Flu season is off to an early start in Australia.
The southern hemisphere country, which is just heading into winter, is having a “particularly unusual” flu season this year, according to Dr. Robert Booy of the National Centre for Immunization Research in Sydney, Australia.
This year’s numbers are much higher so far than in recent years, he said.
“When we had a monster season two years ago, we had 250,000 notifications. And we’re already up to 100,000.”
In June 2019 so far, 31,220 people were diagnosed with the flu, according to figures from the Australian government. In June 2018, there were only 1,984. June numbers haven’t been this high since sometime before 2001 — the earliest year available in the government’s public data.
Usually, flu season doesn’t start until June or July, Booy said. This year, numbers started to pick up in mid-March. So far, at least 192 people have died from the flu, according to a recent report from Australia’s health department.
Flu cases in Australia are “off the charts” said Dr. Gerald Evans, chair of the division of infectious diseases at Queen’s University.
Laboratory-confirmed flu notifications in Australia
And this outbreak on the other side of the world could be bad news for Canada as we head into our winter.
“Our flu season tends to look like the Australian flu season,” he said.
So Australia’s early season, flu strains and hospitalization numbers could all be clues for what Canada can expect later this year. “I guess the analogy is if you line up all these things in the right way, that bodes very badly,” Evans said.
According to Dr. Isaac Bogoch, an infectious diseases physician at Toronto General Hospital, flu season in the southern hemisphere is “not an excellent, but a moderate predictor of what the flu will be like in the northern hemisphere.”
Things can change: the virus can mutate, and some strains might take hold in the north that didn’t in the south, making that year’s flu shot more or less effective than it was in the south, he said. “It’s still something that we would look at very, very closely to help us predict how flu season is going to go.”
So how are things going in Australia?
Early start
Booy hopes that the early start to Australia’s flu season means that it will finish early, too. “That doesn’t mean that we may not peak in the next couple of weeks,” he said. “And then the numbers could come down.”
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Bogoch also thinks it’s possible that flu in Australia will peak soon. “At the end of the day, when the flu season is over in Australia, they might have the same number of cases, they might have the same number of hospitalizations and deaths as in other years. … It was just shifted to a slightly earlier part of the year.”
Booy isn’t sure why flu season started so early this year, though.
“The 2018 season last year was incredibly quiet, so as a consequence not many people got infected,” he said. “And so with the influenza virus mutating constantly, it may be that we built up a larger group of vulnerable, susceptible people who didn’t get influenza in 2018 and started getting it in 2019.”
Different strains
Evans calls the mix of flu strains showing up in Australia “worrisome.” Many of the cases seem to be H3N2, he said. “The H3N2 one is the one that’s associated with more severe illness, particularly in elderly individuals and at-risk people.”
“That bodes for an influenza season that’s likely to be significant in numbers and significant in terms of mortality, dying, and morbidity, illnesses as a consequence of hospitalizations,” he said.
“So that’s all bad.”
The flu vaccine also tends to be worse at protecting against H3N2, he said, which isn’t good, either.
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But Booy said that there’s no indication yet that the Australian flu is particularly deadly. “The outcomes by way of hospitalization, intensive care and deaths are consistent with the numbers,” he said. The Australian government also says that the flu’s severity is currently low.
Preparing for flu
It’s too early to say how Australia’s flu season will shape up, Bogoch said. “But certainly an eyebrow goes up when you start to see this number of cases this early on in the season,” he said. “The hope is that it doesn’t continue like that.”
No matter what happens in Australia, though, his advice for Canadians remains the same.
“You get your flu shot to decrease your risk of getting infected and to mitigate the severity of infection if you’re unlucky enough to get infected. You stay home from work if you’re sick. You wash your hands. And you carry on carrying on as you did before.”
On the flu shot, though, Evans said, “This might be a good year to really get your vaccine. Get your flu shot early in October rather than waiting until a little later into the fall.”