‘It’s really dangerous now’: Australia’s influenza hiatus set to end

Talking points

  • Infectious diseases experts say the flu will likely return to Australia this year.
  • The disease virtually disappeared during coronavirus lockdowns and border closures.
  • Some children born during the pandemic have never been exposed to the disease.
  • Prior to the pandemic, influenza was the leading cause of hospitalisation in children under five.
  • The federal government is urging people to get vaccinated from next month onwards.

For almost two years, the flu has been all but eradicated in Australia, but experts say the nation’s influenza hiatus is set to end in the coming months, posing a new danger to babies and toddlers who have grown up never encountering the disease.

Just 22 cases of the flu were detected across the nation last month – an extraordinarily low count, even for the summer. In February 2020, just before Australia’s international borders closed, there were more than 7000 cases reported.

Most Australian children born in 2020 onwards would have never been exposed to the flu.Credit:Shutterstock

But infectious diseases experts now say it’s a matter of when, not if, influenza will return to Australia, and they are worried that people may have forgotten how severe the disease can be and forgo their annual flu jab.

While COVID-19 is generally much less severe in children compared to adults, the same doesn’t apply for the flu. Multiple children have died from the disease during bad influenza seasons in Australia.

Melbourne paediatrician Margie Danchin said that for the first time in two years, Australian hospitals would be bracing for a potential surge in admissions of children and babies infected with the flu.

“Prior to the pandemic, influenza was the leading cause of hospitalisation in children under five,” she said. “The return of influenza this year is absolutely going to pose a risk to children, particularly very young children, whose immune systems are naive to the flu because they have never experienced it before.”

The Murdoch Children’s Research Institute vaccine uptake expert said this year it was crucial an influenza vaccine campaign could “cut through the high levels of vaccination fatigue” in the community during the pandemic, which was reflected in a plateauing of coronavirus immunisations nationally among five to 11 year-olds.

Only about 50 per cent of this age group have had one dose of a coronavirus vaccine and just over 13 per cent have had two doses.

“I feel like we are back at square one with our messaging to parents about the flu, and it’s really dangerous now because there is so much vaccine fatigue,” Associate Professor Danchin said.

“We are going to need to really push that message particularly around the risks of the flu for kids under the age of five.”

Dr Rod Pearce believes Australia’s holiday from the flu could be over soon.Credit:Immunisation Coalition

Immunisation Coalition chair Rod Pearce said it wasn’t yet clear how the prolonged lack of exposure to the flu had affected overall immunity to the disease, and he’s worried the nation could be in for a bad flu season because of this issue, combined with vaccine complacency, putting extra strain on already stressed hospitals.

As some states loosen mask wearing and other pandemic mandates, Dr Pearce said people needed to remember that if they went out into the community with symptoms, they risked exposing themselves, children and others to serious and deadly viruses.

More than 950 Australians aged one to 106 died with laboratory-confirmed cases of influenza in 2019, according to official statistics, though the real toll is estimated to be many thousands each year when influenza is active. The median age of those who died in 2019 was 86 years.

Infectious diseases physician Kudzai Kanhutu, who has spent years working with migrant communities and at major hospitals in Melbourne, has vivid recollections of caring for severely ill people who had been infected with influenza.

“They get really, really sick and they just die after getting the flu because often it is a gateway for other bacteria to hop on board … and people end up dying of pneumonia,” she said. “It can be just awful.”

Deputy director of the World Health Organisation’s collaborating centre for reference and research on influenza, Ian Barr, expects a moderate flu season in Australia this year given the current low number of cases, but said you could never be 100 per cent confident making predictions as “influenza can erupt quite quickly”.

Professor Barr said quite big outbreaks had recently been detected in Fiji and New Caledonia, while countries in the Northern Hemisphere now emerging from winter have been reporting shorter than usual flu seasons.

The Australian health department says influenza vaccines are expected to be available from April and Mr Barr said the best time to get the influenza vaccine this year was probably April or May.

Babies aged over six months are recommended to have an influenza vaccine twice, at least a month apart, and an annual vaccine is recommended every year following.

Because of their vulnerable status, the flu vaccine is free through the National Immunisation Program for children aged six months to five years, along with pregnant women, people 65 years and over, Aboriginal and Torres Strait Islander people and those with medical conditions that put them at higher risk.

Associate Professor Danchin said up to 10 per cent of children who end up in hospital with the flu can have neurological problems, such as memory loss, seizures and learning and speech difficulties.

She said those at highest risk of death from the flu were babies aged under six months, who were unable to be vaccinated against the flu. She said the safest approach with infants was for women to have the injection while pregnant.

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