The recent deaths of Taiwanese actress Barbie Hsu and Chinese actor Liang You Cheng draws fresh attention to the dangers of influenza, with many wondering ‘how could this happen?’ However, in spite of such news proving that influenza can be deadly, a wealth of misperceptions persists.
“Many people still think that influenza is nothing to worry about, that it is just a concern in cold climates. Even when they do get sick, they think it will be mild and they will recover in a few days. Thankfully, most people recover well without any complications, but there are some individuals who don’t do so well, as these recent high-profile cases show us,” said Professor Dr James Koh Kwee Choy, Professor of Internal Medicine & Infectious Diseases at IMU University.
“However, many people are unaware or ignorant about influenza, until something like this happens.”
The Tipping Point
“Traditionally, influenza is associated with very high fever that comes very quickly – a person can be fine one day and have a high fever the next. Following that, they will have body aches, sore throat, and shortness of breath for some of them. These are the four classic symptoms associated with influenza and they happen within 24 to 48 hours,” explained Prof Koh.
Many people are tempted to just soldier on but a high fever that does not subside in three days is a sign that complications might be setting in. Those with symptoms such as restlessness, agitation, and altered consciousness such as being confused, which is more common among children and older persons, should see a doctor immediately, he explained. Another easily missed warning sign is vomiting, as this is most often associated with food poisoning.
Among children, the signs can be slightly different, added Prof Koh. “Children can deteriorate very quickly, become very quiet or sleepy, and get dehydrated easily. They may also make a lot of sounds while breathing that is not normal, we call it noisy breathing, and this means they are having difficulty breathing and may have low blood oxygen levels.”
“However, you should not wait until these signs appear before going to see a doctor! People can be busy or stubborn and find many reasons to avoid going to see a doctor, even when people around them can clearly see that they are unwell. So, my advice is not to wait, especially if you fall into the category of high-risk, such as pregnant women and children below the age of 5, adults who have comorbid conditions like asthma, diabetes, high blood pressure or heart disease, or those who smoke or vape. These factors increase the risk of complications, and the risk is even higher if those conditions are not well-controlled.”
In addition, Prof Koh points out, many people are not even aware of underlying health conditions that could heighten their risk hence a person can appear to be in good health and still develop complications such as pneumonia.
What You Can Do to Protect Against Influenza
Influenza vaccines, which were first used in 1945, are the most effective way to prevent influenza and should be taken annually to safeguard against the most current influenza strains and to protect against serious and potentially fatal complications.
One such complication is pneumonia, which was the leading cause of death among Malaysians in 2023, overtaking coronary heart disease for the first time in 20 years, with higher incidence among women, older persons 60 and above, and those of Chinese ethnicity.
“Unfortunately, there is low awareness among Malaysians that influenza can be deadly and thus little motivation to protect themselves. In addition, Malaysia does not have clear seasons when influenza cases spike, instead we have sporadic outbreaks that are unpredictable. As it takes around 2 weeks for immunity to develop, those who wait to take the influenza vaccine unless there is an outbreak are still vulnerable to infection during this time,” explained Prof Koh. “This is why annual influenza vaccinations are important.”
Simply put, he added, the difference between a vaccinated and unvaccinated person would be like a person who is trained in self-defense and a person who has no training. Both have the same risk for getting attacked but the person who is trained (the person who is vaccinated) has a better chance of fighting off an assailant (the influenza virus) compared to the person who is not.
“Ideally, I would advise that everyone aged 6 months and older should get vaccinated, while a more targeted approach would be to vaccinate all individuals at higher risk for complications, which are those below 2 and above 65 years, pregnant women, adults with comorbid conditions like diabetes, asthma, heart disease, kidney disease, obesity, and people with weakened immune systems, as well as healthcare workers and caregivers of the very young or old,” asserted Prof Koh. “Remember, everyone is at risk and influenza doesn’t pick and choose.”
