Respiratory illness cases rising on Martha’s Vineyard

Updated 

The Martha’s Vineyard boards of health issued a warning for Islanders to be cautious of various respiratory diseases this winter. These include COVID-19, flu, and respiratory syncytial virus (RSV). 

“All around the country, we are seeing unusually high frequency and severity of multiple respiratory illnesses. The Island is no exception. Longstanding seasonal respiratory viruses, flu, and RSV, which had given us a pass in the past few pandemic seasons, are now back in full force, with COVID once again increasing rapidly. Hospitals are filling up, and the situation in pediatric ICUs (intensive care units) is especially dire,” the information sheet states, adding that “holiday gatherings are a major driver of transmission of these and other respiratory illnesses.”

According to Tisbury health agent Maura Valley, this informational sheet was created with input from Martha’s Vineyard Hospital.

“We are seeing very high incidents for influenza, medium risk for COVID, and we’re seeing some RSV,” Valley said, adding that the ways these three illnesses spread are similar.

Martha’s Vineyard Hospital leadership described in November a surge in RSV cases as part of a “tri-demic” that included COVID and the flu. At that time, 76 cases of RSV were diagnosed in a span of two weeks, 85 percent of them occurring in children under 12. COVID is a lingering concern on the Island as well, with Edgartown courthouse closing for a couple of days after an unspecified number of personnel were infected with the virus. 

Martha’s Vineyard Hospital spokesperson Marissa Lefebvre told The Times that RSV cases have gone down on the Island, and flu cases “have been trending upward.” 

“In the past two weeks, there have been 20 diagnosed cases of RSV and 111 diagnosed cases of flu,” Lefebvre said. “Due to the prevalence of RSV and the flu, we are encouraging patients to manage their symptoms at home when possible by resting, staying hydrated, and taking over-the-counter medication. Patients should seek medical care if they are experiencing severe symptoms, are pregnant, or if they are at an increased risk for complications.”

As for COVID, Lefebvre said the hospital is “unable to statistically speak” on the case trends because most tests on the Island are done with at-home kits.

The boards of health and hospital are not the only ones expressing concerns about respiratory diseases. In the weekly announcement emailed to Martha’s Vineyard Regional High School (MVRHS) students on Tuesday, Dec. 13, school nurse Mike Savoy had an “important message”: “There has been a recent marked increase of influenza and RSV cases on the Island and across the commonwealth. If your child has cold or flu symptoms, please initially test them for COVID-19 before they return to school, and have them wear a mask while in the building,” the message read. “Also, please remember not to send your child to school with medication in their backpacks. Both over-the-counter and prescription medication should only be administered by the school nurse. If they need to take medication during the day for a cough/cold symptoms, consider keeping them home from school.”

Savoy said while COVID cases among the school population were spotted in only a couple of students and staff, the flu, particularly influenza A, and RSV “are pretty rampant.”

“There’s been a noticeable uptick,” he said. According to Savoy, there have been around 80 to 100 students absent with upper respiratory symptoms between Monday, Dec. 12, and Thursday, Dec. 15. On Friday, Dec. 16, there was a spike, with 202 students absent with upper respiratory symptoms, and Savoy sent home 10 more that morning. Savoy said this is “sort of reflective across the country,” based on what he read. 

Some students have both influenza A and RSV, which has been common also at the hospital. Savoy said the hospital tests people for COVID, the flu, and RSV, and “many people” are getting influenza and RSV. “Some unlucky people are getting all three,” according to Savoy. 

“It’s a good snapshot of the Island since they’re from all over the Island,” Savoy said about the MVRHS uptick in cases.

The Massachusetts Department of Public Health’s weekly flu report, updated every Friday at 5 pm, currently estimates the state’s influenza severity to be “very high.” Based on data collected between Nov. 27 and Dec. 3, “influenza-like illnesses” made up 5.47 percent of sentinel site visits, higher than the regional baseline of 2 percent. There have been 5,462 lab-confirmed influenza cases, and 2.87 percent of hospitalizations were associated with influenza-like illnesses. Only 37.88 percent of Massachusetts residents have received a flu vaccine. 

The boards of health’s informational sheet gave a guideline for what Islanders should be vigilant for, and how to take preventive measures or respond. 

“First, last, and foremost,” people should stay at home if they feel sick, since what can be just a cold for one person “could be lethal to someone else.” If a person cannot stay home, they are urged to “take every precaution” to avoid infecting people. Additionally, people should “stay up-to-date” with their COVID and flu vaccines. While vaccines are “not a cure-all” or a guarantee of prevention of sickness, they are “effective at making the infection less severe,” and “are an important measure in addition to other precautions,” such as washing your hands with soap and water, covering mouth when sneezing and coughing, and cleaning and disinfecting surfaces. There is no RSV vaccine at this time. People should also get tested for COVID before attending gatherings. When indoors, people should keep rooms ventilated, and wear a N95 or KN95 mask when in “crowded, public indoor spaces.” 

There are also resources offered by the towns, according to the informational sheet. 

N95 masks are available for free while supplies last at all board of health offices on the Island. The boards of health urged businesses “to provide the best ventilation possible in their space. They also have the right to require mask wearing by their staff and customers.” Additionally, “masks vary greatly in effectiveness. If you are not breathing through the mask, you breathe in viruses hanging in the air.”

Free at-home COVID tests are also available at board of health offices, and people are urged to test if they were around someone who has COVID. People should stay home if they receive a positive test result, and even if they get a negative test result, caution should be taken, with additional tests, since it “simply means that your viral load is low at the time you took the test.” Those who get a positive test are encouraged to report it on rapidtestmv.org and to notify their doctor. 

Vaccines are available from doctors and Martha’s VIneyard Hospital. Vaccines can also be received from Health Imperatives (Family Planning), which is offering a $75 gift card incentive, by setting up an appointment at 508-693-1208 or at walk-in times available in December on Wednesdays from noon to 4 pm. The informational sheet said it is especially important if it has been “more than two months from your last COVID booster.” “Despite reduced protection against infection, COVID vaccines are still effective at preventing severe disease and death,” the informational sheet reads. 

Since COVID, the flu, and RSV can vary from being asymptomatic to severe, the informational sheet states, “it is always a good idea to let your doctor’s office know you are ill, but in most cases, you will not need to see your doctor or go to the emergency room.” However, there are some fever thresholds listed for when to call your doctor, depending on the person’s age.

• Fever of 100.4°F (38°C) or higher for under 3 months old. 
• Fever of 102°F (38.9°C) or higher for 3 months to 5 years old.
• Fever of 104°F (40°C) or higher that does not go down within two hours of treatment for over 5-year-olds, including adults. 

The informational sheet recommends contacting your doctor for advice if “the fever lasts more than three days, the person is not drinking fluids or is unable to hold them down, or you are concerned about how the child is acting.” 

Several “warning signs” were also listed where someone should contact 911. Emergency warning signs in children that need urgent medical attention include:

• Fast breathing or trouble breathing
• Bluish or gray skin color
• Not drinking enough fluids
• Severe or persistent vomiting
• Not waking up or not interacting
• Being so irritable that the child does not want to be held
• Seizures

Emergency warning signs in adults that need urgent medical attention include:

• Difficulty breathing or shortness of breath
• Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion
• Severe or persistent vomiting
• Seizures
• Flu-like symptoms improve but then return with fever and worse cough

Updated with information from Martha’s Vineyard Hospital spokesperson Marissa Lefebvre.