Australia shivers through severe flu season


Woman in bed with flu

Experts have called for greater access to and takeup of flu vaccination, as Australia endures a likely record-breaking season

But this doesn’t extend to pharmacies being able to vaccinate children against the flu.

Communicable disease experts have shared stark figures which demonstrate that the 2017 flu season is very severe, with a mix of strains causing infection across a wide demographic.

“Last week we had more than 4,000 notifications, and to put that into context we’ve never had more than three and a half thousand ever before in Queensland, which occurred two years ago,” says Professor Paul VanBuynder, of the Gold Coast Health Service, and the Immunisation Coalition.

“When we look at what type of influenza notifications there were, most of them were influenza A, but a quarter were influenza B.”

Most of the influenza A circulating in Queensland last week was a H3N2 strain.

“What that means is that this is in fact impacting right across the spectrum of the age ranges of the community. 60% are the elderly person’s nasty disease, A-H3N2, and 40% are influenza B and H1N1 which impacts on the children and the healthy adults and continues to spread in the community,” Prof VanBuynder says.

Professor Bill Rawlinson of NSW Health Pathology outlined “a really big uptick” in presentations to emergency in NSW for influenza.

“We see that in the reference laboratory that I supervise as well, so not only out there in the community but also in the laboratory we’re seeing really much, much larger numbers of cases in NSW over the last four weeks or so.”

Figures for Australia overall show a significant spike in cases.

“The flu data for Australia is not exactly the same as Queensland but it looks like we will again get the greatest number of notified cases in Australia we have ever seen,” Prof VanBuynder says.

“The previous record was when we had a lot of influenza B and a lot of circulation in the community in 2015, and that final number was just over 100,000 cases.

“We’re now into 70,000 cases so far in Australia, and I’m expecting that we’ll break that record substantially.”

Prof VanBuynder warned that the increase in GP takeup of desktop testing methods, which allow them to diagnose influenza in surgeries, does not contribute to the growth in flu notifications because these tests are not included in the record.

“I’m confident that this is not just the biggest recorded year in our data, but it’s also the largest flu outbreak that we’ve seen for quite some time.”

He said that takeup of vaccination against influenza remained disappointingly low.

Among the elderly, around 75-80% of people get vaccinated, as do only about half of pregnant women, around 35% of people with chronic diseases and less than 10% of children.

Children, however, make up the largest number of notifications and act as “super spreaders” of the infection, transmitting it throughout schools and to other vulnerable groups like older grandparents.

Prof VanBuynder called on the Australian Government to fund flu vaccination for all under-fives, in addition to those with Aboriginal and Torres Strait Islander heritage, as children not only spread the virus easily but also “suffer significant consequences themselves”.

“Parents believe that it’s not important because it’s not funded, but this is very important and it should be funded.”

However, while he says he strongly backs pharmacy’s role in vaccinating adults, he stops short of supporting a role for them in vaccinating children against influenza or other communicable diseases.

“I was involved, prior to coming back to Australia, in Canada for six years and I saw the role of pharmacies in both influenza vaccination but also other adult vaccines: whooping cough vaccine and so on,” he says.

“At the moment in the US, pharmacies give about 60% of the elderly vaccines; in Canada, where I was, in British Columbia they give about a third of adult vaccines including influenza, and they were a major capacity, for me, to respond to measles and whooping cough outbreaks, because general practitioners were very busy and it was possible to get into a pharmacy and get your measles shot and so on.

“I’m a huge supporter of increasing access to vaccines for people, and I believe we should continue to develop the role of pharmacies in Australia for adult vaccinations.

“I’m not a supporter of childhood vaccination,” he says. “It’s not allowed in Canada either in pharmacies.

“We have very, very safe vaccines. I rarely get a child who starts fitting or responding in an adverse way in any of my clinics, but I do occasionally see a child who’s having a significant reaction – much more likely in a very young child than in an adult.

“And I don’t believe that pharmacies are set up the way my clinics are to deal with very rare complications in children.

“I don’t think that we set pharmacies up in such a way that they can deal with that sort of stuff.

“The reality is that to maintain my skills I need to do basic life support training on young children every three months; I don’t think that’s the sort of background that we’re going to get in a pharmacy.

“Great that they’re helping with the adults, but no, I don’t believe in it in children.”

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