Flu season is right around the corner—and experts offer insight on where the virus thrives, and how to protect yourself.
10 Places You’re Most Likely to Catch the Flu, According to Infectious Disease Experts
Updated on May 30, 2024
“We are expecting another active season of respiratory virus transmission this fall and winter in the US,” says Erica Johnson, MD, an internist at Johns Hopkins Bayview Medical Center in Baltimore and chair of the infectious disease board of the American Board of Internal Medicine. The American Lung Association estimates up to 20% of Americans will catch the flu in a given season—and this impact can be substantial. Data from the US Centers for Disease Control and Prevention (CDC) shows that between 2010 and 2023, 100,000 to 710,000 people with the flu wound up in the hospital each year.
In a time when we’re all looking out for the latest Covid variant in circulation, these figures underscore how dangerous the flu can be. While the best way to protect yourself is to get your annual flu shot—likely available in September and October, Dr. Jones says—understanding how and where the flu spreads can help you stay healthy this season.
Get The Healthy @Reader’s Digest newsletter
How does the flu spread?
Ravi Jhaveri, MD, an infectious disease expert at Northwestern Medicine, points out that the flu primarily travels through droplets released when someone coughs, sneezes, or talks. Droplets are larger and heavier than aerosols, the other common route through which respiratory viruses (such as Covid) spread.
That means close contact is key, Dr. Jones explains. “Generally, standing within six feet of a person [infected with the flu] who generates the respiratory droplets is necessary to catch the virus.”
The CDC notes that flu droplets spread more easily in crowded, poorly ventilated areas. A 2020 study in the scientific journal PLoS Pathogens supports this, showing lower transmission rates in well-ventilated spaces, even when people aren’t taking protective measures. This research spotlights the importance of good air circulation in reducing the spread of the flu, limiting the reach of these airborne droplets.
Still, Dr. Jones emphasizes the role of indirect transmission as well. “Since these droplets may not fall to the floor but instead may fall onto surfaces, touching a surface contaminated with infected droplets and then touching a mucous membrane such as your mouth, nose, or eyes is a great way to get the flu.” While it is possible to contract Covid from surfaces, the risk is comparatively low. In fact, a study from the University of Michigan School of Public Health found that the risk of catching Covid from a surface like a doorknob or keyboard is 1,000 times lower than airborne transmission.
So, where are the high-risk areas for catching the flu? Awareness of these flu hotspots is essential in keeping yourself healthy during flu season.
1. Public transportation
Buses, trains, and subways are flu transmission hotbeds due to close passenger contact and shared surfaces such as handrails and seats. Passengers’ frequent coming and going increases the likelihood of encountering the virus. Experts particularly recommend wearing masks during peak flu season to protect against airborne droplets carrying the virus. Traveling during off-peak hours is another effective method to minimize exposure and protect against the flu.
2. Schools and daycares
The nature of activities in schools and daycares—shared toys, group activities, and communal eating spaces—further facilitates the spread of germs. Children often engage in hands-on play, share educational materials, and interact closely with their peers and teachers. While beneficial for social and educational development, these interactions can lead to the easy transfer of germs. Educators and caregivers can mitigate this risk by regularly enforcing hand washing, cleaning, disinfecting surfaces and encouraging flu vaccinations.
3. Offices and workplaces
Office environments, especially open-plan ones, are conducive to flu spread due to employees working in close proximity and sharing spaces like break rooms and meeting rooms. The virus can easily circulate through these networks, further aided by shared items like phones, keyboards, and coffee machines. Additionally, the indoor nature of office work, with limited fresh air exposure, can weaken immune responses, increasing susceptibility to the flu. To alleviate these risks, employers should encourage regular cleaning, promote flu vaccinations, offer flexible sick leave policies and educate employees about flu prevention.
4. Hospitals and clinics
These facilities are high-risk areas due to the concentration of sick individuals. Strict infection control measures, such as hand hygiene protocols, patient isolation, and staff vaccination, are essential to prevent the spread of the flu within these settings. Visitor restrictions during peak flu season can also be effective.
5. Shopping centers and malls
The high foot traffic and shared surfaces in these areas, like shopping carts, escalator handrails, door handles, and food court tables, make them potential hotspots for flu transmission. Mall management should regularly clean these high-touch areas and provide hand sanitizing stations. Shoppers are encouraged to consider off-peak shopping.
