Twin Cities area hospitals and state health officials are responding to the deadliest flu outbreak in years by adopting new strategies to combat the virus and better protect the public.

For the first time, some hospitals have started to monitor patients year-round for potential flu symptoms, rather than wait for the traditional winter season. And state health experts expect to have a new, more comprehensive vaccine available this year.

A particularly severe strain of flu killed 201 Minnesotans and sent more than 3,000 to emergency rooms in the most recent season, which began last October and ended two weeks ago. At its peak, the outbreak caused many hospitals to adopt tight visiting restrictions and led state health officials to establish a special vaccine supply exchange.

Most of the deaths occurred among the elderly, which is normal for many strains of influenza. However, the situation was made worse by the fact that last season's vaccine was often ineffective in protecting the elderly. Scores of children and teens also required hospitalization.

"We never had this many lab-confirmed cases," said Patsy Stinchfield, director of the infectious disease division at Children's Hospitals and Clinics of Minnesota. Children's had a record 1,085 lab-confirmed cases of flu; the previous high was 790 during the H1N1 pandemic of 2009-2010.

Kris Ehresmann, director of infectious diseases for the Minnesota Department of Health, characterized the 2012-13 outbreak as falling within the "normal" range of flu seasons, which can vary in duration and virulence, but at the severe end of the range.

At Fairview Southdale Hospital in Edina, the staff will now be on the lookout for flu symptoms at any time of the year. Any patient admitted with a fever over 100.4 degrees, cough and a sore throat — all classic symptoms — will be monitored for the flu.

Because the flu virus is constantly mutating — last season's dominant strain was known as H3N2 — public health officials typically design a new vaccine each year.

This year, for the first time, the formula will be "quadrivalent," meaning it will protect against two A-strains and two B-strains, said Ehresmann. While the flu vaccine is never 100 percent effective, health officials hope that the new formula will offer more protection than previous vaccines.

"Basically, you are getting more bang for your buck," Ehresmann said.

Last year, Twin Cities area clinics and health officials started to report flu cases Oct. 1, leaving many ERs packed.

"It started early — we started to see a large number of reports from hospitals and schools, really, at the end of the winter holiday," Ehresmann said.

Dawn Twenge, who works in infectious disease prevention at Fairview Southdale, said, "We really don't know how many people were in the ER — but it was a ton."

At the peak of the outbreak, more than 40 states reported "widespread" flu activity to the U.S. Centers for Disease Control and Prevention.

Ashley Griffin • 612-673-4652