Influenza has returned to Europe at a faster-than-expected rate this winter after almost disappearing last year, raising concerns about a prolonged “twindemic” with COVID-19 amid some doubts about the effectiveness of flu vaccines.
Lockdowns, mask-wearing and social distancing that have become the norm in Europe during the COVID-19 pandemic knocked out flu last winter, temporarily eradicating a virus that globally kills about 650,000 a year, EU data showed.
However, that has now changed as nations adopt less strict COVID-19 disease prevention measures due to widespread vaccination.
Since the middle of last month, flu viruses have been circulating in Europe at a higher-than-expected rate, the European Centre for Disease Prevention and Control (ECDC) reported this month.
The number of flu cases in European intensive care units (ICUs) last month rose steadily to peak at 43 in the final week of the year, ECDC and WHO data showed.
That is well below pre-pandemic levels — with weekly flu cases in ICUs peaking at more than 400 in the same period in 2018, but it is a big increase on last year, when there was only one flu case in an ICU in the whole of December, data showed.
The return of the virus could be the start of an unusually long flu season that could stretch well into the summer, said Pasi Penttinen, the ECDC’s top expert on influenza.
“If we start to lift all measures, the big concern I have for influenza is that, because we have had such a long time of almost no circulation in the European population, maybe we will shift away from normal seasonal patterns,” Penttinen said.
He said dismantling restrictive measures in the spring could prolong the circulation of flu far beyond the normal end of the European season in May.
A “twindemic” could put excessive pressure on already overstretched health systems, the ECDC said in its report.
In France, three regions — including Paris — are facing a flu epidemic, French Ministry of Social Affairs and Health data showed.
This season, France has so far recorded 72 serious cases of flu, with six deaths.
Further complicating matters, the dominant flu strain circulating this year appears so far to be H3 of the A virus, which usually causes the most severe cases among the elderly.
Penttinen said it was too early to make a final assessment of flu vaccines because a larger number of ill patients was needed for real-world analysis, but laboratory tests showed that the vaccines available this year “are not going to be optimal” against H3.
That is largely because there was very little or no virus circulating when the vaccines’ composition was decided last year, making it harder for vaccine makers to predict which strain would be dominant in the flu season.
Vaccines Europe, which represents top vaccine makers in the region, acknowledged the strain selection was made more difficult by very low flu circulation last year, but added that there was not enough data yet to assess the effectiveness of this season’s shots.
Flu vaccines are adapted every year to make them as effective as possible against ever-changing flu viruses.
Their composition is decided six months before the flu season begins, based on circulation of viruses in the opposite hemisphere. That gives time for drugmakers to develop and make the shots.
European data on flu vaccine uptake is not yet available, but national figures for France show that coverage is not as broad as authorities hoped for.
The authorities there extended by one month the vaccination period to the end of next month to boost inoculations. Figures released last week showed that 12 million people have so far been vaccinated, about 45 percent of the target population.
“There is still a large room for improvement to limit the impact of the flu epidemic,” the French health ministry said in a statement on Tuesday last week.
This year’s target is to vaccinate 75 percent of people at risk.
Vaccines Europe said the industry had supplied large numbers of flu shots, despite the strain on production facilities posed by the COVID-19 pandemic.
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