For the third year in a row, this flu season puts us at risk of contracting both influenza and Covid-19. Influenza detections continued to increase in South Africa.

Bronchodilators such as salbutamol relieve a tight chest by relaxing the muscles around the airways

The influenza virus has three main types A, B and C. Influenza A is classified into different subtypes. The currently circulating seasonal viruses are A (H1N1), influenza A (H3N2) and influenza B viruses. The flu viruses are typically in circulation in the winter months in South Africa with an average start of the first week of June, although this varies.

COVID & FLU

It is possible to have both the flu and Covid-19 at the same time if both viruses are circulating in the community.

In 2022 to date, 377 influenza cases have been detected from all surveillance programmes. There has been an increasing number of reported cases. Many cases were reported from Gauteng (n=125) followed by KwaZulu-Natal (n=67), Western Cape (n=65), Mpumalanga (n=53), North West (n=46), Eastern Cape (n=17) and two each for Free State and Limpopo sentinel surveillance sites.

In 2022 to date, 765 respiratory syncytial virus (RSV) cases have been detected from all surveillance programmes.

Countries are recommended to prepare for the co-circulation of influenza and SARS-CoV-2 viruses. They are encouraged to enhance integrated surveillance to monitor influenza and SARS-CoV-2 at the same time, and step-up their influenza vaccination campaign to prevent severe disease and hospitalisations associated with influenza.

It is important for clinicians to consider influenza in differential diagnosis, especially for groups at high risk for influenza, and to test and treat according to national guidelines. A proportion of those infected with SARS-CoV-2 experience long-term symptoms, cough being one of them. Cough is synonymous with all the winter ailments mentioned already.

WINTER COUGH

Cough is a vital defensive reflex that enhances the clearance of secretions and particles from the airways and protects the lower airways from the aspiration of foreign materials. While a cough can be a common symptom of both a cold and flu, many patients have trouble differentiating between these two types of coughs, and may end up using the incorrect treatments, leading to a cough remaining untreated for longer than necessary.

Cough mixtures for wet coughs either contain a single ingredient, or a combination of ingredients to promote coughing and make it easier to cough up mucus or phlegm. Because a wet cough should not be suppressed, as the phlegm or mucus may cause breathing problems or infection, mucolytics such as bromhexine, help to decrease mucus viscosity, making it easier for the patient to cough up mucus.

Salbutamol is a B2-selective adrenergic bronchodilator which acts by stimulating B2 adrenergic receptors in the lungs to relax bronchial smooth muscle. Bromhexine hydrochloride, in turn, reduces the viscosity of non-infected secretions from mucous cells in the respiratory tract.

Bronchodilators such as salbutamol relieve a tight chest by relaxing the muscles around the airways, allowing for easier breathing. They also reduce the volume of mucus secretion.

A combination of a mucolytic and a bronchodilator (salbutamol/bromhexine combination) work well for a wet cough. This helps relieve a wet cough and expel the phlegm from the chest.

References available on request.