Viral flu is nothing to sneeze at

Have you been feeling out of sorts these days, having a runny nose, or a cough or even a mild fever that makes you want to stay home and not go to work or school? If you are, maybe you should listen to what your body tells you and stay away from your workplace or school for a few days. And if the fever, however mild and other symptoms that accompany persist for several days, here’s a bit of sound advice from a health practitioner: Seek medical advice. You may be a victim of viral influenza.

An outbreak of influenza is now spreading in different parts of the island, prompting health officials to call for public co-operation to take preventive action and contain its spread. While rejecting rumours of avian flu, which the viral flu has been mistaken for by some, the Health Ministry has eiterated the importance of protecting oneself against it, by following a few simple rules and, most importantly, staying away from crowded areas where even a single infected person could easily pass on the infection to several others through close contact.

Here, Senior Registrar, Epidemiology Unit, Health Ministry, Dr Athula Liyanapathirana explains what viral influenza is all about and the golden rules to follow to avoid contracting it.

Excerpts...

Q: Quite a number of people today are walking around with runny noses and sore throats. A few have even developed complications that have led to them being hospitalised. Is this a new disease? Or is it the usual flu we see at this time around?

A. It is the usual seasonal influenza outbreak that occurs at this time around, following the rains.

A: Influenza is an acute febrile illness characterized by respiratory symptoms ranging from influenza-like illness (cough, sore throat, rhinorrhoea – runny nose) to pneumonia.

A:Usually there are two peaks of this flu. We are now experiencing the second peak. Each season has a predominant circulating virus.

Still not a notifiable disease

MOHs from various districts contacted by the Sunday Observer claimed AHINI Influenza was still not a notifiable disease, unlike other communicable seasonal diseases like Rat Fever, Typhoid, Measles, Polio and hepatitis. This, the MOHs said, meant a true picture of the exact number of cases was unavailable from the health ministry website, as hospitals where suspected or confirmed cases are admitted to, don’t have to post their reports to the system.

They also said the non availability of the figures prevented them from carrying out their prevention activities and programmes in areas where there is a higher risk of the disease spreading. “IF we had these figures, it would be easier for us to locate these high risk areas and concentrate our programmes in those areas,” one of the medical officers said.

A: Seasonal influenza viruses are largely grouped as A, B and C. Influenza A viruses are divided into subtypes based on two proteins on the surface of the virus: the haemagglutinin (H) and the neuraminidase (N). Influenza B viruses are not divided into subtypes, but can be further broken down into lineages and strains. Only certain influenza A subtypes and influenza B usually cause severe disease in humans.

Q: How do you come to this conclusion? Have there been any studies or research done on the different viruses/sub types?

A: Based on FluNet (the World Health Organization global tool for influenza virological surveillance), during the latter half of April and early May 2015, 26.1% of the globally tested samples have been influenza A, while 73.9 % were reported to be influenza B. Of the sub typed influenza A viruses, 53.8% were influenza A (H1N1) pdm09 and 46.2% were influenza A (H3N2). The Influenza A virus sub types H1N1 and H3N2 and also type B have been in circulation in Sri Lanka causing influenza recently.

A: Majority of infections are self limiting. But it can cause more severe illness in those in extremes of ages, pregnant women, those with chronic illnesses and immune-compromised patients.

A: Influenza virus spreads mainly by droplets generated when people with flu cough, sneeze or talk. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. Less often, a person might also get flu by touching a surface or object that has flu virus on it and then touching their own mouth or nose.

A: Symptoms start 1 to 4 days (incubation period) after the virus enters the body. Infected people may spread the disease during the latter part of the incubation period and up to 7 days after becoming sick. Children may pass the virus for longer than 7 days. Some infected with the flu virus may not develop symptoms but may still spread the virus to others.

Some symptoms of dengue can be similar to those of influenza. Eg; fever, headache, muscle and joint pains. But symptoms of cough, rhinorrhoea and sore throat are more common with influenza. However in both cases patients are supposed to seek medical advice without delay.

Stomach flu is due to a virus affecting the alimentary tract. This is different from influenza.

Haemophilus Influenza b (HIb) is a bacterial disease contracted through the respiratory tract that can cause respiratory illness and meningitis. It is not a kind of influenza.

A: Treatment for influenza is mostly supportive therapy as for many respiratory diseases. There is also specific antiviral treatment with a drug called Oseltamivir. However, Oseltamivir is not given for prevention of influenza or to those who are managed as out-patients. It is only given for patients with severe disease who are hospital admitted and managed as inward patients.

A flu vaccine may not cover all strains of influenza viruses nor will they give full protection from future attacks. The vaccine is not available in the government sector.

Q: Do you have a proper data base or surveillance system to monitor the disease and find out where it is currently spreading the most?

A: A surveillance system where samples are collected from out patients and inward patients is in place to monitor the influenza status especially with regards to circulating virus types in 19 sentinel hospitals. Necessary circulars and guidelines have been issued on disease prevention and management.

Q: What about anti viral drugs? Are there enough to go round considering the sharp increase in patients every day?

A: Necessary stocks of antiviral drugs and personal protective equipment to be used where appropriate have been made available in government hospitals islandwide.

Sri Lanka has modern technology to diagnose influenza and all the facilities including drugs to manage the disease. Medical Research Institute is the national reference laboratory and it has adequate capacity to handle any outbreak situation.

Q: The flu we are now experiencing has been mistaken for avian influenza, which is also on the increase in some parts of the world. Your comments?

A: Seasonal influenza currently occurring in the country is not avian influenza or swine flu. The difference is that this infection spreads essentially from human to human.

A. To avoid contracting influenza, people should stay away from sick people and stay home if sick. It also is important to wash hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub. Linens, eating utensils, and dishes belonging to those who are sick should not be shared without washing thoroughly first. Eating utensils can be washed either in a dishwasher or by hand with water and soap and do not need to be cleaned separately. Further, frequently touched surfaces should be cleaned and disinfected at home, work and school, especially if someone is ill. While sneezing or coughing, mouth should be covered with a handkerchief or a tissue.

The used tissues used and other waste from patients should be discarded into non touch receptacles.

You can also get more details and updated information from our website: http:epid.gov.lk