The 5 States Where Respiratory Illness Is Spreading the Fastest, According to the CDC

The United States is currently experiencing a significant surge in respiratory illnesses, with the Centers for Disease Control and Prevention (CDC) identifying five states where the spread is particularly rapid. This increase in respiratory illness activity, marked by rising cases of COVID-19, influenza, and respiratory syncytial virus (RSV), has profound implications for public health and healthcare systems nationwide.

The States Facing the Brunt

The CDC has pinpointed five states with exceptionally high levels of respiratory illness:

  1. Arkansas: Ranking at the highest level of activity (level 10), Arkansas reported 1,880 new COVID-19 cases and 22 deaths as of December 20, 2023.
  2. Louisiana: Also at level 10, Louisiana noted 2,318 new COVID-19 cases and 18 deaths on the same date.
  3. Mississippi: With a slightly lower activity level of 9, Mississippi saw 1,075 new COVID-19 cases and 12 deaths.
  4. Oklahoma: Matching Mississippi’s level 9 status, Oklahoma reported 2,075 new COVID-19 cases and 14 deaths.
  5. South Carolina: Also at level 9, South Carolina reported 1,638 new COVID-19 cases and 16 deaths​​.

Factors Contributing to the Surge

The CDC has identified several critical factors contributing to this upsurge:

  • Low Vaccination Rates: As of December 20, 2023, only 64.7% of the U.S. population had received at least one dose of a COVID-19 vaccine, with just 58.3% fully vaccinated. Flu vaccination rates are also concerning, with only 41.2% of adults and 42.1% of children vaccinated. RSV vaccinations are even lower, with only 15.6% of eligible infants vaccinated as of early December 2023.
  • Emergence of New Variants: The CDC is monitoring a new variant, JN.1, a descendant of the BA.2.86 omicron subvariant. This variant, comprising 15-29% of circulating variants, is rapidly growing and may be more transmissible.
  • Seasonal Factors: Respiratory illnesses typically increase during fall and winter due to factors like colder weather, lower humidity, and indoor gatherings. The CDC also anticipates a severe flu season due to the virus’s evolution during previously low circulation periods​​.

Public Health Implications and Recommendations

The increase in respiratory illness has led to significant public health challenges:

  • The CDC estimates at least 2.7 million illnesses, 27,000 hospitalizations, and 1,700 deaths from flu this season.
  • COVID-19 hospitalizations have reached levels not seen since early 2023, with 22,513 hospitalizations in the first week of December alone. RSV hospitalizations, particularly concerning for infants and young children, are also elevated​​.

To mitigate this crisis, the CDC has issued several recommendations:

  1. Vaccination: Urging everyone eligible to get vaccinated against COVID-19, influenza, and RSV.
  2. Wearing Masks: Recommending masks in public indoor settings and crowded outdoor areas.
  3. Social Distancing: Advising to maintain distance from sick individuals and limit the size of gatherings.
  4. Hand Hygiene: Emphasizing frequent hand washing or using hand sanitizers.
  5. Staying Home When Sick: Encouraging people with symptoms to stay at home and seek medical attention if necessary​​.


This situation underscores the ongoing challenges posed by respiratory illnesses in the United States. The CDC’s identification of five critical states and their guidance reflect the urgent need for public awareness and adherence to preventive measures. As the country navigates this surge, collective action, including vaccination and adhering to recommended safety protocols, remains crucial in combating the spread of these illnesses and protecting public health​

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