Cuyahoga County has highest flu hospitalization rate in Ohio, but numbers are down this year – cleveland.com

CLEVELAND, Ohio Ohio for weeks has had some of the highest flu rates in the country, with Cuyahoga County leading the state in flu-related hospitalizations.

But theres another side to the trend. Hospitalizations in Cuyahoga County are actually down this year over a year ago. In fact, outside of two COVID-19 seasons when flu reports dropped to very low levels, this could end up being the lowest year for flu-related hospitalizations in the county since 2015-16.

And county health officials have rated overall flu activity as low for much of the current season.

How could Cuyahoga County be ranked No. 1 for hospitalizations and the rate per 100,000 residents, yet be reporting low flu activity for the last seven straight weeks? The Ohio Department of Health deferred to the county.

Flu activity levels are calculated using factors beyond just hospitalizations, said Vino Panakkal, epidemiologist supervisor at the Cuyahoga County Board of Health.

The flu activity rating is determined by the county through four variables: hospitalizations, school absenteeism, emergency department activity, and over-the-counter medication sales, Panakkal said. These are many of the same criteria the state uses to monitor flu activity.

For example, for the week ending March 10, the county reported 62 flu-related hospitalizations, school absenteeism for any illness at 4% (a flu breakdown was not available), 200 emergency-room visits for flu-like symptoms, and about 230 over-the-counter sales of flu medicines and thermometers.

For that particular week, versus the same week the previous year, numbers were up slightly, with the exception of being down for the medicine sales. But both emergency room visits and medicine/thermometer sales through the season have been running below the five-year median.

As for hospitalizations, the county to date this season has accounted for 12.1% of the flu hospitalizations statewide, down from 13% a year ago. In some years it has been much higher, such as 18.7% in 2019-20, 17.2% in 2015-16 and 16.1% in 2017-18, according to the Ohio Department of Health.

And in pure numbers, in comparison to the 922 hospitalizations so far this flu season, there were 1,156 at this time last season. Season totals in recent years have been as high as 2,769 in 2017-18 and 2,060 in 2019-20.

Yet Cuyahoga County has a rate of 7.83 flu-related hospitalizations this season per 100,000 residents the highest in Ohio, according to state data released Friday.

That rate is well above the hospitalization rates for other populous counties, such as Franklin, home of Columbus (5.57); Hamilton, home of Cincinnati (5.17); and Montgomery, home of Dayton (5.29).

Additionally, the share of hospitalizations in Cuyahoga County has shrunk over the last few weeks.

Theres no research on why Cuyahoga has higher hospitalizations than other counties, Panakkal said.

Statewide, Ohios level of flu activity is ranked very high, after weeks of increasing flu spread, according to CDC. Only Ohio, Nebraska and the District of Columbia were rated as very high for influenza spread in the latest Centers for Disease Control and Prevention map released on Friday, though the data used for the update lags by a week.

Through early March, Cuyahoga County had seen nine flu-related deaths, down from 16 at the same time last year, Panakkal said.

The flu season typically runs from October to May.

(Flu activity) is definitely not as high as it was last year, Panakkal said.

Elsewhere regionally, Summit County reported moderate flu activity, and Medina Countys flu activity is under its five-year average. Ashtabula Countys flu activity is running low to moderate.

Yet, flu activity is high in Lorain County, and some indicators are above five-year averages in Geauga and Lake counties.

Nationally, CDCs preliminary assessment puts this season as moderate for all ages.

Panakkal said she needed a more in-depth look at flu county vaccine data to determine why flu spread is low to moderate in Cuyahoga and some nearby counties, but high in the rest of the state. Nationally, just under half the people have received the vaccine.

After five weeks of sharp decline between late December and early February, the number of weekly flu hospital admissions nationally has been trending downward slightly since mid-February.

The CDC estimates that there have been at least 28 million illnesses, 310,000 hospitalizations, and 20,000 deaths across the country from flu so far this season.

The CDC ranks a flu seasons severity by looking at the number of Americans who sought medical care for flu-like illness, how many were hospitalized for flu, and how many flu deaths occurred.

The effectiveness of this seasons flu vaccine against the influenza A and B strains in circulation this winter helped slow spread of the virus and protected those who got the jab from serious illness, health experts say.

The flu shot was as much as 44% effective in preventing flu-related hospitalizations in adults, and up to 61% effective in preventing flu-related hospitalizations in children, said a recent CDC report. Its about the same as in previous years.

Thats pretty good, especially for children, Panakkal said.

This influenza season has followed the usual cadence of peaking in December and early January, then decreasing in March, Panakkal said. The flu season officially ends in May.

However, everyone should remain vigilant against all of the winter respiratory viruses influenza, COVID-19 and respiratory syncytial virus as winter winds down. These viruses can cause severe illness, especially in the elderly and people with weakened immune systems, Panakkal said.

More than 100 children have died of the flu this season across the country, according to the CDC, though there have been no pediatric deaths reported in the Cleveland area. Children with underlying health problems are more at risk for severe outcomes if they catch influenza.

Flu prevention measures, including getting a flu vaccine, practicing good hygiene such as frequent hand washing, and staying home when sick.

Flu activity locally and nationally was much higher in the years prior to COVID-19. For instance, Cuyahoga County ended the 2019-20 flu season with 39 flu-related deaths and more than 2,000 hospitalizations numbers far above this seasons statistics, Panakkal said.

Something similar has been seen in Ashtabula County, said Elizabeth Holden, emergency preparedness coordinator/epidemiologist for Ashtabula County Health Department.

The influenza virus is constantly adapting and mutating. The COVID-19 pandemic has surely impacted the way the virus interacts with its hosts, Holden said.

During the height of COVID-19 response, influenza-associated hospitalizations in Ashtabula County decreased. Since the 2022-2023 flu season cases have begun to return to normal numbers, Holden said.

Researchers arent certain why the flu has been less severe post-COVID-19, Panakkal said. Increased awareness overall about vaccines in general and the importance of hand washing, along with more acceptance of mask wearing and staying home when sick, may be among the contributing factors, she said.

Among Cuyahoga and its surrounding counties, Lake County has seen the highest number of flu-related deaths this season at 11, followed by Summit County with eight and Geauga County with seven, while Ashtabula County has recorded zero flu-related deaths, according to data available through March 9.

There were two deaths reported each in Lorain and Medina counties. Portage County health officials said they do not receive reports on flu deaths.

In Lake and Geauga counties, the current influenza season is worse than the previous five-year average, said epidemiologist Joseph Rombough, who has access to data from Lake and Geauga counties.

In Geauga County, there were 68 flu-related hospitalizations so far this season, more than in the entire previous flu season, Rombough said.

There have been slightly more Lake County flu-related hospitalizations so far this season (171), than the entire 2022-23 flu season (163), according to county data. Rombough said.

Elsewhere, after Cuyahoga Countys 922 hospitalizations, there have been 314 for Summit, 237 for Lorain, 121 for Medina and 70 for Ashtabula. No data was available for Portage County.

Julie Washington covers healthcare for cleveland.com. Read previous stories at this link.

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Cuyahoga County has highest flu hospitalization rate in Ohio, but numbers are down this year - cleveland.com