Four western states are the nation's hot spots in influenza outbreaks as the flu season heads toward its usual peak and an Arizona epidemiologist predicts the situation will worsen after the holidays as schools and offices reopen.
Arizona, Utah, California and New Mexico report widespread flu incidence in the Centers for Disease Control and Prevention's weekly flu update. It is the CDC's highest designation for influenza activity.
"We think the worst is still yet to come," said David Engelthaler, an epidemiologist with the Arizona Department of Health Services. The nation's flu season typically peaks in January, February or March.
The number of flu cases isn't known. Many patients don't report cases to doctors, and physicians may not test specifically for flu in people who do seek treatment, officials said.
However, Susan Mottice, a state epidemiologist in Utah, said recent reports indicated the rate of flu activity there was rising. "That means we haven't yet peaked, and we don't know when we'll peak," she said.
Deborah Busemeyer, spokeswoman for the New Mexico Department of Health, said her state was experiencing a typical flu season so far.
A random check of a few hospitals in New Mexico found none inundated by patients. But doctors' offices, urgent care centers and some emergency rooms in Albuquerque have reported an increase in cases.
Wait times at some emergency rooms in metropolitan Phoenix were getting longer as flu patients sought treatment, leading some hospitals to rearrange their staffing plans.
Waiting at an emergency room in Phoenix on Friday, Mellissa Voll, said she thought she caught the bug at a halfway house where she works with recovering drug addicts.
Voll, 26, said she didn't have health insurance and went to the hospital after over-the-counter drugs failed to relieve her sore throat, fever and coughing. However, even in midst of flu misery, she said she wouldn't approach flu season any differently in the future.
"If it's free, I'll get a flu shot," Voll said. "Other than that, no."
In Los Angeles, about 6% of visitors to clinics and hospitals reported influenza-type symptoms. That figure was nearly 12% in the San Francisco area.
At the University of Utah Hospital emergency room in Salt Lake City, doctors saw an influx of patients with flu-like symptoms during the week before Christmas. But the increase was described as not significantly higher than that of previous years.
Dr. Art Mollen, who operates two medical offices in metro Phoenix, said this flu season was far busier than those in the past, but that the lion's share of cases were mild to moderate in severity.
"We are not to the point to where we are overwhelmed," Mollen said. He expected the wave of cases to taper off into a fairly normal flu season.
Health officials said no particular demographic group was hit harder than others, though children and the elderly are most vulnerable. Glen Nowak, a spokesman for the CDC, said it was not known how the outbreaks in the West would serve as an indicator for what other states can expect.
"There is no data to indicate it's any different from previous seasons, but we are at the beginning" of the season, Nowak said. Other states still have time to catch up, he said.
Associated Press writers Sue Major Holmes in Albuquerque, N.M., Jennifer Dobner in Salt Lake City, Jennifer Coleman in Sacramento and Joy Hepp in Phoenix contributed to this report.