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Flu season will start soon – here’s what you need to know to protect yourself

Flu season will start soon – here’s what you need to know to protect yourself
The flu season on average can start anytime from the third week of April and can circulate until August. (Photo: iStock)

While some people have come down with the flu, the official flu season – based on the number of cases seen – has not yet started. Also, it’s been confirmed that there are no new Covid strains around.

As flu season is expected to start soon, there are ways to protect yourself and others. We asked Dr Jocelyn Moyes, a medical epidemiologist from the National Institute for Communicable Diseases (NICD), to answer some questions about the flu. 

When does flu season start?

Moyes said that over the last 20 years (excluding the pandemic years between 2020-2022), the influenza season generally started between mid-April and early June. It peaks in late June or early July and ends in August or September.

Which variants will be most in circulation this year?

Influenza viruses constantly change their antigenic structure, so it is impossible to predict which strain(s) will circulate. In most years, there will be a mix of strains.

Does it matter which of the flu strains you have?

Influenza from any strain is a self-limiting illness for most people, and people will recover in 3-7 days. However, influenza can cause severe illness, hospitalisation or even death in some people. 

“All influenza strains can cause severe disease. The annual influenza vaccine (available in public health clinics and private facilities) can prevent illness and protect against severe disease. 

“The vaccine is changed yearly to match the expected circulating viruses. People at risk of severe illness are strongly encouraged to get vaccinated,” she added.

Who is at risk of severe illness?

Moyes listed these categories as: pregnant women and women who gave birth within the previous six weeks; people living with HIV; individuals with tuberculosis; persons of any age with chronic diseases, especially those affecting lungs like asthma; those who require immunosuppressive medication or cancer patients; people who have been diagnosed with cardiac disease (except hypertension); people with diabetes and other metabolic diseases; and those with renal or hepatic (liver) diseases or neurologic and blood conditions. 

Moyes also advised that people older than 65 get vaccinated and those younger than 18, including children, receive chronic aspirin therapy.

Should we still test for Covid?

The NICD continues to do surveillance for SARS-CoV-2 to describe the circulation and identify the variant circulating. There is no indication for individuals to test for SARS-CoV-2, unless it is needed for medical management of their illness.

What are the current respiratory diseases circulating?

“SARS-CoV-2 has been circulating at low levels for two years, with no indication of the circulation becoming seasonal. The RSV [respiratory syncytial virus] season in South Africa starts in mid-February, peaks in April or early May and ends in early June, preceding the influenza season. 

“In our surveillance programmes, the peak of RSV circulation for 2024 has been reached and the detection rate is decreasing,” said Moyes. 

Which respiratory diseases are in circulation?

The disease currently identified by the NICD’s surveillance programmes is flu, although the season has not yet started (based on predetermined thresholds).

Pertussis is a vaccine-preventable illness caused by the bacterium Bordetella pertussis. It’s commonly known as whooping cough.

“From July 2021, we detected an increase in the circulation of pertussis across the country (mostly in young children), lasting until mid-2023. Since then, the numbers have decreased dramatically, and we are only picking up sporadic cases now,” Moyes said. 

“Some respiratory viruses other than RSV, influenza and SARS-CoV-2 can cause similar symptoms, including adenovirus, rhinovirus, enterovirus, parainfluenza and human metapneumovirus. These viruses can circulate all year round but may increase seasonally,” she added.

How can we protect ourselves?

Moyes said the best way to protect yourself is to get the flu vaccine (for influenza) and implement similar measures to those used during the pandemic. 

These include frequent hand-washing, respiratory hygiene (cough/sneezing into a tissue or your elbow), wearing a mask when you have respiratory symptoms (to protect other people) and isolating if you are ill to avoid spreading viruses.

How vital is it to get the vaccine?

Moyes said it is vital for people in the high-risk group. 

“For others, it is advisable, particularly if they wish to reduce their chances of becoming ill, being absent from work or spreading the virus to other vulnerable individuals.”

Is there a new strain of Covid that we don’t know about doing the rounds?

Moyes explained that the SARS-CoV-2 is constantly evolving, but there is no new variant doing the rounds at the moment. 

“The virus has been circulating at a low level since the end of the pandemic,” she said.

She added that current Covid levels are low, with little change in the past two years.

According to the latest genomic surveillance report by the NICD, JN.1 is the current dominant strain of Covid-19 in South Africa. 

