Should we be worrying about the latest round of H3N2 flu? Not really

Influenza viruses have coexisted since at least 6,000 BC. in China with mankind, with Greek writings from the 5th century B.C. Provide disease descriptions consistent with influenza. However, the influenza virus was not discovered until 1931 by Richard Shope as the cause of the then new swine flu. By 1933, influenza A viruses were identified as responsible for infecting humans, with several subtypes being discovered in the years that followed. Influenza B was discovered in 1940, and influenza C and D were identified thereafter.

The mother of all pandemics, the Spanish influenza of 1918-1919, was caused by one such virus. It resulted in over 100 million deaths, which equals 480 million deaths today. The 1957-58 Asian flu pandemic caused by the H2N2 virus resulted in over two million deaths, equivalent to about 7.5 million deaths today. The 1968 Hong Kong flu pandemic caused by the H3N2 virus resulted in over a million deaths. The 2009 swine flu pandemic caused by the H1N1 virus claimed half a million deaths. We are all too familiar with the ongoing COVID-19 pandemic caused by the SARS-CoV-2 virus, which has already resulted in approximately eight million deaths. All of these viruses have mutated into less deadly avatars that are spreading around the world, causing tens of millions of infections and more than a million deaths each year. So why shouldn’t we worry?

First, these are all weakened viruses with varying degrees of infectivity but very low lethality rates. Next, the RT-PCR test is now mature enough to detect these viruses. Third, we have effective vaccines. Fourth, we have learned something from experience.

An outbreak of respiratory infection was detected in India in late December 2022 and early January 2023, with symptoms including common cold, sore throat, fever and fatigue. On March 4, the Indian Council of Medical Research (ICMR) announced that the disease was caused by the influenza virus subtype H3N2, a virus derived from the N2 of the 1957 H2N2 virus and the H3 of the avian influenza A virus consists.

As we know only too well, COVID-19 is transmitted by the SARS-CoV-2 virus. The symptoms of all flu variants and those of COVID-19 are quite similar. These include fever, stuffy nose, sore throat, fatigue and headache. There is slight variation in symptom dominance and recovery times of one to two weeks. For an accurate diagnosis, laboratory tests using the new RT-PCR tests are necessary to determine the genetic or molecular elements of the virus. Testing certainly helps at the epidemiological level to track and monitor the prevalence of the disease, but is of minimal importance in formulating an individual’s treatment plan.

In addition to SARS-CoV-2, we are currently dealing with at least four and possibly even more influenza viruses. All are contagious and transmitted by droplets. Therefore, the prevention of all of them is similar. Precautionary measures that resonated as slogans during the COVID-19 pandemic make a case for being reinstated. Mask use, hand and respiratory hygiene, and social distancing are the best measures to contain the spread of all four viruses. I haven’t given up wearing masks and hand hygiene yet, much to the amusement of many of my friends and some colleagues. Call it luck, genes, vaccination, proper protocols, or any combination of these, but I’ve been spared COVID-19 and the flu through all these years.

What do you do in case of illness apart from the obvious medical advice? Bed rest, isolation, hydration, ventilation and symptomatic treatment of fever, sore throat, body aches, cough and other symptoms. Hospitalization may be considered if it does not improve in 7-10 days and is deemed necessary by the doctor. But unless there’s a secondary bacterial infection, absolutely no antibiotics. Certainly not the ones recommended by the friendly neighborhood pharmacist! Antibiotics do not work on viruses. On the other hand, they do an incredibly sinister job of promoting antibiotic resistance, which is becoming a monumental public health problem. Please avoid them unless your doctor deems it necessary. When indicated, antiviral medications such as Tamiflu are known to facilitate recovery.

One can’t help but wonder if Lord Gautam Buddha could have foreseen the rampage of multiple viruses when he advocated the golden mean? Between recklessness and excessive caution, unbridled bravery and paralytic fear, boldness and timidity lies our salvation.