“Looking at the data on the incidence of flu syndromes which in the last week was substantially stable, at the high levels of the previous one, we appear to be close to the peak“. Giovanni Rezza, former director of Prevention at the Ministry of Health and now extraordinary professor of Hygiene at the Vita-Salute San Raffaele University in Milan, explains this to Adnkronos Salute. “This week we seem to be close to the peak, but It's a very high curve “with a very high incidence which makes a long tail probable – reflects the expert -. Considering that there were days of celebration”, with the return to work activities and with the return of children and young people to schools “could grow a little. But if the peak hasn't arrived, we're close to it.”
As for the vaccination campaign which proceeded slowly and struggled to take off, although the anti-flu campaign went better than the anti-Covid one, according to Rezza “it is never late. But we should get it into our heads that the elderly, vulnerable, fragile person At the beginning of the cold season you should get vaccinated for both influenza and Covid. An annual booster is planned for influenza, I don't see why it shouldn't also be foreseen for Covid”.
Mix between the virus and Covid
“The incidence of influenza syndromes remains very high. As we enter the season and the epidemic becomes mature, the number of positive samples for influenza within the samples analyzed as part of the surveillance of respiratory diseases tends to increase. This always happens, it is not an anomaly. So today the majority of cases are flu. Then come Covid and the respiratory syncytial virus (RSV). And it is clear that, within those flu syndromes that are seen by general practitioners and reported, the lion's share this week was the flu, the first 'accused' of the pressure situation on hospitals in recent weeks. But what also matters is the fact that there are now more viruses acting” says Rezza.
“Before there was only the flu, at most RSV, now we're also adding Covid (although the percentage of hospitalized patients compared to its circulation remains rather low) – he explains to Adnkronos Salute analyzing the data of the bulletins -. Furthermore, many of these viruses that are circulating today had circulated little during the lockdown years. Therefore globally we find ourselves with a high load of flu syndromes. And the higher the number of new cases, the more likely it is that someone end up in hospital or the emergency room. If we therefore add to Covid the viruses that had circulated little previously and which now find prairies for their 'raids', it is clear that we have a pretty high intensity season and this explains the congestion we are seeing.”
“But it's not an alarming situation, it's all explainable in some way – continues the expert -. Afterwards, making a filter with respect to emergency rooms would be ideal because not all those who access them would need them and could perhaps be well looked after at the outside” of the emergency-urgency areas. “The data relating to Covid – Rezza finally points out – is a little underestimated due to the fact that, while the flu manifests itself with a fever and systematically comes to the attention of doctors, Covid is multifaceted and there are also cases in who only have a bad cold. Those people don't go to the doctor, perhaps they do the do-it-yourself test, and therefore remain out of the counts. The respiratory syncytial virus, which is the one that causes bronchiolitis, is at a fairly significant level in children, and even if at a community level it seems not to be very widespread, when you look at emergency room visits and hospitalizations its impact is more important because it affects young children”.
ISS on flu: “Circulation will remain sustained”
“The incidence of flu-like syndromes remains high, driven by the various viruses circulating in this period” underlines Anna Teresa Palamara, who directs the Infectious Diseases department of the ISS, commenting on the RespiVirNet surveillance bulletins. “The analysis of the positive samples shows that influenza viruses are now prevalent, even if a significant share of Sars-CoV- remains 2 and respiratory syncytial virus, which causes bronchiolitis especially in children. Although it is impossible to predict exactly when the peak of cases will be reached, a sustained circulation is conceivable also in the coming weeks, facilitated by the reopening of schools”.
“In addition to vaccinations for those for whom they are recommended – he continues – healthy prudence in behavior is recommended, to be observed especially if you have respiratory symptoms and if you are in the presence of very young children, elderly or frail people. It is recommended Furthermore, not to take antibiotics, which are useless in case of viral infections, unless advised by your doctor, and to go to the emergency room only if strictly necessary”.
Between 25 and 31 December 2023 (week 52), “the percentage of samples testing positive for influenza out of the total samples analyzed was equal to 37.5%, a further increase compared to the previous week (33.5%). Among influenza viruses, type A viruses are largely prevalent (99%) compared to type B viruses and mostly belong to the H1N1pdm09 subtype – reads the report – Among the samples that tested positive, 22% were positive for Sars -CoV-2, 11% for Respiratory Syncytial Virus (Rsv), 37% for influenza A, while the remainder tested positive for other respiratory viruses”.
One million Italians in bed between Christmas and New Year
Over a million Italians in bed with flu syndromes between Christmas and New Year, 1,027,000 to be precise. According to the RespiVirNet surveillance bulletin, between December 25 and 31, 2023, the incidence remained at record levels. “Very high” and “substantially stable compared to last week”, equal to 17.5 cases per thousand assisted (they were 17.7 in the previous week, data updated following notification delays), we read in the note released by the Institute superior of health. Since the beginning of the season, approximately 6,719,000 Italians have been affected.
“It is underlined – explains the ISS – that various respiratory viruses and not just influenza viruses contribute to this increase, although the circulation of the latter is on the rise”. The incidence is “slightly increasing only in children under 5 years old – reports the bulletin – an age group in which it is equal to 48.7 cases per thousand assisted (47.5 in the previous week)”, while it is stable the trend in adults and elderly people.
In detail, in the 5-14 age group the incidence is 19.21 cases, in the 15-64 age group it is 17.15 and among the over 65s it stands at 10.28 cases per thousand assisted. Squeezing the objective, all the regions and autonomous provinces among those that have activated surveillance “record an incidence level of flu-like syndromes above the baseline threshold, except the autonomous province of Bolzano. In 5 regions/Pa in particular it is the 'very high' intensity threshold of the incidence was reached: Campania (24.51), Friuli-Venezia Giulia (23.69), Umbria (22.93), Abruzzo (21.76), Tuscany (19.94 While Valle d'Aosta and Calabria have not activated RespiVirNet surveillance.
In the 52nd week of 2023, which closed the year, the ISS therefore confirms that “the epidemic curve of flu-like syndromes shows an incidence value never reached in previous seasons”.
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