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The Return Of The Flu – Expert Q&A
New Zealand is preparing itself against the arrival of influenza and other viruses as the country continues to reopen its borders this autumn.
The Government will launch its winter flu campaign on Friday. Director of Public Health Dr Caroline McElnay said the Ministry of Health was “very concerned” about low measles, mumps and rubella vaccination rates among children and is urgently working to increase them.
The SMC asked experts to comment on respiratory virus surveillance and non-Covid-19 childhood vaccinations.
Dr Andrea McNeill, Technical Lead Epidemiology, ESR, comments:
How does influenza and other respiratory disease surveillance happen and how has it been affected by the COVID-19 pandemic?
“In New Zealand, respiratory illness surveillance is done in both community and in hospital settings. This allows for a good understanding of the severity and level of spread of respiratory viruses such as influenza, respiratory syncytial virus and SARS-CoV-2 in New Zealand.
“The community surveillance for respiratory illness uses a variety of data sources including calls to Healthline, visits to sentinel general practices, virological sampling of a small number of cases that present to general practices and reporting of symptoms through flu tracking surveys.
“The COVID-19 pandemic response has impacted existing community sentinel respiratory virus surveillance systems, for example, the use of community testing centres has meant fewer GP visits for people with influenza-like illness symptoms.
“However, the pandemic response has also led to the development of new systems that could be further developed to enhance existing surveillance. For example, ESR is working with the Ministry of Health to develop a system for community sentinel respiratory virus surveillance. This system will be implemented in a phased approach as soon as possible, and will include the establishment of a national respiratory virus testing repository, which will allow us to monitor national testing rates and support the establishment of the new system for community sentinel respiratory virus surveillance.
“ESR will operate and analyse both community- and hospital-level surveillance on behalf of the Ministry of Health in 2022. Typically weekly reporting (including of flu tracking data) is provided during the winter illness season (May-September), however with the borders re-opening we will be starting to report earlier this year.
“People can sign up to take part in the weekly flu tracking survey here.”
When do ESR experts think the flu will come back into the community?
“Influenza continues to circulate internationally, mostly at low levels currently, but we expect cases to be arriving at our border now.”
Can several respiratory viruses be tested all at once? And if so, would this be helpful in the New Zealand context?
“It is possible to test for a range of respiratory viruses using one swab. However, this cannot be done with the current rapid antigen tests in use – these are designed to detect SARS-CoV-2 only.
“Part of the community sentinel surveillance system development work includes defining a population-based sampling strategy. Surveillance testing for this sample of the population will be undertaken using a single swab and PCR testing for SARS-CoV-2 and other viruses. The viruses tested and the number of people tested will depend on laboratory capacity and systems and may vary regionally.”
No conflicts of interest declared.
Dr Dianne Sika-Paotonu, Immunologist, Associate Dean (Pacific), Head of University of Otago Wellington Pacific Office, and Senior Lecturer, Pathology & Molecular Medicine, University of Otago Wellington, comments:
“It has been announced recently that vaccinated Australians will be able to enter Aotearoa New Zealand from mid-April, with vaccinated visitors from around the world able to come through on 1st May 2022.
“The definition for being fully vaccinated against COVID-19, ideally should now include a booster shot. Unvaccinated individuals have a higher risk of becoming sick and unwell from COVID-19, and passing on the SARS-CoV-2 virus to others and also becoming hospitalised when compared with those who have been vaccinated and received a COVID-19 booster dose. For those overseas travellers entering Aotearoa New Zealand who haven’t yet received a booster injection, the opportunity to get boosted should be strongly encouraged.
“Monitoring for new variants of the SARS-CoV-2 virus will be important moving forward particularly with further easing of border restrictions. This will be especially important for managing potential future outbreaks caused by any new variants of the SARS-CoV-2 virus arising overseas.
“While issues with unequal global COVID-19 vaccine coverage, availability, accessibility and distribution persist, and remain unaddressed, new variants of the SARS-CoV-2 virus will continue to develop and spread. Community spread will be rapid if any new SARS-CoV-2 variants are capable of evading protection given by currently-available COVID-19 vaccines.
“Although COVID-19 has been a key focus over the past two years, it is important to remember that all childhood vaccinations are still important. An issue of major concern has been the disruption to usual (non-COVID-19) childhood vaccine schedules in Aotearoa New Zealand due to the Covid-19 pandemic. This means, there is potential risk of a measles or whooping cough outbreak for example.
“As a result of the COVID-19 situation, there are also children and young ones in Aotearoa New Zealand who may have never been exposed to the influenza virus. A resurgence of influenza and the respiratory syncytial virus (RSV) could possibly occur.
“The strong demand for the paediatric COVID-19 vaccine for children, tamariki and tamaiki aged 5-11 years has been encouraging, however vaccination efforts must continue. Of those affected by the current outbreak in Aotearoa New Zealand, a total of 191,507, 32 per cent (nearly 1/3) were children, tamariki and tamaiki and rangatahi aged 19 years and under.
“This group has comprised 13 per cent of all hospitalisations, with the majority of these in the 0-9 years of age. Of those children aged 5-11 years, 53.9 per cent of the general population have received their first COVID-19 vaccine dose, and for Māori and Pacific tamariki and tamaiki, vaccination levels for first doses are at 34.8 per cent and 47.0 per cent respectively.
“Although children are overall more likely to have mild or asymptomatic disease, children can still catch the virus and become unwell – and get better quickly, end up with long COVID-19, and for children and youth with underlying medical conditions, have a higher risk of serious illness and hospitalisation.
“Omicron continues to spread rapidly across Aotearoa New Zealand with different areas of the country peaking at different times. These high numbers of COVID-19 case numbers are continuing to place added strain and pressure on our health and other support systems in Aotearoa New Zealand.
“Even though COVID-19 vaccination levels have lifted across Aotearoa New Zealand, care and caution are still needed – especially for our vulnerable communities.”
No conflict of interest.
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