Influenza cases quickly rising in Nebraska with peak expected in the next few weeks

The Nebraska Department of Health and Human Services reported an increase in positive tests for several respiratory viruses, including influenza A and B, RSV and COVID-19, according to the latest Morbidity and Mortality Weekly Report through Dec. 20.

While all data are preliminary, the report shows that Influenza A remains the most detected virus in the state with 1,570 total positive tests reported so far in this flu season. DHHS recorded 965 new type A positives in the most recent reporting week—an increase of 671 from the week prior.

And that aligns with what Nebraska’s neighboring states are seeing, according to Dr. Mark Rupp, professor and interim chair of the Department of Internal Medicine at the University of Nebraska Medical Center.

“We’re seeing the respiratory viruses, particularly the flu but also now COVID-19, really start to take off in our region, compared to previous seasons,” Rupp said. “We very routinely see influenza outbreaks and epidemics every respiratory season, so this is not at all unexpected.”

Rupp said the trajectory of the illness – when cases start ramping up, peaking and decreasing – is similar to what was seen last winter. The flu season of 2024-25 was designated by the Centers for Disease Control and Prevention as one of the most severe flu seasons since 2018. While each season varies a little bit, cases are starting to ramp up later this year compared to last season’s trajectory.

“We’re seeing a very steep rise in the incidence of what we call influenza-like illness, as well as documented influenza cases, and also within the wastewater,” Rupp said. “All the signals are pointing toward a lot of flu being transmitted right now in our community. Similarly, we’re starting to see a bump in COVID-19 as well, particularly in the wastewater.”

Rupp expects the number of cases to peak in the next two weeks. While the number of cases are quickly rising, the number of people being hospitalized is remaining relatively normal for the winter season.

DHHS data showed influenza-like illnesses accounted for 2,057 hospitalizations statewide, including more than 200 in the most recent week. COVID-19 hospitalizations totaled 231, including 24 reported last week. Around 20 respiratory illness-related deaths have been reported, with 14 of them from COVID-19.

Given that the peak of transmission and cases could still be a few weeks off, Rupp said getting vaccinated against the flu now would provide protection to those who have remained unscathed so far.

The surge in national flu cases appears to be catapulted by a new strain of the virus – subclade K of influenza A (H3N2). There have been concerns that the 2025-26 flu vaccine isn’t as effective at fighting off the new strain, but Rupp said even if the current vaccine isn’t a perfect match, it will provide a better defense than none at all.

“If it doesn’t completely prevent you from getting the flu, it will hopefully make the disease less severe than it otherwise would be,” Rupp said. “There’s still real value in getting that vaccine. It's not too late. We’re clearly getting to that point within the next several weeks that the influenza will peak and be on its way down.”

If you end up getting flu or COVID-19 symptoms, Rupp said it’s important to get a diagnosis, particularly if you’re older, have underlying health issues or have other health risks.

“If you’re in one of those risk groups that is more likely to have severe disease, we do have medications that can treat both flu and COVID-19. You want to get that diagnosis, so that you can get specific therapy and hopefully prevent more serious illness.”