Flu activity in Massachusetts has escalated sharply, particularly among children, with pediatric emergency departments reporting a notable rise in influenza cases. At UMass Memorial Health–Milford Regional Medical Center, approximately 75 percent of pediatric patients tested positive for the flu during a single overnight shift late last week, according to Dr. Jeanne McCoy, chair of pediatrics at the hospital. This year’s flu season has unfolded more quickly than usual, with a higher number of cases emerging at an accelerated pace.
The trend is echoed at Mass General Brigham for Children, where Dr. Ari Cohen, chief of pediatric emergency medicine, noted that influenza has become the primary virus sending children and teenagers to emergency rooms in recent weeks. “Everybody’s got the flu,” Cohen remarked, highlighting the widespread nature of the outbreak. As of December 13, 1.9 percent of all emergency room visits resulted in hospitalization due to flu, more than double the rate from the same period last year. Concurrently, outpatient visits for flu-like illnesses have surged to 4.9 percent, up from 2.8 percent the previous week, prompting officials to classify the flu activity as “high” on the state’s health dashboard.
Despite the rise in flu cases, levels of COVID-19 in Massachusetts remain relatively low. Dr. Larry Madoff, medical director of the Massachusetts Department of Public Health’s Bureau of Infectious Disease and Laboratory Sciences, confirmed that the increase in influenza activity aligns with seasonal expectations. “Every flu season is different, but this is typically when we start to see an increase in influenza activity,” he stated.
Health officials are closely monitoring a new flu strain, known as subclade K, a variant of the H3N2 subtype of influenza A. This strain has been responsible for early spikes in flu cases in the UK and several other countries. Madoff noted, however, that it is too early to determine its prevalence in Massachusetts due to insufficient sequencing data from state laboratories. Most flu cases identified in the state thus far are H3N2, with national data indicating that about 70 to 80 percent of sequenced H3N2 samples belong to subclade K.
Clinicians have reported that children presenting at emergency departments often experience high fevers, typically around 103 degrees Fahrenheit or higher, accompanied by headaches, body aches, congestion, coughing, and fatigue. While teenagers often report intense achiness and exhaustion, younger children tend to exhibit more pronounced respiratory symptoms. Despite the influx of patients, doctors emphasize that this surge appears to stem from a higher number of children contracting the virus, rather than an increase in illness severity.
Dehydration and respiratory difficulties are the most serious symptoms to monitor, especially in infants and children with pre-existing health conditions. Additionally, vaccination rates for the flu have lagged compared to previous years, with only about one in three Massachusetts residents receiving a flu shot this season. Madoff suggests that vaccination can significantly reduce the likelihood of emergency care or hospitalization, even if it does not completely prevent infection. “It’s not too late to get vaccinated,” Madoff urged.
Mixed messaging regarding vaccine efficacy may contribute to the lower vaccination rates. Madoff noted that skepticism surrounding vaccines can deter individuals who are on the fence about getting vaccinated. Cohen has observed fewer vaccinated children in the emergency department, suggesting that “vaccine fatigue” may be influencing decisions. He emphasized the importance of the flu vaccine, stating that influenza is a serious illness that claims lives every year.
As cases rise, healthcare professionals encourage families to prioritize supportive care at home when appropriate and to recognize when emergency care is necessary. McCoy warned that emergency departments have been busier than usual, leading to longer wait times. She advised families to seek emergency assistance for serious symptoms, such as breathing difficulties or dehydration, but to consider urgent care or pediatricians for milder illnesses.
For children, maintaining fluid intake is crucial to prevent dehydration, and electrolyte drinks can be beneficial. Saline nasal sprays and weight-based doses of acetaminophen or ibuprofen can alleviate fever and body aches. While honey may help soothe coughs in children over one year of age, McCoy cautioned against using over-the-counter decongestants and cough suppressants for young children, as these can lead to adverse effects. Antibiotics are ineffective against viral infections like the flu and should only be used for confirmed bacterial infections. Prescription antiviral medications, such as Tamiflu, can be beneficial for certain high-risk patients but should complement vaccination efforts.
Families should seek immediate medical attention if a child demonstrates difficulty breathing, shows signs of dehydration, experiences confusion or lethargy, exhibits bluish lips or face, or has persistent vomiting preventing fluid intake. Children with mild symptoms who can drink fluids and breathe comfortably can often be managed at home or seen by a pediatrician or urgent care provider.
As flu season progresses, doctors stress the importance of awareness rather than panic: get vaccinated, stay home when unwell, and seek medical care when concerning symptoms arise.