Wednesday, 20 September 2017

New mum critical as doctors call for super flu vaccine

Sarah Hawthorn, 33, from Cobram, who is fighting for life in hospital after getting the flu

Re-published from The Age, Sept 20 2017. Written by Rick Morton, Social Affairs reporter, Sydney (@SquigglyRick) and Simone Fox Koob, Journalist, Sydney (@SimoneFoxKoob)

A young mother is fighting for her life in a Melbourne hospital having never held her newborn son after contracting a powerful flu strain.

The mother is the latest victim in a deepening crisis that has prompted Health Minister Greg Hunt and the nation’s top doctor to investigate “new and strengthened vaccines” available overseas.

The nation’s deadly flu season started early and has already claimed more than 100 lives, including eight-year-old cub scout Rosie Andersen, and has left 33-year-old mother Sarah Hawthorn clinging to life in an induced coma since the end of August, unaware her first child was delivered safely six weeks early.

Immunologists told The Australian a quadruple-strength flu shot available for years in the US would have had a “significant impact” in protecting older Australians and potentially other vulnerable people.

Sanofi Pasteur, the manufacturer of the Fluzone High Dose vaccine — it contains four times the amount of antigen (the part of the vaccine that prompts the body to make antibodies) — has begun the early stages of gaining approval by the Therapeutic Goods Administration to bring the super dose to Australia.

Dr Ian Barr said the prevalent A-strain H3N2 tended to affect the entire population.

Mr Hunt has not spoken with Sanofi or other potential manufacturers but is keen on an application. “The minister has asked the Chief Medical Officer to examine whether there are ways to strengthen the National Immunisation Program, including holding talks with manufacturers on new and strengthened vaccines,” a spokesman told The Australian.

The renewed look at the vaccination program will include options for children, who are not universally vaccinated for the flu in Australia, unlike those in ­Britain.

New research from Sydney University has revealed that flu spreads much quicker around the country than previously thought, arriving simultaneously in all the capital cities.

In a departure from previous years, the 2017 flu vaccination included four strains of flu — two A and two B strains — but experts said there was no evidence this ­diluted the potency of the shot.
But Australia’s Chief Medical Officer, Brendan Murphy, said other issues had arisen.

“This particular strain has undergone some changes during the season and this may also have contributed to occurrence of a larger than usual number of cases in the vaccinated elderly,” he told The Australian.

“The vaccine appears to be more effective in younger Australians. The Department of Health is, however, examining what strategies could be implemented to improve vaccine effectiveness in future years.”

A fundraising page for Ms Hawthorn has been set up by her sister-in-law Rachael Holt to raise money for the new mum and her partner Rob.

“During the later stages of Sarah’s pregnancy she caught the flu,” Ms Holt wrote. “As a result her gorgeous boy arrived earlier than planned and following his birth Sarah was, and remains, in a critical condition in a coma.
“Funds raised will be used to meet the financial needs of Sarah and her family at this time such as travel, accommodation, living and ongoing medical expenses.’’

Eight-year-old Rosie, a Melbourne primary school student, died after she went into cardiac arrest on Friday morning after battling with the flu for several days.

Christian Brealey of Upper Ferntree Gully in Melbourne’s east spoke on Monday of the family’s grief at losing their “beautiful princess”.

“We urge everyone to get their kids immunised against the flu and ask only that our privacy is respected and our family given time and space to grieve,” Mr Brealey said.

Robert Booy, head of the clinical research team at the National Centre for Immunisation Research and Surveillance and a pediatric infectious disease specialist, said the inclusion of children’s flu vaccinations in the National Immunisation Program — which would make them free — needed to be assessed by the federal government.

“I think we should as a matter of urgency look into the cost effectiveness of such a program, having reviewed the evidence from programs in place already for four years in the UK which shows direct protection of children and secondary benefits on top of that. Parents, grandparents are provided protection because a child is vaccinated,” Professor Booy said.

In the three peak flu months in NSW, there were 68,087 people diagnosed with influenza, more than three times the 19,229 cases in the same period last year. Nat­ionally, more than 160,000 people have got the flu this year compared with 76,000 last year.

As in Victoria, the NSW state government has “on occasions” purchased beds in private hospitals “to assist in managing peak periods of demand during this severe influenza.” World Health Organisation Collaborating Centre for Reference and Research on Influenza acting director Ian Barr said the prevalent A-strain H3N2 tended to affect the entire population, rather than just the elderly, young and vulnerable.

Professor Barr joined a chorus of other experts canvassed by The Australian who agreed the overseas high-dose flu vaccine should be brought here.

“It would be nice if we had that, there would definitely be an age window (among seniors) where that would be beneficial,” he said.

New research by the University of Sydney’s Edward Holmes, together with Professor Barr, shows the flu does not arrive in Australia as a slow-moving wave as once thought. “The old model, as we understood it, had the flu arrive from New Zealand and over weeks and months hit the east coast of Australia and eventually take in South Australia and WA,” Professor Barr said. “But what this shows is that it seems to be a much more simultaneous event ... it kicks off pretty much all at once in the capital cities.”

Immunisation Coalition chief executive Kim Sampson said manufacturers tended to avoid supplying new vaccines in the Australian market unless the government gave an indication it would fund them.
“There is no doubt about the fact that the four-dose vaccine would have a significant impact on the elderly and in particular in nursing homes,” he said.

The H3N2 strain of influenza A has been around since the late 1960s and, according to Monash University’s Allen Cheng, tends to be a bit more diverse which makes it harder to pin down. “The problem with high-dose vaccine is that it only includes three strains of the virus instead of four but, that said, it does look like it is probably more effective,” Professor Cheng said.