Flu cases are surging across Massachusetts, particularly among children, prompting a significant increase in visits to pediatric emergency departments. According to Dr. Jeanne McCoy, chair of pediatrics at UMass Memorial Health–Milford Regional Medical Center, approximately 75 percent of pediatric patients who presented at the hospital during an overnight shift last week tested positive for influenza.
“This year, it started a little more abruptly, and the number of cases we saw became much higher at a much faster rate than we’re usually seeing,” Dr. McCoy stated. This alarming trend aligns with reports from Mass General Brigham for Children, where Dr. Ari Cohen, chief of pediatric emergency medicine, noted that flu has emerged as the dominant virus affecting children and teenagers in recent weeks. “Everybody’s got the flu,” Cohen remarked, underscoring the widespread nature of the illness.
As of December 13, 2023, the percentage of emergency room visits resulting in hospitalization due to influenza stood at 1.9 percent, more than double the rate from the previous year. Additionally, outpatient visits for flu-like illnesses reached 4.9 percent, a sharp increase from 2.8 percent the week prior, marking a significant rise in flu activity according to state health officials.
Despite the surge in flu cases, levels of COVID-19 in Massachusetts remain low. Dr. Larry Madoff, medical director of the Massachusetts Department of Public Health’s Bureau of Infectious Disease and Laboratory Sciences, indicated that the current flu activity aligns with typical seasonal patterns. “Every flu season is different, but this is typically when we start to see an increase in influenza activity,” he explained.
The rise in pediatric emergency visits coincides with the national prevalence of influenza A, particularly a newer subvariant known as subclade K, part of the H3N2 subtype. While public health officials are monitoring this strain, Dr. Madoff cautioned that it is premature to determine its extent in Massachusetts due to a lack of sequencing data. He noted, “Most flu cases identified in Massachusetts so far this season are H3N2, and nationally, about 70 to 80 percent of sequenced H3N2 samples belong to subclade K.”
Clinicians emphasize that while these subclades are being monitored, they do not alter treatment protocols in emergency settings. “Clinically, it doesn’t change anything I do,” Dr. Cohen remarked.
Children arriving at emergency departments this season often exhibit high fevers, frequently reaching 103 degrees Fahrenheit or higher, along with other symptoms such as headaches, body aches, and fatigue. Younger children tend to have more respiratory issues, while teenagers often report severe achiness and exhaustion.
Despite the increase in visits, healthcare professionals stress that the rise appears more related to the number of children getting sick rather than a significant spike in illness severity. Concerns do remain regarding dehydration and breathing difficulties, especially among infants and those with pre-existing health conditions.
Public health officials are also paying close attention to flu vaccination rates, which have not kept pace with previous years. Currently, approximately one in three residents in Massachusetts has received a flu shot this season, a rate lower than desired. Dr. Madoff noted that vaccination can substantially impact health outcomes, even if it does not prevent infection entirely. “It’s not too late to get vaccinated,” he emphasized.
The effectiveness of messaging around vaccines may be influencing lower vaccination rates. Dr. Madoff pointed out that mixed signals from national health bodies regarding vaccine efficacy could deter individuals from getting vaccinated. Dr. Cohen echoed these concerns, observing fewer vaccinated children in emergency departments. “I think there’s probably vaccine fatigue,” he stated, stressing the importance of the flu vaccine, which has proven to be the best protection against the virus.
As flu cases continue to rise, healthcare professionals urge families to focus on supportive care at home when appropriate and to recognize when emergency care is necessary. Dr. McCoy cautioned that emergency departments are experiencing high volumes of patients, leading to longer wait times. Families should seek emergency care for serious symptoms such as difficulty breathing or dehydration.
For milder symptoms, healthcare providers recommend hydration, including electrolyte drinks, saline nasal sprays, and weight-based doses of acetaminophen or ibuprofen to alleviate fever and body aches. For children over one year old, honey can help soothe coughs. However, over-the-counter decongestants and cough suppressants may not be effective for young children and can lead to adverse effects.
Antibiotics are ineffective against viral infections like the flu and should only be prescribed for confirmed bacterial infections. Prescription antiviral medications, such as Tamiflu, can be beneficial for specific patients, especially young children and those with underlying health conditions. These medications should complement vaccination efforts.
In summary, as flu season progresses, healthcare professionals emphasize awareness rather than alarm. Key messages include getting vaccinated, staying home when feeling unwell, and seeking medical attention when warning signs emerge.
