Epidemiologists predicted the fifth wave would hit around winter, which is also associated with flu season. This raises the urgency for everyone to get their annual flu shot asap.

With a significant rise in coronavirus infections across SA, all signs point to the country entering a fifth wave.


ONE OF THE BIG misnomers around influenza is often that it’s a nonserious illness,” said Dr Thinus Marais (Medical head: Africa Zone, Sanofi Pasteur). “But it’s important to note that it may result in hospitalisation and death.

You can see from the numbers worldwide, 3-5 million cases of severe illness, and 290 000-650 000 deaths per year because of influenza, so it’s certainly not a non-severe illness by any stretch of the imagination,” he said at a recent media briefing. “The influenza burden is often underestimated. When we talk about infectious diseases or vaccine-preventable diseases and we try to quantify the burden of disease, we often look at the number of deaths, hospitalisations and cases that are reported within a season. In SA there are over 11 000 deaths, close to 23 000 hospitalisations, and more than 10 million cases per season. From a classical burden of disease perspective this is already a heavy burden on our healthcare system, but what’s often neglected is what influenza does beyond flu, beyond the disease that it causes,” Dr Marais said.

“Influenza influences heart attack, stroke and deconditioning. It can also worsen some underlying chronic conditions in individuals who contract the disease – diabetics, asthmatics, people with COPD, and anyone with renal complications,” explained Dr Marais.

“If we look at heart attack as an example, someone who contracts influenza, in the first week of contracting the disease has a tenfold increased risk of potential heart attack. Inversely, if individuals are vaccinated against influenza, the vaccine can have a preventative effect of up to 15%-45%. That’s equivalent to someone who stops smoking or takes high blood pressure medication as an intervention.”


It’s important for patients to understand that they can in fact get influenza and Covid-19 at the same time and to caution them that co-infection can result in severe disease. Dr Marais explained that studies have shown that there’s a two times higher intensive care unit admission for patients that are co-infected with both influenza and Covid-19 compared with patients with just one of the infections alone. And there’s a two times higher risk of death in patients with a co-infection compared with those suffering from just one infection.

This is significant because both diseases are vaccine preventable,” said Dr Marais. “Trying to prevent one or both of these diseases is certainly helpful in determining your outcome should you contract one or both of the diseases.”


“Fortunately, there are modalities available to us to prevent influenza. Effective vaccines have existed for more than 80 years,” said Dr Marais.

“Seasonal influenza vaccines have saved countless lives and limited pandemic spread. Quadrivalent (QIV) vaccines,
which were made available in SA in 2020 protect against four influenza viruses – two sub-types of type A and two lineages of type B strains.” While the earlier you vaccinate before the season the better your odds are of being protected as the season starts. Dr Marais stressed that it’s important for patients to know that it’s never too late
to vaccinate.