North Carolina faces record flu deaths

A record 484 North Carolinians have died from the flu this year, and that number will likely rise in the coming weeks.

The number is the highest since the state began reporting deaths in the 2008-2009 season.

“Deaths always lag several weeks behind the peaks of the infection,” explained Dr. David Weber with UNC Health. “People start getting sick and that’s when they measure when they test positive or come through the emergency department, that’s the number you see peaking in mid-February. Then they take several days or weeks to get really sick and they come to the hospital. While we save many people, some people then go on and have a downhill course with complications related to the flu.”

North Carolina’s flu history has seen many fluctuations, including overall case and death totals and when the virus itself peaks.

At the end of the 2008-2009 flu season, 12 people had died from the flu statewide. This season’s death toll is 3,933% higher.

Prior to the 2024-2025 season, the highest death toll in a single flu season was recorded in 2017-2018. 391 people died statewide that season.

 The highest number of pediatric deaths -- deaths of people under the age of 18 -- was recorded during last flu season, with 16 deaths.

A review of Immunization Registry records showed that 75% of those children were not vaccinated, according to the North Carolina Department of Health and Human Services.

Weber said the high case counts this year can largely be attributed to fewer social distancing protocols and fewer vaccinations.

“Many people are not masking the way they did in previous years during the height of the COVID pandemic,” he said. “Second, the number of people getting flu vaccines – as with other vaccines like the measles vaccine – has decreased.”

The infectious diseases expert said a common reason people don’t get vaccinated is based on myth.

“I think the biggest reason people don’t get their annual flu shot is they don’t perceive themselves as at-risk for serious illness and think, ‘Oh I’m 20 and can’t get severely ill,'” said Weber. “That’s not true. People can get sick and die from flu at any age.”

The doctor shared people often “minimize the benefits of a flu shot and over-consider the safety concerns” when it comes to their annual vaccination.

Weber said he often equates vaccinations to wearing a seatbelt.

“Someone will say to me ‘I don’t want to wear a seatbelt because I read about a car that got sideswiped and fell into a lake and the seatbelt jammed and the person drowned.’ Has that happened? Yes. But for every person where that’s happened, there are a thousand people walking around healthy today because a seatbelt either saved their life or saved them from severe injury,” he explained.

Flu vaccinations have been shown to significantly reduce risk of death and hospitalization due to serious illness.

Weber advised at-risk groups in particular to make a plan to get their flu vaccine every year.

“Anyone with underlying disease, that puts them at risk of severe case of flu -- heart disease, lung disease, a smoker, asthma, people with diabetes -- I think anyone if you’re 6 months of age and breathing should get a flu shot period,” Weber said.

The doctor emphasized the importance of flu vaccinations for pregnant women and those aged 65 or older.

“While the flu vaccine is not perfect and is usually about 50-70% effective in preventing disease, it is actually much better at preventing death than hospitalization,” said Weber. “It may not prevent everyone from getting ill, but it does a pretty good job of keeping you from dying.”

When asked about future flu seasons, Weber said increasing education and getting more people vaccinated is key.

“Each year the flu virus drifts a little bit, so each year we make up a new flu vaccine to counter those small changes. We look at what happens in the southern hemisphere – which is their winter, our summer – and that’s how companies decide what to put in the vaccine drugs,” Weber explained. “Every 5-20 years, we have a big shift; we get a new flu strain that’s totally different, and we get a pandemic.”

Weber continued, “I can’t predict when there will be the next flu pandemic, I can only tell you there will be a flu pandemic. It’s only a matter of time based on what’s happened.”

The doctor theorized H5N1 could have the potential to cause serious sickness in humans, if the virus mutates further. Since 2024, 70 human cases of bird flu have been reported in the United States.  

“So far that particular strain of flu has not picked up the characteristics that allow it go person-to-person, but that’s a big concern that we could at any point – even this summer – have a pandemic that’s H5N1 for which none of us have any immunity,” said Weber.

The doctor said if the H5N1 virus does begin to jump from human-to-human, a large spike in cases and bird-flu deaths would likely occur.

“If it doesn’t happen this summer, it’s only a matter of time before we see another flu pandemic,” he said.

To be prepared, Weber said North Carolinians need be willing to make vaccinations more of a priority moving forward.

“We need to support the companies to make the best flu vaccine with the most current strains, and we need to take the vaccine, which most people do not,” he said. “Separate from that, we need to support our public health colleagues. Federal, state and local governments need to be prepared for yet another pandemic. I know we all have pandemic fatigue, and we don’t want to think about another one, but much like hurricanes, we’re going to have them and we need to be prepared as a society for how to deal with them.”

Weber said that anyone with flu-like symptoms -- a high fever, dry cough, sore throat, body aches or runny nose -- should take an at-home test or be tested in a healthcare setting quickly.

“We do have therapies for flu, but the flu advances so quickly that you really need to start the therapy ideally within two days,” he said.

If your condition worsens, seek emergency care immediately.