As COVID slowly ebbs, flu season is inching in to take its place, and by the looks of it, it's back with a vengeance.

Different parts of India, including Delhi and UP have seen a spike in cases of viral fever and flu like symptoms in the last few months.

Indians have also turned more receptive to flu vaccines after the pandemic, with more people getting flu shots this year than ever.

This, also in the midst of researchers warning of the possibility of a 'twindemic', suggesting that flu season this year, in tandem with COVID could worsen the pandemic.

So, are you better off taking flu shots this year? Who needs it?

FIT speaks to Dr Mala Kaneria, consultant, department of infectious diseases, Jaslok Hospital, and Dr Anita Mathew, Infectious Disease Specialist, Fortis Hospital, Mumbai.

What exactly is 'the flu'?

According to the US Centre for Disease Control and Prevention, the flu or influenza is a highly contagious viral respiratory infection.

Symptoms of the flu can range from mild sniffles, and cold like symptoms to high fever, vomiting, diarrhoea, and can also turn fatal in some cases.

There is also a considerable overlap in symptoms of seasonal flu and COVID-19 making it difficult to tell them apart without diagnostic tests.

Is flu season really worse this year around?

"The pattern of flu hasn't really changed dramatically," says Dr Anita Mathew, Infectious Disease Specialist, Fortis Hospital, Mumbai.

"You do get to see flu cases during this time, and it will go up post diwali because this is the flu season for us. But the cases have not been typically more, at least in Mumbai."
Dr Anita Mathew, Infectious Disease Specialist, Fortis Hospital, Mumbai

She also adds that one of the reasons we're picking up more cases this time around is "because now we have more testing capabilities to detect them."

"In terms of virilance and mortality, it is no different from any other year."

Dr Mala Kaneria, consultant, department of infectious diseases, Jaslok Hospital, on the other hand suggests that it might seem like flu season is worse this year because of the COVID-19 pandemic that forced us indoors for almost a couple of years.

"During the COVID pandemic, due to universal masking and hand hygiene, the incidence of flu had declined significantly. But now that the cases have declined and people are dropping their guard, the flu virus is back in a new avatar and is causing prolonged symptoms."
Dr Mala Kaneria, consultant, department of infectious diseases, Jaslok Hospital

Is flu season in India different from that in the west?

Yes, says Dr Anita Mathew.

"We normally ask people to get the shots somewhere in the month of May, because that's when our flu season starts off, and again it increases in the later half of the year," she says.

She also adds that she generally recommends taking the shot in the time before schools start, around May.

Dr Kaneria agrees, adding that monsoons (the months of September-October) are a good time to take the shot as well.

Besides, adds Dr Kaneria, "the strains included in the quadrivalent vaccine (in the northern hemisphere), too, differ a little as compared to the Southern hemisphere vaccine strains."

How often do I need to get the flu shot?

Flu shots are annual shots, which means you are required to get one shot a year.

Does the flu virus mutate too?

Yes, says Dr Mala Kaneria, adding, "as we have witnessed with COVID, all flu viruses mutate frequently, and the mutation is important for its survival and propagation. "

"The mutant virus may acquire the ability to become more transmissible or cause more severe disease," she adds.

Dr Mathew adds, "each year, there may be an upgrade in the flu shot depending upon if there was any difference in the strain in the previous year."

"That typically comes out in the months of May, June, or October, which why we recommend taking the shot around then."
Dr Anita Mathew, Infectious Disease Specialist, Fortis Hospital, Mumbai
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Who needs to get the flu shot?

Well, most people don't need to get the shot. It is especially recommended for people with comorbidites, but anyone can get them, including children over the age of 6 months.

"We have (especially) been giving it to people over the age of 65 and those with comorbities," says Dr Mathew.

Dr Maeria further explains this, saying, listing the following categories of people who fall in this group.

  • Elderly over the age of 65 years

  • Children less than 2 years old

  • Those with heart conditions

  • Chronic lung diseases

  • Chronic kidney and liver disease

  • Pregnant women

  • Those with malignancies and transplants

  • Immunocompromised individuals like HIV patients

  • Those on immunosuppressants

Are we headed towards a 'twindemic'?

According to Dr Kaneria, the possibility is there.

"COVID is likely to become endemic eventually and hence the co existence of COVID and influenza, the so called twindemic is a definite possibility and may also occur in the same individual."
Dr Mala Kaneria, consultant, department of infectious diseases, Jaslok Hospital

The the simultaneous spread of both COVID and the flu can put a considerable burden on our healthcare system, but Dr Mathew assures that a person is unlikely to get both as once.

"So far, we haven't come across anyone who has got both COVID and the flu, at least I haven't seen it in my practice," says Dr Mathew.

She talks about a type of testing they do called biofire, that picks up on both COVID and the flu. "It has always been either COVID or flu. We haven't seen both of them."

The Bottomline: Yay or Nay to Flu Shots?

Both Dr Mathew and Dr Kaneria recommend taking flu shots irrespective of if you fall in the category of people with comorbidites, but not any more this year than usual.

"The flu shot is something you should be taking every year. Its something that's available and it actually prevents diseases so it would be useful if people go ahead an take it,"
Dr Anita Mathew, Infectious Disease Specialist, Fortis Hospital, Mumbai

Dr Kaneria, agrees, adding, "with the COVID crisis, everyone has learnt that a flu virus can kill. Even though cases of COVID are ebbing, we are still in its grip and will continue to be for a long time."

"Hence, the flu shot which was considered unimportant earlier, now has gained attention. One reason for this is also the realisation of the benefits of COVID vaccination."
Dr Mala Kaneria, consultant, department of infectious diseases, Jaslok Hospital

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