The flu is poppin’ early in Tennessee. Hospitals fear a ‘tri-demic.’

Tennessee now has some of the highest flu activity in the United States, according to the latest tracking by the Centers for Disease Control and Prevention. Along with Alabama, South Carolina and Washington, D.C, Tennessee is rated as “very high” for influenza spread.

State data, which is current through the end of October, finds the Memphis area clinics reporting the highest prevalence of influenza-like illness.

“It could presage a very long, hard winter season,” says Dr. William Schaffner, an influenza expert at Vanderbilt University Medical Center. “And of course ,there are a couple of other viruses that we’re concerned about.”

The other viruses include RSV, a respiratory disease that’s sending many toddlers to the hospital, and COVID, which has calmed down but may surge this winter as it has in years past.

Schaffner calls this mix of flu, COVID and RSV a potential “tri-demic.”

Influenza was somewhat dormant for a year or two as the world was preoccupied with COVID precautions, including with getting the COVID vaccine and boosters. Schaffner says looking at early flu vaccination numbers, it appears people have forgotten how serious the virus can be too.

“We are behind across the country in the acceptance of influenza vaccine, and that bothers us a great deal,” he says. “We think this is a consequence of general vaccine fatigue.”

To complicate low vaccination numbers, the flu showed up about a month earlier than normal.

Local health department clinics started offering flu shots for free on Wednesday. At many pharmacies, they’re also free with private health plans.

Courtesy CDC

Flu activity is rated as “very high” by the Centers for Disease Control and Prevention tracking map.