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Everything You Need to Know About Israel's Flu Outbreak

Why this flu season is different, what the complications can be, and how to protect yourself

A person gets a flu vaccine shot in Tel Aviv on December 26, 2019.
Moti Milrod

Although every winter brings a wave of influenza, this year’s outbreak appears to be dangerous and alarming. The high number of seriously ill patients and fatalities – including previously healthy youngsters at a relatively early stage of the flu season – indicate the need for special attention from the health system and the public. Here are answers to the most acute flu-related questions.

What is different about this flu season compared to previous years?

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Two main characteristics distinguish this flu season from previous ones. The first is that the vaccination program led by the health clinics was postponed by a month due to a delay in the World Health Organization’s approval of the vaccine. As a result its production and arrival to Israel were late. The vaccine is prepared every year anew on the basis of the disease strains that appear in the southern hemisphere and are expected to reach our region. This year, due to the delay in the approval process, the vaccine was administrated to Israelis beginning only in mid-November. Consequently the vaccine rates to date have been low compared to this time last year.

The second, more critical characteristic, is related to the flu strains themselves, including the genetic traits, and their ability to harm the organ systems. The prevalent strains are A, B, H1N1 known as “swine flu” and A/H3 and A\H1. Every year they appear in a different genetic composition, which determines their genetic properties and ability to affect the body’s organs.

“This year the flu strains are much more aggressive and cause harsher symptoms, even in cases of young people who don’t suffer from other diseases. Since it’s a very common disease, this is reflected in more sick people,” says Dr. Erez Carmon, head of Meuhedet HMO central district.

What complications can the flu cause?

The most common complication related to the flu is pneumonia. Other complications include ear and sinus infections as well as graver chronic diseases like lung and heart disease and, in rarer instances, encephalitis. In the worst cases the disease leads to organ failure and death. In Israel a few dozen people die every year from flu complications. Many dozens of Israelis are hospitalized every year in serious condition following flu complications. Since the beginning of winter about 100 seriously ill patients have been hospitalized with the flu. About 30 seriously ill patients are currently hospitalized, considerably more than usual for this time of year. By comparison, last winter the number of seriously ill patients suffering from the flu or flu complications was 54.

What is the meaning of the presence of the “swine flu” virus in the flu?

The “swine virus” (N1H1), which was discovered in 2009, is only one of the flu strains. In most recent winters its presence has been low, according to samples taken from flu patients. In this flu season it’s more dominant. “The N1H1 strain is seen as more violent and better able to lead to organ failure,” explains Dr. Tuvia Segal, deputy director of the Tel Aviv district in the Clalit HMO. “This year it’s more dominant and flu patients who were not immunized were more seriously ill because of this strain.” The swine flu strain was found in nine out of 10 mortality cases in recent weeks.

Does this year’s flu vaccine protect from the disease?

Yes. This year’s vaccine corresponds to the disease’s strains and their genetic properties, including the swine flu. In general, the vaccine’s protection scope varies from person to person according to age, medical state and immune system condition, as well as the vaccine’s correspondence to the disease strains. With healthy people up to 65 years old the vaccine is effective in the range of 70 – 90 percent. With people above 65 the effectivity is 50 -60 percent.

Health professionals stress that even if the vaccine’s protection is partial, it’s more significant when the disease is aggressive, both to the individual and in terms of its spread.

Is it too late to get the vaccine?

No. We have several winter months ahead and the flu season has not reached its peak yet. The time it takes the vaccine to grant maximal protection is about two weeks.

Are this year’s vaccine’s side effects harsher due to the flu strains’ aggressiveness?

No. Possible side effects are weakness, muscle aches, low fever and a general feeling of malaise.

Can the vaccine supply run out?

The HMOs still have a supply of vaccines and some of them have ordered more supplies. But at this rate of vaccination, there may be a shortage in the next few days before new supplies arrive. In that case, the HMOs may give priority to people aged 65 and up, infants, toddlers and pregnant women.