When it’s not flu’….  

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While the ‘official’ flu season may still be a month or two away, reports indicate a rise in respiratory illnesses like the flu, Respiratory Syncytial Virus (RSV), and Human Metapneumovirus (HMPV), suggesting an early start to the respiratory virus season, with these viruses circulating earlier than usual. 

Respiratory infections can pose serious health risks, especially for vulnerable groups such as young children, the elderly and those with chronic conditions. That’s why Bonitas Medical Fund has created the Respiratory Hub – a go-to resource for members and non-members -talking about all things related to your respiratory health. From prevention and symptoms to treatment and support, you’ll find all the information you need to take control of your respiratory wellbeing. www.bonitas.co.za/Respiratory-Hub.

Respiratory illnesses that are NOT flu and for which there is no vaccine

What are the most common?

Dr Themba Hadebe, the Clinical and Managed Care Executive at Bonitas Medical Fund says, ‘both RSV and HMPV are being detected at increasing rates, potentially indicating a broader respiratory illness surge and are more common in young children and older adults.’

Are these respiratory diseases restricted to the winter months?

Studies show that in temperate regions, HMPV mainly spreads in late winter and spring, at the same time as other common respiratory viruses such as seasonal flu and RSV. RSV is highly contagious and the season in South Africa usually runs from February to May. However, it continues to spread at lower levels and can make some people sick all year around.

According to The World Health Organization (WHO), it spreads like other common cold viruses do, through infectious respiratory particles that circulate through the air. This means you can catch the virus when you are in contact with a sick person or sharing a closed space with them. You can also get infected by touching contaminated surfaces like doorknobs or handles and then touching your eyes, nose or mouth. 

Why are these viruses a concern?

Early increases in respiratory viruses can put added strain on healthcare systems, especially for vulnerable populations like young children and older adults. 

Symptoms 

Coughing, wheezing, runny nose, sore throat, fever, fatigue, muscle pain, loss of taste or smell and breathing difficulties.

  • HMPV is closely related to RSV and primarily causes upper and lower respiratory tract infections
  • HMPV usually causes symptoms like the common cold, which last roughly 2-5 days but can vary depending on how sick you get. The symptoms typically go away on their own
  • Most children who get infected with HMPV are age 5 or younger
  • If infected during early childhood, it can lead to long-term respiratory issues, including asthma and impaired lung function

Who’s at risk?

Children under 5, adults over 65 and people with weakened immune systems. While anyone can catch HMPV and RSV, infants, older adults and those with health conditions like immunosuppression, chronic obstructive pulmonary disease (COPD) and asthma are at higher risk for severe illness. Extra care should be taken to protect at-risk groups and health care workers from any respiratory infections.

How to prevent getting them 

  • Cleaning your hands regularly and thoroughly, with either soap and water or an alcohol-based hand rub
  • Avoiding touching eyes, nose or mouth without cleaning your hands first
  • Wearing a mask in crowded or poorly ventilated spaces
  • Improving ventilation where possible (such as by opening a window for air flow)
  • Having a strong immune system can also help fend off infections. Eating a balanced diet, exercising regularly and getting enough sleep
  • When someone is sick, they can avoid making others sick by staying at home if they feel ill
  • Covering your nose and mouth with a tissue or bent elbow when coughing or sneezing

How are they treated?

  • Most cases are mild and go away within 2–5 days
  • If symptoms last more than two weeks or become severe, seek medical advice
  • While some people may be hospitalised with bronchitis or pneumonia with RSV, most people infected with HMPV have mild upper respiratory infections

Is there medical prevention? 

At the moment no. Two new RSV prevention strategies are being considered for licensing and use in South Africa, namely nirsevimab and a maternal RSV vaccine.

  1. Nirsevimab is not a vaccine. It is monoclonal antibodies that do not activate the immune system. Rather, the antibodies themselves protect against disease. 
  2. Maternal RSV Vaccination: Maternal RSV vaccination, during pregnancy, can protect infants against RSV-associated lower respiratory tract infection through antibody transfer. These strategies have shown high efficacy in reducing RSV- lower respiratory tract infections in infants. RSV is a significant cause of hospitalisation for lower respiratory illness in young children in South Africa, making the development and implementation of effective prevention strategies crucial. 

Dr Hadebe says, it is the time of the year to take precautions against all respiratory diseases. ‘Not only do these respiratory diseases make you feel ill and put added strain on the healthcare system but they can compromise your long-term health. Prevention is always best, so we urge you to follow the guidelines to avoid contracting any of these viruses and also to have a flu vaccine. While the vaccine won’t always prevent you or your family from getting the flu, it can prevent severe and secondary illness related to the flu.’  

For more health tips and resources on respiratory illnesses, visit the Respiratory Hub on the Bonitas website: www.bonitas.co.za/Respiratory-Hub

Remember: Your GP or clinic is your first healthcare port of call.

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