H3N2 influenza outbreak in India: Amid the rising incidences of H3N2 influenza in the country, the fear of H3N2 influenza being another COVID-19 looms at large. However, doctors and health experts point out that this outbreak is normal. According to doctors, Covid-induced lockdowns led to no exposure of influenza to children in the past two years.

According to the Journal of American Medical Association published in February this year, influenza virus infections declined globally during the COVID-19 pandemic due to the loss of natural immunity from lower rates of influenza infection, and documented antigenic changes in circulating viruses may have resulted in increased susceptibility to influenza virus infection during the 2021-2022 influenza season.

“We all have witnessed the rampant spread of flu (Influenza infection) during last two months. Every other person is down with fever, cough, loss of voice, and breathlessness. Uncontrollable cough is a frequent symptom (with or without wheezing) that I have seen in my practice. The Influenza A Virus (H3N2) is frequently diagnosed when tested. This study emphasizes the rapidity of transmission of flu in post-Covid pandemic time giving various reasons.(altered immunity, decline in flu
vaccination etc.) Unfortunately, everybody is gulping antibiotics (Sometimes many courses),” Dr(Prof) G C Khilnani, Chairman, PSRI Institute of Pulmonary, Critical care and Sleep Medicine, Formerly Professor and Head of Dept of Pulmonary, Critical care and Sleep Medicine told Financial Express.com.

According to Dr. Khilani, Azithromycin is the most frequently abused antibiotic which has no role in the treatment of influenza.

H3N2 influenza should not be confused with H1N1(Swine flu) which is a potentially lethal infection. However, elderly (>75 yrs of age) and those with compromised immunity due to comorbidities may have severe disease , especially due to secondary bacterial infection requiring ICU care. In my experience in clinical practice, almost all my patients have acquired infections by going to large gatherings, flights and train journeys where there is high potential for exposure,” Dr. Khilani told Financial Express.com.

Three years into the pandemic, people are anxious if there is a possibility that H3N2 influenza can become another covid-like outbreak. However, doctors emphasise that there is no need to panic, as they don’t expect massive waves.

“Currently, the severity of human illness associated with H3N2v resembles that of seasonal flu. Keep in mind that even seasonal influenza can be a serious disease. Sometimes seasonal influenza can lead to complications (like pneumonia). It also can lead to hospitalization and even death. The south Indian state of Karnataka reported one death from H3N2, marking the first fatality in India from the influenza virus. Certain people are at greater risk of serious flu-related complications including young children, elderly persons, pregnant women and people with certain long-term medical conditions,” Dr. Yash Javeri-Director Critical Care and emergency medicine, Regency Health told Financial Express.com.

According to Dr. Javeri, the virus leads to respiratory symptoms including persistent cough and many more. A quick change in weather from extremely cold to warm has been identified as one of the major reasons behind this rapid increase in flu symptoms among people.

“Fever, chills, cough and cold are common in both while shortness of breath can be experienced more in case of Covid than influenza. Headache, muscle aches are common in both, while fatigue is more in Covid. Apart from this stuffiness of nose, sneezing, sore throat, loss of smell is seen in both the viral infections. Earache, nausea, diarrhoea are again common symptoms of both Covid and H3N2 influenza. In comparison to covid the symptoms in vast majority of cases are mild. Severe and critical form of disease is less with H3N2,” Dr. Javeri told Financial Express.com.

According to Dr. Javeri, the currently recommended drugs – oseltamivir, zanamivir, peramivir, and baloxavir – are available by prescription from your doctor. According to the CDC, the flu vaccine reduces the risk of flu illness in the general population by between 40-60% during most flu seasons when the vaccine strains are a good match to circulating strains.

Dr. Bindumathi P L, Sr. Consultant – Internal Medicine, Aster CMI Hospital told Financial Express.com that H3N2 influenza is less severe than COVID-19 and it has a shorter isolation period than COVID-19.

Some doctors have also maintained that H3H2 is a seasonal virus, eventually, it will go away.

“H3H2 is a seasonal virus, eventually, it will go away. Normally we experience peaks in the occurrence of influenza infections whenever the season changes and in winter. So it’s nothing unusual except that it may last a little longer. Covid-19 and influenza, there is no link between the two as they both are respiratory infections, both spread the same way. Mild Covid and mild influenza practically resemble each other in terms of symptoms except that cold element is more common in influenza, body ache, and headache are also most common in influenza and there is no proof that those who had a brush with Covid-19 are at high risk of contracting influenza as both are independent, separate infections and there is no link between the occurrence of the two. Individuals with chronic illnesses, such as asthma, must exercise special caution since they might provoke severe respiratory difficulties and asthma episodes,” Prof. Dr. SK Chhabra, HOD- Pulmonary, Primus Hospital, New Delhi told Financial Express.com.

Immunocompromised patients and those with comorbidities are at a higher risk of developing a more serious illness, Dr. Chhabra added.

“H3N2 is not Covid. It is a subtype of the influenza virus while Covid is caused by SARS CoV2 virus. Both are highly contagious but Covid symptoms tend to last longer than influenza and are more infectious,” Dr. Siddharth Gautam, Consultant Neurosurgeon, Cooper Hospital & HBT told Financial Express.com.

On Friday last week, Union Health Ministry issued a statement and said that it is keeping a close watch on the Seasonal Influenza situation in various States/UTs through the Integrated Disease Surveillance Programme (IDSP) network on real-time basis.

“Seasonal influenza is an acute respiratory infection caused by influenza viruses which circulate in all parts of the world, and the cases are seen to increase during certain months globally. India every year witnesses two peaks of seasonal influenza: one from Jan to March and other in post monsoon season. The cases arising from seasonal influenza are expected to decline from March end. State surveillance officers are therefore fully geared to meet this public health challenge,” The Ministry said in a statement.

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