JN.1 is a subvariant of Omicron that was first identified in the US in September 2023. While it is distinct due to some mutations on the spike protein, there is no clinical evidence that it causes more severe diseases than other subvariants of Omicron.

Can you get the flu and Covid at the same time? 

Yes, although this is uncommon, Moyes said.

How can your flu help others?

The NICD is inviting eligible community members to join its respiratory health survey.

The online survey developed by the NICD is known as CoughWatchSA and aims to monitor respiratory symptoms for influenza-like illness. 

CoughWatchSA will ask people to report their respiratory symptoms (or lack of symptoms) on a weekly basis for six months during the influenza season. The NICD will use this data to monitor trends in respiratory illness.

CoughWatchSA needs eligible participants to join a home-based testing study, CoughCheck. This study will ask participants to take a nasal swab in their homes for a laboratory confirmation for flu, respiratory syncytial virus or Covid. 

This service is only available in Johannesburg, Durban and Cape Town and there are no cost implications. Participants can also register for WhatsApp notifications to fill in the survey. DM

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  • Malcolm McManus says:

    “The vaccine is changed yearly to match the expected circulating viruses”. How does one change a vaccine if they have no idea what variation to expect. I am not a conspiracy theorist, but I do feel its plausible that the pharmaceutical companies mutate these strains to sell their vaccines and make billions of dollars every year.

    • Bruce Watson says:

      I would say that very literally makes you a conspiracy theorist: you find it “plausible” that the pharma companies conspire to do something like that. Of course that’s not true: it costs nothing to let nature rapidly mutate it. The monitoring/sequencing network globally keeps a leaderboard of variants, and the most likely 3 or 4 are chosen to go into the year’s vaccine. Simple. The two hemispheres (N and South) benefit from what’s already unfolded in the other hemisphere’s population. BTW, vaccines are almost never the big money spinners for pharma. That would be statins, viagra, etc.

    • Geoff Coles says:

      All done, as always, and not had flu in 2 decades.

    • Ed Rybicki says:

      Actual virologist here: flu is monitored closely in SA, as in many other countries, and vaccine composition recommendations (eg: which isolates / substrains of H1N1 and H3N2 and influenza B) are made for each hemisphere separately, given that flu is generally seasonal and there is a six month lag between north and south for peak flu incidence. This means we get a recommendation based on northern hemisphere viruses circulating in their peak season, in time for vaccines to be made for our peak season. Sometimes they get it wrong – a few years ago the H3N2 flu recommendation did not cover the virus we actually got, so vaccine efficacy for that strain was only around 20% – but mainly they get it correct.

      THERE IS NO CONSPIRACY: the WHO is in charge of collecting data on virus variation and in authorising companies to make specific mixes of viruses for the seasonal vaccines, and they are not in anyone’s pockets. Flu viruses are very good at mutating themselves; they don’t need any help!

      All of this info is in the public domain, BTW, on the WHO websites and on the US CDC sites – so it’s very easy to check.

    • William Dryden says:

      I agree Malcolm and as for the WHO and the Pharmaceutical companies, are all on the same page with their promotion of vaccines and Bill Gates is the biggest shareholder in pharmaceutical companies. How is it that between 2018 and 2019 there were approx. 2.5 million people who died from influenza, yet between 2021 and 2022 (the covid year) there were no deaths from influenza all were supposedly died from Covid. It was also a red flag when Bill Gates sat next to the head of the WHO ( I think it was Fauche), and said the whole world has to be vaccinated to cure Covid. Nice pay day for him as an investor.

      • Ed Rybicki says:

        This is actually ridiculous beyond measure: why is Bill Gates pegged as the biggest investor in pharma, when actually it’s American pension funds? Your flu figures are also incorrect – it’s actually 300K – 600K in any normal year, and flu deaths went DOWN during COVID because, guess what?? Masking works to prevent flu transmission!! Bill Gates HELPED fund SARS2 vaccine development to SOME extent as a philanthropist; he did NOT own it. And Anthony Fauci was head of the US NIH, NOT the WHO: that’s Tedros. Please educate yourself better, and not by using crank antivax sites?

  • Patricia Beukes says:

    No jabs for me thanks, after covid I will never trust any pharmacutical company again!!

    • Agf Agf says:

      Precisely. My thoughts exactly.

