As the flu season worsens, local hospitals have begun discouraging or flatly restricting visits from children and anyone with symptoms of respiratory illness.
UNC Hospitals in Chapel Hill this week banned children under the age of 12 entirely from inpatient areas, waiting areas and play rooms. Children are still allowed in outpatient areas, and the system is asking adults with symptoms such as fever, chills, fatigue, sore throat and nasal congestion to stay away.
In a statement announcing its new policies, UNC officials wrote that more than 200 of its patients had tested positive for flu, and three of them had died.
Other hospitals in the Triangle have enacted a variety of flu-related policies for visitors.
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Last week, Rex Healthcare in Raleigh began barring children under 12 from patient care areas of its emergency department. It has posted signs encouraging everyone with cold or flu symptoms to stay home, as has Duke Medicine in Durham.
At WakeMed in Raleigh, child visitors have been restricted from some areas, said Debbie Laughery, a hospital spokeswoman. Those include the pediatric intensive care and neonatal intensive care departments, among others.
That policy has been in place since September, she said, and wasn't specifically aimed at flu, but rather at an array of respiratory illnesses that had become more common. WakeMed, like Rex and Duke, is keeping an eye on the flu situation and will tighten its polices if things get bad enough.
Hospitals carefully weigh any decisions to restrict visitors, Dr. Cameron Wolfe, an infectious disease expert at Duke, wrote in an emailed response to questions Wednesday.
"Ultimately it's about the safety of our inpatients and our staff, and balancing that against our natural desire to visit sick loved ones," he wrote.
Duke's flu policy leads it to re-emphasize several precautions each year when cases begin popping up, he wrote. Those precautions include lots of hand washing, aggressively testing patients for the virus, encouraging sick staff members to stay home, and making sure all at-risk patients and members of the hospital staff are vaccinated.
Duke re-evaluates its flu-related policies several times a week from November through March, looking at the rate of cases and suspected cases it is seeing. It also considers statewide data and the latest information from the U.S. Centers for Disease Control and Prevention.
So far, Duke has decided against tougher restrictions on visitors.
"No one likes to implement visitor restrictions unless it's really necessary, especially at Christmas when so many families want to visit their loved ones in hospital," Wolfe wrote. "But we've certainly done it before and will be watching this season's developing flu rates closely."
Across the state, flu cases have become more common in recent weeks, according to data traced by the state Department of Health and Human Services.
Two factors have added to the potential for a particularly bad flu season this winter. The main strain of the virus that is showing up this year has evolved slightly, making the vaccine only about half as effective as hoped. Also, that strain is H3N2 - which was the dominant strain during the nation's three deadliest flu seasons of the past decade.
Adding to those problems is a local shortage of Tamiflu, a key drug used to blunt the impact of the virus, particularly among patients at risk of serious complication and death.
At least five people across the state have died from flu-related complications since the season began.