.

Michaels said the spread is inevitable.

“When you bring the kids back to daycare, and in close proximity to other kids, they are going to spread the virus,” he said. “Same thing with school age kids. If they are sick, they are giving it to others. Unfortunately, that is the risk of our society today. We come into close proximity to other people.”

Stubblefield and Michaels both urge anyone who is sick with influenza-like symptoms to stay home. According to Stubblefield, a student is recommended to be “fever free for 24 hours” before returning to the classroom.

Another piece of advice familiar to society since the pandemic: Social distance.

“If you’re sick, stay away from others,” Michaels said. “You put them at risk. If you are sick, stay away.”

The Jefferson County Public Health Department also provides the following advice:

• All people ages 6 and older should get a flu shot. Many weeks of flu season remain, and it is not too late to get a flu shot. Public health officials advocate for people to get a flu shot during the fall months, such as in September and October.
• Medication are available to treat both influence and COVID-19, and persons who are ill should speak with their medical providers about these.
• Given the rate of increase in the ADPH data, people over 60 should be cautious if they have multiple medical conditions that might make them more susceptible to influenza.