Lebanon has been witnessing an increasing discussion over the past month regarding school children suffering from high fevers lasting for several days, along with severe cold symptoms, which have been presumed to be a return of the H1N1 virus. However, specialists have confirmed that it is the H3N2 virus that is causing this situation, often leading to high hospitalization rates. Therefore, it is advised to return to preventive measures to shield against it.
Patients are queuing at the clinic of a specialist in infectious diseases in Beirut with a “first come, first served” policy due to the high number of patients needing examinations. According to this doctor, “the situation is not good” as “people have removed their masks and relaxed on preventive measures while we are in the midst of a global wave of flu spread in general.”
Dr. Atika Berri, head of the Preventive Medicine Department at the Ministry of Health, confirms the spread of the virus, clarifying that it is the H3N2 strain and not H1N1, which has become part of the normal influenza viruses since 2009, the year of the pandemic. She reassures that “this strain is not new; it is well-known.”
It is known that in every year where influenza spreads, a particular strain dominates. According to studies, during years when H3N2 is prevalent, hospitalization rates rise as is currently happening. The alarm for this strain was first sounded in Germany in March of this year, when it reported to the World Health Organization about cases of H3N2 influenza. Currently, the H3N2 strain constitutes 80% of the influenza cases in Lebanon, while H1N1 accounts for 22%, and there are cases of a weaker strain estimated at 8%.
Dr. Nabil Al-Haj Hassan, a pediatric specialist, describes the situation as “bad and alarming,” noting that he has not seen a spread like this in Lebanon “for years, as the speed of transmission among children in schools and kindergartens is significant, and through them, the virus reaches parents at home.” However, he reassures that “infected individuals do not need hospitalization, provided that the infection is not neglected and symptoms are treated to prevent their progression.”
It is noteworthy that the significant similarity, to the point of perfection sometimes, between the symptoms of various influenza viruses currently present in Lebanon, alongside transmission methods via airborne droplets or through contaminated surfaces and hands, leads some to downplay their condition, calling it merely “a draft” or caused by “strong air conditioning.” However, all these symptoms are attributed to “autumn viruses,” as stated by specialists, “which spread infections during the cold seasons due to people’s behaviors during this time, since they tend to stay in closed rooms to retain warmth and prevent its drop,” which contributes to the virus’s spread.
The optimal environment for spreading this infection remains crowded places, especially schools where students are close together for long periods, enhancing the likelihood of virus transmission. Here, Al-Haj Hassan called for “closing schools and kindergartens for two weeks to control the infection and curb the viral wave.”
### The Fall of the Mask
Statistically, respiratory viruses, including influenza, rank fourth globally in causing death, killing hundreds of thousands annually across the planet, and remain under the scrutiny of scientists out of fear of a new mutation leading to a pandemic. Today, the concern returns to two matters: first, the concurrent spread of influenza with the ongoing COVID-19 pandemic in its second year, and second, the spread of H3N2, which causes more severe symptoms.
Dr. Abdul Rahman Al-Bizri, an infectious diseases specialist, adds that “the fall of masks from our faces” is due to “the decrease in COVID-19 infection numbers and the fatigue from wearing masks.” He fears that continuing these behaviors will lead to “the reinfection of all respiratory viruses after their absence for two years due to strict previous health measures.” This is supported by Berri, who recalls that in 2020, “influenza cases were at their lowest levels.”
Al-Bizri warns against “negligence and allowing the virus to spread, as it is one of the most severe for health and causes severe lung infections,” advising “to avoid crowded places, pay attention to patients with chronic diseases, and get vaccinated against influenza.”
### Vaccine and Its Price
In this context, the influenza vaccine is continually available, both globally and in Lebanon, with sufficient quantities. However, the economic crisis prevents the most vulnerable patients with chronic diseases from accessing it, as “the price of the vaccine has increased from 23,000 LBP last year to nearly 600,000 LBP for a single dose,” causing these individuals to neglect getting vaccinated after it had been a regular part of their annual medication list for years, making them more susceptible to severe symptoms.
### Attention for the Elderly
The most susceptible individuals to infection are the elderly. Therefore, Dr. Eid Azar, an infectious diseases specialist, draws attention to the recording of “high infection rates with the coronavirus among patients over 60 years of age who were vaccinated more than a year ago and needed special medical care due to this infection.” While he confirms that the degree of severity cannot be compared between the coronavirus and influenza viruses, he calls for “not to worry about a new pandemic, as the viral strains are not new; they are known,” mentioning “several other respiratory viruses that are spreading today with the onset of the cold season, but no cases requiring intensive care for influenza have been recorded thus far.”
