Over the past two years, Taiwan has not had a major influenza outbreak, a knock-on effect of the public wearing masks and avoiding going out too often because of the COVID-19 pandemic.
Now, a wave of COVID-19 infections has been triggered by the Omicron BA.5 subvariant of SARS-CoV-2, with nearly 40,000 local cases being reported daily for several consecutive days, along with hundreds of imported cases.
Nevertheless, the Central Epidemic Command Center (CECC) is under pressure to reopen the borders and reduce requirements for arrivals to only undergo seven days of “self-health monitoring” without COVID-19 testing or quarantine.
The public was previously told to prepare, as reopening the border would not only cause another wave of COVID-19 infections, but also bring the influenza A virus subtype H3N2 currently rampant abroad, which would hinder the nation’s fight against COVID-19.
In March, there was an H3N2 outbreak in Australia, and the epidemic is still raging. In June, the Chinese government’s flu surveillance report indicated that the rate of people testing positive for flu in several southern provinces continued to rise, with the outbreaks dominated by the H3N2 flu virus.
Based on previous influenza epidemic patterns, the H3N2 virus is more likely to affect the elderly and young children, often causing moderate-to-severe illness and even death.
If flu becomes prevalent, encephalitis and multisystem inflammatory syndrome in children might increase. The CECC should take appropriate precautions.
Starting next month, Taiwan is to start administering quadrivalent influenza vaccinations, using egg-based vaccines according to the WHO’s recommendation. For the vaccines, the original strains for influenza A are from Australia or the US, while the original vaccine strains for influenza B are from Austria and Thailand.
The WHO’s latest data show that these vaccine strains are antigenically compatible with the influenza strains expected to be prevalent in the northern hemisphere this fall and winter, and they would provide effective protection for high-risk groups, reducing the cases of severe illness or death by 30 to 60 percent.
The Centers for Disease Control recently said that the priority targets for influenza vaccination are medical workers, people aged 65 and older, preschool children aged six months to eight years, chronically ill patients and pregnant women. When there is sufficient supply, vaccinations would be extended to all age groups. Given the benefits of vaccination, the CECC should promote flu vaccines to the general public.
As there has been no major influenza outbreak over the past two years, few Taiwanese would have the necessary antibodies to fend off the illness. When arrival numbers increase after the reopening of the border, it would only be a matter of time for the H3N2 virus to spread in communities.
As it is not easy to distinguish flu symptoms from those of COVID-19, clinics and hospitals should have flu test kits ready for diagnosis, to avoid confusion between the diseases, which might interfere with epidemic prevention efforts.
Vaccinations might be the only way to battle influenza this flu season. Perhaps people in high-risk groups should take their flu shots at the same time they receive the next-generation Moderna COVID-19 vaccine.
Liou Pei-pai is a former director of the Taiwan Animal Health Research Institute.
Translated by Eddy Chang
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