Pat Campbell is the public health nurse for Pittsfield – the largest and most densely populated community in largely rural Berkshire County.
She says the ramp up to this year’s harsh flu season in the city of around 43,000 residents began as far back as late August, but really took off during the holidays.
“I've seen cases this year for a number of weeks that were well over 20 cases, 25 to 30s- low 30s, I would say, on a daily basis, coming through," said Campbell. "So, it is a really high rate.”
According to the Massachusetts Department of Public Health, the end of 2025 far outpaced recent years in terms of emergency room visits for the flu by a dramatic margin. The week of Dec. 21 to Dec. 27 saw almost 6,700 such visits, compared to around 2,400 during the same week in 2024.
“It is very contagious," said Campbell. "It is a virus, a respiratory virus. It will stay around for a while on high touch surfaces, and it is easy to pass along. And it starts out sounding like a cold if you're younger. Sometimes that includes vomiting along with the aches and pains, fever, and generally feeling lousy. But sometimes with children, like I said, it has vomiting in addition to that headache. Severe headache is a common thing, and it does not take long to spread.”
So far, at least 107 adults and five children have died from the flu in Massachusetts this season.
One of those deaths was in Pittsfield.
Campbell says anyone with a fever of 104 or higher is sick and should stay home, rest, and hydrate, using at-home testing to monitor their condition.
Berkshire Health Systems, the county’s largest health care provider, operates the region’s major hospitals in North Adams, Pittsfield, and Great Barrington, as well as numerous other facilities and offices. Spokesperson Michael Leary says BHS is at a moderate warning level for virus transmission.
“We're currently at yellow, and it actually looks like those numbers may be going down rather than up," he told WAMC. "We did start January with a pretty significant increase in the number of flu cases in the community. COVID-19 numbers have gone from fairly low to moderate range and now back down to low again, and RSV seems to be, at least at this point, very low in the community. So, we're hopeful that maybe we are plateauing when it comes to influenza, which has been the most virulent virus that we have seen so far in this respiratory season.”
Volunteers in Medicine Berkshires, which provides healthcare for people ineligible for insurance, says the community it serves is feeling the flu surge, as well as RSV and COVID cases. Executive Director Ilana Steinhauer says now is the time to ensure community members have access to care, including vaccines.
“These illnesses always reach a community that's underserved more," she said. "They're oftentimes working in closer conditions, they're living in homes that have more people oftentimes. We want to prevent these community illnesses from escalating. We want to prevent those secondary effects and prevent hospitalizations.”
For economically vulnerable Berkshire residents, sickness often has a quick and painful ripple effect.
“Anytime anyone is sick, they can't go to work, your kids can't go to school," said Steinhauer. "For people who are struggling, those moments can lead to not being able to pay rent, not being able to make a car payment or a phone payment. And so ensuring that we can keep our clients healthy, our community healthy, keep those viral illnesses lower, and especially prevent those secondary impacts that lead to more missed days of work and school.”
Berkshire County, with its low population and small communities dotting a large, hilly landscape, faces unique public health challenges.
“We don't have the pharmacies that other parts of the state have, and I am not always sure that Boston quite understands that," Jayne Smith told WAMC. "And so I think that it's a little bit harder for our citizens to find a vaccination or schedule one, just because we don't have a lot of pharmacies, and there's a shortage of pharmacists as well.”
Primary care physicians can also be hard to come by, says Smith, the Shared Services manager for Southern Berkshire Public Health Collaborative, which supports 12 boards of health in the region from its Stockbridge headquarters.
“We don't have the robust amount of primary care physicians that other areas might have, which also is a barrier, not just to preventative but also when you're actually ill," Smith continued. "It puts people in a in a harder situation to get the care that they need. But I think that one of the biggest issues in Berkshire County that you might not see everywhere in Massachusetts is that we are have a lot of outside visitors come in, and so it's not only our own communities that are circulating these viruses, but you also get input from other areas because of the people coming from other areas, and that's a little bit harder to get that public messaging out.”
Heading back to Pittsfield, public health nurse Campbell expects more flu and COVID cases this winter -- particularly for the unvaccinated. She says vaccines are a critical tool.
“It will definitely help to reduce that severity, it will reduce risk of hospitalization, and it will reduce risk of death," the public health nurse told WAMC. "So it is not just the flu. People get cardiac issues as a result of this, a lot of times they get pneumonia. So there are other complications. People don't necessarily die from the flu, but it could well be the complications they see."
Campbell says the flu season could extend as far as into May.
