‘Don’t let guard down on flu’

Public concern: Dr Roslina says the government must not lose sight of the importance of curbing influenza, especially among health workers.

PETALING JAYA: Amid the battle against Covid-19, doctors are reminding authorities not to lose sight on influenza which, according to the World Health Organisation (WHO), kills between 250,000 and 500,000 people each year.

Consultant respiratory physician Prof Dr Roslina Manap said curbing influenza, which exists year round in Malaysia, must remain a priority.

The Universiti Kebangsaan Malaysia’s Faculty of Medicine deputy dean said the importance of stepping up influenza vaccination cannot be overstated.

Malaysia was in an influenza panic late last year, which eventually resulted in at least two schools shutting down to contain an outbreak of influenza A (H1N1).

In January, the Health Ministry (MOH) said SM Sains Teluk Intan, Perak, as well as SK Stella Maris, Tanjung Aru, Sabah, were both closed for a week, while three schools in Penang cancelled selected classes.

Concerned parents began to immunise their children and themselves in droves since last December, resulting in a somewhat unforeseen shortage of the influenza vaccine and related antivirals in the market, to the extent of even affecting compulsory vaccination for public healthcare workers who are in the frontline (those with clinical contact with patients).

Health director-general Datuk Dr Noor Hisham Abdullah had been diligently updating the country on the mild spike in influenza cases at the end of 2019.

In his last statement on influenza on Jan 21, he explained what the government was doing to solve the shortage of influenza vaccine and antivirals in Malaysia.

“For MOH facilities, antivirals supplied by the concessionaires are sufficient, even when demand spiked up to four times more for December 2019. The spike in demand from the private healthcare sector has exhausted supplies to the extent that the five existing suppliers cannot keep up.”

He said the MOH had granted special dispensation to import from alternative suppliers.

There has been no further updates on influenza since then, probably because of the focus on the virus that causes Covid-19.

Some doctors fear the heightened attention on Covid-19 – necessary as it is – could lead authorities to let their guard down on other diseases, infectious or otherwise.

For example, the Malaysian Influenza Working Group (MIWG), of which Dr Roslina is part of, is concerned the public may have forgotten about the prevalence and severity of influenza in Malaysia.

MIWG is a special interest group under the auspices of Malaysian Society of Infectious Diseases & Chemotherapy that was created in 2012, and revived in 2017 as part of the Asia Pacific Alliance for the Control of Influenza network.

The concern expressed by MIWG has been echoed by WHO, which launched the Global Influenza Strategy for 2019-2030 in March.

“Influenza is a serious global health threat that impacts all countries: every year, there are an estimated one billion cases, three to five million severe cases, and 290,000 to 650,000 influenza-related respiratory deaths worldwide.

“In this interconnected world, the next influenza pandemic is a matter of when not if, and a severe pandemic is believed by many experts to be potentially the most devastating global health event with far reaching consequences, ” it said in its preamble for the framework.

The Global Influenza Strategy for 2019-2030 provides a framework for WHO, countries and partners to approach influenza holistically through robust national programmes – from surveillance to prevention and control – with the goal of strengthening seasonal prevention and preparedness for future pandemics.

According to Dr Roslina, as far as flu is concerned, a lot of things happened from last December to January this year.

“There was insufficient vaccine in that period, but when Covid-19 came, it (influenza) dropped off the radar.

At the end of March, WHO came up with a statement reminding healthcare workers to get vaccinated, said Dr Roslina.

She also believed that Malaysia’s actual flu deaths among the elderly is quite high, even if solid data is hard to come by.

“In Malaysia, tracking the actual contribution from influenza to mortality and morbidity figures is harder as respiratory infections are all categorised under ‘pneumonia’.

“In addition, influenza may contribute to demise from chronic lower respiratory diseases. Pneumonia does not distinguish whether it was caused by bacteria or virus, ” she said. - Star