5 Things You Need to Know for this Year’s Flu Season

5 Things You Need to Know for this Year’s Flu Season

This year marks a century since one of the deadliest disease outbreaks in recorded history, the Spanish flu, which saw the loss of around 50 million lives worldwide - comparable to the number of fatalities in the First and Second World War combined. This year also follows a high severity 2017/2018 flu season, with many wondering what they might expect this year. To help better understand both seasonal and pandemic flu, I have created a list of 5 things you need to know for the 2018/2019 flu season.

1.   Are we at risk of an influenza pandemic?

Influenza pandemics tend to occur every 10 to 50 years and our last was the H1N1 flu pandemic in 2009. However, just because we have reached the 10-year mark since the last pandemic, this does not mean that we are at high risk of a pandemic this winter, next summer or next year. We can be certain that a flu pandemic will happen, we just don’t know exactly when; flu is and will stay unpredictable.

What we do know however is that modern medical technologies, advances in vaccinology, and state-of-the-art critical care facilities can help us to prepare for and handle a pandemic faster once it hits. This enables us to help protect people against the strain of viruses causing it, thus helping to reduce the fatality rate of a future pandemic.

2.   Why was the Spanish Flu so significant? 

Back in 1918, scientists didn’t fully understand what was actually causing the Spanish Flu, thinking at first that bacteria were to blame, while it was in fact a virus. What’s more, poor hygiene was widespread and there was a lack of community containment measures to help stop the spread of the disease. 

But of course, the Spanish Flu was not the only crisis in 1918. The outbreak occurred at the same time we were fighting a world war. This caused the increased movement of people – soldiers, civilians, and healthcare workers - who helped the spread of the flu. We also weren’t prepared to deal with the large numbers of people who were infected, compounded by the fact that healthcare workers were deployed to take care of soldiers.

3.   What is the difference between pandemic and seasonal flu?

Let’s start with one key similarity. Both the pandemic and seasonal flu viruses spread in the same way – from person to person (or from person to doorknobs or other surfaces to person) through droplets when someone coughs, sneezes, or talks to a person within six feet.

So, how do they differ? The seasonal flu is caused by a few dominant flu viruses and occurs on an annual basis. People usually have some immunity from previous exposure to seasonal flu strains (which differ slightly from year to year) and from their annual influenza vaccination. Pandemic flu on the other hand is far less common (there have only been 4 flu pandemics in the last 100 years), involving one drastically mutated flu virus that is fundamentally different from current or recently circulating strains. Therefore, pandemic flu is likely to spread to more people because the number of people who will have immunity to the virus is very low to non-existent.

4.   How has the treatment and prevention of flu changed since 1918?

In 1918, we were left vulnerable because we didn’t have a flu vaccine to help protect us against it nor antiviral medicines or sufficient antibiotics to help prevent and treat potentially fatal secondary bacterial infections.

Today, influenza vaccines help prevent seasonal influenza and thereby decrease the strain on healthcare systems that are already under pressure, for example, by reducing GP visits and hospitalisations. Influenza vaccination has also been demonstrated to reduce the use of antibiotics which is a critical step towards reducing the likelyhood of bacteria becoming resistant to antibotics.

Another factor that personally motivates me to get my annual flu shot is that it not only helps me stay protected, it can also help protect those around me, including my family, friends and colleagues. Herd immunity, or indirect protection, helps control or eliminate diseases when the number of people vaccinated reaches a certain point, as explained in a recent post – a vaccination rate we are not generally reaching for flu.

5. What can we do to decrease the impact of influenza?

There is one subset of the population that is vulnerable to catching influenza and even more importantly, plays a major role in the spread of the disease in a community: our children (especially those attending kindergarden and school). Vaccination programmes that include children,which unfortunately have only been implemented in less than a handful of countries, can greatly extend protection to the vulnerable populations kids come in contact with, namely: very young children, pregnant women, older adults, and other vulnerable populations such as the immuno-compromised.

The effect that children have on the spread of influenza in particular becomes apparent whenever the flu season overlaps with school breaks. Incidents of the disease and physician visits will start to drop during the time that schools are closed, only to pick up again when the children return to the classroom. It is for this reason that school closures are an intervention commonly suggested for reducing transmission for both seasonal influenza and pandemics, in addition to vaccination. It would be great to see governments such as the US and the UK more frequently share their progress and the impact of their vaccination programs, including for children, to enable other countries to take advantage of their learnings and act if and when advisable.

ii NHS England, 2016. Flu Plan: Winter 2016/17. (accessed May 2017)

 

Victor Hoff

CEO Blatchford Norway and Scandinavia/Konsernsjef Blatchford Ortopedi AS

5y

Hi Thomas, great information, do you think regular seasonal flu vaccination could provide some protection against a pandemic flu? Cross protection?

Francois Meurice

Senior Consultant Vaccines

5y

Great post, very clear and striking data - well done! I guess one of the additional reasons why 1918 pandemic took so many lives at the end of WWI, was the deprivation and exhaustion status of so many in war-devastated countries... Disease severity is always a result of the interaction between the virus and the host...

Lenny Demers

Market Development Manager - MA - VaxCare

5y

For a fascinating read (from a non-HCP perspective), consider Eula Biss’ book, “On Immunity.” She argues, for example using a different term for “Herd Immunity” (suggesting we are all cattle waiting to be slaughtered). Exchange the metaphor of the herd for a bee hive; “Perhaps the concept of a shared immunity might be more appealing.” (Page 21) Benjamin Demers

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