What to know about flu and cold season

By Alexander J. Schorr

Photo via CDC.gov

January 21,  2026 (San Diego) — The current 2025–2026 flu season in the United States has seen high activity, primarily driven by a dominant influenza A(H3N2) strain known as subclade K. According to the latest CDC preliminary estimates as of January 12, at least 7,400 deaths have occurred due to flu so far this season. Last year alone ,288 children in the U.S. died of flu. Approximately 180,000 individuals have been hospitalized, and an estimated 15 million people have been sickened.

To prevent the flu in 2026, health authorities emphasize a multi-layered approach centered on annual vaccination and everyday hygiene. The current version, H3N2 subclade K, is spreading rapidly due to mutations, but vaccination still remains crucial for protection against severe outcomes.

The World Health Organization (WHO) estimates that seasonal influenza causes between 290,000 and 650,000 respiratory deaths worldwide every year. Historically, the CDC estimates that annual flu deaths in the US range from 12,000 to 52,000 during typical seasons.

What is recommended

The CDC has long recommended that everyone 6 months and older should receive a flu vaccine every year.  Recently, the CDC under Health and Human Services Secretary Robert F. Kennedy Jr. eliminated that recommendation for healthy children, advising parents to instead consult their physician. However that decision had no basis in science and has been blasted as “dangerous and unnecessary” by the American Academy of Pediatrics, which urges parents to continue vaccinating children for flu. The AAP and other health organizations have filed a lawsuit against HHS seeking to overturn those changes.  

For this season, the CDC specifically recommends a single-dose, thimerosal-free formulation for children, pregnant women, and adults who choose to get the vaccine. For adults age 65 and up, high-dose or adjuvanted vaccines like Fluzone High-Dose, Flublok, or Fluad, are preferentially recommended to provide a stronger immune response. Additionally, FluMist (nasal spray) is now approved for self-administration or caregiver-administration for eligible people aged 2 to 49.

The flu shot targets H3N2, but its effectiveness against subclade K is reduced. However, vaccination still significantly lowers severe illness and hospitalization; prescription antiviral drugs (like oseltamivir) can treat H3N2 infections. Frequent handwashing and avoiding sick people helps.

Flu symptoms

A reminder about influenza (or the flu): its symptoms include, but are not limited to fever, headache, cough, sore throat, muscle aches, loss of appetite, nausea, vomiting, diarrhea (more common in children), and respiratory issues like chest-pain and asthma-like breathing difficulties.

Prevent spreading flu virus

Wearing a mask can help reduce flu transmission by acting as a physical barrier, especially if you are sick or in high-risk situations to protect yourself and others. The CDC recommends masking for 10 days after symptoms start or if there is a positive test; ensure that there is a good fit over your nose, cheeks and chin. Cloth, surgical masks, or the N95 masks work well to mitigate the spread of droplets. Vaccination may be key to helping with decent health, masking offers an extra layer of protection, working best with other hygiene practices like handwashing.

Medications for cough and congestion

Robitussin DM is an over-the-counter cough medicine that contains the active ingredients dextromethorphan and guaifenesin to relieve coughs and chest congestion. Dextromethorphan Hbr is a cough suppressant that works on the brain to reduce the urge to cough. Guaifenesin is an expectorant that helps loosen mucus and phlegm in the airwaves. Guaifenesin is for mucus and cough, and dextromethorphan can be effective for a dry cough.

Robitussin temporarily relieves cough due to minor throat and bronchial irritation while loosening phlegm to drain bronchial tubes. It is typically a non-drowsy formula for daytime use, though a nighttime version, doxylamine succinate (an antihistamine) is also available for sleep. The adult formula for Robitussin is intended for adults and children 12 years of age and over. For 12 years and up, the typical dose for the maximum strength liquid is 20 milliliters every 4 hours, not exceeding 6 doses in any 24-hour period.

Avoid taking Robitussin DM if you are taking or have stopped taking a monoamine oxidase inhibitor (MAOI). Consult a doctor before use if you have a chronic cough, a cough with excessive phlegm, or if you are pregnant or breastfeeding. Discontinue use and seek medical advice if the cough persists for more than 7 days, if it returns, or is accompanied by symptoms like a fever or rash.

Pain and fever relief: Acetaminophen and NSAIDs

Acetaminophen (also known as paracetamol outside the US) is one of the most common medications used for pain relief (analgesic) and reducing a fever (antipyretic). It is the active ingredient in more than 600 different medicines, including over-the-counter (OTC) products like Tylenol and various prescription drugs.

Acetaminophen in basic Tylenol is good for fever and variable instances of pain, but it is usually recommended for children and people who have high blood pressure.

