Flu season could come early this year

Flu season may have come early this year. This has been warned by the Basque Government in a release issued recently in which they warn that “the hospitals and emergency services of Osakidetza are registering a notable increase in flu cases in recent weeks, especially in Biscay”.

“This increase suggests that it has arrived earlier this year and that the infection curve could be getting ahead of itself,” they assure.

According to the healthcare data collected between October 13 and 19, 506 cases of flu have been identified, a figure much higher than the 166 in the same period last year and 105 two years ago.

By territories, Biscay has the highest incidence, with 74.35 cases per 100,000 inhabitants, followed by Guipúzcoa (32.10) and Álava (9.85).

A trend across the country?

However, This trend is not yet observed throughout the country, hence the experts consulted by 65AND MORE They are not yet clear if we are facing a widespread phenomenon.

On the one hand, the incidence on Primary Care (AP) and hospitals, which remains at low levels, does double that recorded in October 2024 and 2023 and is more similar to that of 2022, when the epidemic began earlier than expected, according to the indicators of the Acute Respiratory Infection Surveillance System of the Carlos III Health Institute.

Furthermore, in the last two weeks there has been an increase in the positivity of the tests carried out in health centers, which would have gone from 4.1% to 6.8% –mainly, cases of influenza A are detected. And specifically, in certain communities, such as the Basque Country, La Rioja and Castilla y León, this percentage would be higher than 10%.

However, in hospitals there would not be an upward trend in detections throughout Spain. On the contrary, in the week of October 13 to 19, lThe incidence would have dropped from 1.3 cases/100,000 to 0.9 cases/100,000 and positivity from 11.6% to 8.4%.

“There is a small increase, but it cannot be considered that there is high activity, but rather medium and, in some communities, low,” comments the spokesperson for the Spanish Society of General and Family Physicians (@SEMG_ES), Lorenzo Armenteros, who believes that in the Basque Country, possibly, “due to the cold that is sweeping through the north”, cases would have increased.

However, he maintains, we cannot yet speak of a general advance of the season and “the forecast continues to be that “The big peaks will be at the end of December and beginning of January”.

Juan Antonio Ramón Soriasecretary of the Madrid Association of Public Health (@amasap), explains that we are facing a general increase since September in all respiratory infections and that the incidence of flu is somewhat higher than other seasons on these same dates.

Thus, in his opinion, he understands, “we could be facing an advance of the peak of incidence, but it is still at a low intensity and we must continue carrying out epidemiological surveillance.” In addition, this trend has occurred in certain communities in the north, but not in the entire country, so there would be no reason to think that this year the season will be very different.

For his part, the head of Immunology at the Virgen de la Arrixaca University Clinical Hospital, Manuel Muro (@manuelmuro5), agrees with Armenteros that the temperature factor may be influencing these increases, and recognizes that the fact that, “in some communities, especially in the north of the country, there is an increase of 25-50% compared to last year’s figures at this same time”, invites us to think that “the flu has arrived earlier this year and that the contagion curve could be advancing.” “In any case, we are still below the epidemic threshold,” values.

Finally, the immunologist and professor of parasitology, Rafael Toledo (@alfwarrior), does not rule out this possible advance and affirms that it would not be a phenomenon either “unusual or strange”, just as happened in 2022, with the alternation of several strains, with a first peak of influenza A and later another of variant B.

The case of Japan

It should be noted that this early start of the epidemic would have been observed recently in Japan –a country also located like Spain in the northern hemisphere –, which would have recorded an early increase in cases and hospitalizations, especially of influenza A (H3N2), straining the health system.

However, the Japanese trend has not yet been observed at the European level. According to data published by the European Center for Disease Prevention and Control From the week of October 18 to 24, the circulation of the flu would still be at “low levels.”

Vaccination

Even so, whether the season is finally advanced or not, vaccination remains the most effective tool to reduce the impact of flu cases and is now available for at-risk groups. Specifically, it is recommended for the following groups:

• People 60 years of age or older.
• Child population between 6 and 59 months of age.
• People from 5 years to 59 years of age with the following risk conditions:

– inmates in disability centers, nursing homes and closed institutions.

– diabetes mellitus and Cushing’s syndrome; morbid obesity.

– chronic cardiovascular, neurological or respiratory diseases, including bronchopulmonary dysplasia, cystic fibrosis and asthma.

– chronic kidney disease and nephrotic syndrome.

– hemoglobinopathies and anemias or hemophilia, other coagulation disorders and chronic bleeding disorders, as well as recipients of blood products and multiple transfusions.

– asplenia or severe splenic dysfunction; chronic liver disease, including alcoholism; serious neuromuscular diseases.

– immunosuppression.

– cancer and malignant hemopathies.

– chronic inflammatory disease.

– disorders and diseases that lead to cognitive dysfunction.

– celiac disease.

– cerebrospinal fluid fistula, cochlear implant or waiting for it.

• Smoking people.
• All pregnant women in any trimester of gestation and women during the puerperium.
• People of 5-18 years old who receive prolonged treatment with acetylsalicylic acid, due to the possibility of developing Reye’s syndrome after the flu.
• Staff of public and private health and socio-health centers and establishments.
• People who work in essential public services, with special emphasis on the following subgroups: State security forces and bodies, with national, regional or local dependence; Armed forces; firefighters; and civil protection services.
• People who provide home care and cohabitation with patients collected in the previous section.
• Staff and interns in public and private health and social health centers, centers for minors, both primary and hospital care, as well as pharmacy office staff.
• Staff of daycares and centers of early childhood education (up to 6 years old).
• People with direct occupational exposure to animals or to their secretions on farms or farms.