June 2019
In yet another sign that this year’s flu season looks set to be a nasty one, pathologists are reporting an unusually high number of requests for diagnostic tests.
Staff at Australian Clinical Labs, one of the country’s largest pathology practices, have seen a steep spike in requests for Respiratory Viral Pathogen PCR testing, which is used to diagnose flu (and other respiratory diseases).
“We’ve been running these tests for ten years and this is the busiest year I can remember,” says Dr Travis Brown, supervising pathologist at Australian Clinical Labs in Adelaide.
Dr Brown and his colleagues are seeing nearly two and half times the number of positive diagnoses of cases of influenza across the country, compared to the same time in 2017 (the last serious flu season).
“In fact, we have seen more positive diagnoses every month so far in 2019 than any of the previous three years,” says Dr Brown.
The experience at Australian Clinical Labs reflects the wider national trend, with the Department of Health reporting 139 people have already died so far this year. Three times the average number of people for this time of year have been formally diagnosed (57,761).
Dr Brown says predicting the influenza season ahead is notoriously difficult, but all the trends point to this year being particularly serious.
“The best predictor tends to be the previous season but this is by no means fool proof - 2018 was unexpectedly low compared to 2017.”
It can be hard to distinguish flu from other upper respiratory tract infections, so Dr Brown says getting a formal diagnosis from a GP is important, particularly for people who may be susceptible to complications like those aged over 65.
“Flu is so virulent and the complications can be life-threatening,” he says. "Treatments are available for high risk patients with the Influenza A strain but it is essential the virus is detected early (ideally within 24 hours or at the latest 48 hours) for them to be effective."
And while the majority of people won’t need treatment, receiving a formal diagnosis is still useful.
“We need to monitor influenza from a public health perspective, so diagnoses help with that tracking component” he says. “And knowing you have flu means you can make an informed decision to stay away from friends or family who might be more susceptible, like elderly people or pregnant women.”
The Respiratory Viral Pathogen PCR test can confirm influenza infection within 24 hours. Doctors take a swab of secretions from the back of the patient’s nose and their upper throat (a ‘nasopharyngeal swab’) and send it to the lab for rapid diagnosis.
“Getting a flu diagnosis confirmed quickly means doctors can determine the correct medical course of action as well as refer patients for further treatment if they need it,” says Dr Brown.
The most vulnerable groups for influenza are the immunocompromised, young children, and adults aged over 65 years.
“The best way to protect yourself against flu is to get vaccinated every year,” says Dr Brown. “At risk groups receive the vaccination free.”
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Advice for people aged 65+
There are multiple reasons older adults (over 65) fall into the 'at risk' category.
The immune system can become less robust as we age, reducing our ability to fight the infection and also increasing the time it takes to recover afterwards. Older people tend to also have other conditions that may impair their immune systems, making them more vulnerable to an infection.
The Government recommends every Australian who is eligible over the age of 65 gets the influenza vaccine every year. The reason for getting the vaccination every year is threefold.
Firstly, there are many strains of influenza virus and while we can vaccinate against one strain, we may be still susceptible to another. Secondly, the virus itself is subject to 'drifts' and 'shifts', meaning its genetic code changes, so that the old vaccination may no longer be effective. Thirdly, more people getting vaccinated confers an overall benefit to the community known as 'herd immunity'. If enough people are vaccinated then the infection’s ability to spread is limited, helping to protect the whole population.
The symptoms of influenza are mainly a respiratory illness (cough, runny nose, sneezing) with systemic features (fever, headache, chills, painful joints, rigors/shakes, weakness). Unfortunately, it can be difficult to distinguish between influenza and other types of upper respiratory infections. However, as a general rule of thumb, influenza feels much worse than other respiratory infections.
If you think you may have influenza, book an appointment with your GP.