Taking too much acetaminophen is a leading cause of acute liver failure, with overdosing occurring by “doubling up” on different products like cold medicine and a pain reliever— both of which would contain acetaminophen. Dosages for children must be based on weight, not age, whenever possible.

To ensure safety and prevent liver damage, follow these general adult guidelines:

• Standard Dose: 325 milligrams to 650 milligrams every 4 to 6 hours.
• Maximum Single Dose: 1,000 milligrams.
• Maximum Daily Limit: Generally, 3,000 to 4,000 milligrams in a 24-hour period from all sources.
• Alcohol Precaution: Avoid or limit alcohol; taking acetaminophen while consuming three or more alcoholic drinks significantly increases the risk of severe liver damage.

Acetaminophen is best utilized to treat headaches, muscle aches, backaches, toothaches, and menstrual cramps. It is good for reducing fevers caused by the cold or flu. Acetaminophen relieves mild pain associated with osteoarthritis but does not treat inflammation in the form of NSAIDs like ibuprofen. Unlike ibuprofen (Advil) or naproxen (Aleve), acetaminophen is not an anti-inflammatory drug. It is generally easier on the stomach and carries fewer heart-related risks.

NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) are a class of medications used primarily to reduce inflammation, lower fevers, and relieve pain. Unlike acetaminophen, which works centrally in the brain, NSAIDs work throughout the body to black enzymes (COX-1 and COX-2) that produce prostaglandins, the chemicals responsible for swelling and pain at the site of an injury.

Common over-the counter NSAIDs available without a prescription at standard strengths include:

• Ibuprofen such as Advil and Motrin are fast-acting; typically lasting 4 to 6 hours.
• Naproxen Sodium like Aleve is typically longer-lasting; typically taken every 12 hours.
• Aspirins such as Bayer are often used at low dosas for heart health due to its blood-thinning properties.

NSAIDs are superior for conditions like swelling, such as sprains, arthritis, and menstrual cramps. Because they have different mechanisms, NSAIDs and acetaminophen can often be taken together for enhanced pain relief under medical guidance. Stronger versions or specific chemical formulations require a doctor’s oversight:

• Celecoxib (Celebrex): A COX-2 selective inhibitor designed to be gentler on the stomach.
• Diclofenac (Voltaren): Available as a pill or a popular topical gel for arthritis.
• Meloxicam (Mobic): Frequently prescribed for chronic arthritis pain.
• Ketorolac (Toradol): Potent NSAID used for short term management of moderate to severe pain.

More Over-The-Counter Remedies

A reminder: take only if recommended or advised by a provider and use the recommended dosages.

Dayquil, which has Acetaminophen— good for pain and fever, and Phenylephrine— which will not help with congestion. Additionally, NyQuil is more effective if you are having trouble sleeping with the flu. (Doxylamine) Combining Dayquil and Nyquil can lead to liver damage from excessive acetaminophen.

Saline Nasal Sprays like Afrin, are good for congestion, especially if you have high blood pressure, and are unable to take Sudafed. Afrin is a popular nasal spray containing oxymetazoline, which is a decongestant that shrinks swollen blood vessels in the nose and can provide temporary relief from cold or allergies, offering up to 12 hours of relief. Its key drawback is rebound congestion (called rhinitis medicamentosa) where using it for more than 3 to 5 days can worsen congestion and lead to dependency.

Propolis Soothing Lozenges are a decent enough type of cough drop, as they contain zinc, vitamin c, and honey— all of which are good to take before one gets the flu. If one has a dry cough that is persistent, cough drops like these help alleviate discomfort.

Theraflu possesses Acetaminophen and Dextromethorphan, and added to a hot liquid, this product does well for a sore throat, a fever, or even a dry cough. Theraflu offers a variety of formulations in different forms like powders and hot liquids, syrups, and caplets, tailored for daytime or nighttime use. It does not cure the cold or flu virus, but it can manage the symptoms while your body fights infection. Theraflu products are generally recommended for adults and children 12 years and older.

The Mucinex Severe Congestion and Cough— which is very identical to Mucinex DM, is more effective with the “maximum strength” for it to be very effective for a productive cough. If you do not have a mucousy cough, it is better to avoid this product as a definitive treatment for discomfort.

A Cold Remedy like Cold-Eeze may be homeopathic, but it does have 13.3 milligrams of zinc. Ultimately, Cold-Eeze would be decent to take before you become sick; if someone in your household is sick, it may be a good idea to take it.

Natural treatment options

Natural flu remedies include staying hydrated with water, broth, and tea. Additionally, get plenty of rest, and you can use remedies like a saltwater gargle or honey to soothe a sore throat. Other methods to relieve congestion and inflammation include steam inhalation, humidifiers, and consuming foods with anti-inflammatory properties like ginger and garlic, as well as supplements like zinc or elderberry.