This piece is part of MS Explains, a segment where we provide clarity to common or key topics, making them easier to digest.
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News that Taiwanese actress Barbie Hsu — popular for her role in the 2001 TV series Meteor Garden — had died at the age of 48 on 3 Feb shocked her fans across Asia.
The actress’ sister revealed that Ms Hsu died due to influenza-induced pneumonia (infection of the lungs) while they were on holiday in Japan, which is currently experiencing its biggest flu outbreak in 25 years.
Source: My Asian Idols on Facebook
In particular, the actress is believed to have contracted Influenza A, the dominant strain currently affecting the country.
In late December, medical institutions in Japan were averaging 64.39 patients per facility, more than twice the warning level of 30.
Source: China News via Dotdotnews
Professor Hiroyuki Kunishima of St Marianna University School of Medicine explained why Japan is currently facing an influenza outbreak.
“People have a weakened immune system as there hadn’t been an influenza outbreak for a while,” he said, adding this was due to the measures people collectively observed to curb the COVID-19 pandemic.
This poses the question of whether Singaporeans should be worried about the flu and cancel their travel plans to Japan, especially with the upcoming sakura season coinciding with the March school holidays.
Influenza A, the strain which allegedly took Ms Hsu’s life, is a common, seasonal type of flu. It is also the only one among the four types of influenza viruses known to have caused pandemics.
Every year, there are around a billion cases of seasonal influenza. Out of this number, three to five million are severe.
Seasonal influenza spreads easily and rapidly, especially in crowded areas, through sneezing and coughing.
Its symptoms include fever, chills, body ache, cough, headache, sore throat, runny or stuffy nose, and fatigue. Children who contract the strain of flu may also experience diarrhoea and vomiting.
Most people can recover from the symptoms of this flu variant within a week simply by taking antiviral medication, drinking plenty of fluids, and adequate rest.
However, it can also lead to severe complications, including pneumonia, myocarditis (inflammation of the heart muscle), encephalitis (inflammation of the brain), sepsis, or even death.
Source: CDC on Unsplash
According to the Singapore Ministry of Health (MOH), certain groups of people also have a higher risk of complications when they get infected by the flu.
These include people over 65, children between six months old and five years old, and pregnant women.
Even so, younger adults are not completely spared from the flu’s deadly complications.
Healthline notes that anyone with compromised immune systems is at a higher risk of dying from the flu as the body struggles to fight off infections.
Long-term stress, and unhealthy habits such as smoking, lack of sleep and exercise, could also weaken the responses of the immune system — no matter your age.
Soon after Ms Hsu’s death, 26-year-old Chinese actor Liang Youcheng was reported dead, also due to influenza.
He fell ill around 18 or 19 Jan, and sought medication as well as an IV infusion.
Police only found him on 28 Jan — unconscious in his home, where he had fainted after a fever.
Mr Liang then passed away in hospital two days later from a central nervous system infection.
A World Health Organisation (WHO) factsheet states that seasonal influenza causes 290,000 to 650,000 respiratory deaths annually.
In industrialised countries, however, most influenza-associated deaths occur among the elderly.
Several countries in Asia — including Taiwan, Hong Kong, and Singapore — have seen a significant increase in flu vaccinations which were attributed to the news of Ms Hsu’s death.
The actress’ home country recorded 40,000 and 73,000 government-funded flu shots on 3 and 4 Feb, compared to the daily average of 24,700 from 1 to 20 Jan, Focus Taiwan reported.
Additionally, the Taiwan Centers for Disease Control (CDC) has urged people at high risk to get vaccinated and be alert to signs of severe illness.
Source: superohmo on Canva
Similarly, clinics in Hong Kong and Singapore have also reported a surge in inquiries and bookings for influenza vaccination.
In Singapore, a family doctor at Chua Medical Clinic said that calls to the clinic enquiring about flu vaccines or making vaccination appointments have increased by 20%, The New Paper reported.
While it stemmed from a popular celebrity’s death, people’s hurry to get flu vaccinations is not baseless.
Vaccination is the best way to protect oneself from the disease.
The WHO recommends annual vaccination against influenza as immunity diminishes over time.
The Japan CDC has not issued travel health notices as of the time of writing, so Singaporeans can carry on with their travel plans for the spring.
NHK also reported that the peak of influenza cases has passed, with cases declining in some prefectures, but hospitals in Japan may remain overwhelmed for some time.
Dr Sunao Ishida, chairman of the Influenza Committee of the Japanese Society of Infectious Diseases, also said Influenza B, which may similarly come with severe symptoms, could replace the currently prevalent type A.
To err on the safe side, those who plan on travelling to Japan — especially high-risk individuals — should update their vaccination against the flu.
As the disease is contagious, the MOH recommends that people living with and caring for high-risk individuals get a jab.
Source: dodotone on Canva
When travelling, Singaporeans should also remember to practice good hygiene, including washing their hands and wearing a mask, when travelling, and see a medical professional when experiencing severe symptoms of flu.
As for whether Singapore would ever face a severe outbreak of seasonal flu such as Influenza A, a study by researchers from Mount Sinai School of Medicine suggests this is unlikely.
Viral spread is more common in places with temperate, cold, and dry weather conditions as these improve the survival rate of viruses.
Also read: 26-year-old Chinese actor believed to have died from influenza complications
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Featured image adapted from @hsushiyuan on Instagram and Mlenny on Canva.
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