Flu cases nearly seven times last year across SA, and experts say it will get worse

Official flu rates are surging in SA, but experts agree the number of confirmed cases is just “the tip of the iceberg”.

SA Health has received 8787 notifications this year, compared to 1280 for the same period last year.

Adelaide University expert Nigel Stocks says it’s impossible to determine the full extent of the problem.

“It's very hard because what we have to remember is the people who get tested are basically the tip of the iceberg,” Prof Stocks said.

“In general practice some people are tested and some people aren't. Perhaps the majority aren't tested.

“And there's a whole group of people out in the community who may have influenza and don't do anything.

“They self-treat, self-manage, rest up at home and try to reduce transmission to other people.”

The National Centre for Immunisation Research has warned of a horror season to come, with 4000 flu-related deaths predicted across the country.

While young children and the elderly are the most vulnerable, a 15-year-old girl died in Flinders Medical Centre last month. The other three deaths in SA so far this year included people aged 62 and 89.

More than 260 SA cases have required hospital admission this year.

Glynde GP and flu expert Dr Rodney Pearce said the virus strains circulating in the community were no worse than previous years and covered by the current vaccine, which remained “the most effective preventative measure” we have against the deadly disease.

He agreed with Prof Stocks that official numbers did not paint the full picture.

“There is an underestimate of the true incidence and the death rate we believe is understated,” he said.

“If someone has complications of influenza, like pneumonia, or has a heart attack, both of which are sequel of influenza, they'll be recorded as pneumonia or heart attack and the place of influenza in that is underestimated.”

This week, some suburban Adelaide GP clinics claimed they did not have adequate supplies of vaccine to deliver free jabs to vulnerable over-65s.

That came after SA Health temporarily ran out of vaccines to give its own staff at Flinders Medical Centre.

However, SA Health has said there are no shortages and supplies are being delivered equitably across the state.

It said it had already distributed 250,000 doses with 116,000 more on the way.

Distribution to clinics was based on previous demand and storage capacity, it said.

However, SA Health did concede some GPs were not getting as many doses as fast as they would like.

How do you know it’s the flu

WHAT IS THE FLU?

■ Influenza, commonly known as the flu, is a highly contagious infection of the nose, throat and lungs caused by the influenza type A or B (or rarely C) viruses.

■ In South Australia, influenza is most common in winter and causes illnesses including fatal pneumonia. However, this year’s flu season has started early and is yet to peak.

SIGNS AND SYMPTOMS

■ Rapid onset of fever (38C and above), headache, muscle aches, fatigue, sneezing, runny nose, sore throat and a cough.

■ A diagnosis may be suspected on clinical symptoms and examination, but is best confirmed by laboratory testing of mucus from the back of the nose or throat.

WHO NEEDS A FLU JAB?

■ Annual flu vaccination is strongly recommended for anyone six months of age and older.

■ Due to changes in circulating strains and waning immunity, vaccination is required each year.

■ Under the state-funded Childhood Influenza Program, children aged 6 months to less than five years of age are eligible to receive the vaccine for free.

■ Higher-risk groups include: Healthcare workers; nursing home staff; police or ambulance officers; early childhood education staff; people who provide care for the homeless; people who lives with a person who is in a high-risk category.

VACCINES AVAILABLE

■ The flu vaccine is updated each year to provide protection against the most common strains of flu circulating globally. Two types of vaccines are available in Australia for the 2019 influenza season, for different age groups.

Quadrivalent (four strains: two influenza A and two influenza B) for people aged under 65 years of age:

FluQuadri Junior – 6 months to less than 3 years of age

Fluarix Tetra - From 6 months of age

FluQuadri - From 3 years of age

Afluria Quad - 5 years of age and over.

Two doses of vaccine, at least one month apart, are recommended for children aged less than nine years who are getting a flu vaccine for the first time.

Trivalent (three strains: two influenza A and one influenza B) for people aged 65 and over. This vaccine has been formulated to produce a higher immune response for older people, offering better protection.

Fluad trivalent influenza vaccine, available through the 2019 National Immunisation Program, is the recommended and free vaccine for this age group.

WHERE TO GET IMMUNISED

■ To receive the vaccine, contact your doctor, local council, community health centre or Aboriginal health centre to arrange an appointment.

■ Those not eligible for free vaccines can pay for a flu jab at approved pharmacies.

STOP THE SPREAD

■ The viral disease is spread by airborne droplets released when infected people breathe, cough or sneeze, or direct contact with secretions from the nose or throat.

■ The incubation period is one to four days, with an average of two days.

■ People infected with influenza are considered infectious from the day before onset of symptoms until up to seven days after onset of symptoms.

■ Viral shedding is greatest in the first three to five days of illness. Young children may shed the virus for up to 10 days.

■ Cover a cough or sneeze with a tissue or arm (not a hand); immediately put used tissues into a rubbish bin; wash hands with soap and running water, or using an alcohol-based hand rub, after sneezing, coughing or touching used tissues; wipe down all frequently touched surfaces.

■ Exclude people with flu from childcare, preschool, school and work until there has been no fever for 24 hours.

TREATMENT

■ Most people recover with rest, drinking plenty of fluids and use of paracetamol for the relief of pain and fever.

■ Aspirin should not be given to children under 12 years of age, unless specifically recommended by a doctor.

■ Patients with uncomplicated influenza do not require antibiotics.

■ People with moderate or severe illness, pregnant women, Aboriginal and Torres Strait Islander people and those with chronic medical conditions may benefit from specific antiviral medication.

■ Antiviral therapy may sometimes be used to prevent the flu spreading to people who are in close contact with an infected person, such as vulnerable household members.

WHEN TO SEEK MEDICAL ADVICE

■ Shortness of breath or difficulty breathing.

■ Symptoms are getting worse, or you are concerned about the symptoms.

DEADLY DISEASE

■ In 2017, there were 124 deaths in South Australia because of the flu.

■ Severe disease is more common in pregnancy, people aged over 65 years and in people with underlying chronic conditions, such as heart disease, diabetes and lung disease. But anyone can get sick with the flu.

■ Complications can include pneumonia, myocarditis (inflammation of the heart), neurological conditions and bacterial infections.

■ Pregnant women are more likely to have severe complications from the flu, especially in the second and third trimesters. High fever and any chest complications caused by flu can be potentially harmful to the baby.

Source: SA Health