Influenza-like illness among kids: It will get worse before it gets better

Private clinics and hospital emergency departments in Malaysia are crowded with children who have influenza-like-illness (ILI), with influenza A, human metapneumovirus (hMPV), rhinovirus, respiratory syncytial virus (RSV) A, and bocavirus cases rising since the start of the year.

There was a surge of cases in May, and Malaysian Paediatric Association (MPA) president, Dr Selva Kumar Sivapunniam, warned that the situation could get worse if parents do not take precautions to stop the spread of these viruses.

Explaining the rise in these cases, Dr Selva Kumar said the opening up of the economy and schools – now that the country is transitioning from the Covid-19 pandemic to the endemic stage – played a part.

“The number of cases started rising early this year, but it got worse from May,” said Dr Selva Kumar.

“For the better part of the last two years, adults and children were working or studying at home due to Covid-19.

“Children who were at home, and kids born during this period, were not exposed to the influenza viruses.”

He said because of Covid-19, children frequently washed and sanitised their hands, and wore masks.

“That helped stop the spread of not only Covid-19, but also ILI.

“But now that they are back in school with Covid-19 restrictions eased, they are exposed to RSV A and the other types of influenza, and are more vulnerable.”

He added that was also the reason for the spike in hand, foot and mouth disease (HFMD) earlier this year.

As children are now more vulnerable to influenza, those aged three and below suffered severely from ILI and had to be admitted to hospitals.

Due to the severity of their cases, their average length of stay in hospitals is prolonged, leading to crowded medical centres.

A doctor based in Kuala Lumpur, who requested anonymity, told Twentytwo13: “The situation is bad in my clinic and the hospital’s emergency department. Many children are falling sick.”

“It is the same situation at other hospitals, too. Parents have to be extra careful.”

Dr Selva Kumar said that with a long weekend coming up following the Hari Raya Aidiladha celebrations, parents should reintroduce Covid-19 protocols, such as wearing face masks, and avoiding crowded places, where possible.

“Keep sanitising your hands, and your children’s hands, and wash them frequently. If your child is not well –coughing, sneezing and has a fever – skip school and do not go anywhere,” he said.

“The younger ones are also getting the infection from the older children who are exposed to the virus in school.”

ILI affecting the whole world

Last week, Brunei’s Health Minister, Datuk Seri Setia Dr Mohd Isham Jaafar, revealed that laboratory tests identified the rhinovirus as a dominant virus among ILI cases.

In India, it has been the protocol since early last month for hospitals to activate flu corners and test those with ILI symptoms for Covid-19.

Health authorities in the United States and Britain have issued warnings about the increase in ILI cases with RSV infections, usually associated with the autumn and winter months.

Separately, Dr Selva Kumar said parents of immunocompromised children should consider getting a Covid-19 booster jab.

“It is not for everyone, such as those who are undergoing cancer therapy, have had transplants, and other illnesses,” said Dr Selva Kumar.

“It is up to the doctors managing these patients, especially the specialists and paediatricians, to advise the parents.”

‘Influenza can be as deadly as Covid-19’

Meanwhile, the Malaysian Influenza Working Group, a special interest group under the Malaysian Society of Infectious Diseases & Chemotherapy, aligned with the Asia-Pacific Alliance for the Control of Influenza, issued a call for citizens to take flu shots.

It said influenza can be as deadly as Covid-19.

The group also advised Malaysians to follow Covid-19 protocols – wearing masks indoors and outdoors, washing hands often, and avoiding crowded areas – as a way to stop the spread of ILI.

“We are particularly concerned with the low population immunity due to the lack of exposure to influenza over the last two years and the low flu vaccination uptake in Malaysia,” the group said in a statement recently.

“This makes the population more susceptible to catching the flu, and high-risk groups are at risk of severe, prolonged, and even fatal disease.”

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