By almost any metric, Australia is in the grips of one of the worst flu seasons in modern times. As of July 17, 2023, there have been more than 160,000 laboratory confirmed influenza reported to the National Notifiable Diseases Surveillance System (NNDSS) during the calendar year.
Of greater concern is the effect of this year’s flu season on children, with Victoria alone reporting over half of its 24,000 plus cases in children under the age of 15.
The story is even worse in Queensland, who has seen a nearly 20% growth in influenza cases year on year. Distressingly, since the start of July, almost 80 children aged between six months and four years were hospitalised with the flu, and only one was vaccinated.
The Immunisation Coalition shows this is not just a state-by-state issue, with just 22% of children aged six months to five years old vaccinated against influenza nationally, compared with 61% of those aged 65 and above.
Dr Rob Grenfell, Chief Strategy & Regions Officer for Grampians Health, said the reasons for these vaccination numbers come from a multitude of issues.
“People’s attitudes to influenza can be very lax. They don’t necessarily understand that it in fact can be a very serious illness, and it can be at any age group,” Dr Grenfell said.
“But it can be serious [in] people with pre-existing medical conditions, or having say cancer therapies, and others can be more prone to very severe outcomes from influenza.”
“Anybody can be impacted by a severe dose of flu. Now, when I was a GP, I used to say to my patients when they’d come and see [me] with a respiratory complaint and they’d ask, have I got influenza? And the answer to that is usually if you’ve got a cold, you feel like you’ve got the flu. If you’ve got the flu, you’re actually feeling not very good at all.”
Some are calling for cautious optimism that vaccination rates will increase now that children have returned from school holidays and the introduction of further free vaccination programs will boost participation.
Dr Grenfell, whose previous roles include Director of Health and Biosecurity at CSIRO, National Director of Cardiovascular Health at the Heart Foundation, and Senior Medical Advisor at the Department of Health Victoria, spoke to the work being done by businesses to keep their staff well.
“There are so many workplaces now that offer influenza vaccines because the studies were done decades ago that showed that influenza creates increased rates of absenteeism the workplace. And if you have vaccine programs in your workplace, you decrease the absentee rates. So that’s a productivity issue in that sense.”
At its current stage, the latest national surveillance report notes there is currently not enough information to comprehensively assess the potential severity of the 2023 influenza season, however reporting does show that influenza is in the community at significant levels.
Thankfully in terms of testing, there are multiple options available to medical practitioners. Dr Grenfell added that point-of-care testing in high-risk settings could play a more vital role in the future, given the learnings of the COVID-19 pandemic.
“Aged care, cancer treatment services, I would suggest that even just hospitals because people’s immune systems are usually challenged when they’re in hospital, even for elective procedures,” Dr Grenfell said.
“So to reduce that risk, the idea of staff testing themselves, that’s worked extremely well for managing outbreaks of COVID in aged care, I would view that point-of-care testing for all staff for particularly volatile agents like influenza or COVID, is a great idea to [limit] outbreaks in your facilities and also to protect the vulnerable groups.”
“If I was a healthcare worker in community health and other settings, I would obviously be interested in the idea of risk and the idea of point-of-care testing for people with respiratory symptoms coming into my practice.”
Like any disease, early diagnosis can help reduce the likelihood of the most severe outcomes, such as hospitalisation. It is why tests like these, and the pathologists who perform them, are an indispensable part of the equation.
Appropriate testing then also allows for appropriate surveillance, allowing for targeted measures to protect vulnerable populations and areas.
Vaccination is vital to ensuring a healthy populace, but both surveillance and testing must continue to be part of a three-pronged attack to combat influenza, just as it was to combat COVID-19.