    • Robert Gornal says:

      And once again the recommendation of wearing a mask that (a) does not prevent the virus, flu or other, from being inhaled nor exhale because masks cannot block viruses that are much smaller than the gaps in the fabricd whilst (b) restricting the wearer from properly inhaling oxygen needed by the bodwe do haveevidence showing mask wearing can cause harm.

      For example, in its December 2020interim guidance on masks, the WHO noted that mask disadvantages included “a false sense of security,” and that:
      “Several studies have demonstrated statistically significant deleterious effects [of masks] on various cardiopulmonary physiologic parameters during mild tomoderate exercise in healthy subjects and in those with underlying respiratorydiseases.”
      A German registry of reported effects among children found 68% experienced some sortof impairment, such as irritability, headache, poor concentration, reduced happiness,reluctance to go to school, general malaise, impaired learning and fatigue. Other investigations have revealed children are exposed to potentially dangerouselevations in carbon dioxide when wearing a face mask. These findings suggest that mask use might pose a yet unknown threat to the user instead of protecting them, making maskmandates a debatable epidemiologic intervention.

      • Ed Rybicki says:

        Utter garbage: if your mask-wearing “facts” were true, then all surgeons and theatre staff would be brain damaged, and all patients infected with whatever they had – which doesn’t happen, because masks WORK to prevent airborne spread of TB, flu and SARS2. As for comments on how pore sizes are too large to stop virus particles, well, that would be true if that were how the viruses and TB are transmitted – as naked particles – rather than in a spectrum of sizes of droplets and aerosols, which ARE stopped by masks.

        THERE IS NO SERIOUS DEBATE AMONG MEDICAL FOLK ABOUT THE EFFECTIVENESS OF MASKS.

        Moreover, a study I read while COVID was still raging showed that elite athletes who did a punishing regime of exercises while masked, and wired up to every monitor imaginable, showed NO CO2 build-up and there was NO drop in O2 saturation. There are a lot of conspiracy theorists out there still spreading garbage about things they know distressingly little about – don’t be one of them?

        • Robert Gornal says:

          Mask worn by surgeons and nurses act as to help block large-particle droplets, splashes, sprays, or splatter that may contain germs (viruses and bacteria), keeping it from reaching your mouth and nose. Note it is not keeping a virus out but large-particles which may contain a virus, bif difference to what you wrote.

          • Ed Rybicki says:

            Are you qualified to say anything like that? Virology, or microbiology, medicine or epidemiology? If not, and if all of your “knowledge”comes from conspiracy theory-spouting antivaxxers in the interwebs, then it is worth what you paid for it. Next to nothing, in other words. How do you think TB and viruses are transmitted via the air? IN DROPLETS, or as quite large aggregates complexed with other material. NOT as individual particles, which COULD theoretically get through masks, but don’t because the droplets adhere to the multiple-layered masks. If you don’t have the qualifications, don’t offer opinions – because equally unqualified people might actually believe you, which could make you complicit in them harming themselves.

    • Ed Rybicki says:

      You are probably alive now because of vaccines: do you know how childhood mortality was reduced by around 75% for under-5s in less than 100 years from the late 1800s? Vaccines. COVID vaccines probably saved 20-odd million lives as a CONSERVATIVE estimate – because COVID was about 10-20 times worse than flu in terms of killing people, across the spectrum from children to the elderly, with the latter having about a 15% chance of dying. Educate yourself a little better?

      • Robert Gornal says:

        Most people in this country have been cut off from what scientists around the world are finding out about the mRNA injections due to our government forbidding discussion on these dangerous injections. By original definition the Covid injections was never a vaccine. There is a big difference between vaccines of old and this injection. The latest scientific news is that these gene-therapy injections have the potential to alter our DNA. If it was going to be a vaccine then all that would have been needed was for a small sample of the Spike protein to be injected but to use the mRNA which has been found to be contaminated was and continues to be a money making business for Big Pharma. Strange that China did not go down this route of injecting their people. But trying to get some people to fully comprehend what has happened results in being called a conspiracy theorist rather than them looking at the number of people injured, who have died following being injected and the rising excess deaths in countries where the population was mainly injected compared to countries which were not. Watch the videos of the UK parliament becoming empty when a Member raises these points. There is so much being discovered, that it is impossible to cover it all in a few sentences but anyone interested to know more could start with Dr John Campbell’s videos particularly where he interviews world-renowned scientists in the UK and Australia. One can’t help feeling that the use of “conspiracy theorist” is being used in a manner similar to the frequent use of the word :apartheid in this country.