6. Fitness centers and gyms
Gym-goers should wipe down machines before and after use and maintain good personal hygiene. Additionally, the communal areas in gyms, such as locker rooms and showers, are typically humid, allowing the flu virus to survive longer on surfaces. Gym management can contribute by regularly cleaning these areas and improving ventilation.
7. Restaurants and cafes
The close seating arrangements and shared items like menus and condiments can facilitate the spread of the flu. Enhanced cleaning protocols and promoting hand hygiene among staff and patrons can help reduce transmission. Spacing out tables and improving air circulation are also beneficial.
8. Airports and airplanes
Large numbers of people from different regions converge in these places, increasing the possibility of flu virus exchange. The high density of travelers in confined spaces like boarding areas, security lines, and shuttle buses creates close contact scenarios where the flu can easily be transmitted from person to person. On airplanes, the situation is compounded by the confined cabin space where passengers sit nearby for extended periods. Although filtered, the recirculated air in the cabin can still carry respiratory droplets from one passenger to another, especially if they are coughing or sneezing.
9. Nursing homes and assisted living facilities
These environments house vulnerable populations, making them susceptible to flu outbreaks. Shared dining areas, group activities, and everyday living spaces foster close interactions among residents, staff, and visitors, facilitating the spread of the flu virus. Preventive measures include enforcing strict cleaning and hygiene protocols, promoting flu vaccinations, and implementing visitor restrictions during the flu season.
10. Community events and gatherings
Concerts, sports events, religious services, and festivals are prime venues for transmitting the flu virus due to the high concentration of people in often limited spaces. The nature of many such events, which involve cheering, singing, or talking loudly, can also increase the emission of respiratory droplets into the air, heightening the risk of airborne transmission. During peak flu season, these gatherings can become hotspots for outbreaks, especially if attendees include individuals who are already infected but may not yet show symptoms.
How to protect yourself this flu season
To effectively shield yourself from the flu, consider these preventive strategies:
Vaccination
The cornerstone of flu prevention is vaccination. The flu vaccines for the 2024-2025 season in the U.S. are designed to protect against three different virus strains, and the CDC advises annual flu vaccination for everyone over six months old. Dr. Jhaveri emphasizes the vaccine’s importance, noting the variety of available options, including the needle-free FluMist nasal spray vaccine, an excellent alternative for those apprehensive about needles (and it’s currently under review by the FDA for self-administration, meaning you can take your flu vaccine yourself at home).
Good hygiene practices
Frequent hand washing with soap and water, complemented by hand sanitizers, reduces your chances of contracting the flu. It’s also important to avoid touching your face unless your hands are clean. (In fact, here are 8 parts of your body you should never touch.)
Stay updated
Keep up to date with local health announcements and the status of flu outbreaks in your area.
Healthy lifestyle
Building a robust immune system is critical in combating the flu. This means eating an immune-boosting diet rich in lean proteins, fruits, and vegetables, regularly exercising, and ensuring adequate sleep. Dr. Jhaveri emphasizes the role of daily health practices in fending off infections. He also recommends wearing a mask in public if you’re feeling under the weather to prevent spreading the flu.
Environmental Awareness
Be conscious of your surroundings, especially where the flu is more likely to spread, and practice the recommended preventive measures.
About the experts
|
Stay ahead of virus season by subscribing to The Healthy @Reader’s Digest newsletter and follow The Healthy on Facebook and Instagram. Keep reading:
Sources
People
- Erica Johnson, MD, an internist at Johns Hopkins Bayview Medical Center in Baltimore and chair of the infectious disease board of the American Board of Internal Medicine
- Ravi Jhaveri, MD, is an infectious disease expert at Northwestern Medicine
- American Lung Association: “Learn About Flu”
- Centers for Disease Control and Prevention: “Burden of Flu”
- AstraZeneca: “US Food and Drug Administration accepts for review AstraZeneca’s Supplemental Biologics License Application for self-administration of FluMist Quadrivalent”
- PLoS Pathogens: “Minimal transmission in an influenza A (H3N2) human challenge-transmission model within a controlled exposure environment”
- Journal of Exposure Science & Environmental Epidemiology: “Monitoring SARS-CoV-2 in air and on surfaces and estimating infection risk in buildings and buses on a university campus”
Medically reviewed by 
