Influenza Update

From Wisconsin Division of Public Health (January 2026):

• Wisconsin Department of Health Services memo on Routine Childhood Vaccine Schedule Recommendations

Influenza circulation continues to be high, with increasing cases of influenza B. Rates of influenza-like illnesses (ILI) in Wisconsin outpatients are moderate.

CDC estimates that there have been at least 23,000,000 illnesses, 300,000 hospitalizations, and 19,000 deaths from flu so far this season. Across the U.S. there were 14,223 (18.6%) influenza detections at clinical laboratories, from the 76,625 specimens collected last week. Of detected influenza viruses at public health laboratories last week, 87.3% were influenza A and 12.7% were influenza B. Among influenza A viruses, 85.4% were H3, 14.6% were H1, and 0% were H5. Of genotyped viruses, 92.0% of AH3 viruses were from subclade K. Overall, subclade K comprises 69% of influenza viruses. CDC has reported current match estimates between circulating and vaccine strains for this season (H3: 3%; H1: 98%; B: 52%). The percentage of primary care patients with influenza-like illness (ILI) is 4.6% and is at a high level. ILI activity is very high in 11 states; high in 13 states, moderate in 8 states, low in 14 states, and minimal in 4 states; Wisconsin has low levels. Six additional pediatric deaths have been reported. 62 pediatric deaths due to influenza A and four due to influenza B have been reported for the 2025-2026 season to date; with one death in Wisconsin.

7.1% of all deaths during week 5 (Feb. 1-7) were due to pneumonia, influenza, or COVID-19, and below the seasonal epidemic threshold.

The use of rapid influenza testing is reasonable at this time based on increasing levels of circulating virus. Positive results do not need confirmation. Use of rapid COVID-19 testing is reasonable, and positive results do not need confirmation.

• Only 32.7% of Wisconsinites have received influenza vaccine this season.
• See: https://www.dhs.wisconsin.gov/immunization/influenza.htm

• Only 12.3% of Wisconsinites have received the updated 2025/2026 COVID-19 vaccine.
  • See: https://www.dhs.wisconsin.gov/immunization/covid-19-vaccine-data.htm

https://www.cdc.gov/flu/hcp/antivirals/summary-clinicians.html

Antiviral treatment is recommended as soon as possible for any patient with suspected or confirmed influenza who:

• is hospitalized
• has severe, complicated, or progressive illness
• is at higher risk for influenza complications.

Decisions about starting antivirals for patients with suspected influenza should not wait for laboratory confirmation. Empiric antiviral treatment should be started as soon as possible in the above priority groups. Clinicians can consider early empiric antiviral treatment of non-higher-risk outpatients with suspected influenza based upon clinical judgment if treatment can be initiated within 48 hours of illness onset.

Antiviral Drug Options - supplies may be limited

• For hospitalized patients with suspected or confirmed influenza, initiation of antiviral treatment with oral or enterically administered oseltamivir is recommended as soon as possible.
• For outpatients with complications or progressive disease and suspected or confirmed influenza (e.g., pneumonia, or exacerbation of underlying chronic medical conditions), initiation of antiviral treatment with oral oseltamivir is recommended as soon as possible.
• For outpatients with suspected or confirmed uncomplicated influenza, oral oseltamivir, inhaled zanamivir, intravenous peramivir, or oral baloxavir may be used for treatment, depending upon approved age groups and contraindications.

The most common viral cause of acute respiratory infections in Wisconsin primary care practices is influenza A. For the week ending February 7, 2026, 8.7% of 12,045 specimens tested across Wisconsin and compiled by the Wisconsin State Laboratory of Hygiene were positive for SARS-CoV-2. The most commonly identified gastopathogen is norovirus.

Over the past 4 weeks the typical ARI case has been 37.0 years old; 65% of patients have been female. 67% of patients identified a sick contact 1-3 days before illness onset and they typically present to the clinic 5.3 days after illness onset. 25% of illnesses are characterized as mild, with 75% having moderate symptoms and 0% having severe symptoms.

*estimate based on WSLH statewide data

** estimate based on primary care patients seen at five clinics and 1 urgent care in Dane County

*** includes HKU1, NL63, 229E and OC43