Flu in tropics
As the autumn advances in Northern Hemisphere people living in Europe and North America hear more and more about the seasonal flu. But rejoice as vaccination has proven to be the most effective strategy for preventing influenza transmission and reducing morbidity. It is especially important in vulnerable part of population which are children under 5 years of age, adults aged 65 years and over, pregnant women, healthcare workers and people with underlying health conditions such as chronic respiratory disease, chronic heart disease and obesity as in these patients disease (quite serious and damaging by itself) is accompanied with severe complications, such as secondary bacterial pneumonia (which is the top cause of flu-related mortality) and in case of healthcare workers it’s kind of important to help and heal people, but it’s also nice not to transmit to them any of your personal afflictions.
As an interesting and rather long aside, I’d guess that almost everyone have heard of ongoing antibiotic resistance crisis but even taking it into account, we still have a good armament against most bacterial (and fungal) invaders, though this state of affairs may not continue for much longer, however this is a different topic. What I wanted to mention here is that we are nowhere near with antiviral treatments available now. Yes, we sure do have a range of anti-retrovirals, particularly anti-HIV meds, we have drugs to treat or sustain heptatitis C, a few types of herpes virus, and several vaccines (vaccines against hepatitis A, B, papilloma virus, chickenpox, rabies, rubella, measles, mumps, Japanese encephalitis, rotavirus, yellow fever, shingles, polio, adenovirus). From this list you might make a conclusion that it’s not that bad and at least we do have some tools, and you’d be right, but only partially because there are well over 200 types of viruses causing common cold alone. Now you might think, well people generally do not die from common cold and again, you’d be right but the hours-to-days lost due to disease and subsequent reconvalescence is not to look forward too, not to mention that having a cold could be nasty and obnoxious, or it could be a precipitating factor for a chronic condition exacerbation, that in turn could be very dangerous. And there’s basically nothing as effective as antibiotics with bacterial infection to help us out with most pathogenic viruses. It’s nice when a person’s immune system kicks in and saves the day (which it does for the young and healthy with a notable exception of Spanish flu, of which you can learn from this wonderful podcast called This Podcast Will Kill You), but there is almost nothing that is proven to be effective in helping the immunity on the way and again there are people for whom the immune system won’t be able to do much. So taking all that in consideration, why won’t you take at least some insurance that a vaccine provides in this world full of microorganisms eager to multiply at the expense of your body (not that I expect any answers to this).
Back to the flu in Thailand though. Most people I’ve talked to were either outright surprised or somewhat doubtful on the topic. “It’s tropics! It’s hot throughout the year!”. So I’ve checked that out with a few sources available in English and I have found a few interesting facts.
First, in temperate climate zones influenza activity is associated with low temperatures and humidity which explains flu seasons during winter, Thai flu season generally coincides with wet season — June to October rather than cool season, and risk factors include high temperatures, high humidity and high levels of precipitation. Also in tropical climate influenza tends to “turn up” around the year.
In 2018 as reported through August by Thailand Department of Disease Control: 89,846 influenza cases, including 12 deaths. The disease incidence is about 3 times higher than the median of the past 5 years. There were 93 influenza outbreaks. Provinces with the highest number of outbreaks were Bangkok (11), Chiang Mai (8), Nakhonratchasima (8), Songkhla (5), and Phichit (5).
In 2017 there were 106,415 cases from January to August, and 29 people died. Overall, numbers are not that dramatic, but not negligible either.
And influenza A(H1N1) 2009 pandemic estimated to have caused between 151,700 and 575,400 human deaths in its first 12 months, with over half occurring in Africa and Southeast Asia.
So what conclusions can be made?
Flu is still a thing even when you are on your vacation in South-East Asia (as well as the laws of physics, FYI — wear a helmet and don’t rent a scooter if you’ve never used it before).
Living in tropics does not make anyone automatically invincible to viral diseases typically associated with “The North”.
Influenza is still a dangerous disease, but probably it’s not worth loosing your sleep over.
Wash your hands with soap, try not to touch your eyes/nose/face as much, and do not drink tap water in general. If it is “the season” avoid public places and group activities and gatherings as much as possible.
And at least consider having a flu shot every year, in Thailand probably around April-May but any time of year is beneficial than not doing it at all.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4503703/
http://thainews.prd.go.th/website_en/news/news_detail/WNSOC6108240010002
