Australian Influenza – Cough and Sneeze Into Your Elbow

Professor Patrick Ball and Dr Hana Morrissey from the School of Pharmacy 

Not content with the four-nil drubbing in the Ashes series, Australia now hits us when we are down with Australian ‘flu?  Not really; the strain of influenza currently doing the rounds is the H3N2 serotype of the influenza A virus.  Influenza A is the most common type causing human infections, and the H3N2 serotype has been known to science since it caused the epidemic of Hong Kong ‘flu in 1968.  The name comes from the last place it was known to affect rather than where it comes from. 

So what is different?  The present ‘Australian Flu’ looks much like any other influenza but within the spectrum that is observed from the various sub-types, this one seems to cause more severe symptoms, and to be easily transmitted.  The major mode of transmission is through respiratory droplets, so the best way to avoid transmission is to avoid close contact; those affected should stay away from work, try to keep away from vulnerable groups such as the elderly, those with other illness, and those who are pregnant.  This particularly involves avoiding droplet transfer through avoiding close contact, containing sneezes with a tissue to reduce their range of travel, and regular hand hygiene.  As the virus remains viable on surfaces for some time, some doctors are also recommending what they call the ‘Dracula manoeuvre’ of arching your arm around your face and sneezing into the fabric of your sleeve where the virus will be less likely to escape, rather than onto your hands which are a major source of transfer. 

The symptoms though generally more severe than average, are very much the same as for other influenza viruses; high temperature (38^oC or above), feeling tired and washed out, aches and pains, dry cough and sore throat.  It can also cause difficulty sleeping, loss of appetite and abdominal pains and diarrhoea. 

Except for people who are very severely affected, or in a high risk group (young, elderly, another serious condition, pregnant), the best treatment is rest.  This is helped by good hydration and medicines to relieve the symptoms.  There are many products marketed for influenza symptoms but the effective ones do have potential to interact with other medications people may be taking or affecting conditions such as high blood pressure.  Talking to a pharmacist will help to find the safest, most effective product(s) for individual circumstances.  People who should seek medical attention are those over 65, pregnant or in a high-risk group, anyone who experiences difficulty breathing or who develops sudden chest pains.

After symptoms subside, it is important for those keen on exercise to restart slowly whilst recovering.  It is rare, but every year a few keen athletes die or suffer serious cardiac complications, trying to return to too quickly to exercise routines.  Just taking a brisk walk, many will find it difficult to complete their normal distance in the first few days.  Build up gradually over 7 days.

It is a well-known problem that the influenza virus evolves rapidly and that each year the new vaccines are based on a best guess of the likely virus forms to be seen, based upon the pattern seen in the previous year.    This provides considerable protection, but every few years an unexpected sub-type emerges against which the vaccine offers limited protection.  However, even in these cases, evidence suggests that having had the ‘jab’ may still reduce the severity of the infection even if it cannot prevent it. 

There is hope on the horizon; the current vaccines have been produced in the same way for about 40 years and target these characteristics of the virus that tend to change.  A range of new vaccines are in development targeting parts of the virus that are much more consistent strain to strain, year to year.  These hold out the hope of something closer to a ‘universal’ vaccine that could protect against a much wider group of viruses.  There is even hope for those who hate needles as one of the most promising new vaccines, in trials to date, produced disappointing results when injected in the same way as the current vaccine, but has been far more promising when delivered as a skin patch.  The patch does have microscopic probes that reach into the outer layers of the skin but this is not noticeable to the user.   

Intranasal vaccines have been with us for some years and are currently recommended for children in the UK and further developments of this technology are likely.  In a few years’ time we may be able to have our influenza vaccinations around once every 5 years, no needles and much broader protection, but that is tomorrow.  In the meantime, please also remember influenza is a viral infection and antibiotics do not treat it or aid earlier recovery.  A few at risk individuals may develop concurrent bacterial chest infections, but for most people it is bed rest, symptom relief and try not to spread your germs.