THE Department of Health has urged private sector doctors to refer patients who are at high risk of dangerous complications from flu to state facilities to ensure they get vaccinated ahead of this year's flu season. The department's head of communicable diseases, Frew Benson, said public facilities could not turn anyone away. SA has not been able to secure sufficient stock to immunise the entire population ahead of the winter flu season. In the private sector, the 400 000 doses supplied by Solvay were sold out within weeks on a first come, first served basis, while the government has rationed the limited stock it has obtained, prioritising people at greatest risk from flu. Most people will recover without complications but some patients with chronic diseases or a suppressed immune system are more vulnerable. The high-risk groups include pregnant women, people with chronic lung diseases, diabetes, chronic heart disease, HIV or other diseases that suppress the immune system, and people over the age of 65. SA's flu season usually starts towards the end of May, peaks in June and tails off by the end of August. The peak coincides with the five-week Soccer World Cup. Three strains are expected to circulate this winter - pandemic A(H1N1) or swine flu is likely to dominate, but people may also be infected with seasonal strains A(H3N2) and influenza B, according to the National Institute of Communicable Diseases (NICD). The department bought 1,3-million doses of a trivalent vaccine that offers protection against all three strains from Sanofi Aventis. So far only 300 000 doses had been supplied to government hospitals and clinics, due to delays in clearing the stock with authorities in Bloemfontein, said Benson. The bottleneck should be cleared early next week, he said. The first batch of government vaccine was earmarked for frontline workers at ports and in healthcare facilities, and HIV-positive children under the age of 15 on antiretroviral therapy. The next phase will target the elderly, people with chronic diseases and pregnant women, he said. SA had no budget for procuring unused H1N1 vaccine from European governments, Benson said, but it had secured a donation of 3,5-million doses from the World Health Organisation (WHO). He said 40 000 of these shots had been earmarked for private hospitals for vaccinating their frontline staff. The WHO shipment had arrived in SA, and was expected to be cleared by authorities by the end of next week, Benson said. Most World Cup visitors are likely to have been vaccinated against swine flu and the likelihood of transmission in open-air stadiums is low, but the NICD said earlier this month flu outbreaks can occur at outdoor mass gatherings. Since most South Africans will not be immunised, the NICD said people should observe "cough etiquette", wash their hands, and stay at home if mildly ill until 24 hours after symptoms disappear.
Fifa said earlier this week that the biggest demand for tickets had come from the US, the UK and Australia, which have all run mass flu vaccination programmes.

Tamar Kahn: Business Day, 6 May 2010