Flu season defies media and remains “moderate”

THE 2019 influenza season is moderate and nowhere near the severity of 2017, despite media headlines doing their best to whip up panic, say experts from NSW Health.

In a Letter to the Editor published online by the MJA, Dr Vicky Sheppeard, Director of the Communicable Diseases Branch of NSW Health, and colleagues wrote that the record number of notifications for influenza in 2019 was being misinterpreted by the mainstream media.

Sheppeard and colleagues cited front page coverage by the Daily Telegraph on Saturday 9 July 2019, which included the headlines “Mutant flu crisis”, and “Exclusive: Jab fail fears as killer strain takes hold”, as an example of the skewed reporting.

In an exclusive podcast, Dr Sheppeard told InSight+ that she and her colleagues were “frustrated that there was a lack of understanding, particularly in the media, about the different indicators about flu”.

“While it’s good to get information out to the community about what’s happening with flu and how it might affect them, there were a lot of headlines that were talking in ‘crisis speech’.”

The change in the way influenza is diagnosed, from being based mainly on serology to rapid, highly discriminatory polymerase chain reaction testing widely available in primary and acute services has resulted in an impressive annual increase in test numbers, from 29 232 in NSW sentinel laboratories in 2010 to 338 828 in just the first 6 months of 2019, according to the authors.

“It is good that we have a better identification of who has flu, because that means a person with a positive test has the opportunity to have antivirals, which are effective,” Dr Sheppeard told InSight+.

“They can be given the appropriate information about isolating themselves from others. It’s very useful with outbreaks, so that we know what bug we’re dealing with. So, there’s a lot of positive things [about the increase in testing].”

Testing, however, does not inform about the severity of the current influenza outbreak.

“We appreciate the media bringing flu to the awareness of the community,” said Dr Sheppeard. “But it’s about being able to report it so that it’s not always about panic, about saying that there’s something wrong with a vaccine.

“We’ve been monitoring very closely how well the viruses that are circulating are matching to the vaccine. And overall, the vaccine’s been looking quite good this year.

“It’s certainly a typical flu vaccine performance, which is never anything like 100%, but it’s performing as one would expect. The other things we monitor are admissions into critical care units and deaths, and they’re tracking as per a moderate season.”

Dr Sheppeard confirmed that residents in aged care facilities had been hit hard this year, with about 280 outbreaks in NSW. But even that number, compared with 543 in 2017, was indicative of a moderate season, she said.

Dr Sheppeard and her colleagues wrote that overall other indicators needed to be examined to accurately assess the burden of influenza rather than the raw notification numbers.

“One indicator is the influenza test positivity rate,” they wrote. “This was highest in 2017 (an acknowledged severe season due to ineffectiveness of the vaccine against the predominant influenza A[H3N2] strain), and is at a moderate level so far in 2019.

“Of course, influenza is a serious infection, with a mortality rate of around 1% in confirmed cases and most of the mortality burden affecting the vulnerable elderly.

“We are working to reduce the impact of influenza on the community; hopefully, we can achieve this without generating unfounded community concern,” they concluded.