By Jacqueline Howard, CNN
(CNN) — As millions of Americans hit the road or take to the skies for the holidays, another seasonal traveler is picking up speed: influenza.
Flu activity is already rising across the country. In the week ending December 13, roughly 4% of visits to health care providers were for respiratory illnesses, and nearly 10,000 patients were hospitalized with influenza, according to the latest data from the US Centers for Disease Control and Prevention, released Friday. So far, three children already have died from flu-related causes this flu season.
Those numbers mean the virus may be closer to home than many families realize. Holiday gatherings could include someone just recovering from the flu, or someone beginning to feel sick. Should they still show up to open presents on Christmas morning? How long should a visit be postponed before heading to grandma’s to bake cookies?
As flu cases climb, here are the flu-related rules families should know this holiday season.
If I’m having symptoms, when should I take a flu test?
There are several over-the-counter flu tests available in the United States, and they can be taken at home as a nasal swab, similar to Covid-19 tests.
Many doctors recommend taking a test as soon as you experience symptoms.
“Particularly if you’re a person in a high-risk group,” said Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical Center.
“Those persons are people who are age 65 and older, anyone who has a chronic underlying medical condition, if you’re immune compromised, if you’re a pregnant person and very young children,” he said. “Those are all people who are in high-risk, and once they have symptoms, that’s the time to get tested, because we would have antivirals available to help keep you out of the hospital.”
Flu symptoms usually start suddenly with fever, chills, headache, body aches and fatigue, Dr. Pamela Lindor, a pediatrician at Bluebird Kids Health in Jacksonville, Florida, said in an email.
While you should quickly start treatment and avoid exposing others when you test positive for flu, “if the over the counter test is negative but your symptoms are severe, consider getting a more accurate test from your doctor or urgent care center,” she said.
Testing is key because once it is determined which respiratory illness you have, you can then receive appropriate treatment, Schaffner said.
“Flu is not the only illness we’re concerned about. Maybe you have Covid, and if you have Covid, we have another medication that could help keep you out of the hospital,” he said.
At what point should I take antiviral medications for flu?
Flu antiviral drugs, such as Tamiflu or Xofluza, are prescription medications, and they work best when started early, ideally within two days after flu symptoms begin.
“For the flu, if you are ill, the sooner you begin the antiviral, the more effective it is,” Schaffner said. “There is the 48-hour rule. That is, for it to be maximally effective, you have to initiate treatment within the first 48 hours after you get symptoms. But even after 48 hours – and this is especially true for high-risk people – you can still have some modulating effect of the antivirals.”
If I test positive, for how long should I avoid contact with others?
As soon as someone starts to show symptoms, they should stay home and avoid contact with other people to not spread the virus.
“You’re capable of transmitting the influenza virus the day before you get symptoms,” Schaffner said. “But nonetheless, wear a mask and avoid other pe