Explained: Why flu strain is so deadly and when to go to hospital

Health authorities are pleading for Queenslanders to obtain their annual flu shot following the tragic death of 11 year-old Emma Schwab from influenza B.

The tragic death on July 6 of 11-year-old Emma Schwab from the Sunshine Coast has sent a shockwave through the state, with health authorities pleading with Queenslanders to make sure they have received their annual ’flu vaccination. Picture: Brianne Makin

The tragic death of 11 year-old Emma Schwab after contracting influenza B has sent a shockwave through the state, with health authorities pleading with Queenslanders to make sure they have received their annual ’flu shot.

The Courier-Mail has spoken to three eminent doctors and infectious disease physicians to break down how the flu strains are circulating through the community, what the difference between them are and why you and your loved one need to be protected.

Emma Schwab, 11, from the Noosa region died from influenza B on July 6. Picture: GoFundMe

What is the difference between influenza A and B?

Griffith University Infectious Diseases and Immunology program director Professor Nigel McMillan said there was some subtle but important differences between influenza A and B.

“Influenza A can infect animals and humans, so ducks and pigs mainly but waterfowl, this is where birds fly in from Asia and they can bring influenza with them,” he said.

“The source of influenza pandemics are influenza A, so that’s the one we kind of worry about, in terms of what it might do in terms of becoming a pandemic.

“Influenza B only infects humans … so it spreads around less, and in that sense it has less chance to rearrange itself, which is what we worry about in terms of it changing.”

Queensland Health’s chief health officer, John Gerrard said the state experienced an influenza A wave leading into winter, but influenza B has taken over as the dominant strain in July.

Professor Nigel McMillan is the director Infectious Diseases and Immunology at the Menzies Health Institute at Brisbane’s Griffith University. Pictured: Supplied

Which one is more serious?

Influenza A is typically considered more severe, but health authorities are reporting plenty of cases of influenza B, particularly among children in hospital, Mater Health Services’ Infectious Diseases director Professor Paul Griffin said.

“We can’t underestimate the significance of either but, you know, typically flu A is more significant,” he said.

Prof McMillan said it was not clear why influenza B impacted children more.

“The reality is that the clinical interface, it’s noted to be more severe in children,” he said.

“But influenza A can also cause problems in children too, and ultimately, I guess the message is you need to vaccinate.”

Dr Gerrard shared his concern on Wednesday, saying the B strain was causing severe illness in otherwise healthy Queenslanders, young people in particular.

“We experienced an influenza A wave leading into winter, but influenza B has taken over as the dominant strain in July,” he said.

There have been three times more hospital admissions for influenza B than influenza A in children aged less than five years.

“Influenza B is known to be associated with more severe disease in children, many of whom would never have been exposed to influenza because of Covid-19 restrictions over the past three years,” Dr Gerrard said.

Nurse Alison Clancy vaccinates Dr Paul Griffin from Mater Health. Picture: Annette Dew

What are the symptoms?

Symptoms can include; sudden high fevers, a dry cough, body aches (especially in the head, lower back and legs), feeling extremely weak and tired, chills, aching behind the eyes, loss of appetite, sore throat and a runny or stuffy nose.

Just like Covid-19, people may experience only some or all of these symptoms.

What should I do if my child or I have symptoms?

Your first port of call should be your general practitioner (GP) who would likely take a swab to see which respiratory virus you or child might be suffering from. They could check for the flu, Covid or Respiratory Syncytial Virus (RSV).

Just like during the Covid-19 pandemic, it is important that anyone who is experiencing symptoms stays home and considers wearing mask to protect others.

“Don’t leave home if you’re sick. I have a rule of no heroes at work,” Prof McMillan said.

“I think employers will accept the fact that if you have flu-like symptoms, even though you may feel otherwise, okay, but you’ve got a runny nose and sniffling, slight temperature, you probably could go to work, don’t go to work. Don’t send your kids to school.”

Prof McMillian said he’d also like to see hand sanitiser widely available.

“They seem to have fallen off the radar a bit you go to a shop or somewhere and you go to use it and there is nothing in there. We need those to be maintained especially now,” he said.

The tragic death on July 6 of 11-year-old Emma Schwab from the Sunshine Coast has sent a shockwave through the state, with health authorities pleading with Queenslanders to make sure they have received their annual ’flu vaccination. Picture: Brianne Makin

When should we go to hospital?

Most symptoms can be managed with plenty of rest, regular paracetamol and ibuprofen to relieve pain and fevers and staying hydrated with regular sips of water.

But it’s vital that you go to hospital if you or child start experiencing any symptoms.

“If you’re worried, get kids checked out, that’s the simple message,” Prof Griffin said.

“In terms of the things we typically notice or are concerned about with the flu, the first one is it’s a respiratory virus. So if those symptoms become more severe, there’s trouble breathing, a pronounced wheeze, anything like that, that’s a sign you should get checked out,” he said.

“Nasty infections can have an impact on the central nervous system of children, so if they’re confused or drowsy or irritable, again, that’s a sign they should get checked out, or if kids are not able to maintain their fluid intake, so they’re not able to drink adequately, absolutely get checked out.”

Prof Griffin said parents know their kids best and to trust their instincts.

“If they have skin changes, if their skin appears mottled or very pale, that’s a good sign and the final one is severe pain, if they’re in significant pain anywhere, that’s another good sign that they should definitely get reviewed.”

Why is it so deadly?

Serious complications from flu occur in a small proportion of people who are infected and include pneumonia, inflammation of the heart muscle and neurological complications, which can lead to hospitalisation and death.

People at highest risk of complications from flu include those with pre-existing medical conditions.

Sepsis – your body’s extreme response to an infection – in is another complication that can lead to death.

Sepsis can affect multiple organ systems, sometimes causing organ failure.

Queensland chief health officer Dr John Gerrard said it was important for pregnant women to also get the influenza vaccine to help protect their babies.

Why are vaccination rates so low?

Since July 1, 78 children aged from six months to four years old were hospitalised with flu – 50 with the B strain in Queensland alone.

Only one of these children was vaccinated.

There have also been 11 infants under six months old hospitalised with flu, eight of whom had the B strain.

Dr Gerrard said it highlighted the importance for pregnant women to get vaccinated to protect not only themselves but also their babies.

Flu vaccines are free for children under five, people aged 65 and over, Indigenous Australians and for those with compromised immune systems.

Experts say ‘vaccine fatigue’ off the back of the Covid-19 pandemic and cost of living pressures could be playing a part, but influenza vaccine rates in Australia had always been quite low.

“There’s also an element I think – there was a lot of discussion on social media about vaccination and the anti-vax movement were a lot louder – I think in those times around the new Covid vaccines, and potentially maybe people have lost a little faith or trust in vaccination,” Prof McMillan said.

“But I think with the over five not being free, maybe that’s an impediment too.”

Many children around the sate would never have been exposed to influenza because of the restrictions imposed throughout the Covid-19 pandemic over the past three years.

“I think people have lost sight of the significance of the flu,” Prof McMillan said.

“We obviously had two years, essentially, with no flu cases, and so much of a focus on staying home, and I think people have almost forgotten that the flu itself is a very significant infection.

“We’ve got a great vaccine, but the uptake is just nowhere near where it needs to be at the moment.”

This year’s flu shot covers four strains of flu – two each of A and B – and Prof Griffin said anyone who has already been infected this year with the flu could still be at risk.

“Even if you’ve had the flu, or think you’ve had the flu, this season, it’s still worth getting the vaccine so that you don’t get one of the other strains that you haven’t yet had,” he said.