        • District Six says:

          Yup. Dr John Campbell, who isn’t a medical doctor but a medical nurse, on Youtube, is where all the world’s scientists go for medical virology information. Word is, even in China, they are watching youtube videos instead of medical school. Who needs 9 years of actual study when one can, you know, youtube with Dr John Campbell.

          Gosh, now the aviation industry is onto this clever scheme. Delta, BA, United, and KLM are soon to start training pilots by making them watch Youtube, the Dr John Cambottom channel. He isn’t a pilot, but is a cabin crew member with a PhD. I feel safer in the skies already!

        • Ed Rybicki says:

          Good gods almighty, but you are
          A) grotesquely uninformed
          B) hugely ignorant
          The SARS2 vaccineS – note the S – are ALL legitimate vaccines. There were 2 mRNA vaccines, which are NOT gene therapy vaccines even though other formulations of them can be used as such. However, there are also the adenovirus-based vaccines – J&J and Chadox – which are nothing like the mRNA vaccines (and we had J&J in SA), AND the inactivated vaccines from China, AND the protein-based vaccines from the USA like Novavax. You have bought so deeply into the conspiracy theories that you seem incapable of climbing out far enough to see some sense – and you BADLY need to, because you are hopelessly misinformed.

          I say again: I AM AN ACTUAL VIROLOGIST. I have lectured on the subject at UCT for 43 years; I have worked and taught on vaccines for over 20 years – and just about everything you write is so much 🐴💩. And no, I have no Big Pharma connections or funding, although I would like it if someone would develop our plant-made SARS2 vaccine.

      • William Dryden says:

        I’m alive because I didn’t get vaccinated by choice and never will, yes I had a bout of flue for 2 weeks total in 2022. My Dr said was Covid which I didn’t agree and refused to go and get tested, so he gave me some blood thinning tablets, 1 large anti biotic tablet and some cortisone tablets. It took one week and I was right as rain as they say, also my wife slept with me throughout my 2 weeks of flue and didn’t get sick. Makes one think.

        • Ed Rybicki says:

          Makes me think that you are and were lucky – by a combination of genetics and a good innate immune system. As you get older, this will diminish and your chances of dying of flu and now COVID and even one of the other common cold coronaviruses will increase exponentially. And guess what most elderly people die of if cancer or heart attacks or strokes don’t get them? That’s right: respiratory diseases like flu.

  • Soil Merchant says:

    Crikey – Already had something this year that was equivalent or worse than the flu … EUGH!

  • Sandi Holley says:

    As an asthmatic I swear by the flu vaccine. Before having the vaccine I was man down with this new variant of flu.

    • Ed Rybicki says:

      Excellent! As an elderly virologist myself, I am rather upset we don’t have Novavax protein-based COVID vaccine available – and I have already vaxed up for flu.

  • Bick Nee says:

    Nice try Ed, but no amount of science and fact will ever convince anti-vaxxers, anti-maskers, conspiracy theorists and fools.

  • Erika Jansen says:

    Thank you Ed for the sane voice of true scientifical knowledge.
    When your loved one lies in icu on a ventolator with influenza pneumonia the unscientific and unsubstantiated theories will become meaningless. Hold on to the partial protection of masks and efficacy of hand hygiene.
    Thank you to Estelle for the researched and well presented articles

  • Jane Trembath says:

    Years ago I read an article in the New Yorker about how cold and flu viruses can stay alive on impervious surfaces such as handrails, lift buttons etc for a couple of days, and got there from infectious people who had wiped snot from their noses with their hands.
    The best way not to catch the virus was never to touch your nose or eyes unless your hands were clean, as their membranes allow the viruses in. After reading that I didn’t have a cold for years.

    • Ed Rybicki says:

      True, and it was initially thought that SARS2 and flu were very largely transmitted via large droplets and contaminated surfaces – but after overwhelming evidence of airborne transmission has accumulated, the WHO now acknowledges that airborne transmission is at least as important as picking up the viruses from surfaces. Hence masking! It’s probably a dose thing, BTW: you may pick up a lot more virus from touching a deposit on a stair rail or counter top than you would from a disseminated aerosol cloud – but the latter type of dispersal was responsible for whole choirs catching COVID from aerosols caused by loud singing.

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