Core Insights - Japan is experiencing a significant flu outbreak, with over 190,000 reported cases in the week ending November 23, marking a 1.4 times increase from the previous week [1] - The flu epidemic has reached "alert" levels in 39 out of 47 prefectures, with the situation in Fukushima being particularly severe, reporting the highest infection levels in nearly a decade [2][4] Summary by Sections Flu Cases and Trends - As of November 23, Japan reported 196,900 flu cases, averaging 51.12 cases per reporting medical institution, with a continuous increase for 14 weeks [1] - The flu outbreak is approaching last year's peak levels, which saw an average of 64.39 cases per institution [1] Regional Impact - 39 prefectures have reached flu epidemic alert levels, an increase of 15 from the previous week, with Miyagi, Fukushima, and Iwate being the most affected [3] - In Fukushima, 4,162 cases were reported from 48 medical institutions, a rise of over 1,300 cases from the previous week, marking the highest level since 2015 [4] Educational Impact - Due to the flu spread, 8,817 schools have closed or partially closed classes across Japan [3] Healthcare System Strain - Medical institutions are under significant pressure due to the rapid increase in flu cases, with shortages of common cold medications and antibiotics reported [6] - The upcoming year-end period will further complicate access to medical care as many institutions will reduce services [7] Early Flu Season Factors - Japan entered the flu season earlier than last year, attributed to decreased public health measures and increased international travel [9][10] - Factors such as climate change and lower vitamin D synthesis due to less sun exposure may have contributed to a decline in immunity among the population [10]