The National Institute for Communicable Diseases has reported a spike in South Africa's influenza cases. Picture: Pexels/ Andrea Piacquadio
The National Institute for Communicable Diseases has reported a spike in South Africa's influenza cases. Picture: Pexels/ Andrea Piacquadio

NICD reports spike in influenza cluster outbreaks at schools and workplaces

By Se-Anne Rall Time of article published Nov 17, 2021

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Durban – The National Institute for Communicable Diseases has reported a spike in South Africa's influenza cases.

According to the NICD, there has been a sharp increase in cases between August 23 and November 1. In some cases, people have had to be hospitalised.

The NICD reported that between from November 7, the total number of influenza cases detected by the syndromic sentinel surveillance programmes conducted by the NICD has increased from 68 in week 34 to 226.

"The increase in case numbers has been identified in all five provinces where surveillance is conducted. To date, the most commonly detected subtype and lineage is influenza B Victoria (87/226, 38.5%) followed by influenza A (H1N1)pdm09 (53/226, 23.5%) and influenza A (H3N2) (24/226, 10.6%).

“Even though the detection rates for influenza in our surveillance programme exceed previous seasonal thresholds, absolute numbers remain relatively low compared to previous years, possibly as a result of reduced health-seeking behaviour following the SARS-CoV-2 pandemic," said NICD head of Centre for Respiratory Disease and Meningitis (CRDM), Professor Cheryl Cohen.

She said a sharp increase has been reported from the influenza-like illness (ILI) and pneumonia hospitalised cases surveillance sentinel sites. In addition, private laboratories have reported an increase in influenza case detections and the NICD.

Cohen explained that influenza A(H3N2), influenza A(H1N1)pdm09 and influenza B are seasonal influenza virus strains that are common in human populations.

"Influenza A(H1N1)pdm09, which is sometimes incorrectly referred to as 'swine flu', has been one of the circulating seasonal influenza strains following its emergence in 2009. The term “swine flu” should not be used as it causes unnecessary panic. The clinical course of infection with this influenza strain and clinical management is similar to that of other influenza strains," Cohen said.

Medical epidemiologist at the CRDM, Dr Sibongile Walaza, added that although most people with influenza will present with mild illness, influenza may cause severe illness, which may require hospitalisation or cause death, especially in individuals who are at risk of getting severe influenza complications.

Picture: Supplied by the NICD

"Groups at an increased risk of severe complications of influenza include pregnant women, HIV-infected individuals, those with chronic illnesses or conditions like diabetes, lung disease, tuberculosis, heart disease, renal disease, obesity and those older than 65 or younger than 2-years-old. These groups should be encouraged to seek medical help early," Walaza said.

Cohen said the increase in influenza in the summer, which is not the typical time for the influenza season, is likely the result of relaxation of non-pharmaceutical interventions to control Covid-19, combined with an immunity gap due to influenza not circulating for two years between 2020 and 2021 in South Africa as a result of the interventions.

She stresses that the influenza vaccine remains the primary means for preventing seasonal influenza infection and should ideally be administered before the influenza season from March to April.

"Currently, because of recent reductions in transmission, influenza may not circulate in the traditional seasonal period. It is never too late to vaccinate during periods when influenza is circulating, especially for individuals with underlying conditions which put them at increased risk of severe influenza illness or complications," Cohen said.

To prevent contracting or spreading flu avoid close contact with sick people, stay home when you are sick, cover your mouth and nose when coughing or sneezing, clean your hands regularly, avoid touching your mouth, eyes and nose and clean and disinfect common places. Clinicians are encouraged to consider influenza as part of a differential diagnosis when managing patients presenting with respiratory illness.

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