Health Services expect a Killer Flu season and Measles warning

Health experts are warning Australia is on track for a killer flu season, with numbers showing three times as many people have been diagnosed with the virus so far this year, compared to the same period in previous years.

In March, more than 10,000 people were diagnosed with the flu.

In March 2018, that number was 3,173.

Chair of the Immunisation Coalition, Professor Robert Booy, said those affected were mainly in New South Wales, Victoria, Queensland and South Australia.

"The data I have received shows that we are seeing three times as many cases this year as last year," he said.

At the end of the first week in April, we were nearly halfway to our 2018 annual total.

Professor Booy said so far this year, nearly 27,000 people had been struck down by flu.

  • New South Wales: 7,595 cases
  • Queensland: 7,289 cases
  • Victoria: 4,627 cases
  • South Australia: 4,397 cases
  • Western Australia: 1,498 cases
  • Tasmania: 322 cases
  • Northern Territory: 296 cases
  • Australian Capital Territory: 203 cases

So, why is there so much flu around already?

In 2018, Australia had a pretty quiet flu season and that means that community immunity wasn't built up to protect against this year's virus.

"It means many more people will be prone to the flu this year and susceptible to getting it," Professor Booy said.

There was also a long flu season in the Northern Hemisphere earlier in the year, up until about March.

"Many Australians went to the US for holidays earlier in the year and brought the flu back, and in February, school goes back and kids mix and spread the flu," Professor Booy said.

How deadly is it?

Most deaths from the flu occur in people aged over 65, and are usually from complications such as pneumonia, heart attacks or stroke.

Professor Booy said in a busy year, there were a number of people who would be expected to get the flu and die from it.

"This year, we expect the flu to kill at least 4,000 people which is the same number as deaths from suicide and the road toll combined," he said.

Professor Booy said most years, 12 Australian children died from the flu.

"If we had a high rate of immunity in kids, it would also stop the spread of the flu to susceptible adults," he said.

Chair of the Australian Medical Association council of GPs, Dr Richard Kidd, said one in 10 people who died in intensive care from the flu were otherwise healthy.

"More than half of all kids who end up in hospital with the flu were healthy and didn't have any chronic health conditions," he said.

When to get the vaccine?

The earlier the better.

Experts said early April is a good time to get a vaccine as it takes two weeks for your immunity to develop.

"With the flu [rates] three times as high this year as last year, we can stop transmission now if people get vaccinated," Professor Booy said.

"Otherwise the numbers could rise even more."

Flu season in Australia usually runs from June to September, peaking in August.

Chief Medical Officer for the Federal Government, Professor Brendan Murphy, recommends vaccinating from mid-April in order to develop immunity before rates of influenza increase.

Where do I get the vaccine?

In most states, the vaccine has already been distributed to GPs and many pharmacies.

If you are a healthy adult with children or looking after someone with a chronic illness, Professor Booy said it was fine to go to a pharmacy for the flu vaccine.

"But if you are elderly or pregnant, it's best to go to the GP who can give you the flu shot as well as oversee your health generally," he said.

And if you are healthy, is it still worth getting the vaccine?

Experts say, yes. It's not just about you, community immunity helps protect everyone.

"I encourage healthy people to get the flu shot as it protects you from getting and from spreading it to more vulnerable groups like the elderly," Professor Booy said.

George Tambassis from the Pharmacy Guild, whose members sell the flu vaccine, said boosting community immunity was the best way to protect against the flu.

"While there are people at high risk of the flu, including those aged 65 and above, the flu can in fact strike anyone, even the young, fit and healthy," he said.

Which vaccine am I likely to get?

This year, the four strain or quadrivalent vaccine is available for people aged under 65 years old.

People aged over 65 will get an enhanced vaccine, which has a component in it which boosts their immune system.

Separate to the Federal vaccine program, all states are providing free vaccines for babies from six months up to the age of five.

In countries such as the United States, most children get the flu vaccine for free.

Will we have vaccine shortages?

There were shortages last year, but that meant vaccine manufacturers produced a lot more doses this year.

Experts said any shortages were unlikely to happen again and if there were any supply issues, it should be fixed in a few days.

Some Australians can get a free vaccination. Who's eligible?

Many Australians can get vaccinated against the flu for free thanks to the National Immunisation Program (NIP).

This year, the Government has secured more than 6 million doses of the vaccine to help protect those most at risk of getting sick.

For the first time, all Aboriginal and Torres Strait Islander people aged six months or older will be eligible for a free flu vaccination.

Previously, only Aboriginal or Torres Strait Islander people aged six months to five years, or older than 15, were eligible.

Other Australians who are entitled to a free flu vaccination include:

  • Adults aged 65 and over
  • Adults and children (aged six months and over) with certain medical conditions
  • Pregnant women

A spike in measles cases in Australia has prompted immunisation warnings

Australians are being urged to check their immunisation history as the number of measles cases in the country climbs towards a five-year high.

