KUALA LUMPUR: Father-of-four Hairi Zolhaini did not realise how crucial it was to have his children vaccinated against influenza until his eight-year-old son Qaleef Iman Rayyan fell ill in January this year.
Hairi, 37, who is a part-time event management worker, said he became worried when his son’s fever did not go away after a few days even though he had taken him to a clinic.
“I then took him to a hospital where a PCR (polymerase chain reaction) test was done on his nasal swab and the result showed he had influenza A,” he said.
Qaleef Iman Rayyan was immediately treated with the anti-viral drug Oseltamivir to prevent complications from setting in.
“I am thankful my son received treatment immediately... I dare not think what would have happened if treatment was delayed,” Hairi said, adding that it was only then he realised the importance of the flu-prevention vaccine.
“I’m now advising my relatives and friends to get themselves vaccinated against the flu.”
RISING TREND IN CASES
Influenza, also known as the flu, is a contagious viral infection that affects the respiratory system. Influenza viruses that infect humans can be classified into three main groups: A, B, and C. Type A influenza infection can be serious and can cause widespread outbreaks.
According to the World Health Organisation (WHO), annual influenza epidemics worldwide result in an estimated three million to five million cases of severe illness and about 290,000 to 650,000 deaths.
Incidentally, towards the end of December 2019 and early this year, Malaysia recorded an increase in influenza A cases, with most of those affected being schoolchildren.
Selangor had recorded the highest number of cases then with more 800 schoolchildren infected. Two schools in Perak and Sabah had to close temporarily due to an influenza outbreak which got many parents worried.
In January this year, Health director-general Tan Sri Dr Noor Hisham Abdullah said in a statement that lab surveillance by the Institute of Medical Research and the National Public Health Laboratory showed that the consultation rate for influenza-like illness (ILI) and the admission rate of patients with severe acute respiratory infection (SARI) had increased since the last week of December 2019.
The number of ILI and SARI cases reported by Malaysia’s influenza surveillance centre to WHO showed an influenza positive rate of 21.2 percent in 2019. For the first quarter of 2020, the influenza positive rate was even higher at 32.8 percent.
In comparison, the influenza positive rate was only 10.4 percent in 2018, 13.3 percent in 2017 and 8.6 percent in 2016. Dr Noor Hisham, however, was quoted as saying that influenza infections in Malaysia were still under control and within the normal range.
CASES MAY NOT SPIKE
Meanwhile, an expert interviewed by Bernama said although flu outbreaks occur throughout the year in tropical countries like Malaysia, surveillance activity data for the consultation rate for ILI and SARI, however, revealed a pattern of spikes in such cases between April and June and later from October to January.
KPJ Damansara Specialist Hospital consultant paediatrician and neonatologist Datuk Dr Musa Mohd Nordin, however, said that it is very likely that this month’s hike in influenza cases may not be as high as in previous years.
In fact, Dr Musa, who is also head of the hospital’s Infectious Disease Control Unit, expects a downward trend in influenza cases compared to previous years.
“Based on data obtained from FluNet, influenza (incidence) trend in Malaysia is declining and flattening.
“And, if this trend continues, I don’t think there will be an increase in influenza cases in December 2020,” he told Bernama.
(FluNet is a global web-based tool for influenza virological surveillance. The data at the country level are publically available and updated weekly.)
For the record, in Malaysia, actual statistics on influenza cases are not available mainly due to the fact that it is not among the list of infectious diseases that have to be reported or notified under the Prevention and Control of Infectious Diseases Act 1988.
The Ministry of Health, nevertheless, constantly monitors influenza activity trends and related outbreaks through the existing influenza reporting system from sentinel locations nationwide. The surveillance data is then sent to WHO for the purpose of updating the data displayed on FluNet.
According to Dr Musa, the projected drop in influenza cases this month can be attributed to several factors, the main one being public compliance with the standard operating procedures (SOPs) set by the government to stem the transmission of Covid-19.
SOP COMPLIANCE
“The SOPs, which include physical distancing, wearing a face mask and washing hands frequently, are not only preventing the spread of Covid-19 but also other diseases such as RSV bronchiolitis, para-influenza and adenovirus pneumonia that are transmitted through respiratory droplets ejected whilst talking, coughing and sneezing,” he explained.
Furthermore, a number of institutions such as universities, schools, kindergartens and nurseries are currently closed due to the Covid-19 pandemic while many companies are allowing their employees to work from home.
“The measures (to fight Covid-19) are helping to control the spread of the influenza virus,” he said, adding that public awareness on this disease is also rising and more people were also taking the influenza jab.
Dr Musa is confident that when more people adhere to the Covid-19 SOPs and also realise the importance of the influenza vaccine, the government would be able to flatten influenza cases in the nation.
“It will help to avert a ‘twindemic’ or twin pandemics involving Covid-19 and influenza,” he added.
The projected decline in influenza cases does not only apply to Malaysia but also worldwide, according to WHO data as of Nov 8, 2020.
Globally, despite continued or even increased testing for influenza in some countries, influenza activity remained at lower levels than expected for this time of the year.
COMPLICATIONS
There is still confusion between the common cold and influenza as both manifest similar symptoms such as fever, cough and cold.
The two infections, however, are completely different. Unlike the common cold, influenza can lead to various complications if treatment is delayed. These complications can be serious in the case of babies and children below the age of five, pregnant women, senior citizens aged 65 and above, and individuals with chronic health issues such as asthma, cancer and chronic obstructive pulmonary disease.
Malaysian Influenza Working Group chairman Prof Dr Zamberi Sekawi said influenza should not be taken lightly as the majority of patients who succumb to it are senior citizens.
Although there is a vaccine to prevent influenza, many individuals in both healthy and high-risk groups fail to get themselves vaccinated against the disease.
It is understood that only two percent of the population in Malaysia have obtained flu jabs.
“Ideally, everyone should get the influenza vaccination and not just the high-risk groups,” he said, adding that the vaccine is recommended to be taken every year as the influenza virus is always mutating which renders the previous vaccine ineffective.
Pantai Hospital Kuala Lumpur lung specialist Dr Helmy Haja Mydin said for now it is best to prevent influenza through vaccination as the anti-viral drug Oseltamivir is only effective if taken immediately within 48 hours after a person is infected with the virus.
“What we are worried about is that due to the similarity in symptoms, people with influenza would think they have the common cold and end up seeking treatment late,” he added.-Bernama
