Hundreds of students at a Michigan university have been sickened with the flu, triggering an investigation into what the Centers for Disease Control and Prevention have called a “large and sudden” outbreak.

Since Oct. 6, 528 cases have been recorded across the University of Michigan’s Ann Arbor campus in Washtenaw County. Approximately three-quarters of those infected were unvaccinated against influenza, according to a statement from the university.

What’s more, the majority of cases — 313 — have been reported within the last two weeks alone, the University Health Services said.

With CDC’s investigators, the Washtenaw County Health Department, the Michigan Department of Health and Human Services and the university’s administration will work together to understand how the flu has spread as quickly as it has as well as examine vaccine effectiveness.

“While we often start to see some flu activity now, the size of this outbreak is unusual,” Juan Luis Marquez, medical director at the Washtenaw County Health Department, said in a statement.

Health officials have urged residents to get their flu shots amid the recent spike in cases, noting vaccine distribution is down by about 26% compared to this time last year. COVID-19 cases are also on the rise, they warned.

Michigan earlier this week again became the nation’s hot spot for coronavirus cases. According to the latest data from the Centers for Disease Control and Prevention, Michigan over the last week recorded 50,311 new COVID-19 cases. That averages out to about 503.8 new infections per 100,000 people, marking the highest infection rate in the United States.

It is the second time this year the state has lead the country in cases, with the last time occurring in April, between the third and fourth waves of the pandemic.

“This outbreak comes at a time when COVID-19 infections are again surging in Michigan, with case rates, positivity rates, hospitalizations and deaths all increasing,” the department said. “State and local public health officials are concerned with the potential for increased strain on health systems if COVID-19 and influenza cases surge at the same time this winter.”

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