Why the flu season is not to be sneezed at: We all get it some time

Every year, the flu kills between 6 000 and 11 000 people in South Africa.

Every year, the flu kills between 6 000 and 11 000 people in South Africa.

Published May 31, 2023

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Ogone Motlogeloa

Cape Town - The Covid-19 pandemic had us all on the verge of panic with even the smallest sneeze causing concern.

During the pandemic, however, flu and other acute respiratory diseases were still killing people and putting others in hospital.

Let’s face it, some of us reading this article may never have caught Covid-19. Yet we have all had the flu at some point in our lives, and it is a horrible feeling. Nasal drip, sneezing, coughing, and a painful body are all symptoms of the dreadful flu virus. It is at this time when it mainly strikes.

Every year, the flu kills between 6 000 and 11 000 people in South Africa. Approximately half of these deaths occur in the elderly, and 30% occur in HIV-infected individuals.

The elderly (65 and older), HIV-infected people, and children under the age of 5 have the highest rates of hospitalisation. Pregnant women are also more likely to be hospitalised and die of flu infections.

People with chronic illnesses such as diabetes, lung disease, tuberculosis, and heart disease are also more likely to be hospitalised with flu.

There is widespread agreement that the incidence of flu cases increases during winter because meteorological conditions are more conducive to the survival of the viruses.

Despite general recognition of the winter seasonality of flu, there is little agreement on how to define the season’s onset or timing.

The flu season is rarely quantified, and when it is, there is little agreement in the methodology used.

The Centers for Disease Control and Prevention (CDC) developed and implemented a new approach for assessing flu season severity in 2017.

The CDC analysed important flu indicator data from previous flu seasons to construct intensity thresholds (ITs) to characterise the severity of flu seasons and set a particular threshold to mark the start of the flu season.

An intensity threshold is a figure calculated using data from previous flu seasons to estimate the likelihood that a flu indicator, such as “influenza-like illness” (ILI) or “influenza percent positive” will exceed a given level.

The SA National Institute for Communicable Diseases reports that the average duration of the flu season over the last 13 years has been 19 weeks, but it has not set an intensity threshold or published any methodologies for delineating the flu season.

Knowing exactly when we are at a higher risk of getting the flu would be fantastic, especially for individuals such as myself who suffer from a chronic illness.

Being able to put in place preventive measures shall surely do all of us a great deal of good. The potential for an outbreak of a disease dictates whether it should be monitored.

An epidemic threshold denotes the level of occurrence above which a disease necessitates immediate action.

Each illness has a different threshold based on its infectiousness, other transmission factors, and the degree to which it is locally endemic.

Surveillance is frequently focused on illnesses that have the potential to trigger an outbreak and be a major public health problem.

Monitoring case numbers in less severe diseases, on the other hand, has value. This enables improved public communication and preparedness of health-care facilities.

In a developing country like South Africa, critical aspects of primary health care are lacking, and the health-care sector is suffering a significant human resources crisis. Climate change will exacerbate the country’s existing issues in the public health-care sector. As a result, pushing for a specific classification of the flu season is critical.

This will benefit the public, since they will have a better understanding of their illness risk and will be able to limit it and be vaccinated on time.

This has the potential to reduce disease burden and human health risks. It also helps medical insurance companies to anticipate surges in claims, which improves their financial sustainability.

This article is based on the study by Ogone Motlogeloa, Jennifer Fitchett and Neville Sweijd, titled “Defining the South African Acute Respiratory Infectious Disease Season”. Motlogeloa is a final-year PhD candidate at the University of the Witwatersrand. School of Geography, Archaeology, and Environmental Studies.

Cape Times