Editor’s note: This story was updated May 22 with new data on the growing number of measles cases.
March 7, 2025 – It’s called “cold and flu season” for a reason. And so far, 2025 has been a doozy for contagious respiratory ailments in the United States.
We’re having the worst flu season in 15 years; it’s killing more than COVID-19. A measles outbreak in northwest Texas has sickened 722 people so far, mostly under age 18, and caused the first measles death in the U.S. in a decade. And while bird flu has only infected 70 humans here, it’s claimed many millions of animals, mostly chickens and dairy cows.
“I don’t think we have to be in panic mode,” said Alexea Gaffney-Adams, MD, an infectious disease specialist with Stony Brook Medicine in New York, “but we need to be informed, aware, and alert to what’s going on immediately around us, as well as in places we might travel to in the near future.”
Big Trouble: Measles
“Measles worries me the most,” said Robert H. Hopkins Jr., MD, medical director of the National Foundation for Infectious Diseases. “It’s the most infectious pathogen we know of.”
Nationwide, we’ve seen 1,024 cases so far this year – that’s more than the full-year case counts for 29 of the last 30 years. Along with the outbreak in Texas, cases have been reported in Alaska, Arkansas, California, Colorado, Florida, Georgia, Hawaii, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Missouri, Montana, New Jersey, New Mexico, New York City, New York state, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, Tennessee, Vermont, Virginia, and Washington. Two school-aged children have died of measles in Texas. New Mexico officials confirmed the measles death of a resident.
Each measles-infected person can potentially infect 18 more, who can each go on to infect another 18, and so on. Once exposed, 90% of unvaccinated people will get measles. The disease itself can be severe or even deadly, and it can also lead to long-term complications.
A big worry: “neurological complications for children who will survive the measles,” said Isaac O. Opole, MD, president of the American College of Physicians. Those cases won’t make headlines, he said, but “we're going to see children who will have a potentially lifelong disability as a result of a measles infection.”
Back in 2000, measles was declared officially eliminated in the U.S. Vaccination rates had surpassed 95%, high enough to provide herd immunity to people who, for whatever reason, can’t be vaccinated. But that number has been falling steadily. In the 2023-2024 school year, just 92.7% of kindergarteners had been vaccinated.
“Vaccines have become victims of their own success. We no longer see our children crippled with polio or dying from measles and meningitis,” Opole said. “The reason we don't see that is not because those things are not there. It is because we are vaccinated as a community. We have herd immunity, and that protects us all.”
Nearly all this year’s cases have hit people – mostly children – who are unvaccinated, or whose vaccination status is unknown.
Still Raging: Influenza
Measles might be the scariest respiratory infection spreading now, but the flu is the most common – and it, too, can be deadly. So far this season, the CDC estimates we’ve had at least 37 million cases, with almost half a million hospitalizations and 21,000 deaths. Last year at this time, the country had seen 42% fewer cases. We’re in the midst of the first highly severe season since 2017-2018.
“Plain old boring flu isn’t plain or boring,” Gaffney-Adams said. “Flu deaths are outpacing COVID for first time in five years.”
Think about that: Flu is now more deadly than COVID.
Vaccination numbers may be partly to blame here, too. In the U.S., 10 million fewer shots have been given than at this point last year. Only 46% of children have been vaccinated, down five percentage points from 2023-24.
According to CDC data, the worst of flu season may have passed – cases have declined for two consecutive weeks – but levels are still high nationwide. Expect the season to continue for several more weeks.
Future Concern: Bird Flu
Unless you work with animals, you can probably breathe easy here. To date, there haven’t been any cases of human-to-human transmission of H5N1, or bird flu. Of the 70 known cases and one death in the U.S., almost all were among people who worked with infected dairy cattle, birds (mostly chickens), and other animals.
For now, at least, your odds of catching bird flu are low but not nonexistent.
“We’re not seeing large numbers of cases in humans yet,” said Adam Ratner, MD, a pediatric infectious diseases doctor in New York City and the author of the book Booster Shots: The Urgent Lessons of Measles and the Uncertain Future of Children's Health. “So far, the cases have mainly been in people who have occupational exposure to animals – but that’s not 100%. There was a pediatric case in Canada, a handful elsewhere. It’s something we definitely need to keep an eye on.”
That said, if you keep backyard chickens or have a cat that spends time outdoors, you should be more watchful – wild birds and small animals can spread the disease.
Assuming you’re not regularly exposed to farm animals, right now bird flu poses its biggest threat to your bank account. Experts say the slaughter of more than 166 million birds to limit the spread is behind current sky-high egg prices. Most were egg-laying chickens.
How to Protect Yourself
You’ve heard this before, but it bears repeating: Make sure your vaccinations are up to date.
- Flu: It’s not too late to get a shot, for anyone over 6 months of age. Exceptions: Avoid the shot if you’ve had severe allergic reactions to a past flu vaccine or to vaccine ingredients. (These can include gelatin or antibiotics.) Have an egg allergy? You can still get a flu shot, even if it’s egg-based, according to the CDC.
- Measles:
- Children should get their first MMR (measles, mumps, rubella) shot between 12 and 15 months of age, and the second between ages 4 and 6 – but if you live near an outbreak of measles or travel internationally, your baby can be vaccinated as young as 6 months.
- Adults should have protection from their childhood vaccines. Not sure? You can be tested for measles IgG antibodies to confirm immunity, but it’s easier to skip the blood test (and the copay) and go straight for the jab, experts say. There’s no harm in getting a booster, and you may be able to receive one at your local pharmacy, no doctor’s visit needed. Also: If you received a measles vaccine between 1963 and 1967, consider a booster – a vaccine used at that time wasn’t effective. (Note: Don’t get the shot if you’re pregnant or immunocompromised, or if you have a life-threatening allergy to one of the vaccine’s ingredients.)
All the advice you learned during the COVID pandemic can also help prevent these illnesses:
- Stay home if you’re sick. That means no work, no school, no public transportation.
- Avoid large crowds and wear a high-quality face mask if you can’t.
- Wash your hands, often. Lather up while singing “Happy Birthday” – it takes roughly 20 seconds, enough time to kill most germs.
- Not near running water? Grab hand sanitizer with at least 60% alcohol content.
If you have children who can’t be vaccinated, take some extra steps:
- Isolate your little ones as much as possible. If you can arrange private child care, opt for that over day care.
- If you think you’ve been exposed, wear a mask around your baby.
- Don’t let people hold or kiss your baby, or touch their hands – remember how often infants put their hands in their mouth.
- Breastfeed your baby, if you’re able to. Some immunity will transfer through your milk.
“Don’t worry about offending people,” Gaffney-Adams said. “You don’t want to have any regrets. These diseases can be devastating to young children.”
