Flu season and other respiratory viruses arrive a month early in Malaga province

The emergency rooms of public and private hospitals are the first to notice the downward slide of temperatures and the consequences of recent rains, as that's usually when cases of the flu, colds, coronavirus and bronchiolitis start to rise. Although the higher incidence typical of the period from mid-December to the end of February has not yet started, cases of these pathologies are on the rise.

In fact, the Spanish society of family and regional medicine (semFYC) has announced that the flu season has been brought forward by one month throughout the country, which is atypical behaviour but in line with what has happened in Europe. In Malaga province, consultations and emergency rooms have been dealing with flu cases for a couple of weeks now. They are few, for now, but the season has arrived four weeks early.

Head of the emergency department of Hospital Clínico Universitario Virgen de la Victoria Dr Francisco Temboury has confirmed this announcement, adding that the seasonal graph "is expected to increase in the coming weeks". Although he is mostly referring to the flu, coronavirus, which is no longer a seasonal virus, will also be on the rise. "We can see that the flu is rising a little, coronavirus is more or less stable and respiratory infections are also increasing a little," he said, warning that the spread concerns the entire region of Andalucía.

According to Dr Temboury, as temperatures start to drop, people seek shelter indoors, in bars and restaurants, which increases the likelihood of disease spread.

Spokesperson for semFYC José María Molero has stated that "a variant of the H3N2 virus (influenza) that has been circulating since April or May in different countries of the EU" is likely to have reached Spain, given that "viruses cannot be confined within a country". This subtype is more transmissible, without implying greater seriousness. The most vulnerable groups are the elderly, the immunocompromised and patients with chronic illnesses. According to Molero, "although the virus is not more virulent, it can cause more admissions and complications because the vaccine shields people against variants with fewer antigenic changes".

This epidemiological advance not only anticipates an increase in cases earlier than usual, but also shortens the window of effective vaccination, which is particularly important for the protection of the population at risk. Moreover, it could lead to an influenza season different from that of recent years. A significant increase in respiratory symptoms compatible with influenza has already been detected in primary care centres, although we are at the time of year when circulation is traditionally still low. The peak in transmission, however, has not been reached yet.

If it is confirmed that the genetic subclade K of A(H3N2) is the predominant strain this season, it should be noted that it exhibits alterations in the haemagglutinin protein, which is key to the virus's ability to bind to human cells. These changes may make it more difficult for the immune system to recognise the virus, both after vaccination and following a previous infection, which could explain the earlier-than-usual circulation and possible infections even among vaccinated individuals.

The problem with influenza is that it is unsettling for those with pre-existing illnesses such as cancer, which requires immunosuppressive treatment, COPD or those with heart problems. A young person easily overcomes a cold. "But if someone who hasn’t been vaccinated yet catches it and they have underlying conditions and are of a certain age, it can throw them badly off balance," Dr Temboury told SUR, adding that the same is true of coronavirus.

Health experts recommend that people wear masks when going to a hospital, a health centre or an elderly people residence.

A total of 259,764 people have already been vaccinated against the flu in Malaga province and 658,633 Andalusians have been vaccinated against coronavirus. "The vaccine is the best tool to protect us from the respiratory viruses that fill our hospitals in winter," regional minister of health Antonio Sanz said. He stated that 171,930 people over the age of 60 have been vaccinated against the flu (39.2% of that age group), while care homes for the elderly in Malaga province have reached a vaccination coverage of 84.9%.

The regional minister reminded the public that 580 flu and Covid-19 points have been set up so that the target population can be vaccinated. These procedures take place on Wednesdays.

In addition, Andalucía has already reached 93.6% vaccination coverage against respiratory syncytial virus (RSV), the cause of bronchiolitis, and 6,260 children have been vaccinated in Malaga.

Doctors have also noticed a "notable increase" in the flu, colds and other respiratory viruses in HM hospitals in Malaga. Specialists emphasise the need for prevention and vaccination, especially in risk groups such as young children, the elderly and people with chronic diseases.

"We are seeing a spike in the number of cases in our consultation rooms and emergency departments, which is unusual at this time of year. Colds and pharyngotonsillitis predominate, although we are also seeing cases of influenza, Covid-19 and respiratory syncytial virus in children," head of the adult emergency department of HM Málaga and HM Santa Elena Dr Alberto Puertas warned.

Head of the pneumology service of HM in Malaga Dr Borja Valencia says that "although the flu and colds are respiratory infections, their symptoms are usually clearly distinguishable. The flu usually appears more abruptly, with high fever, intense muscle pain, general fatigue and sometimes difficulty breathing. A cold, on the other hand, is milder, with nasal congestion, sneezing, sore throat and, on rare occasions, high fever".

Doctors recommend avoiding self-medication, especially with antibiotics. "Over-the-counter anti-influenza, mucolytics and antitussives can be used to alleviate symptoms while awaiting medical evaluation," Dr Puertas says.

Frequent hand washing, room ventilation and use of masks in enclosed or poorly ventilated places can help protect oneself and people at risk. Coordinator of the paediatric emergency department at HM Málaga Dr Maria Gonzalez warns that the flu can cause complications such as otitis or pneumonia in children.

Experts advise going to the hospital if the fever persists for more than 72 hours, there is respiratory distress or chest pain or if symptoms continue or worsen.