Flu awareness still lacking in China(2)

Cold, dry winters often see a rise in the incidence of flu, according to He Xiong. That rise is exacerbated by the fact that people tend to spend more time indoors, further increasing interpersonal contact, particularly in public places, and allowing more opportunities for the virus to spread, he added.

"Spring Festival, which sees a huge number of people take to the roads for family reunions, also increases the risk," he warned.

From a socioeconomic point of view, the illness "likes the rich but is isolated from the poor", he said, pointing out that the spread tends to be wider in places where economic activity and interpersonal contacts abound. "It's complex and has both natural and social determinants."

Shu was of the same opinion, but ruled out the possibility of a flu pandemic this year because there have been no mutations to the known viruses. The H3N2 and H1N1 strains have predominated this season, with H1N1 being more prevalent in Beijing, he said.

"So far, flu activity is within the normal range compared with previous years and people are familiar with the dominant viral strains," he said, adding that surveillance is ongoing.

Low awareness

Public awareness of flu has risen in tandem with the improvement in surveillance capability that followed the SARS outbreak of 2003, said Wang.

However, he conceded that understanding of the illness remains relatively limited, even among medical professionals.

A study conducted by the China CDC in 2012 discovered that seasonal flu was responsible for more deaths in the country than had previously been thought. The study, based on data from eight cities with especially accurate mortality figures, showed that between 2003 and 2008, a large number of deaths that had originally been attributed to respiratory and circulatory failures were actually caused by flu and that in 86 percent of cases, the victims were aged 65 and older.

Also, unlike the United States where the H3N2 virus caused most flu-related deaths, the Influenza B virus led to most of the deaths on the Chinese mainland, according to the report.

Worryingly, most people in China mistook cases of flu for common colds, said He. That may be caused, in part, by a linguistic quirk, he said: In Mandarin flu is called liugan, which means "infectious cold" and is derived from the word for common cold. However, unlike the common cold, flu tends to produce more intense symptoms and much more serious complications or even death, according to He.

"That's the reason why we have to pay special attention to viral infections and carry out interventions to avert any extra deaths caused by a flu epidemic," he said.

Demand for inpatient care, particularly among the elderly and those with underlying chronic conditions, usually increases substantially in flu season, further straining limited medical resources and other related sectors, according to He.

An epidemic can take an economic toll through lost or reduced productivity, and also strain medical and related services, he warned.

Ma Anlin, deputy director of the department of infectious diseases at the China-Japan Friendship Hospital in Beijing, said the hospital's fever clinic is receiving an average of around 300 people a day, many more than earlier in the winter.
Most outpatients have fevers, headaches and sore throats that may be attributable to flu, he said.

Wang Yan, the hospital's respiratory specialist, said she has to work a 24-hour shift on alternate days in response to the rising number of patients. "Sometimes, more than 30 people will be admitted after midnight," she said. "I am exhausted through lack of sleep."
Consulting a doctor is the wise choice for people with serious flu-like symptoms, she said, emphasizing the first 24 hours after the onset are crucial for effective treatment.

A World Bank study in 2008 estimated that a flu pandemic could cost $3 trillion and cause a roughly 5 percent drop in global GDP.

Also, at least 70 million people could die worldwide in a severe pandemic, it estimated.

During the 2003 SARS outbreak, the epidemic halted travel, trade and workplaces and cost the Asia-Pacific region $40 billion, according to the WHO. The six-month-long outbreak killed 775 people in 25 countries.

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