Keep calm, get your jab
● South African doctors have had their hands full with runny noses, wheezing, fever and chest infections as the peak of a viral infection and the flu season hits hard.
National health department spokesperson Doctor Tshwale said South Africa is experiencing the respiratory syncytial virus (RSV), which has now reached its peak.
“The strain was detected through a surveillance system by the National Institute for Communicable Diseases (NCID). No reports of deaths have been confirmed linked to this strain,” Tshwale said.
“There are pockets of cases across the country, but there is no need for the public to panic. Symptoms include a running nose, a decrease in appetite, fever and wheezing.
“The virus is spread across the country, there is no specific hotspot. The strain hasn’t caused a sudden surge in hospital admissions, because people manage to recover without being admitted to hospital.”
The NICD notified clinicians to look out for patients presenting the symptoms.
“The current flu vaccinations assist to manage the different flu strains. The department encourages and recommends that people do take the flu vaccine,” Tshwale said this week.
On Friday, the NICD also confirmed that the flu season started on April 22 based on detection rates of influenza A (H1N1), also known as swine flu, influenza A (H3N2) and influenza B/Victoria, which are both influenza viruses, at public hospitals.
Dr Cathelijn Zeijlemaker, Netcare Medicross medical director, said the importance of vaccinations cannot be understated. “Vaccinating is not only a personal choice. It is also about protecting your loved ones and especially the elderly and young people you come into contact with,” Zeijlemaker said.
“People should not delay if they haven’t already been vaccinated. Remember, it takes about two weeks after vaccination for it to really become effective.”
While not as threatening as Covid19, doctors and health-care facilities are busy.
Well-known pulmonologist and author Dr Emmanuel Taban said his 184-bed ICU is filled with flu patients.
“Most of my ventilated patients are RSV and rhinovirus. Most of my influenzas virus are simple influenza A and so far few H1N1,” said Dr Taban, who works at the Midstream Medical Centre.
“I have two patients with the Covid-19 virus, but they are stable.”
“Most are 50-80 [years old] and most of them suffer from obesity or underlying lung problems such as chronic obstructive pulmonary disease/emphysema, asthma uncontrolled and bronchiectasis. We have a few uncontrolled diabetics mellitus. Most under 50 years old are in the ward and they respond quickly.
“The problems with the influenza virus outbreak is the presence of secondary bacterial infection — gram positive — and this unfortunately makes patients sick and needs to be recognised quickly,” he said.
Spies and Partners Tzaneen GP Dr Shani Fritz van den Heever is also battling the flu wave.
“The flu season is here in all its might and it has come a little earlier than expected,” she said. “Being this busy does bring memories of Covid-19 times, but the big difference now is we don’t have people dying.
“Tamiflu works quite well as a preventive measure. It is a little more expensive, but it works well in most cases. In paediatrics we have had some patients with the RSV virus, but also there it is mostly H1N1 or influenza A.
“The symptoms are quite unpleasant. I had Covid-19 twice and I never coughed. I had this flu and I am still coughing almost a week later,” she said. Fritz van den Heever says very few of their patients are vaccinated against the flu. “People normally come for their flu injections mid to end of May. I think the flu might have come a bit early and caught them by surprise.”
Dr Jacques Koning, an internist at Pretoria’s Netcare Montana hospital, says that while not overrun, they have been busy.
“The practices and hospitals in the area all have many cases. When flu kicks in like this, it spreads like a wildfire. We still pick up the odd case of Covid-19. We have had some RSV, but mostly H1N1 and influenza A. At paediatrics it is mostly H1N1, which is by far the most prevalent here. We are busy because many patients need support the first day or so, but they should then be fine,” he said.
Vaccination is a good idea.
“It might be a little late to halt the spread of this current wave of flu infections, but it is probably worth it to get vaccinated,” Dr Koning said.
NICD said that ideally the vaccine should be administered before the start of the season as it takes about two weeks for antibodies to develop after vaccination but it is never too late to vaccinate. Another difference at his hospital between this wave and its Covid-19 predecessors, said Koning, is the age group most at risk.
“In Covid-19 we mostly struggled with older people, but yesterday I put a 17-year-old in the ICU. That is not what I would call normal. It also spread around staff quite fast. Most people will feel very sick for two or three days and then still suffer some irritant symptoms for days after.” He himself was struck down last week.
“My initial thought was Covid-19, because I experienced the same symptoms. If you have it, take your Tamiflu, get under a duvet and eat some chicken and noodle soup while watching a movie as you sweat it out. The time-tested remedy that works.” A doctor from a state clinic in Soweto, who did not want to be named, told the Sunday Times they still have open beds, but they are busy.
“I haven’t admitted anyone this week yet. Last week and the week before I admitted four to six people per day. I do have an itch in my own throat now though,” the doctor said.
“We get a lot of young ones with wheezy chests, aka bronchitis. These people I can nebulise and send home. The ones with SATS under 91 are the ones we admit. Looks like we learnt very little from Covid-19. At least the most important lesson remains learnt — when you are sick, stay at home!”