Respiratory illnesses start to ramp up

According to CDC, cold and flu season in the United States typically begins in October and lasts through May.

However, data from Epic Research shows that flu rates have had their earliest start since the COVID-19 pandemic this year. In mid-September, flu encounters reached 140.6 per 100,000 people, the highest level of flu for the time period in five years and double the rate of the same time in 2024 and 2025.

So far, CDC estimates that there have been at least 1.7 million flu cases, 25,000 hospitalizations, and 1,400 deaths (including three pediatric deaths) this flu season.

According to health experts, a flu strain with a new mutation that could affect its ability to evade preexisting immunity may be contributing to the earlier rise in cases. The current H1N1 flu strain is different than the H3N2 strain that was dominant last flu season.

 "Even people who got the flu last year are vulnerable," said Bernard Camins, an infectious disease physician and professor at a prominent New York medical school.

While the flu season may have started earlier this year, it's not clear if the season will be more severe than before. So far, it's too early to tell how the season will pan out.

"The only thing predictable about the flu is that it's unpredictable," said Natalie Azar, a physician and NBC News medical contributor.

What to keep in a cold and flu prep kit

As respiratory illnesses continue to spread, health experts recommend creating a cold and flu prep kit ahead of time.

"Have things readily available so that you're not scrambling or depending on someone else to run to the drugstore for you when you become sick," said Alisha Reed, a pharmacist.

Since illnesses like the cold and flu can often be managed at home, Reed and pediatrician Mona Amin recommend keeping these over-the-counter medications on hand:

• Pain relievers: Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen can help reduce inflammation and reduce pain from headaches, body aches, and sore throats.
• Fever reducers: Medications like acetaminophen and ibuprofen can both help reduce body temperature.
• Decongestants: Pseudoephedrine pills or nasal sprays can help relieve a stuffy nose and reduce sinus pressure. Since these medications can cause serious side effects if they're used longer than recommended, only use them as directed.
• Cough suppressants: Dextromethorphan (DM) can temporarily suppress the brain signal that triggers your cough reflex. However, avoid overmedicating on DM medicines to avoid adverse side effects.
• Cough expectorants: Guaifenesin can reduce chest congestion by thinning mucus in your airways. However, Reed recommended staying hydrated first since "[w]ater is a natural expectorant."

In addition, Amin said that honey can be a great sick day remedy, especially for small children who are at least one year old but not old enough for cough medicine. "Honey is an anti-inflammatory that also helps with coating the throat, which can help with that cough trigger that children will have," she said.

Other helpful items to have in your prep kit include a thermometer, nasal saline treatments, chest or vapor rubs, disposable vomit bags, a humidifier, and hydrating drinks like Pedialyte, water, juice, and Gatorade.

Although most respiratory illnesses can be managed on their own at home, there are also some concerning symptoms to watch out for:

• A fever in infants younger than three months, one above 102 degrees Fahrenheit for children and 103 degrees Fahrenheit in adults, or any high fever that lasts longer than one to two days or doesn't respond to fever-reducing medicine
• Shortness of breath or erratic breathing
• Extreme thirst, an inability to drink liquids, trouble urinating or producing tears, dark urine, or severe/persistent vomiting
• Confusion, disorientation, extreme irritability or weakness

If these symptoms occur, reach out to a doctor for help. These aren't the only signs to be aware of, though, so if you have any concerns, be sure to contact a healthcare professional.

"Don't be afraid to call your doctor or talk to a pharmacist about what's going on," Reed said. "It doesn't hurt to double check."