More flu killed than reported


Photo: Ariane Bühner

An expert of the Robert Koch Institute to determine the disease numbers, the right vaccine and the influence of the weather
published on 13.04.2018 In the past week, 20 people in Saxony died of influenza, including a one-year-old boy, who had received triple vaccination and was severely damaged due to a complex heart failure, as informed by the State Investigation Center (LUA) Saxony. The number of deaths in Saxony has thus increased to 131. However, the number of illnesses in the Free State is now falling further and further – after 26 weeks, the flu epidemic is in sight. The LUA reported about 1300 new cases last week, 45,000 since October. How these numbers are determined and how safe the vaccine is, Stephanie Wesely wanted to know from the spokeswoman of the Robert Koch Institute (RKI), Susanne Glasmacher.

Free press: Was the flu episode heavier this year than the year before?

Susanne Glasmacher: This can only be assessed in a few months if we were able to evaluate all the data. What we do know is that this time there were an unusually high number of influenza-related visits to the doctor, including more laboratory-confirmed flu deaths. But that’s not enough to assess the severity of a disease wave.

How is the number of influenza patients determined?

A network of around 700 home and pediatrician practices reports weekly the number of acute respiratory diseases. By comparing it to a period when there were also many infections but no flu, we can calculate the number of flu-related visits to the doctor and sufferers.

Why was there so many visits to the doctor this time?

This winter, an influenza virus dominated that had barely occurred in recent years. Then the immunity is lower.

This season, mainly adults between the ages of 40 and 60 fell ill, and in the past year, more very old people. Is that synonymous with the virus type?

All seasonal influenza viruses can cause relatively mild and even severe illnesses, including deaths. Each type of virus has its own characteristics. For example, the one that dominates this season is more likely to cause illness in middle-aged adults, ie those over the age of 35 years. This age group is from the basic constitution but mostly healthier than 60-year-olds. Therefore, the number of deaths is usually not as high as in seasons with virus types that affect above all very old people. That was the case in winter 2016/17, for example.

So far, however, more deaths have been reported than last winter – nationwide almost 1300th In the preseason about 680 people had died of influenza around this time. Are the numbers realistic?

Not all influenza-related deaths are recognized as such or even confirmed by laboratory diagnostics. The reported data is therefore only a fraction. The actual influenza-related mortality is estimated by statistical methods from the number of total deaths. To put it simply, the number of deaths in months with and without influenza viruses is compared. The number of deaths can vary greatly with the individual influenza waves. Most were valued at 21,300 in the 2014/15 season. The figures for 2016/2017 do not yet exist; for the current season, this is not possible until the end of 2019 at the earliest, if the data of the Federal Statistical Office are available.

What influence does the weather have on the number of illnesses? In the summer there are hardly any flu patients.

Influenza viruses are more stable at low temperatures and in dry air. In addition, with dry heating air in winter, the mucous membrane of the upper respiratory tract is more susceptible to infection. Another factor could be that you spend some time with other people in less well-ventilated areas during the winter. The immune system is less effective in winter than in summer. The weather has no influence on the severity and the course of a flu epidemic.

The current flu season was marked by the dispute over the right vaccine. How is the composition determined?

Reference laboratories around the world – in Germany the National Reference Center for Influenza at the Robert Koch Institute – continuously monitor circulating influenza viruses throughout the year and communicate their findings to the World Health Organization (WHO). At the end of February, WHO will publish the composition of the next flu vaccine based on this data so that vaccine manufacturers have enough time to produce. Influenza viruses are very changeable. It is possible that in the meantime, other influenza variants prevail, so that recommended vaccine strains no longer fit optimally.

Can the vaccine be made more accurate? What effectiveness is possible?

The protective effect of influenza vaccination is lower because of the high mutability of viruses than other vaccinations. In addition, older people often have a reduced immune response, making the vaccine less reliable. You can approximately halve your influenza risk by the vaccine on average. This means that every second vaccinee is protected from illness. Although the efficacy of the flu vaccine is not optimal, many cases of influenza can be prevented due to the frequency of influenza. In Germany, even with the currently moderate vaccination quotas, there are about 400,000 influenza cases per year in persons over the age of 60 years. In addition, numerous studies have shown that the flu in vaccinated people often milder, so with fewer complications and thus fewer deaths, than in the unvaccinated run.

information . Maps and reports about the virus flu and flu infections in Germany and Saxony can be found on the Internet

The weekly reports of the State Investigation Institute of Saxony are below

Photo: RKI Photo: RKI

The RKI spokeswoman

Susanne Glasmacher since 2000 speaker of the Robert Koch Institute in Berlin. Previously, she worked in the cancer research center in public relations. She studied biology and journalism.

Viruses are quick-change artists

influenza viruses are constantly changing, especially a particular surface molecule, which is important for recognition by the immune system. Therefore, you will not be immune to overcome flu. Viruses do not have their own metabolism and adapt to their host cell.


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