The Flu in Africa

The flu also called “influenza” is an infectious respiratory disease caused by the influenza virus. It is a major cause of death and illness worldwide, the group of people at particular risk include pregnant women, young children, the elderly, and people with underlying medical conditions. Influenza could be spread mainly in three ways; by the airborne route, by direct transmission (when an infected person sneezes mucus or droplets directly into the eyes, nose & mouth of another person), lastly by hand to eye, hand to nose & hand to mouth transmission (these occurs by touching contaminated surfaces cause the virus can survive for a few hours on the surface touched by an infected person or through direct personal contact such as handshake).

The common symptoms associated with the flu include; coughing, fever, sore throat, runny nose, muscle and joint pain, diarrhea & vomiting (seen mostly in children, not in adults). These symptoms occur two days after exposure to the virus and most last than a week. Flu is a pandemic disease and has occurred occasionally since the last decades taking millions of lives. Three majors causes of Influenza include the Influenza A, B (cause epidemic diseases), and Influenza C (mild, cold-like illness).

The flu outbreak in Africa hasn’t been properly recorded due to poor surveillance systems hence leading to inadequate and incomprehensible data. Since the first outbreak in 1918 to the 2000s, various Flu outbreaks have occurred and Africa hasn’t been able to produce sustainable data about the effect of Flu in the continent leading to limited data. Proper surveillance system and the record wasn’t taken until the 2009 spread of Influenza A where African countries started producing regular updates through the impact of the pandemic disease wasn’t well recorded due to various factors such as public hospitals having small overextended clinical staff, therefore the surveillance system can’t rely on them to find patients and collect samples due to sustainability of these systems, the government; the bureaucratic procurement system, making it difficult to buy testing equipment, lack of safe and reliable transport system from rural areas to transport specimens to other remote areas.

The rate of mortality due to respiratory disease in Africa is higher than anywhere in the world. In Africa, there are several risk factors such as poor nutritional status, poor access to health care, poverty, underlying medical conditions e.g. HIV/AIDS, malaria, tuberculosis is disturbing e.g. In 2010 nearly two-thirds of the 34 million people was with HIV; a risk factor. In 2009, nearly one-third of patients with tuberculosis lived in Africa, half of the death occurred in patients who are HIV positive and 10% in patients with tuberculosis. As a result, the impact of this disease in this region is negligible, a recent review of published studies of the 1968 influenza pandemic in Africa found that the pandemic caused significant morbidity across the continent.

During the Influenza surveillance during the 2009-2012 flu pandemic; 28 countries were invited in which 23 countries responded (82%) and 11 collected mortality rates 8 provided data, the overall result based on all-cause and Influenza-Associated severe acute respiratory illness (SARI) cases and deaths during 2009-2012, by country. Based on cases on all-cause SARI, there is a total number of 37714 cases and 1073 deaths recorded. Based on cases on Influenza-Associated SARI, a total case of 3091 cases and 57 deaths recorded. Data based on underlying medical conditions reported among deaths due to severe acute respiratory illness (SARI) detected by surveillance during the 2009-2012 in 8 African countries overall and by influenza virus status includes patients that tested positive to the underlying medical conditions, a total number of 130 cases and 35 deaths.

Influenza vaccines have served as a protection from the virus in recent decades so further influenza vaccination strategies for Africa should include targeting high-risk groups or maternal vaccination to prevent high rates of severe disease in very young infants through passive immunity. New vaccines with longer durations and more heterosubtypic protection such as adjuvanated vaccines or live attenuated influenza virus may have particular use in Africa settings. Also, the cost of influenza vaccines should also reduce and vaccines that are now cost effective should become more economically accessible.

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