Seasonal Flu

Why in news?

Recent reports of a rise in the seasonal influenza cases in the Delhi-NCR area signifies the importance of seasonal flu vaccination, especially for high-risk groups like the elderly.

What is seasonal flu?

• It is an acute respiratory infection caused by influenza viruses.
• Spread – According to the World Health Organization (WHO), there are around a billion cases of seasonal influenza annually, including 3–5 million cases of severe illness.

Seasonal flu causes 2,90,000 to 6,50,000 respiratory deaths annually. 99 % of deaths in children under 5 years of age with influenza-related lower respiratory tract infections are in developing countries.

• Transmission – It is contagious and can be passed on from one person to another when they cough or sneeze.
• Onset of symptoms – It begin 1–4 days after infection and usually last around a week.
• Symptoms – They are high fever, cough, sore throat, body aches and fatigue.
• Severity – It causes mild to serious illness and in a few cases, mostly coinciding with a delay in hospitalisation, can even lead to death.
• Treatment – Most people recover without treatment.
• Medicines such as paracetamol, antihistamines and cough Syrups can help and in severe cases, antiviral medications are recommended.
• Prevention – Vaccination is the best way to prevent the disease.
  • Injectable form – Inactivated influenza vaccines and recombinant influenza vaccines.
  • Nasal Spray – Live attenuated influenza vaccines.

What are the different types of influenza viruses?

• There are 4 types of influenza viruses
  • Influenza A, B, C and D.
• Influenza A and B viruses circulate and cause seasonal epidemics of disease.

There are 2 peaks of seasonal influenza in India, one from January to March and the other in in latter part of the southwest monsoon, in August-October. Predominant strains in this season are Influenza A and Influenza B.

What are the control measures taken?

• Surveillance – India has developed a near real time surveillance of cases of Influenza like Illness (ILI) and Severe Acute Respiratory Infections (SARI) presenting themselves in health facilities.
• It is also through the country-wide network of diagnostic laboratories.
  • Integrated Disease Surveillance Programme (IDSP)
  • Virus Research & Diagnostic Laboratories (VRDLs)
• Public awareness campaigns – Information, Education, and Communication (IEC) materials are used to inform the public about symptoms, preventative actions, and when to seek medical assistance.
• Efficient healthcare guidelines – Extensive guidelines covering ventilatory care, treatment procedures, and patient classification have been released to reduce complications and mortality.
• Supplying antivirals – The public health system provides free access to oseltamivir (Tamiflu), which is advised by the WHO.
• Its sale has been allowed under Schedule H1 of the Drug and Cosmetic Act from February 2017.
• Protecting healthcare professionals – Steps are being taken to provide safety kits like N-95 face masks and personal protective equipment (PPE) kits.

What are the challenges in control measures?

• Continuous evolution of Influenza viruses – High population density, poor hygiene practices, indiscriminate antimicrobial use and conducive weather lead to the survival and spread of the virus.
• Low vaccination rates – Influenza vaccine is not included into the government’s Universal Immunisation Programme.
• Low adult vaccination rates – It is often overlooked due to a lack of information, misconceptions, and financial hurdles.
• No national policy requires flu vaccine for high-risk persons, leaving it up to state discretion.
• Disparity in healthcare access – Rural & marginalized communities have limited access to immunizations and treatments.
• Surveillance gaps in private healthcare - While public facilities disclose incidents, private healthcare data is frequently underreported, limiting real-time monitoring.
• Climate change – Seasonal epidemics of influenza may shift spatially and temporally.

What lies ahead?

• Improve preparedness – Anticipating an outbreak and inculcating a sense of preservation, particularly among the high-risk groups.
• Prioritise vulnerable groups – More attention to children, senior citizens and people with chronic respiratory conditions.
• Targeted awareness campaigns – It must be clear, urgent in tone, and make an impact on the high-risk groups particularly, because, very simply, vaccines save lives.
• Formulating a national flu vaccination strategy – Steps can be taken to make annual flu vaccines mandatory for high-risk populations and incorporating influenza vaccines into government health programs and subsidize expenses.
• Strengthening surveillance – Encouraging private hospitals to provide real-time data to flu surveillance networks.

References

1. The Hindu| Challenges in Controlling Seasonal Flu in India
2. WHO| Seasonal Influenza