I’m not joking around when I say vaccines have been created to reduce the worst of the diseases caused by some infectious nasties. We all know about the success of vaccines in dealing with smallpox and almost eradicating polio but I wonder if we think enough of them as being important to deal with influenza (Flu) viruses.

A portrayal of >200 known and genetically distinct respiratory viruses that infect humans are constantly circulate.

It’s true that we can get mild illness after Flu virus infection or ‘flu-like illnesses’ caused by one of hundreds of other viruses) but there are many among us – from all walks of life and from all ages, who can acquire a flu infection and get very ill. Some can even die.

As you’ve probably already heard[1], parts of Australia have had their worst influenza season in years. Queensland’s has been rightly described as the worst in the past 5-years.[2]

Victoria’s Department of Health and Human today reported the Flu-associated deaths of 7 elderly residents, all with comorbidities, in a long-term care facility.[3,4]

Date from Queensland Health Statewide Weekly Influenza Surveillance Report, 1JAN-27AUG2017

In Queensland – I refer to my home State again because after weeks of being buried in publicly available State flu reports this season, Queensland by far produces the best weekly Flu data in Australia – we can see that this season has been particularly harsh among the elderly who make up the greatest numbers of confirmed cases seeking hospital care. This the pattern for an A/H3N2 dominated Flu season – the elderly bear the brunt of disease.

But some questions remain.

• which Flu virus subtype (presumably A/H3N2) was the cause?
• was it only one variant in the facility?
• were other virus contributing (other As, FluB, coronavirus and HMPV are around)
• how many residents were vaccinated? How many were immune after that?
• how well-matched was the Flu virus(es) was to the vaccine?
• how far apart were the deaths were spaced?

Some of these details may not come out for quite some time. The fraction of Flu viruses that have been strain-typed from cases in Victoria so far, show matches to those strains included in the seasonal vaccine.[4] But Flu vaccination rates are much lower in Australia than rates for other vaccinations. For example, 75-80% in the elderly, 50% among pregnant women, below 10% in children and in high risk groups with chronic disease, only around 30%.[5] It’s not clear, but that may be no different from last year so it remains unclear what has driven 2017’s huge Flu case load in some States. Answers won’t come in time to help out our northern hemisphere friends as they enter autumn. But they have a vaccine.

We know that Flu vaccines need to be more effective but they are still a much safer bet than getting the Flu. This is true for the vast majority of those vaccinated, who include those at medically high risk of severe complications and death.

A ‘universal Flu vaccine’ we’re told, like Christmas, is coming. Hand washing and surface cleaning, care when coughing and sneezing, disposal of used tissues and staying away from work and vulnerable populations are all very important factors for minimising the local spread of Flu viruses. But they won’t stop its spread. We have antiviral drugs for Flu – most effective if prescribed early. We have vaccines. Hopefully carers in facilities like the Victorian one got their Flu shots to reduce the risk of bringing a deadly virus to their susceptible charges. 

At the end of the day though, this is a respiratory virus and they are hard to contain. That’s why we see epidemics of Flu and other such viruses every year.

Sadly, this single incident reminds us of the real risk to our loved ones from Flu infection – even in today’s more hygienic and medically tech’d up world, Flu still kills.

To the north I say: Flu is coming and we have no dragons to offer by way of aid.

References…

1. https://theconversation.com/this-may-not-be-the-biggest-flu-season-on-record-but-it-is-a-big-one-here-are-some-possible-reasons-82642
2. https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/diseases-infection/surveillance/reports/flu
3. http://www.abc.net.au/news/2017-09-01/seven-people-in-victorian-aged-care-facility-die-of-flu/8863278
4. http://www.vidrl.org.au/surveillance/influenza-surveillance/
5. https://thewest.com.au/news/health/australia-is-in-the-grip-of-the-worst-flu-season-on-record-but-wa-may-get-off-lightly-ng-b88568275z