Several viruses are circulating in North Carolina right now, with flu, COVID-19, and norovirus all active across the state. A measles outbreak that began in late 2025 has also put parts of western and central North Carolina on alert, with 24 cases reported so far. Here’s what’s spreading, what symptoms to watch for, and how each virus differs.
Flu and COVID-19 Remain the Main Respiratory Threats
Seasonal influenza activity remains elevated across the country, and North Carolina is no exception. Flu typically peaks between December and March, and this season has followed that pattern. Symptoms include sudden fever, body aches, chills, fatigue, cough, and sore throat. Most healthy adults recover within one to two weeks, though the first few days can be intense.
COVID-19 is also still circulating, though activity has been decreasing nationally. The dominant strains in North Carolina are sub-lineages of the Omicron variant. For most people, current COVID infections look a lot like a bad cold or mild flu: sore throat, congestion, cough, fatigue, and sometimes fever. Loss of taste or smell, once a hallmark of earlier variants, is less common now. North Carolina monitors COVID levels through wastewater testing at dozens of treatment plants in cities including Charlotte, Raleigh, Greensboro, Fayetteville, and Wilmington, which helps track community spread even when fewer people are getting tested.
RSV (respiratory syncytial virus) rounds out the trio of major respiratory viruses the state tracks. It hits hardest in infants and children under 4, where it can cause wheezing, difficulty breathing, and sometimes hospitalization. In older children and adults, RSV typically feels like a regular cold.
Walking Pneumonia Is Elevated in Some Areas
Infections caused by Mycoplasma pneumoniae, the bacteria behind “walking pneumonia,” remain elevated in parts of the U.S. Walking pneumonia gets its name because it’s usually mild enough that people stay on their feet rather than being bedridden. Symptoms come on gradually: a persistent dry cough that can last for weeks, low-grade fever, fatigue, and sometimes a sore throat or headache. It spreads through respiratory droplets, and kids between 5 and 17 tend to be most affected. If your child has had a cough that just won’t quit, this is worth considering.
Norovirus (Stomach Bug) Is Active
If you or someone in your household has been hit with sudden vomiting, diarrhea, and stomach cramps, norovirus is a likely culprit. North Carolina is one of 14 states that reports outbreak data to the CDC’s NoroSTAT surveillance system. For the current seasonal year (August 2025 through early February 2026), 644 norovirus outbreaks have been reported nationally by participating states. That’s actually lower than the same period last season, which saw 1,707 outbreaks, and falls within the normal historical range.
Norovirus spreads incredibly easily through contaminated food, surfaces, and close contact with someone who’s sick. Symptoms hit fast, usually 12 to 48 hours after exposure, and most people feel better within one to three days. The biggest risk is dehydration, especially in young children and older adults. Frequent handwashing with soap and water (hand sanitizer is less effective against norovirus) and disinfecting surfaces with a bleach-based cleaner are the best ways to prevent it from tearing through your household.
A Measles Outbreak in Western and Central NC
North Carolina is dealing with its largest measles outbreak in over a decade. Since December 2025, 24 cases have been reported, with clusters in Buncombe County (7 cases), Polk County (5 cases), and Mecklenburg County (3 cases). For context, the state had only 35 total measles cases across the entire 20-year span from 2005 through 2024, and went from 2019 through 2023 with zero cases.
Most of the cases are in children 17 and younger (18 of 23 cases with age data available). Among those infected, 65% were unvaccinated or had unknown vaccination status, and 30% had received only one dose of the MMR vaccine. Just 5% had received the recommended two doses. One person has been hospitalized.
Health officials have identified possible community spread in Buncombe County and the greater Charlotte metro area, including Cabarrus, Gaston, Iredell, Lincoln, Mecklenburg, Rowan, and Union counties. Measles is one of the most contagious viruses known. It spreads through the air and can linger in a room for up to two hours after an infected person leaves. Early symptoms resemble a cold (fever, cough, runny nose, red eyes), followed by a distinctive rash that starts on the face and spreads downward.
How to Tell What You Might Have
With so many viruses circulating at once, it can be hard to know what’s making you sick. A few patterns can help narrow it down:
- Sudden high fever with body aches: Flu is the most likely cause, especially if symptoms came on fast and you feel wiped out.
- Sore throat and congestion with mild fever: COVID and common colds overlap heavily here. A home COVID test can help sort this out.
- Vomiting and diarrhea without much respiratory symptoms: Norovirus or another stomach bug. These tend to be short but miserable.
- Lingering dry cough with low energy: Walking pneumonia is worth considering, especially in school-age children.
- Fever, cold-like symptoms, then a spreading rash: If you’re in one of the outbreak areas and are unvaccinated, contact your doctor about measles before going to a clinic or ER, since it’s highly contagious in waiting rooms.
Vaccines Cover Most of What’s Spreading
Updated COVID-19 vaccines for 2025-2026 are available to everyone 6 months and older, including pregnant individuals. Even if you’ve had a COVID vaccine in past years, the updated version targets the strains currently circulating. The annual flu shot is also still worth getting if you haven’t already, since flu season can stretch into April or May. For measles, two doses of the MMR vaccine provide about 97% protection. If you’re unsure whether your child has had both doses, your pediatrician’s office can check their records quickly.