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Flu: Not something to sneeze at

Flu: Not something to sneeze at
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Influenza should be taken seriously, especially if you are over 65 and have diabetes, kidney disease, or other chronic health conditions

Some of you will be travelling abroad for a much-needed getaway. Malaysia will also be seeing an influx of tourists from all over the world. What a refreshing change from the restrictions of the last two years.

Mind you, Covid-19 is not gone yet, and everyone still needs to guard against it. However, we are here to spotlight another looming respiratory illness that could ruin your holidays and your health.

It is none other than influenza, also known as the flu. This disease is not something to sneeze at (pardon the pun). This is especially if you are 65 or older, more so if you have diabetes, kidney disease and/or other chronic health conditions.

The flu can cause acute respiratory distress, pneumonia, and other serious complications. It can also increase the risk of a heart attack by more than 10 times in the first seven days of catching the flu. Stroke risk may also double or triple in the first two weeks of infection.

It is sobering to think that the flu can be associated with a heart attack, pneumonia and stroke, which rank as the 2nd, 3rd and 4th principal causes of death (after Covid-19) in Malaysia in 2022.

A rough flu season

In light of this, Professor Datuk Dr Zulkifli Ismail, Technical Committee Chairman of the Immunise4Life programme, advises caution if you are planning to visit the northern hemisphere where flu cases are surging.

He explains: “Whereas the flu circulates all year round in Malaysia, temperate countries tend to have their flu season in the winter months – December to March in the northern hemisphere, and June to August in the south.

Datuk Dr Zulkifli Ismail

“In 2022, however, flu season started early in the northern hemisphere. Cases have been increasing dramatically since October and have already overtaken the number of cases reported this time in 2021.

“The rise is expected to continue, and we expect a rough flu season in most northern destinations popular with Malaysian vacationers.”

As at Dec 2, 2022, the United States Centres for Disease Control (CDC) estimated 8.7 million Americans had been infected, 78,000 hospitalised, and 4,500 died of flu-related causes in what media outlets have called the country’s ‘worst flu outbreak in a decade’.

Meanwhile, the French Health Authority has declared a flu epidemic in three areas in France, while identifying another five – including Paris and its surrounding areas – to be in a pre-epidemic phase.

In its first winter update in 2022, the National Health Service (NHS) of England reported an average of 344 flu patients in hospitals per day in a single week – 10 times more than the number seen at the beginning of December 2021.

Over in the Far East, the health authorities of South Korea, Taiwan and Japan are also expressing concern over the steadily increasing number of flu cases, amid mounting fears of a possible twindemic – the concurrent spread of flu and Covid-19.

Close encounters

Datuk Dr Christopher Lee feels travellers would do well to understand how flu viruses get around. He is a Consultant Infectious Diseases Physician and a Malaysian Influenza Working Group member under the Malaysian Society of Infectious Diseases & Chemotherapy.

He says: “Picture yourself enjoying the crisp, chilly outdoors. Before long, you hastily make your way into a cosy café, joining other patrons warming up over steaming mugs of hot chocolate.

Datuk Dr Christopher Lee

“It all sounds wonderful, except that you are more likely to catch the flu indoors in winter. By coughing, sneezing or speaking, infected persons could send flu viruses circulating inside the crowded and poorly ventilated environment. You might also pick up flu viruses that have settled onto the tabletops, door handles and other surfaces.

“Depending on your proximity to the source and duration of exposure, you might end up with a full-blown bout of the flu, and waste precious holidays in bed or in hospital.”

Dr Lee continues: “Now, let’s say you managed to evade the flu throughout the trip. Don’t be too quick to think you are flying home flu-free.

“On board the plane, you have an 80 per cent chance of getting the flu if there is an infected person – who may or may not have symptoms – sitting one row in front or behind you, within two seats to either side.

“Additionally, flu viruses can survive for up to 48 hours on certain surfaces, including your overhead compartment handle, seat-belt buckle, video screen, food tray, arm-rest and control panel.

“You might try disinfecting these items. However, it would be impractical to disinfect everything you touch when you land, such as your luggage bag, trolley, the toilet flush, car door handle and so on.”

Flu prevention tips for travellers

Dr Lee says: “Follow the Covid-19 SOPs when possible. Masking, although no longer promoted in most countries, may help reduce the chances of catching the flu.

“It is, however less effective when those around you are not masked. Therefore, the additional protection conferred by the annual flu vaccination is recommended to prevent the disease.”

“When injected, the vaccine introduces inactivated flu viruses into the body. These have been killed and are unable to cause disease. However, they stimulate your body to produce antibodies that will spring to your defence if you happen to be exposed to the flu. Allow two weeks to reach the desired level of immunity before flying off.”

Like Covid-19 vaccination, the flu vaccination helps prevent severe disease, hospitalisation and death. Flu vaccination is also associated with a 34 per cent lower risk of major adverse cardiovascular events. There was also an 18 per cent reduced risk of death reported in patients with heart failure.

In people with Type 2 diabetes, flu vaccination has been associated with a reduced risk of heart failure by 22 per cent, stroke by 30 per cent, heart attack by 19 per cent and pneumonia by 15 per cent.

Noting that flu viruses mutate constantly, Dr Lee adds that currently available flu vaccines have been updated to effectively fight virus sub-types that are circulating in the northern hemisphere at this time.

He says: “This will help reduce your risk of contracting the disease. The flu vaccination is not only recommended for those travelling abroad but for everyone, especially high-risk groups, as the importation of flu cases through air travel can result in the spread of flu within the community.

So, if you have not been vaccinated against the flu, now is a good time to get it done. The annual flu vaccination is your passport to healthy holidays. Don’t leave home without it.” – The Health


This article was contributed by the Flu Prevention is An Act of Love campaign under Immunise4Life, a major initiative to promote life course vaccination by the Ministry of Health, Malaysian Paediatric Association and the Malaysian Society of Infectious Diseases & Chemotherapy.

Tags: InfluenzaopinionThe Health 2023The Health Jan/Feb 2023theHealthVaccination
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