Puerto Rico Declares Influenza Epidemic: 42 Dead, Over 1,000 Hospitalized

A building displays a banner urging visitors to wear face masks in San Juan, Puerto Rico, on July 20, 2020. Ricardo Arduengo/AFP via Getty Images

The U.S. territory of Puerto Rico has declared an influenza epidemic, with a majority of the nearly 30,000 cases being children.

It was Puerto Rico’s first such declaration since 2016, according to a Nov. 9 press release by the Puerto Rico Department of Health. Fatalities rose to 42 individuals as of Nov. 4, with 1,048 hospitalizations and 29,947 infections this influenza season, which began in July.

“This epidemic declaration is to alert and inform citizens about the actions we must take. This is not the time to be alarmed, but to prepare to help prevent the increase in the spread of this virus,” said Puerto Rico Secretary of Health Dr. Carlos Mellado Lopez.

“Already the health providers are working with measures to reduce the spread and prevent the virus. Fortunately, we have enough screening tests, vaccines, and treatments required to deal with cases of influenza,” he added.

Children between the ages of 0-19 are the most affected group this influenza season, accounting for 13,666 of the total cases. There were 9,656 infections in people between 20-59 years of age and 2,578 cases among older adults.

Dr. Iris Cardona, chief medical officer, called on Puerto Ricans to “get vaccinated,” saying that vaccination is the “main shield against some diseases and anyone over 6 months old is eligible to receive it.”

The health department is looking to vaccinate as many people as possible before Christmas festivities begin. Flu vaccines are provided free of cost.

Pedestrians on a street in Old San Juan, Puerto Rico, on July 20, 2020. Ricardo Arduengo/AFP via Getty Images

The CDC recommends that every American aged 6 months and above get influenza shots. The recommendation has been made annually since the 2010-2011 flu season.

However, the effectiveness of the flu shot is questionable, according to agency data. In 2022-2023, the flu vaccine’s effectiveness was estimated to be only 54 percent. In 2021-2022, it was 36 percent, and in 2019-2020, it was 39 percent. A year earlier, it was 29 percent.

In the 19 years since 2004, flu shots have been at least 50 percent or more effective in combating the infection in only five of the years.

There are also concerns about vaccine injuries. Between 2006 and 2019, the majority of people compensated under the National Vaccine Injury Compensation program had faced injuries after taking the flu shots.

The CDC insists that flu vaccination “can keep you from getting sick with flu” and has been “shown in several studies to reduce severity of illness in people who get vaccinated but still get sick.” It claims that the shot “can reduce the risk of flu-associated hospitalization.”

In a recent interview with the “American Sunrise” program, cardiologist Dr. Peter A. McCullough said that “for the last few years, [flu shots] have had statistically insignificant—from zero—efficacy against severe outcomes. So, flu shots don’t offer really any significant protection.”

He does not recommend influenza shots for healthy people in the fall season, claiming that the vaccines are not “compelling” and that the condition is “easily treatable.”

Defining an Epidemic

During the 2022-23 season in Puerto Rico, there were 31,710 influenza cases, 1,224 hospitalizations, and 15 fatalities.

“The current flu season (2023-24) began above the alert threshold early, and recently, it has already shown epidemic behavior with 5.7 times more cases compared to last season to this moment,” said Dr. Melissa Marzan, chief epidemiology officer.

In 2016, when the last influenza epidemic was declared, 53,708 cases were reported.

In order for influenza to be declared an epidemic, it has to meet a few conditions. First, the case numbers must be above the alert threshold for four consecutive weeks and should be close to 50 percent of total cases registered during the season.

Secondly, infections must be identified in all health regions of Puerto Rico, with an incidence level of at least 100 cases per 100,000 individuals. Alternatively, the monitoring system of the U.S. Centers for Disease Control and Prevention (CDC) should reach a high level, which is the red level.

According to Ms. Marzan, all these requirements “have been met.”

The health department encourages people to wash their hands regularly; disinfect surfaces that are touched frequently; and stay home if they are sick.

“If you have fever, chills, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches, tiredness, vomiting or diarrhea, it could be influenza. Make one test and if it is positive, seek an evaluation from a doctor,” said Ms. Cardona.

330 Deaths Nationwide

According to the CDC’s weekly influenza update for the week ending Nov. 4, “Seasonal influenza activity is increasing in most parts of the country, most noticeably in the South Central, Southeast, and West Coast regions.”

The CDC estimates that there have been at least 490,000 illnesses, 5,300 hospitalizations, and 330 deaths from flu so far this season in the United States.

As of Nov. 4, the cumulative hospitalization rate stood at 1.2 per 100,000 individuals. The 2023-2024 flu season’s first pediatric death was also reported.

The national vaccine coverage for adults aged 18 and above was at 28.4 percent. Among children between the ages of six months and 17 years, coverage was 27.7 percent.

Over 145 million doses of flu vaccines have been distributed across the country. Vaccine manufacturers project between 156 million and 170 million flu shots to be administered during this season.