Flu outbreak and concurrent deaths in Tasmania…

Posted onAuthorIan M Mackay, PhD (EIC)4 Comments

Okay I don’t want to follow up the last post with another to try and paint a picture that the sky is falling. 

Those described as medically at risk from severe outcomes if infected. From the Immunise Australia Program website [5] 

Influenza (Flu) can kill. That’s my point. It can kill your loved ones – very young, elderly, those with comorbidities. In 2017, the Australian winter’s Flu season has been about the elderly; someone’s grandmother or grandfather, aunt or uncle, brother or sister, mum or dad, son or daughter. The virus cannot discriminate between them or their beliefs, the colour of their skin or who they choose to love.

Viruses infect the cell in front of them if it suitably hugs them, welcomes them inside and has the right stuff in the pantry.

Influenza notifications for Tasmania, 2017. Third biggest annual peak in 5-years. From Department of Health and Human Services, Tasmanian Government.[7]

Flu can cause pneumonia directly or pave the way for a bacterial pneumonia, which has been called the old man’s friend” (elderly person’s friend would be better considered version).[1,2,3] Pneumococcal vaccines and Flu vaccines can help reduce cases of pneumonia.

Yesterday we saw another report of “a number of deaths” in a long term care facility in Tasmania, Australia.[4] (Update: 6 deaths[8]) The facility had an outbreak of influenza A virus. This raises the same questions as in the last post – plus the following:

  • how many deaths (see anew Tweet below, from ABC news Tasmania this morning)?
  • were healthcare workers vaccinated? If not, why not?
  • were the residents treated with antivirals or antibiotics?

In Australia we are lucky to have government funded Flu vaccination for the medically risk groups listed below. If you fall into one of these categories, talk to your GP about vaccination.

In Australia, the Flu vaccine is recommended for everyone from 6-months of age, but is available free under the National Immunisation Program for people at medically high risk from Flu and its complications. From the Immunise Australia Program website.[6]

References…

  1. https://www.health.harvard.edu/newsletter_article/An_update_on_the_old_mans_friend
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071116/
  3. http://www.netdoctor.co.uk/ask-the-expert/cancer/a10366/why-is-pneumonia-called-the-old-mans-friend/
  4. http://www.abc.net.au/news/2017-09-01/influenza-outbreak-fatalities-at-strathdevon-aged-care-latrobe/8865300
  5. http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/medically-at-risk-groups
  6. http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/immunise-influenza
  7. http://www.dhhs.tas.gov.au/publichealth/communicable_diseases_prevention_unit/flutas_2017_report_4
  8. http://www.abc.net.au/news/2017-09-02/six-flu-nursing-home-deaths-in-tasmania/8866068

4 thoughts on “Flu outbreak and concurrent deaths in Tasmania…”

  1. You’re quite right about the need of vaccinate against flu & pneumococci, since H3N2 could be very nasty bug when major antigenic changes appeared. Last year, here in Europe, we had a moderately severe H3N2 seasonal epidemics, started earlier than usual (a thing that happened rarely, in fact the last time I saw an epidemic well before Xmas was at least twenty years ago, except the 2009 pandemic waves). In Italy we had a particularly sever season, with earlier onset of epidemic and very high incidente of ILI among children. Vaccination coverage for influenza in Italy is almost non-existent (for the pediatric age, no vaccines are provided by NHS) and only the elderly access to free shots.

  2. This may be due to the specific H3 clade that is circulating in Australia.
    In Italy the following characterization has been done at the end of the season (remember that first sporadic cases of the 2016/17 season have been detected as early as late August):

    ”Influenza A(H3N2) viruses have predominated during all the season. Since the end of february 2017, an increasing proportion of isolates belonged to B type, but at the lower level. As stated before (epi-update n°14, 22/02/2017), antigenic characterization of H3 subtype remains difficult since the lack of hemagglutination of red blood cells in various animal species. At European level, hemagglutination inhibition test has been performed only on a small fraction
    (around 10%) of the H3N2 isolates at the WHO CC of London. Molecular and phylogenetic analysis confirmed that all recent isolates belonged to the genetic clade 3C.2a, most of them however form an additional subclade 3C.2a1, with following amino-acids residues in the HA: N171K, I406V and G484E, with respect to the vaccine-reference strain A/Hong Kong/4801/2014 (subgroup 3C.2a). WHO and ECDC outlined that the virus belonging to these subgroups were antigenically indistinguishable. However, during the current season, a substantial diversification has been noted in the 3C.2a1 sub-clade, with the appearance of several clusters with further amino-acids residues in the HA, with unclear antigenic significance. In the 3C.2a1 group, the substitution N121K has been identified in some isolates. This substitution is sometimes associated with additional mutation such as T135K o I140M.” (Source: National Institute of Health (ISS): http://www.iss.it/binary/fluv/cont/Agg.Vir_03_05_17.pdf )

    1. Very interesting. I’ve heard tell of H3N2 diversification in Aus too. Will be very interesting to watch. What causes this decreases haemagglutination? Not a molecular Flu expert, but thought that was a pretty integral aspect.

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