It’s flu season and no one knows that more than those in Southeastern states, where rates of influenza infections are higher than in most other regions of United States.
And it’s not just the flu causing life-threatening illnesses, according to the Centers for Disease Control and Prevention. Southern states lead the nation in cases of influenza-like-illnesses (ILI), which include COVID-19 and the respiratory syncytial virus (RSV), as well as other viruses that may cause flu-like symptoms.
ILIs may be a particular threat to cancer patients, many of whom have compromised immune systems caused by their disease or as a side effect of treatment.
“We know that cancer patients can face a higher risk of being immune compromised and so a normal respiratory illness that might put a healthy person in bed for a few days can be life threatening to a cancer patient,” says Jeffrey Metts, M.D., chief of staff at City of Hope® Cancer Center Atlanta.
In this article, we’ll explore:
- What Are ILIs?
- Respiratory Viruses in the Southeast
- Why Do Cancer Patients Have Low Immunity?
- What Can Patients and Loved Ones Do to Protect Themselves?
If you or a loved one has been diagnosed with lung cancer and are looking for a second opinion, call us 24/7 at 877-524-4673.
What Are ILIs?
Influenza is a serious illness. It may cause symptoms that result in hospitalization and even death. While it’s difficult to pinpoint the exact number of people infected, the CDC estimates flu deaths are in the tens of thousands and hospitalizations are ten times that each year. In 2023-24, more than 200 children died of the flu.
The flu is just one of several illnesses caused by highly contagious viruses that may cause similar symptoms, especially fever or fatigue. Nearly 10% of the U.S. population comes down with an ILI annually.
ILIs are most often caused by:
- Influenza viruses
- Viruses that cause common colds, such as adenoviruses or rhinoviruses
- Respiratory syncytial viruses
- Coronaviruses, including variants that cause COVID-19
According to the CDC, ILIs are infections that may cause the following symptoms:
- Fever
- Chills
- Fatigue
- Cough
- Loss of appetite
- Body aches
- Nausea
It’s important to see a doctor if these symptoms worsen or persist. They could be a sign of a more serious illness, including cancer. Some ILI symptoms, including fatigue, loss of appetite and chills, are also signs of some cancers.
Respiratory Viruses in the Southeast
According to the Georgia Department of Public Health, from Oct. 5, 2024, through Jan. 18, 2025, nearly 1,900 Georgians were hospitalized with influenza and 23 people died from the disease.
The CDC considers Georgia’s ILI rate “very high.”
In fact, most southern states are similarly ranked by the CDC. Neighboring South Carolina has one of the highest ILI rates in the country. Between January 12 and 18, 2025, more than 600 South Carolinians were hospitalized with the flu or an ILI. Other southern states ranked very high by the CDC include:
- Tennessee
- Louisiana
- Alabama
- Mississippi
North Carolina and Florida are considered to have high rates of ILI.
In 2022, the five states with the highest influenza/pneumonia mortality rates were all in the South, according to the CDC.
Why Do Cancer Patients Have Low Immunity?
Cancer and its treatments take a toll on the body and may exhaust or damage the immune system, making patients more vulnerable to ILIs and other contagious conditions.
Cancer itself has ways of shutting down the immune system or even hijacking immune cells to help cancer cells grow. And some cancer treatments can kill or damage immune cells, as detailed below.
Chemotherapy: These drugs are designed to kill fast-growing cells, including cancer cells. But cells in bone marrow, which produces immune cells, also grow fast and are often killed or damaged during treatment.
Surgery: Surgical procedures require incisions and may expose the body to germs, exhausting the immune system as the body fights to prevent infection and heal wounds.
Radiation therapy: This treatment is designed to destroy cancer cells but may also damage healthy cells and lead to an increased risk of infection.
Immunotherapy: Treatments with checkpoint inhibitors or chimeric antigen receptor (CAR) T cell therapy tinker with the immune system and may cause side effects that affect the body’s ability to fight infections.
Stem cell transplants: These procedures often require intense conditioning regimens of chemotherapy that essentially wipe out the immune system so it may be rebuilt with new cells.
“The conditioning regimen for a stem cell transplant really leaves patients vulnerable,” Dr. Metts says. “You’re essentially getting rid of all their white blood cells. So, the caregivers, medical professionals and everybody who’s around those patients have to be hyper vigilant and doing all the things that can to decrease the risk of infection and allow the patient to focus on their recovery.”
What Can Patients and Loved Ones Do to Protect Themselves?
It’s important for cancer patients with compromised immune systems to take steps to reduce their risk of on an ILI infection of other disease. Family members, loved ones and caregivers should also take measures to help ensure they are not passing on illnesses to others.
Here are some tips for protecting yourself and those close to you.
Be vigilant. Watch out for warning signs such as fever, fatigue, cough or diarrhea.
Clean wounds. Keep cuts, scrapes or surgical scars clean and beware of swelling or redness.
Practice good hygiene. Wash your hands often with warm water and soap. Keep your home clean.
Use hand sanitizer. If you are unable to wash your hands, use a sanitizer approved by the U.S. Environmental Protection Agency.
Avoid large crowds. Stay away from people you know may be sick.
Eat well and stay hydrated. Do not share food, drinking glasses or utensils with others. Avoid raw or undercooked foods. Eat and drink only pasteurized juice or dairy products.
Keep a clean house. Disinfect countertops, door handles, telephones and other frequently touched objects.
Get vaccinated. Make sure your immunizations are up to date.
“When the flu vaccine becomes available, you should get it,” says Suji Mathew, M.D., M.S., F.I.D.S.A., infectious disease physician and chief of medicine at City of Hope Cancer Center Atlanta. “It’s a good preventive tool to use. It’s an important first step for caregivers and family members of cancer patients to take to prevent getting an infection.”
If you or a loved one has been diagnosed with lung cancer and are looking for a second opinion, call us 24/7 at 877-524-4673.