Australia has had a big summer of flu with numbers way up from what we’re used to.
Photo by Kelly Sikkema on Unsplash
As my recent posts here and here flagged, it’s hard to know whether this isn’t just the new normal. There’s been a lot of new fast influenza (flu) virus testing added over the past two years. But maybe something different is happening. I thought I’d throw together some recent stories that might suggest this is more about the virus than the testing.
It is an unusual season
More confirmation – although the data are solid – that we’re seeing a good number more laboratory-confirmed flu cases than normal…
“About 3 or 4 times what we normally see this time of year”
-Professor Ian Barr, Deputy Director, World Health Organization Collaborating Center for Reference and Research on Influenza, Australia.
Professor Barr makes it clear that we’re still pondering what’s underlying this strange interseasonal flu activity. There is no single indicator of why this is a year with a difference. There have been out-of-season outbreaks in nursing homes, some posit a relationship to travel [4] and others propose a link with summer crowding. These would need to be different patterns from those we experience in previous years to be a cause.
These came out during the local Immunisation Coalition’s [2] annual scientific meeting,[3] along with some details on next season’s influenza vaccine formulation (official info came out in September and can be seen here [5])…
You heard it here. Your new 2019 #flu vaccine 🦠🦠 @immunisationgap pic.twitter.com/yR6fTnMLEC— Dr Ginni Mansberg (@Dr_Ginni) February 3, 2019
New South Wales notes that numbers
#Flu in #Queensland.
Weekly notifiables report at: https://t.co/VW1ueESuZb
😷432 notifications to week beginning 28JAN2019
🤧QLD total: 2,155
🔖year-to-date mean of 2014-2018: 726
🔖 2019: so far 3 times higher than that mean
Which Flu virus?
Western Australia reports 78% of characterized viruses being A/H3N2[8] while New South Wales reports 159 A/H1N1 viruses among 399 (40%) typed viruses followed by A/H3N2 (28%) and Flu Bs (32%).[9] In South Australia Flu A is dominating and, as elsewhere, counts are well above the previous 5-years at this same time.
With some increases in H3N2 apparent over summer, it’s interesting to wonder whether we might be seeing a virus that’s drifted enough genetically to have escaped all that immunity out there among those who were infected during the huge 2017 season.
Detailed Flu reports
These are rarer at this time of year, but some States are helping us to understand what’s happening in Flu-land. Western Australia’s (WA) Communicable Disease Control Directorate really shows the summer
More hospital visits and sick days than normal.
All of this so far has been the result of increased laboratory testing numbers. But what if that’s just due to more samples being tested (for whatever reason)? Is there any evidence for more people being sick with Flu over summer this year? These next two links suggest the answer is definitely probably.
In Queensland, Gold Coast Health reported that the number of people attending emergency departments hit an all-time high and among those were a higher-than-normal number of people testing positive for the Flu virus.[1]
In Western Australia, more staff in workplaces have been calling in sick with Flu-like illness, than normal for summer.[4]
So there do seem to be more sick people around, not just the use of cool testing technologies on the normal number of sick people during summer.
Flu viruses; here all year
This is all a nice reminder that Flu viruses can circulate and cause illness at any time of the year.
While they usually float in droplets under the radar during the warmer months, something different has happened this summer. Something we’ll have to wait for those whacky Flu boffins to clear up and then communicate to us. For now, there is no good explanation for what’s happening but Flu cases have been way up, as have Flu virus-positive test results.
References
- Record number treated in Gold Coast hospital emergency departments
http://www.mygc.com.au/record-number-treated-in-gold-coast-hospital-emergency-departments/ - Immunisation Coalition
https://www.immunisationcoalition.org.au/ - Summer flu spike on RN Breakfast – Separate stories podcast
https://radio.abc.net.au/programitem/pgE7JRQgj7?play=true - Summer flu on the rise in Perth
https://thewest.com.au/news/wa/summer-flu-on-the-rise-in-perth-ng-b881091862z - https://www.who.int/influenza/vaccines/virus/recommendations/2019_south/en/
- https://ww2.health.wa.gov.au/Articles/F_I/Infectious-disease-data/Virus-WAtch
- https://www.news.com.au/national/nsw-act/summer-influenza-cases-double-in-nsw/news-story/3a42bd85804800b4c07fdd9015399faf
- https://ww2.health.wa.gov.au/Articles/F_I/Infectious-disease-data/Virus-WAtch
- https://www.health.nsw.gov.au/Infectious/Influenza/Pages/reports.aspx
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Some hint from the extreme weather condition of this summer?
H1 from travellers? If they were from Europe, it need to keep into account the very high intensity of activity in some European countries, namely Italy, where the 0-4, 5-15 classes of age are seeing a high attack rate. In a single week, nearly 5% of children fell ill with influenza-like illness. Albeit minimized by public health officials, the situation is grim, with two consecutive influenza season with substantial morbidity and mortality, due in part to the negligible vaccine coverage. This season, the record low coverage due to the vaccines stock rupture early in the course of immunization campaign. Why all these avoidable illness and deaths?
Be aware Aussie people that H1 is still strong and probably is better to get the flu shot, irrespective of individual health status or chronic conditions.
We’ve come off one of the biggest flu vaccine uptake ever as I understand it. Perhaps a reason for out very minor season in the southern winter of 2018. I simply don’t believe travel patterns have changed this year compared to others. I think it’s the uptick in H3N2 and the variability in those strains that is inherent to their success (from a viruses POV).