The flu season in the United States continues to get worse.

Health officials said Friday that 7.5% of outpatient doctor visits last week were due to flu-like illnesses. That’s just as high as the peak of the 2017-2018 flu season and higher than any season since.

The annual winter flu season doesn’t usually start until December or January, but this time it started early and has been complicated by the simultaneous spread of other viruses.

The measure of traffic in doctors’ offices is based on reports of symptoms such as cough and sore throat, not laboratory-confirmed diagnoses. Therefore, it can include other respiratory diseases.

This makes it difficult to compare with flu seasons prior to the COVID-19 pandemic. In other years, there has not been an unusually strong wave of RSV, or respiratory syncytial virus, as there is now. RSV which is a common cause of cold-like symptoms and can be serious for infants and the elderly.

Meanwhile, 44 states across the country reported high or very high flu activity last week, the Centers for Disease Control and Prevention reported Friday.

There has likely been a greater spread of respiratory viruses during Thanksgiving gatherings and in crowded airports, experts say.

The dominant flu strain so far is the one typically associated with higher rates of hospitalization and death, especially in people 65 and older.

The CDC estimates that there have been at least 78,000 hospitalizations and 4,500 deaths from the flu so far this season. The deaths included at least 14 children.

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