With fewer residents getting vaccinated for respiratory illnesses and more visitors traveling throughout the state, Hawaii has seen an increase in flu cases in recent weeks.
Chad Shibuya, an infection control nurse manager at Hilo Medical Center, has been monitoring flu, COVID-19 and RSV cases in the emergency room throughout the flu season, which began in August 2023.
“When you go month-by-month, there are more flu cases than anything else. COVID in comparison is low, and cases of RSV increased but have now leveled off,” Shibuya said. “However, this January, we’ve had more COVID than flu, so there is fluctuation.”
From October to December, 250 cases of Influenza A, 139 cases of Influenza B, 187 cases of RSV and 21 cases of COVID were hospitalized at HMC.
This month, Influenza A and RSV have been trending down, COVID is trending up, and Influenza B has become rare, according to Shibuya.
“When we look at the respiratory viruses going on right now, there are not many hospitalizations compared to previous years, and risk groups remain the same,” Shibuya said. “Mostly patients 60-years and older end up in the hospital. Occasionally, we will admit a pediatric case, but they are rare, and they don’t stay long.”
The state Department of Health on Tuesday announced the first influenza-associated death of a Hawaii resident under the age of 18 during this flu season. The child was an Oahu resident.
Unlike flu activity in other states, flu transmission in Hawaii is observed year-round.
“I’m not sure specifically why our flu season is longer than that of states on the mainland, but the flu does travel in a pattern,” Shibuya said. “We have visitors coming from all over the world, as well as residents traveling more and spending more time indoors during the holidays. All of this can allow the flu to spread easily.”
At Queens North Hawaii Community Hospital in Waimea, there were 178 cases of influenza from October to December 2023, compared to 101 cases for the same period in 2022.
“(Reasons for) an increase in cases could be that people are out more and not wearing masks,” said Lynn Scully, marketing and communications manager for QNHCH. “Flu usually peaks here in Hawaii a bit later than the U.S. mainland, so it is safe to expect that our cases will continue to increase.”
While there are more cases of the flu this year, their severity is not the worst that Hawaii Island has seen. However, recovery can still take a long time, according to Dr. Christine Chan with East Hawaii Health Clinics.
“Once the virus passes through the respiratory system, it causes inflammation, and that damage can take three to four weeks to repair,” Chan said. “Even if you’re better in a few days, there are long-term social consequences after illness with many people developing a post-viral cough.”
State Epidemiologist Sarah Kemble recommends that everyone 6 months and older get vaccinated against the flu.
While this year’s flu season began in August, there is still time to get a flu vaccine because Hawaii’s flu season can last until April.
“It takes two weeks to build immunity from the flu vaccine, so it’s important to get the vaccine early, around August or September,” said Chan. “Because the season is so long, you can still build immunity to protect yourself and others through February, March and April.”
According to Shibuya, one reason why fewer people are getting flu shots is the overall public fatigue surrounding vaccinations.
“People are tired of talking about vaccines, even if they aren’t opposed to them. Each year, there are COVID, flu and RSV shots recommended, and people are not getting them as much,” Shibuya said. “It is still a good idea to get vaccinated every year, because you never know if you’ll be that one person who gets really sick, and getting those shots will reduce the risk.”
Health experts highly recommend vaccines against respiratory viruses for vulnerable populations such as those with heart disease, diabetes, asthma, COPD and people over 65.
“Protection with the flu vaccine can reduce rates of cardiovascular events, which can cause inflammation and damage to the heart, kidneys, brain and body in general,” Chan said. “If people do have symptoms, we urge them to see primary care doctors, Urgent Care clinics, or go to the emergency room if it’s serious, as soon as possible.”
A list of COVID-19 and flu vaccination locations can be found at vaccines.gov.
Email kelsey Walling at kwalling@hawaiitribune-herald.com.
