It was an outbreak that forced public health emergencies: the flu struck across Massachusetts, leaving 18 people dead and more than 6,000 infected.

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Weeks later, is the flu emergency over?

At the emergency room at Brigham and Women's Hospital in Boston, Joshua Kosowsky said things are finally quieting down.

"In the first week of January we were seeing an additional 30 to 40 patients a day with flu like symptoms,” he said. “Now it's just a handful."

Kosowsky said even vaccinations didn't stop all types of the flu. There are technically 3 strains out there.

"During the peak of the flu epidemic our staff -- even some staff who had been vaccinated -- got the flu, so that was an additional strain,” he said.

The strain took the lives of 18 people in Massachusetts since December. Most of those were in Boston.

"We do know of 13 deaths due to influenza,” said Anita Barry, director of the infectious disease bureau at the Boston Public Health Commission. “Twelve of them in seniors and one in a younger person."

City, state and federal public health officials have been tracking the number of flu-like cases showing up in clinics, school nurse’s offices and hospitals. Dozens of free clinics were set up for vaccination, and in some towns, a 24-hour hotline for residents who have flu-related questions. A widespread outbreak of flu in Boston prompted Mayor Menino to declare a public health emergency last month.

"We are announcing that in partnership with our community health facilities, free flu shots across our city in a coordinated effort with the public health commission,” Menino said at the time. “There will be special hours and special attention given to this effort. We'll provide extra doses to accommodate this important campaign."

Even though everyone is encouraged to get vaccinated, Barry said the elderly and children continue to be at highest risk, along with pregnant women. What's been difficult is helping people decide whether they need to go to the hospital. Kosowsky said the treatment is likely what it would be at home.

"For the vast majority of patients the treatment is supportive care,” Koskowsky said. “It's the things your mom told you when you were a kid and you had the flu. You take Tylenol and you get plenty of rest and fluids. For the sickest patients we have anti-viral medication that's particularly effective if started within 48 hours of the onset of symptoms."

Hundreds of thousands of people took all this advice, and at least half of the population is estimated to have been vaccinated, so the question looms -- if you didn't get a flu shot, do you still need one to get through winter without getting the flu? Kevin Cranston at the state health department says yes: Get a shot.

"People should consider getting vaccinated until the flu season is over," he said.

Flu season lasts until the end of March.