Here’s what state health and hospital officials are saying about the flu in Massachusetts

The Bay State, like most of the country, continues to experience widespread flu activity in the 2017-2018 season.

A nurse prepares an injection of the influenza vaccine at Massachusetts General Hospital in a January 10, 2013 file photo.
A nurse prepares an injection of the influenza vaccine at Massachusetts General Hospital. –Reuters, File

There’s no doubt about it — Massachusetts is experiencing a bad flu season.

According to the latest flu report from the state’s Department of Public Health, the Bay State has seen 8,152 laboratory-confirmed cases of influenza so far in the 2017-2018 flu season. In the week ending Feb. 9 alone, Massachusetts had 2,281 confirmed cases of the flu.

And Alfred DeMaria, medical director of the state’s Bureau of Infectious Disease, said the actual number of people with the flu in the state is likely much higher, given the vast majority of people don’t go to the doctor or get tested for the illness.

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“There’s been a lot of flu activity,” he told Boston.com.

Massachusetts isn’t alone — more than half of the country is experiencing high flu activity, according to the Centers for Disease Control and Prevention, the highest recorded since the 2009 swine flu pandemic.  Nationally, there were 63 pediatric deaths as of the first week of February related to flu.

—The Centers for Disease Control and Prevention

DeMaria said he’d have predicted that the peak of the season would have happened by now, but that the state hasn’t seen a drop in activity yet. He said he doesn’t believe the severity of the disease the state is seeing to be connected to the effectiveness of the vaccine against the H3N2 strain of the illness, which is behind the majority of the confirmed cases.

Instead he posited that one factor for this season’s severity could be its unusually early start.

“It was peaking around the time of the holidays,” he said. “And it may be that everybody sort of going off to their holidays and then coming back together again might have caused a second wave that might have burnt out over the holidays if people had continued in their normal interactions.”

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—Massachusetts Department of Public Health

Additionally, the state health official said because of the attention paid to this year’s flu season, people are likely seeking care for the illness who might not have done so in past years.

“We have to look at the data with that in mind,” he said.

And while this season is severe, DeMaria cautioned that it’s not beyond what he’s seen in the last three decades. The flu, he said, is “always bad.”

“People don’t take flu seriously enough, and if this is what it takes to get people’s attention, then yeah, people should pay attention,” he said. “It’s a severe flu season, but they shouldn’t forget that next fall.”

DeMaria said those who haven’t already should get a flu shot.

—Massachusetts Department of Public Health

To get more of a sense of how bad the 2017-2018 flu season is and how it compares to past years, Boston.com asked local hospitals to share what they’ve seen so far:

How many hospitalizations have been seen this season related to the flu?

Massachusetts General Hospital

Erica Shenoy, associate chief of the Infection Control Unit, said as of Feb. 6 there have been 815 laboratory-confirmed cases of influenza and 210 admissions related to the illness at MGH.

Newton-Wellesley Hospital

Matthew Leibowitz, chief of the hospital’s infectious disease division, said since early January, Newton-Wellesley has had between five and 10 patients in the hospital at any time with the flu.

Beth Israel Deaconess Medical Center

Associate Hospital Epidemiologist Graham Snyder told Boston.com BIDMC has been seeing “many patients with influenza” through both its primary care clinics and the emergency department.

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“The volume we are seeing is as intense as any year recently including the 2014-15 season and 2009 H1N1 seasons,” he said.

Tufts Medical Center

Brian Chow, an infectious disease physician at the hospital, said over the course of the season there have been dozens of people admitted with “influenza-related illness.”

“Our laboratory has had more than 200 tests positive for flu, coming from our clinics, emergency room, and hospital,” he said. “There have been 52 flu cases (both adult and pediatric) in hospital during the season. Many patients transferred to us for care may have had a positive flu test at another facility.”

Brigham and Women’s Hospital 

Paul Sax, the hospital’s clinical director of the division of infectious disease, said that on Feb. 1 alone Brigham and Women’s had 36 positive flu tests.

“That’s a very high number,” he said, adding that the hospital began to see an uptick in cases in mid-January.

“It’s actually now at its highest level,” Sax said.

How many deaths have been seen at your hospital related to the flu?

Massachusetts General Hospital

According to Shenoy, the hospital has seen a total of 12 flu-related deaths.

Beth Israel Deaconess Medical Center

“According to the Centers for Disease Control and Prevention (CDC), there are 12,000-56,000 deaths annually in the U.S. associated with influenza,” Snyder said. “While it is too soon to know where this season will fall in that range, Boston area hospitals have certainly taken care of patients that have succumbed to this illness despite receiving the best care available.”

Tufts Medical Center

Chow said he couldn’t confirm if the hospital has seen deaths related to the flu.

“I can confirm that we have patients who are critically ill with influenza and its complications,” he said.

Brigham and Women’s Hospital 

Sax said its “difficult to say” that deaths are specifically due to the flu.

