Raleigh -- November 3, 2026: State health officials report modest increases in the Asheville region while broader respiratory activity remains low statewide.
Emergency department visits for flu-like and COVID-like illnesses ticked up slightly in Western North Carolina during late October, according to state public health surveillance figures.
Data released by the North Carolina Department of Health and Human Services (NCDHHS) showed small increases in both categories across Region 6—which covers Buncombe County and ten surrounding mountain counties—for the reporting week ending October 24.
Visits for flu-like illness rose by 0.12 percentage points from the prior week, while visits categorized as COVID-like illness edged up by 0.03 percentage points.
Despite the regional movement, statewide emergency department visits for acute respiratory illnesses held steady at 6.6 percent. Serious outcomes requiring hospital admission actually dropped statewide, falling from 1,176 admissions down to 1,054.
Wastewater Signals and Viral Spread
While emergency room visits for COVID-like illness remain far below historic seasonal surges, wastewater testing continues to track active viral circulation across the state.
The state's wastewater monitoring network registered a SARS-CoV-2 viral activity level of 7.8, placing it in the moderate band just shy of the "high" threshold (7.9). Wastewater surveillance detects virus shed in municipal systems regardless of whether infected residents experience mild symptoms or seek clinical treatment.
By contrast, wastewater activity for Influenza A and RSV remained at baseline levels, each measuring 1.0 (very low). Overall, the Centers for Disease Control and Prevention continues to categorize North Carolina’s respiratory illness level as very low.
State epidemiologists caution that syndromic ER numbers track patient-reported symptoms and preliminary physician impressions rather than confirmed laboratory tests, meaning common fall viruses can produce overlapping numbers. Because Region 6 data aggregates reports from across Western North Carolina's regional medical centers—including Mission Hospital in Asheville—the metric reflects regional healthcare patterns rather than Buncombe County in isolation.
State Health Guidance: Vaccines and Prevention
NCDHHS continues to urge residents across the state to protect themselves as peak respiratory virus season approaches, noting that fall remains the optimal window to build immunity before winter gatherings.
Flu Vaccine: State officials recommend an annual flu shot for everyone six months and older, noting it reduces doctor visits by 40 to 60 percent. NCDHHS announced the state's first confirmed flu-related death of the season in early October (an adult in central North Carolina).
Updated COVID-19 Vaccine: Health officials advise everyone six months and older to receive the updated 2026–2027 COVID-19 formulation, which provides an estimated 30 to 60 percent additional protection against severe illness and hospitalization. Those recently infected can choose to get the shot immediately upon recovery or wait up to three months.
RSV Immunizations: Recommended for all adults aged 75 and older, adults aged 50 to 74 with chronic heart, lung, or immune conditions, pregnant individuals between 32 and 36 weeks, and eligible infants. Clinical studies show the adult immunization is 72 to 85 percent effective at preventing RSV hospitalizations.
Co-Administration: State health officials note that flu, COVID-19, and RSV shots can safely be administered during the exact same visit. No prescription is required at retail pharmacies for adults and older children.
Everyday Precautions: Beyond immunization, NCDHHS advises staying home when sick, washing hands regularly, covering coughs with an elbow or tissue, and seeking prompt antiviral testing and treatment within the first 48 hours of symptom onset.