South Africa faces an annual health threat that claims more than 10 000 lives and leads to thousands of hospitalisations, according to the National Institute for Communicable Diseases (NICD).  

This figure represents the average impact of influenza, a disease often underestimated as a common cold. The NICD stresses that vaccination is the most effective preventative measure against this potentially deadly illness. 

Flu season in South Africa typically begins in April, with the peak expected in June. Health officials recommend that individuals, especially those in high-risk groups, receive the flu vaccine by late March or early April. The NICD also emphasises the importance of vaccination for healthcare workers to protect both themselves and their patients. 

Prof Cheryl Cohen, the NICD’s head of the centre for respiratory diseases and meningitis, answered these questions asked by Caxton Network News:

Q: Do medical aids typically pay for vaccines? 

A: Many medical aids do pay for the influenza vaccine. The National Department of Health (NdoH) also provides the influenza vaccine for individuals at increased risk of getting severe influenza and influenza complications. In addition, they also provide the influenza vaccine for health workers. 

Q: Who is considered at high risk for complications from the flu? 

A: Pregnant women, individuals living with HIV; those with chronic conditions such as diabetes, lung disease, TB, heart disease, renal disease and obesity; and people 65 years of age or older.  

Q: How long before the flu vaccine is effective? 

A: A protective antibody response takes about two weeks to develop. Although the best time to vaccinate is before the influenza season starts, getting it later will still protect you during the rest of the season.  

Q: Can my baby be vaccinated? 

A: Yes. From six months of age. 

Q: What are the key symptoms of flu, and how can it be distinguished from other respiratory illnesses? 

A: The most common symptoms are sudden onset of fever, muscle pains and body aches, dry cough, sore throat, runny nose, feeling tired or unwell and headache. The symptoms develop anywhere from one to four days after infection and last for two to seven days. For the majority of people, the symptoms commonly resolve without treatment. Complicated influenza infections can cause serious illness and, in some cases, death.  

Some of the influenza symptoms are similar to symptoms in patients infected by other respiratory viruses (SARS-CoV-2, rhinovirus, human metapneumovirus), although influenza-infected patients may be sicker. You cannot tell whether the illness is caused by influenza from the symptoms. A laboratory test is required to make the distinction. 

Q: When should someone seek medical attention for flu-like symptoms? 

A: It is advisable to seek medical attention if symptoms do not improve in three to seven days or if symptoms worsen in that time. Severely ill patients with influenza should be admitted to the hospital. People at risk of severe influenza illness or complications should seek medical help sooner rather than later. 

Q: When is the expected peak of the flu season in South Africa this year? 

A: We can’t say with certainty. However, based on data from previous years, on average, the peak of the influenza season occurs in June. 

Q: What are the most effective measures to prevent the spread of influenza? 

A: Influenza vaccination is the best way to prevent infection. Non-pharmaceutical measures can minimise the transmission of seasonal influenza, however. These include avoiding close contact with sick individuals; practising proper hygiene, including frequent hand washing; avoiding touching the mouth, eyes and nose; and covering coughs and sneezes (preferably coughing into an elbow or a tissue, which should be promptly disposed of away from others). Individuals experiencing flu-like symptoms should stay at home to avoid infecting others.

Q: Flu is often dismissed as a severe cold when it can be deadly. Do you have hospitalisation and fatality figures for last year’s flu season?   

A: We don’t have information for last year’s season specifically, but we do know that, on average, influenza is responsible for around 11 000 deaths and over 55 000 hospitalisations each year. 

Q: How does the NICD track flu cases, and what do they do with that data? 

A: The NICD conducts surveillance/monitoring for influenza-like illness and pneumonia using different platforms. Patients with influenza-like illness (mild respiratory illness) consulting GPs or seeking care at the surveillance clinics and patients with pneumonia (severe cases) hospitalised at surveillance hospitals are tested for influenza. The data are used to monitor influenza activity, including the start, peak and end of influenza season, circulating strains and how the current season compares to previous seasons in terms of patients testing positive for influenza. 

Q: What are the predominant influenza strains expected to circulate in South Africa this flu season? 

A: It is not possible to predict the strains that will be dominant in 2025. However, each year a combination of influenza seasonal strains circulate. These include influenza A(H1N1)pdm09, influenza A(H3N2) and influenza B/Victoria. Updated influenza reports with information on circulating strains are published weekly on the NICD website and can be accessed here.

Q: What messages does the NICD have for the public about flu season?  

A: It’s better to be safe than sorry. Get the influenza vaccine as soon as it is available from the clinics or pharmacies. Receiving the vaccine can reduce visits to clinics or doctors’ offices, absenteeism from work and school, and help prevent influenza-related hospitalisations. The influenza vaccine is safe and will prevent influenza infection – but not the other respiratory viruses circulating during winter, so you may still get flu-like symptoms. 

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