A year after emergency rooms and urgent care centers were strained by a spike in flu cases, all seems relatively quiet now in Butler County, said the director of Butler Health System’s Emergency Department.

In December 2014, Dr. Dave Rottinghaus’ department, which normally treats about 130 people a day, was seeing as many as 180 people a day, and the state Department of Health had confirmed 442 cases of the flu in Butler through Dec. 27.

But this year Rottinghaus said confirmed cases of flu are few. The department hasn’t seen a broad influx of any seasonal, communicable diseases, and is seeing more “gastrointestinal-type illnesses” than flu cases this year.

At this point doctors believe that’s because this year’s influenza vaccination has proved more effective than last year, he said.

“Really it’s a guess,” Rottinghaus said. “They’re guessing which viruses to include” in the vaccine, which only targets the flu, not gastrointestinal illnesses.

The difference between the illnesses may seem minor to many people. They often combine influenza, which affects a person’s upper respiratory system, with gastrointestinal infections, which Rottinghaus said cause vomiting, diarrhea and other symptoms concentrated in a person’s digestive tract.

“Some people call it the ‘stomach flu’ but that’s really a misnomer,” Rottinghaus said.

In addition to their symptoms, the illnesses also spread in different ways. Rottinghaus said gastrointestinal illnesses can generally be stopped by good handwashing and general hygiene, as well as avoiding sharing straws or other items that bring people in contact with either other’s bodily fluids.

Influenza is more highly communicable, Rottinghaus said. To avoid spreading the flu virus, people need to remember to cover their mouths when they cough, wash their hands, and avoid being around people who are exhibiting flu symptoms.

Because it’s easily spread, the best way to avoid getting sick is to get a seasonal vaccination against the disease.

If you do come down with symptoms, focus on keeping yourself hydrated and limiting your exposure to other people, Rottinghaus said. If your symptoms worsen or persist, or you have other medical problems that could be exacerbated by the illnesses, the best action is to see your primary care physician or got to an urgent care center an emergency room.

“Most people who don’t have a lot of medical problems are going to tolerate both just fine,” Rottinghaus said. “Older folks and younger folks and people with significant medical problems have to be the most on guard and seek help.”

Despite the absence of widespread flu cases this year, Rottinghaus said the season is far from over.

“There is a lot of unpredictability, and it (flu) can hit anytime from October to May,” he said. “I wouldn’t count this season out. We’re definitely not out of the woods yet.”