PREVENTION IS THE BEST POLICY
The World Health Organisation estimates that the virus causes up to 500,000 deaths each year
AS a respiratory physician, I’ve been seeing a relatively high number of patients with influenza over the past few weeks. This is obviously anecdotal, but the frequency and severity of cases appear to be higher than in recent years and my experience seems to mirror the findings of more robust data collected.
Reports from Australia’s influenza season this past winter have been worrying. They have record levels of confirmed cases with matching higher levels of hospitalisations and deaths. According to the Australian Department of Health, the number of notifications have surpassed 200,000 with 29,000 hospital admissions. Most deaths were that of the elderly and were related to Influenza A (H3N2 strain).
But, what is influenza? Influenza is a highly contagious respiratory disease that is caused by a virus. It is spread from person to person by droplets in a cough or sneeze as well as hand-to-hand contact. It is different from the common cold, although the latter is sometimes referred to as the “flu”.
Influenza symptoms vary, but may include fever, headaches, joint and muscle aches, fatigue, sore throat, blocked or runny nose and cough with or without phlegm. In the majority of cases, all that is needed is a good rest, plenty of fluids, a small amount of painkillers and a bit of TLC (tender loving care).
However, influenza can be dangerous. The World Health Organisation estimates that it causes up to 500,000 deaths globally each year. Those who are most affected are the very young, the very old, pregnant women and those with chronic medical conditions, such as asthma, chronic obstructive pulmonary disease and heart failure.
As with most things in medicine, prevention is the best policy when it comes to influenza. At the most basic level, it is advised that those with straightforward influenza stay at home to prevent its spread at work or in the community. Regularly washing one’s hands in public places is also a simple but important way of reducing transmission.
Influenza vaccines are available but grossly underused. A vaccine is needed every year — the influenza virus changes all the time; as with any other microorganism, it evolves to survive. The different strains that arise due to the changes in the virus mean that we have to regularly change the content of influenza vaccines to ensure that they work as well as possible. Moreover, the body’s immune response from vaccination declines over time so an annual vaccine is needed for optimal protection.
Vaccines are not 100 per cent protective, but they decrease the probability of contracting influenza and reduce the severity of those who have it. They tend to be given prior to the winter seasons, as most countries have a concentration of cases during the winter months. Malaysia is stuck in the middle — many Malaysians travel regularly to Australia and to countries in the Northern Hemisphere, such as the United Kingdom.
This results in exposure to influenza strains that may differ. The situation is made even more complex when we take into account the number of umrah and Haj pilgrims who return to Malaysia after being exposed to pathogens from around the globe. Those who are travelling should get vaccinated at least two weeks beforehand as it takes approximately two weeks for immunity to develop.
It is almost inconceivable that insurance companies generally do not cover the costs of influenza vaccines. It is also unfortunate that they are not readily available in all Klinik Kesihatan branches. A wealth of clinical data is readily available to inform policymakers that provision of vaccines for those who require it would be cheaper than the costs of hospitalisations and high levels of absenteeism.
Until then, doctors and patients alike should ask themselves if they would benefit from an influenza vaccine given the particularly high level of activity so far this year. This is especially relevant for those who are at higher risk for severe complications (pregnant women, those above the age of 65, young children, and those who have chronic medical conditions) as well as carers for these individuals.
Influenza vaccines are available but grossly underused. A vaccine is needed every year — the influenza virus changes all the time; as with any other microorganism, it evolves to survive.