“What typically happens is that people with very severe underlying conditions, when they get the flu, their underlying conditions deteriorate,” he said. “So we have not ascribed any specific cases indirectly to influenza.”

How does this season compare to past years? Is it among the worst or most severe?

Massachusetts General Hospital

Shenoy said the week of Feb. 6 broke “all prior records of number of cases” for the flu.

“In the week ending Feb. 3, we diagnosed 198 cases, exceeding our prior record of 182 back in the 2007-2008 season,” she said. “We are not sure if we have peaked yet this year, so we can expect that this year we will likely exceed the total number of cases from most recent years. Severity can be thought of in a few metrics—total volume of cases, the proportion of cases that result in admissions, and deaths attributable. We certainly have high volume this year compared to prior.”

Newton-Wellesley Hospital

Leibowitz said the rates of hospitalizations and deaths this year have been higher than usual.

“This is one of the worst influenza seasons since the 2009 novel H1N1 swine flu epidemic,” he said.

Beth Israel Deaconess Medical Center

Snyder said the 2017-2018 flu season “continues to be significant.”

“The 2014-2015 season was a severe influenza season, and this season we are experiencing now is developing to one comparable in the number of ill patients and hospitalizations,” he said.

Tufts Medical Center

Chow said compared to the two most recent flu seasons, this year started earlier and “hit harder.”

“However, it still has many characteristics of a typical flu season, such as the timing, peak, and, so far, duration,” he said. “In contrast, 2009-2010 (the pandemic year) was marked by flu cases in the summertime and many deaths in patients not previously believed to be at high risk. 2017-2018 is a severe and widespread flu season, and among the highest flu activity seen since 2009-2010.”

Brigham and Women’s Hospital 

“It’s way higher than the last two years,” Sax said of this year’s flu season. “Both of those years had flu that was relatively late in the season and then the total numbers were never that high. So this is more like the three year ago flu season, and it reminds me a little bit of the peak of the 2009 flu season.”

Do you think we’ve reached the peak of the season? If not, when do you think that will be?

Massachusetts General Hospital

Shenoy said she expects there’s likely several more weeks to go for the flu season.

“It is hard to tell when the peak will be, and we’ll only know it when we are on the other side,” she said. “Based on our MGH numbers, we are still on the rise.”

Newton-Wellesley Hospital

Leibowitz said the peak “may have happened” on a national level, but cautioned that a resurgence could still occur.

“Influenza B cases often peak later in the season, but are usually less severe than Influenza A cases,” he said.

Beth Israel Deaconess Medical Center

Snyder said what is being seen at BIDMC suggests Massachusetts may have yet to see the peak of the season.

“There may be many weeks of high flu activity yet, and for people who did not receive a flu vaccine this year it is not too late to benefit from receiving the vaccine,” he said.

Tufts Medical Center

Chow said as of last week, Tufts was still seeing a rise in the number of flu cases.

“We may not yet have reached the peak, but I suspect the peak will be within the next month or so,” he said. “It is important to note that even when we are past the peak of cases, it does not mean the flu season is over. Even if we are past the peak, flu can still circulate for several weeks or even months.”

Brigham and Women’s Hospital

Sax said it’s hard to predict.

“If it goes like most seasons it’s probably peaking, and then it’s going to go down,” he said. “But again we can’t say for sure.”

Is there anything the public should be especially aware of for this flu season?

Massachusetts General Hospital

Shenoy said prevention is “key” with the vaccine and added that if you do get the flu, you should do your part to stop it spreading further.

“People with the flu are actually shedding the virus, and therefore can infect others, about one day before symptoms start and for about a week after getting sick,” she said. “Hand hygiene—that is, cleaning your hands by handwashing with soap and water or using an alcohol-based hand sanitizer can help stop the spread of many infections.”

Newton-Wellesley Hospital

Leibowitz advised speaking with your health care provided if you experience symptoms of the flu.

“Prompt medical evaluation of influenza-like symptoms is important,” he said. “Antiviral therapy (oseltamivir) may help reduce severity and is recommended by CDC.”

Beth Israel Deaconess Medical Center

Snyder said your health care provider will also tell you how to reduce a fever or other symptoms, in addition to discussing whether you should take an antiviral medication like Tamiflu.

“If taken early in the illness [it] reduces the duration of illness by 1 or 2 days and may reduce the risk of having complications of influenza,” he said. “Taking an antiviral is recommended for people with certain medical conditions, pregnant women, and those with moderate or severe influenza infection.”

Tufts Medical Center

Chow warned that it takes 14 days to get fully protected by a flu shot.

“Even if we are past the peak in 14 days, there will still be flu around, so it is best to protect yourself and those around you,” he said.

Brigham and Women’s Hospital

Sax advised populations most vulnerable to the flu — pregnant women, the elderly, and patients who have immune systems that are compromised — get the vaccine if they haven’t already.

“Pregnant women when they get the flu are at risk for severe influenza and that can influence their pregnancy outcomes,” he said. “So I definitely recommend that pregnant women get the flu vaccine.”