Influenza- Monthly Update (Feb 2004)

09 Feb 2004

Influenza in temperate countries

Countries in Central and Eastern Europe (such as Austria, Switzerland and the Russian Federation), Italy, and Japan continue to report increased influenza activity; influenza activity appears to have peaked and is on the decline in the US, UK and other Western European countries.

The most common strain of influenza virus isolated in Europe and the United States continues to be the influenza A Fujian variant.

Situation in Singapore

The average weekly attendance figure for acute respiratory infections at the polyclinics for January 2004 is about 2.5% lower than that for December 2003 (see Table 1). The chart shows the weekly outpatient attendances for acute respiratory infections at polyclinics in 2003 and 2004. MOH will continue to monitor attendances for acute respiratory infections closely.

Table 1: Average weekly Acute Respiratory Infections attendances at polyclinics in Singapore

Ministry's Advice

Vaccination

As there is ongoing influenza activity in temperate countries in the Northern hemisphere, the Ministry of Health continues to encourage travelers, both adults and children 6 months and older, going to temperate countries in the Northern Hemisphere to protect themselves against the disease with influenza vaccination. The vaccination should be taken at least 1 to 2 weeks prior to departure as it takes time for the vaccination to take effect. (Children younger than 9 years old will require 2 vaccinations at least 4 weeks apart; the second vaccination should be taken at least 1 week prior to departure.) Influenza vaccination is available at the travel clinics in Tan Tock Seng Hospital, National University Hospital, Kandang Kerbau Women's and Children's Hospital and Changi General Hospital, polyclinics and General Practitioners.

The current influenza vaccine composition will give good protection against the Moscow strain. It may not fully protect against the Fujian strain, but will offer some protection. Immunized persons may still come down with some symptoms if they are exposed and infected by the Fujian strain, but the severity and duration of the disease will be lessened.

Persons who are at higher risk of developing complications from influenza are also advised to get themselves vaccinated against influenza. A list of persons who may be at higher risk of developing complications from influenza is listed as Annex A. The public should consult their family doctor for further advice on influenza vaccination.

There are other common viruses that can cause acute respiratory infections. The influenza vaccination will not protect against these viruses. Persons who have been vaccinated may hence still come down with acute respiratory infections.

How to combat influenza

People can build up their body resistance to influenza by having a proper diet with adequate exercise and rest. Regular hand washing may help to reduce the risk of being infected, especially after contact with persons who may have the flu, and after handling soiled tissue and other material. When sharing food from a common bowl or plate, it is advisable to use a serving spoon.

People who develop influenza-like symptoms are advised not to go to work or school and avoid crowded places to minimize the transmission of the infection to others. They should also cover their mouth and nose with a tissue when coughing or sneezing. They should increase fluid intake (water, juice, soups etc.) and get plenty of rest for the 7 to 10 days that symptoms might continue. Strenuous physical activities like running and jogging, and smoking and alcohol should also be avoided during the illness until complete recovery.

Persons who are at risk of complications from influenza infection should consult their family doctor if they have symptoms of influenza. A list of persons who are at increased risk of complications from influenza infections is shown in Annex A.

You can also view the answers to Frequently-Asked Questions (FAQs) on influenza infection and vaccination on the Influenza FAQ page.

ANNEX A

RISK FACTORS FOR COMPLICATIONS FROM INFLUENZA INFECTION*

• Persons aged 65 years and older;

• Residents of nursing homes and other chronic care facilities;

• Adults and children who have chronic disorders of the lungs or heart, including asthma;

• Adults and children who have required regular medical follow-up or hospitalization during the preceding year because of chronic metabolic diseases (including diabetes mellitus), kidney or blood disorders, or lowered immunity caused by medications or by the Human Immunodeficiency Virus (HIV);

• Children and teenagers aged 6 months to 18 years who are receiving long-term aspirin therapy;

• Women who are in the second or third trimester of pregnancy.

* Adapted from recommendations made by the US CDC Advisory Committee on Immunization Practices