Facing up to the flu

Flu kills at least 5 000 South Africans a year and although experts vary in their predictions for the impact of this year’s flu strains, one thing is certain, an anti-flu injection is a must.

This winter, we can expect a return visit from the virulent Sydney virus, which first arrived in South Africa two years ago. And we can expect two new unwelcome visitors, the New Caledonia and Yamanashi strains, as well.

Yet flu is preventable. An anti-flu vaccine will significantly increase resistance to all three strains of the virus. Flu injections are available from doctors and pharmacies at a cost of about R40. The optimum time to be innoculated is March, a month or two before winter begins to set in.

While most experts agree that there is no scientific way to predict the severity of the flu we can expect this winter, they all endorse the anti-flu vaccine. They say immunisation is advisable because it reduces the average person’s chances of catching flu by 60 to 80 percent. In healthy, young adults, the vaccine is at least 70 to 90 percent effective in preventing illness.  

Even if an immunised person still gets flu, their symptoms will be fewer and milder. According to Dr Stephen Toovey from MedInfo, the chances are high that that we are in for a worse flu epidemic in South Africa this year than that which has already struck the United States and United Kingdom.

In Britain, there have been more than 200 000 emergency hospital admissions in the past few weeks and people have been asked not to call on doctors except in urgent cases, to allow them to handle the heavy flu case load.

In the United States, the Centre for Disease Control (CDC) reported that 9,3% of all deaths were caused by influenza and pneumonia during the first week of January this year. This means that flu in the USA has now reached epidemic proportions.

According to Toovey, Britain and the UK have only had to deal with the Sydney flu strain. He argues that the New Caledonia and Yamanashi strains, on route from the East, pose a bigger threat, as they are new flu strains for which South Africans have not yet developed any immunity.

“Two years ago, we had a shocking epidemic with Sydney flu. Now, with two new strains, it could be twice as bad. You could get flu twice this winter, one strain after another.”

But Prof Barry Schoub, Director of the National Institute of Virology, argues that there is no reason for alarm about the two new strains.

“It is the sub-type that the Sydney virus belongs to which causes the most wide-spread epidemics,” he said.

Dr Andrew Jamieson from British Airways Travel Clinics agrees that B virus’s like New Caledonia are usually milder than A viruses [like Sydney] but he argues that, “We have no crystal ball. My understanding is that it’s hard to be certain about the severity of a flu strain. We know a lot about Sydney but the others are uncertain. The problem is that the New Caledonian and Yamanashi are unknown quantities.”

For Jamieson, the cause for concern is not only the specific strains in circulation but also that the incidence of flu in general is increasing. This is because more and more people are at high risk of infection. “Immunodeficiency due to retrovirus infection [HIV] has caused a huge leap in the people at risk here in South Africa.”  

Others at particularly high risk for infection include people over 65, anyone who has a chronic disease of the heart, lungs or kidney, diabetes, or severe anemia. Healthcare workers, and others in close and frequent contact with high-risk groups, are also considered to be at high risk.  

Clearly, all high-risk individuals should be vaccinated. But, argues Toovey, there is no reason for everybody not to have the vaccine.  

“These new vaccines are potentially life-saving and they are extremely well-tolerated. They don’t make people feel sick. Those few people who feel a little achy a few days later are those who, if they had gotten flu, would have had very severe symptoms.”

Schools and employers should strongly consider vaccinating pupils and employees free of charge, says Toovey. “There’s good data to show that apart from being life-saving, it’s also a cost-effective vaccine. If it’s just a mild epidemic, for every R1 spent, R4 will be saved. And if it’s severe, for every R1, there will be an R11 return.”  

Toovey also argues that the Department of Health should be more active in promoting the use of the flu vaccine. At the very least, he says, staff at state hospitals should all be immunised. This is not just because health care workers are exposed to infection but because this will decrease the risk of health workers passing flu on to patients at high risk for serious complications.

“Studies have shown that you can reduce the death rate in all hospital patients if you vaccinate the staff,” says Toovey.

According to Dr Neil Cameron, the Health Department’s Director for Communicable Diseases, policies on vaccinating health care staff vary from province to province. Provincial hospitals supply the vaccine to patients when prescribed by doctors. Patients pay the standard consultation fee to be vaccinated.  

At this stage, the health department has no plans to launch a wider-scale flu vaccination campaign.  

“There’s not enough evidence to advocate large-scale flu vaccinations. The department’s current position is that the department has got other priorities in immunisation. We don’t have enough information to divert funds from our current vaccination programme to another vaccination programme. Normal childhood vaccinations against measles, hepatitis, etc have had a higher priority up till now,” said Cameron. – Health-e news agency  

  Fact File  

  •  Flu is a potentially fatal disease.
  • Get your flu vaccination from a doctor or pharmacy in March. It takes up to two weeks after vaccination for immunity to develop and flu starts to strike in S.A. from April onwards.  
  • The latest vaccine innoculates against all three of the virulent, and potentially deadly, flu strains which are headed our way this winter.
  •  The latest vaccines are all very well tolerated. The popular belief that the vaccine will give you flu or flu-like symptoms is a myth.
  •  The shot reduces the average person’s chances of catching flu by 60% to 80%.
  • Even if an immunised person still gets flu, their symptoms will be fewer and milder.
  •  Flu starts rapidly, causing high temperatures, severe headaches, fatigue and muscular pain. Children may experience nausea and vomiting.
  • Maintaining your general health by eating and exercising will help keep your immunity strong. However, these should be seen as additional precautions rather than as a substitute for the vaccine.
  • Flu vaccines are updated yearly. Last years vaccine will not protect you from the new flu viruses in circulation.
  • Those at particularly high risk for infection and for developing complications from flu include: People over 65; people with chronic diseases of the heart, lung or kidney, metabolic disorders such as diabetes and renal failure, or with low immunity, for example, as a result of HIV or chemotherapy; caregivers, health care workers and anyone in close or frequent contact with other high-risk people; children and teenagers receiving long-term aspirin therapy. – health-e news agency


  • Bibi-Aisha Wadvalla

    Bibi-Aisha is an award-winning journalist whose career spans working in radio, television, and development. Previously, she worked for eNCA as a specialist science reporter, and the SABC as the Middle East foreign correspondent, and SAfm current affairs anchor. Her work has appeared on Al-Jazeera, The British Medical Journal, The Guardian, IPS, Nature, SciDev.net and Daily News Egypt. She’s been awarded reporting fellowships from the Africa-China Reporting Project, Reuters Foundation, National Press Foundation, International Women’s Media Foundation. Pfizer/SADAG, and the World Federation of Science Journalists. She’s currently an Atlantic Tekano Fellow For Health Equity 2021.

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