FLU cases have tripled since last year and Tamworth's country hospitality could be to blame.
All those handshakes and hugs help the spread of influenza in one of the biggest seasons to date.
Already 68 cases have been laboratory confirmed compared to just 21 last year.
And, it appears we have our American cousins to thank at the Center for Disease Control and Prevention for the development of our influenza vaccine.
At the end of every winter we return the favour to help develop theirs, Hunter New England Health public health physician Dr David Durrheim said.
"The flu virus continues to evolve and the genetic material drifts every year, it changes slightly so that is monitored," he said.
"We have World Health Organisation labs around the world, there's one in Melbourne, to try to predict what's going to spread in the next hemisphere's season."
There's a few theories as to why the spread of flu is particularly bad this season.
With more cases at the end of summer than previously seen, some doctors believe the flu might have been brought back to Australia by overseas travellers.
The hotter weather may have seen more people indoors where dry air from air conditioners provides a great opportunity for the virus to thrive and with more people inside, makes it easier to spread.
So far 988 cases have been confirmed in the Hunter New England area and already 37 people have died in NSW, Dr Durrheim said.
"Flu itself and complications don't uncommonly lead to death in Australia, every year the flu results in 3000 deaths across the country mainly in elderly people with pneumonia as a complication," he said.
"It is not a trivial illness, if one develops chest pain that's a sign of pneumonia, or if the person becomes confused with a high fever that's a reason to make sure you have medical review."
The difference between the common cold and the flu is that people infected with influenza will have higher fevers, a dry cough, muscle weakness, fatigue and aching that can be so bad sufferers don't want to get out of bed.
The best thing to do is stay at home, be well-hydrated and take paracetamol to lower a fever rather than spread it in hospitals or the doctor's office where there is little doctors can do, influenza does not respond to antibiotic treatment.
While the flu vaccine isn't perfect, it's the best protection people have, Dr Durrheim said, with 30 to 70 per cent protection.
"If one has a viral symptom one should do the polite thing and not shake hands," he said.
"Every winter the flu season has an impact on the GP and hospital emergency departments, we need to reduce the spread as much as possible.
"The flu might take longer to get into country areas but when it does it actually spreads just as effectively - country people are friendly, they shake hands and hug each other."