Latest Study: Flu Has Affected Almost Twice As Many Lithuanians Every Year, The Consequences Of An Inaccurate Diagnosis Fatal

Monika Kuliešė, an infectious disease doctor at LSMU Kaunas Hospital, conducted a study that examined how many people admitted to the hospital due to severe respiratory infections actually have the flu.

Professor Auksė Mickienė, Head of the Infectious Disease Clinic at LSMU Kaunas Hospital, spoke further about the study and the surprising results.

Every second hospital patient with a respiratory infection actually has the flu

According to the professor, the efficacy of seasonal flu vaccines under real-life conditions has been studied at Kaunas Hospital since 2012. Initially, these were pilot studies, but then doctors were able to join an international consortium of researchers. . Even the World Health Organization trusts this consortium and its results.

Dr. M. Kuliešė began studying the spread of influenza and the effectiveness of vaccines in 2015. All people who were hospitalized for a severe respiratory infection during the 6-year flu season, as well as those who were at risk.

Over 6 years, more than 800 people were studied. A PCR test for influenza was performed on all persons who were hospitalized at that time due to serious respiratory infections or who were at risk.

“In the study, we found that exactly half of the patients admitted to the hospital due to an acute upper respiratory infection have the flu. One out of every two hospitalizations is caused by the flu virus. As a result, it is It is possible to imagine how widespread the flu really is, ”said Prof. A. Mickienė.

What is even scarier is that all of these cases would have gone uninvestigated and no one would have found out that they had the flu, because in Lithuania there are very few PCR tests for the flu. In this case, as the professor said, the diagnoses remain unclear: “bronchitis” or “exacerbation of chronic pneumonia.”

So this new study showed the true burden of the flu.

Influenza is usually detected without testing, so many cases are unknown

According to the doctor, influenza in Lithuania is almost always detected by clinical symptoms. However, they are not specific enough and it is almost impossible to distinguish influenza from other respiratory viruses or covid without investigation. And this season, 3 very similar infections will appear at the same time: cowpox, flu, and all other respiratory viruses.

The problem is that CRP tests are not performed on hospitalized patients with a respiratory infection. As a result, the real numbers differ significantly from the statistics. Needless to say, to our detriment. According to the doctor, a PCR flu test should be performed on almost anyone who is hospitalized for a severe respiratory infection.

“Maybe 5 percent. GPs take PCR samples during flu season if flu is suspected. However, this is very rare. These doctors work on an outpatient basis, not in severe cases. PCR tests However, the objective of this small percentage of doctors is to detect when the flu reaches our society and to determine in the laboratory which subtype of flu has reached Lithuania. Even so, the number of people surveyed is very small.

Our study looked at people who were seriously ill. These are people who already need hospitalization, according to global guidelines, they need to be tested for the flu, because only then will we know the importance of the pathogen, and the flu has a specific treatment that can prevent a tragic outcome, “said prof … A. Mickienė.

During flu season, the National Public Health Center (NVSC) provides the latest morbidity statistics weekly. However, these statistics, according to the professor, are very, very approximate and certainly do not reflect the true morbidity situation. After all, a doctor who has been referred by a person for a fever, cough, and other similar symptoms may write that it is simply a respiratory infection. Flu testing is not performed and the patient still does not realize that they are not actually suffering from any circulating infection at the time, but the most likely flu.

“Looking at those numbers, I can tell that when you’re not looking, you can’t find it. And there really is very little research,” the professor said of the statistics released by NVSC.

After the study, the geriatrics and internal medicine wards were surprised

Patients from the geriatrics and internal medicine departments were also screened for influenza in this study. The results were also unpleasantly surprising.

“Our fellow physicians who work in these wards said before the study that there really was no flu in their wards. When we examined all of their patients, it was found that 20% had the flu in one ward and 30% in another. This means that they did not search, find, or get diagnosed. If it weren’t for this test, these patients would not have been diagnosed with the flu, “said the interlocutor.

However, the exact prevalence of influenza in society remains unclear. The teacher can’t say that either.

“I cannot speak at all about the prevalence of influenza in society as a whole, because the subject of our study was those people who had to go to the hospital due to a serious respiratory illness. Therefore, our study showed that every second hospitalization for a respiratory infection is actually due to the flu; this was the case before the coronavirus pandemic. This is a really important find. The fact that there is much more flu among hospitalized people than we think.

A family doctor can rule it out without proof that it is the flu, and another with the same symptoms, if it turns out otherwise, can write it down as another infection. So there are definitely many more cases of influenza than are recorded, but I cannot speculate exactly how much, “said Prof. A. Mickienė.

Undiagnosed flu poses a significant risk

As the professor said, undiagnosed influenza cases pose a very real risk in several respects.

In particular, without the detection of influenza, a person does not receive specific medications. This means that there is a much higher risk of complications that can even lead to death.

Second, the flu is a respiratory infection that can be contracted in the same way as a coronavirus. Therefore, it is very easy to catch the flu in the hospital when it is not clear if another patient has the flu and is not isolated.

“We see this in hospital practice, when a feverish patient comes in, and then there are more and more,” added prof. A. Mickienė.

Influenza infection is especially dangerous for people with chronic, cancer, and immunosuppressive diseases.

Third, when the flu is not detected but pneumonia develops, antibiotics are started and the body begins to develop resistance to them.

“Currently, the most important thing is to confirm the coronavirus using PCR methods, because it is a more serious and faster-spreading infection, the disease is not yet fully known, so we must first look for this virus. The PCR test to flu doesn’t really need to be recorded by anyone easily. But for those who are seriously ill, they should be significantly more covered by PCR diagnoses than they are now. 100 percent. and other countries don’t check, but they do apply PCR to detect the flu much more frequently ”, concluded the professor.

By the way, the second part of the work was dedicated to determining the real effectiveness of the influenza vaccine. The study found that vaccines are indeed very effective in protecting people from hospitalization in the age group up to 65 years, with an effectiveness of about 90 percent.

In the age group over 65, they were moderately effective, with efficiencies ranging from 40 to 50 percent. However, this means that almost half of the hospitalizations could have been avoided if people had been vaccinated.

“Therefore, although vaccines are imperfect, especially in the elderly due to their worse immune response, they are certainly very effective in the young and vaccination against influenza should be encouraged,” said prof. A. Mickienė.

According to the Institute of Hygiene, in 2019, more than 52,000 people had the flu, more than 560,000 people had acute upper respiratory infections, and 55,000 people had pneumonia. Influenza in 2019 was identified as the leading cause of death in 54 people.