Flu season is back! Experts recommend getting vaccinated to ensure you are protected

Nasifa Sulaiman

Feverish, achy, zero energy, a throat like you’ve swallowed razorblades, a lingering cough, even tummy issues...

The flu doing the rounds is no joke and if we haven’t had it ourselves yet, we’re bound to know someone who has.

 It left Jaimie Davids, a 28-year-old teacher from Cape Town, flattened for days. “I had this heavy feeling in my head and I was coughing a lot,” she says.

“As a teacher I’m used to coughing a lot because of all the talking I do, but this was something else. I’ve never had flu like this before.”

Jacques Watermeyer (54) from Jeffreys Bay can relate. “I was down for more than a week,” he says. “I found it extremely difficult to breathe and that’s the thing that gets to you.”

Which, after the terror of Covid, is perfectly understandable - we all know how quickly that escalated into a nightmare.

The Department of Health recently urged the public to take extra care to protect themselves against respiratory infections which increase over the winter season.

So, is this normal or should we be worried? We asked the experts.

IS IT A NEW STRAIN?

 The answer is no.

Daniel Kapelus, a vaccinologist at Wits’ Vaccines and Infectious Diseases Analytics Research Unit, says flu season usually runs from April to September and there are several strains that circulate.

There are two main types of influenza that cause illness in humans: flu A and flu B, with flu A generally being more pathogenic and flu B being milder. Flu A strains are defined by an H type and an N type.

“What we are seeing now is basically the H1N1 (influenza A) virus which is the 2009 pandemic strain but it’s no longer as virulent because most people have some pre-existing immunity to it through exposure and vaccination. We’re also seeing the H3N2 strain (another variety of influenza A),” he tells YOU. Flu B generally appears later in the season, but is less of a concern.

Gauteng-based clinical virologist Dr Ramokone Maphoto says the rise in flu cases is because of constant changes in the flu virus - viruses continue to mutate because that’s the way they survive.

“Influenza viruses are highly variable. They go through minor changes every year, thus ending up with different strain than the previous one. These changes are the cause for seasonal influenza epidemics,” she says.

In other words, our immune system builds up a resistance to a virus and when it changes we become vulnerable again because the germs are different.

WHY IT’S ON THE RISE

 There are several reasons, including declining numbers of people seeking vaccination and socio-economic factors.

Because a large percentage of the population is underprivileged, infection can be easily spread in densely populated areas where ventilation in homes is poor.

But our Covid history is also playing a part with something called "vaccine fatigue", Kapelus says.

“Vaccine fatigue refers to people’s inertia or inaction towards vaccine information or instruction due to perceived burden and burnout - there was just so much information and instruction and focus around the Covid-19 vaccines that some people aren't responsive to further discussions around other vaccines,” he says.

However, the impact of these infectious diseases won’t diminish itself, so it is important that we keep up with whatever vaccines are required at a particular timepoint in order to limit the impact of circulating diseases. It may also be an access problem but we're doing everything we can to increase equitable access to vaccines,” Kapelus adds.

HOW IT PRESENTS

Influenza has a wide range of symptoms. Some people can have the virus without even realising while others can get severely ill. In extreme cases it can even lead to death.

“Uncomplicated cases mostly presenting at a primary healthcare have fever, headache, muscle pains, fatigue, sore throat and runny nose,” Maphoto says.

“Severe cases may present with viral or bacterial pneumonia, ear infections, sinus infections and worsening of an existing chronic condition.”

Dr Charl Verwey, head of paediatric pulmonology at Wits University, says it’s often difficult to differentiate between flu and other viral respiratory tract infections. But he adds flu usually has quite a rapid onset and if there are no complications people should start feeling better after three or four days.

Over-the-counter treatments such as ibuprofen and paracetamol are usually sufficient in treating symptoms.

“There's an antiviral drug available called oseltamivir, but this needs to be administered very early during the onset of the infection and generally only improves the duration of symptoms by one or two days,” Verwey says.

Antibiotics are only prescribed if there's a secondary infection - a viral infection like flu won't respond to antibiotics.

“If your symptoms aren’t resolving then you might not have flu but a bacterial chest infection, for example,” Kapelus says. “If your symptoms don’t improve it’s important your doctor examines you to make sure you get the right treatment.”

IS IT LINKED TO COVID?

It isn’t. What we're seeing is a return to a normal flu season after the interruption of the pandemic.

“The flu season was majorly affected by Covid with very few cases during the pandemic,” Verwey says. “But for the past season it's been normal.”

This flu strain is no more or less dangerous than in the previous seasons, he adds - and as in previous years those most at risk are the very young, people over 65 and those with pre-existing diseases such as heart and lung conditions, diabetes, TB and obesity.

“The flu itself will not get worse infection-wise but the numbers will dramatically increase over the next few weeks and months,” Verwey says.

We should always be concerned during flu season, he adds. “Every year there are approximately three to five million severe cases requiring hospitalisation worldwide and around 500 000 flu-related deaths.”

VACCINATE, VACCINATE, VACCINATE

Flu vaccinations are recommended for all as they're effective in preventing severe disease, Verwey says.

“Every year the flu strains that are circulating are monitored and the vaccine is adapted so

it will be effective against the strains found. It's a very efficacious preventative technique to limit the infections caused by flu,” he says.

Dr Jocelyn Moyes, a medical epidemiologist at the Centre for Respiratory Disease and

Meningitis at the National Institute for Communicable Diseases, says the vaccine is available nationwide and safe for everyone over the age of six months.

“Ideally the vaccine should be given in late April or early May before the start of the flu season but it's never too late to vaccinate,” she says.

People with high-risk factors, including pregnant women and women up to six weeks postpartum, are strongly encouraged to get vaccinated. You can get a flu vaccination at any pharmacy or clinic at a cost of between R95 and R150.

Most medical aids cover the cost and people who rely on government healthcare can get it for free at most government clinics, although Kapelus says people in high-risk groups are prioritised.

He stresses flu season always needs to be taken seriously. People tend to say, ‘I’m not worried because I’m young and fit and I’ll be fine’ - but maybe you'll give it to someone who won't be fine.

“Getting vaccinated saves lives. You can have the best vaccine in the world but if it stays in its vial, it will never save a life.”