Cases of Influenza-A subtype H3N2 are on the rise, some deaths have been reported across India. The government says it is closely monitoring the situation and has issued an advisory. Is there cause for concern? Peppermint telling:
What is H3N2 virus?
There are four types of flu virus: A, B, C and D. Of these, only A and B cause seasonal outbreaks or epidemics in humans. C causes mild illness and D does not affect humans. There are over 130 subtypes of A, based on the combination of hemagglutinin (H) and neuraminidase (N) proteins found in nature. H3N2 is one of two A subtypes that regularly circulates between humans, the other being H1N1. Influenza B is another circulating strain. The 1968 Hong Kong flu, which killed millions, was caused by H3N2, while the 2009 swine flu pandemic came from a new strain of H1N1 virus.
Is the current flu outbreak unusual?
Not necessary. The World Health Organization (WHO) estimates that there are 1 billion cases of flu each year, of which 3–5 million are severe, causing between 290,000 and 650,000 deaths. Most recently, Australia reported more than 220,000 flu cases in 2022 and nearly 8,500 in the first two months of 2023. In India, till March 9, a total of 3,038 cases have been reported this year, with H3N2 being the dominant subtype. Annual data on H1N1 infections in India suggest a sporadic pattern in the rise of cases with a decline in 2020 and 2021. But 2022 sees 13,202 H1N1 cases, compared to 778 in 2021 and 2,752 in 2020.
What is the reason for the recent surge?
Flu cases are reported year-round in India, with two peak seasons: post-monsoon and January–March. Experts say the increase in 2022 and 2023 could be due to a sudden increase in exposure to the flu virus once Covid-appropriate behaviours, such as wearing masks and avoiding public places, were relaxed. Air pollution worsened the situation by damaging immune cells.
Which population groups are at risk?
Seasonal influenza infects (spontaneously and symptomatically) one in five unvaccinated children and one in 10 unvaccinated children. Five groups are at high risk: children aged 6-59 months, pregnant women, the elderly, adults with co-morbidities and healthcare workers. The WHO recommends the flu jab for these groups, but coverage in India is very low (only 1.5% of the elderly population). The government recommends vaccination for healthcare workers dealing with current H1N1 cases.
What are the measures and precautions?
Those who become infected are given medicines that treat specific symptoms such as fever and cough. An antiviral drug (oseltamivir) is recommended only for high-risk populations or in specific cases. Experts recommend wearing a mask in crowded places, covering your mouth and nose with a tissue when you sneeze or cough, staying home if you feel sick, and washing your hands frequently. According to some experts, the temperature is likely to rise by the end of March or the middle of April.
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