Key points:

  • A sharp increase in measles cases has prompted Government immunisation warnings
  • Individuals born between 1966 and 1994 and those planning to go overseas are at higher risk
  • Measles is a highly infectious disease that requires high vaccination rates to stop its spread

Nationally, there have been 92 confirmed cases of measles so far this year, compared to 103 for the whole of 2018, and 81 for the whole of 2017.

Just five years ago, Australia was declared measles-free, and high vaccination rates have meant the virus has been largely kept at bay.

However, because it is so highly infectious, measles outbreaks occasionally happen when people travelling overseas catch the infection and bring it back into Australia, said Kristine Macartney, director of the National Centre for Immunisation Research and Surveillance.

"Globally, we're seeing hundreds of thousands of cases of measles, and indeed tens of thousands of measles deaths," Professor Macartney said.

"Measles is incredibly contagious, and where there are not very high vaccination rates — over 90 per cent — we are at risk of seeing it rear its ugly head.

"Unfortunately, that's what's happening around the world at present … it is quite a serious situation."

How do measles spread?

Measles is a highly contagious viral illness — it spreads through coughs and sneezes.

But it's not just spluttering that will pass it on. The measles virus can survive on surfaces for up to two hours, meaning you can catch it by touching the same surfaces or breathing in the same air as an infected person.

Measles is so contagious that about nine in 10 people who come in contact with the virus will catch it if they are not immunised.

It typically takes 10 days between a person being exposed to the virus and becoming sick, which is also when they become contagious.

Early symptoms of measles include fever, a cough, sore throat, runny nose, watery eyes, and feeling tired. About four days after the first symptoms appear, a rash will emerge.

For most people, a case of measles usually means taking a couple of weeks of bed rest, plenty of fluids, and some paracetamol to ease the pain and fever, before they make a full recovery.

Occasionally, however, measles can lead to serious and sometimes fatal complications, including:

  • Middle ear infection
  • Diarrhoea and vomiting (which may cause dehydration)
  • Pneumonia and other respiratory infections
  • Problems for pregnant women
  • Swelling of the brain

According to the Department of Health, about 1 in 15 people infected with measles gets pneumonia, and 1 in 1,000 develops brain swelling, which can lead to brain damage or death.

It's also possible for a person, many years after a measles infection, to develop a devastating and disabling brain disorder known as subacute sclerosing panencephalitis, which is fatal.

In 2017, there were 110,000 measles deaths globally, mostly among children under the age of five.

In Australia, children routinely receive two doses of the measles-mumps-rubella vaccine (MMR) — once at 12 months, and again at 18 months. Two doses are recommended for full protection.

While vaccination rates are high among children — 93.5 per cent of 2-year-olds have received two doses of the MMR vaccine — Professor Macartney said many Australians aged in their 20s to early 50s (born between 1966 and 1994) may not be fully vaccinated.

"That second dose of the measles vaccine wasn't routinely given until the early 90s … so people may think they've had the two recommended doses, when actually they haven't," she said.

The two-dose vaccination program was introduced in Australia in 1992 and school-based programs provided children with catch-up vaccinations until 1998 (at which point it was routine).

But Professor Macartney said many Australians born earlier may have missed out on the second dose, or indeed missed out on the measles vaccine altogether.

"We know that in the 1980s and early 1990s, for example, our immunisation rates were as low as 70 per cent," she said.

"So, for people who were children in the 80s and are now in their 30s, they may not have been vaccinated at all against measles."

Australians born before 1966 don't have to worry, she said. They're likely to have natural immunity to the virus because of how widely it was circulating prior to the introduction of the national vaccination program.

Getting a booster shot

On Monday, Health Minister Greg Hunt urged all Australians to check their measles immunisation history and book in for a catch-up vaccination if necessary.

"In particular, any individual planning to go overseas and those born between 1966 and 1994 are at higher risk and should be take action to protect themselves and their community," Mr Hunt said.

You can check your immunisation history with your GP, through the Australian Immunisation Register, or via a blood test.

"There is also no problem in receiving an extra dose of the measles vaccine if you're unsure about how many doses you've received in the past," Professor Macartney said.

"It's a safe vaccine, and very highly effective."

In addition to protecting yourself, Professor Macartney said it was important to protect more vulnerable members of the community who are unable to be vaccinated.

This includes babies under 12 months old, people with immune deficiency disorders or receiving immunosuppressive treatments such as chemotherapy, people taking certain medications, and people with chronic diseases.

"We rely on herd immunity to protect these most vulnerable people in our community," Professor Macartney said.

"Modelling shows us that we absolutely need coverage rates of above 95 per cent across all age groups to be able to prevent the sort of spread of the virus we're seeing," she said.

"Even then, we will still see these occasional outbreaks."

Australians under 20 years old, refugees and other humanitarian entrants of any age, can get measles vaccines for free under the National Immunisation Program.

Anyone born in or after 1966 and who has not previously received two measles vaccines is also eligible for a free MMR vaccine in all states and territories, except Tasmania.

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