Health Department Tightens School Protocol After 16 Flu Outbreaks and Nine Deaths So Far This Season

The Department of Health (DS) has reactivated a round of training for school directors and school nurses to get ahead of flu outbreaks on campuses, after the Epidemiology Division documented 16 outbreaks in educational institutions since the school year began, amid a season that has already logged 2,816 confirmed cases, more than 266 hospitalizations, and nine deaths tied to the virus ¹.

The update was presented by Miriam Ramos Colón, chief epidemiology officer and auxiliary secretary for Public Health Surveillance and Protection at the DS, during a press conference on Monday, September 14 ¹. Although the island remains below the epidemic season's warning threshold, she warned that "now is the time to act" to reinforce prevention measures, both for influenza and for COVID-19, which she said is also rising ¹.

Background: a previous season that left 232 dead

The alert is not coming out of nowhere. The 2025-2026 season closed with roughly 73,479 flu cases islandwide, with the Caguas region reporting the highest count, and 232 associated deaths ¹. To contain that wave, the DS and the Department of Education, together with private institutions, responded to 426 school outbreaks and administered more than 470,000 vaccine doses ¹.

This year, the Bayamón region has reported the most cases so far ¹. Since the 2026-2027 flu vaccine became available a little over six weeks ago, about 68,166 doses have been administered, Ramos Colón said ¹. Dr. Víctor M. Ramos Otero, the DS secretary, noted that the vaccine is available to everyone over six months old, as well as to caregivers of infants younger than that who cannot yet be vaccinated themselves ¹.

Ramos Colón explained that although the Epidemiology Division had already reviewed respiratory-illness management guidelines with schools at the start of the semester, the emergence of new outbreaks forced them to resume those trainings and conversations with school principals and nursing staff, in both public schools and private institutions ¹. The DS also maintains an official guide on managing and preventing influenza specifically aimed at educational institutions ³.

Children remain the hardest-hit group. Last season, the 5-to-9 age group had the highest case count, but overall the population most affected is children ages 0 to 14, followed by older adults ¹.

What this means for you

If you have children, grandchildren, or family members of school age, this season calls for extra attention. Outbreaks in schools tend to be an early sign that community transmission is climbing, and children ages 0 to 14 are, per the DS's own data, the group most likely to get infected ¹. If you work at a school, public or private, your campus is likely receiving or has already received reinforced guidance from the DS on how to identify and manage an outbreak ¹. And if you are an older adult or have a chronic condition, the risk of serious complications remains high even though the island is technically below the warning threshold ¹.

How to do it / Checklist

1. Get vaccinated now: the 2026-2027 vaccine is available to everyone six months and older at health centers, pharmacies, and hospitals ¹.
2. If you have a baby under six months old, vaccinate yourself and any close caregivers, since the infant cannot be vaccinated directly ¹.
3. Reinforce frequent handwashing and cough/sneeze etiquette at home, at school, and at work ¹.
4. If your child develops fever, cough, or general malaise, see a doctor and request testing to distinguish between influenza, COVID-19, or another respiratory illness ¹.
5. If you are a school director, teacher, or school nurse, contact your corresponding Health Region if you notice an unusual spike in absences due to respiratory illness; the DS specifically asked that outbreaks be reported promptly ¹.
6. Keep children with active symptoms home from school until they have been fever-free without medication for at least 24 hours, per the DS's general guidelines for educational institutions ³.
7. Check the DS's influenza surveillance system for weekly case trends by region before attending large gatherings ².

What's next

The DS said it will continue the cycle of training with public and private schools for the rest of the season, and will keep publishing weekly updates on cases, hospitalizations, and deaths through its surveillance system ¹². The official said that if the current upward trend in COVID-19 alongside influenza continues, the push for combined vaccination will intensify in the coming weeks, especially ahead of large fall gatherings ¹. The stated goal is to avoid repeating last season's toll of 232 deaths ¹.

Sources

¹ Metro Puerto Rico, "Buscan reforzar orientación sobre brotes de influenza en las escuelas," September 14, 2026. https://www.metro.pr/noticias/2026/09/14/buscan-reforzar-orientacion-sobre-brotes-de-influenza-en-las-escuelas ² Puerto Rico Department of Health, Influenza Surveillance System. https://www.salud.pr.gov/CMS/92 ³ Puerto Rico Department of Health, "Manejo y prevención de Influenza en las instituciones educativas" (official guide, PDF). https://www.salud.pr.gov/CMS/DOWNLOAD/8271