Are we headed for a rough flu season? Southern Research scientist Landon Westfall, who specializes in influenza and vaccines, says one indicator is flashing a warning sign that the months ahead could bring flu-related misery to many Americans.

The reason: Australia experienced a fairly severe flu season. That suggests the same fate could be in store for the North Hemisphere. It’s precisely what happened in 2017, when the H3N2 flu strain clobbered Australia. In the U.S., almost 80,000 people died during that flu season.

“It’s too early to precisely gauge how severe this flu season will be for us,” said Westfall, Ph.D., associate director, influenza, in Southern Research’s Drug Development division. “But you can get an idea from how it unfolded in Australia and New Zealand. They had a relatively hard flu season this year. This often predicts we’re likely to have a severe one as well.”

Westfall said a change in how flu vaccines are being produced this year has the potential to offer increased protection. The vaccine viruses were grown in cell cultures, rather than in chicken eggs, which should reduce the risk of mutations that can lower the vaccine’s effectiveness.

“This approach should make the vaccine a better match for the circulating, ‘wild type’ flu strains,” he said. “It makes for a more stable vaccine.”

INCREASING ACTIVITY

Southern Research flu vaccine
Landon Westfall is an infectious disease scientist at Southern Research.

Levels of influenza-like illnesses have been increasing across the U.S., particularly in the South. According to the Centers for Disease Control and Prevention (CDC), high rates of influenza-like illness were being reported in the five states stretching from Georgia to Texas, including Alabama, as of late November.

The Alabama Department of Public Health reported in early December that significant influenza activity has been detected throughout the state.

Westfall — who advises everyone to get a flu shot now, if they haven’t done so already — says influenza activity typically begins to spike around this time of year.

“Right now, the level is low, but it will increase pretty dramatically over the next four to six weeks,” he said. “Once we start getting into holiday season, and people start gathering together, it will pick up.”

While Australia’s 2019 flu season didn’t match 2017 in severity, it was an unusually tough one, with the dominant strain again being H3N2, which is blamed for more hospitalizations and deaths than other strains.

Australian health authorities reported laboratory-confirmed flu cases reached the nation’s highest recorded level during the 2019 season. The number of deaths attributed to the flu — 662 — was higher than normal but trailed the total of 745 from two years earlier.

Across the U.S., the 2017-18 influenza season was brutal, with nearly 49 million Americans sickened by the flu and almost 1 million of them ending up in the hospital. The death toll was estimated at 79,400, according to the CDC.

The nation’s most severe flu outbreak since the 2009 global pandemic was worsened by the fact that the seasonal flu vaccine was less effective against the H3N2 strain than usual.

While it’s too early to assess how much protection this year’s vaccine will offer, Westfall said it’s a good idea to roll up your sleeve and get the shot immediately. The vaccine is designed to protect against four different virus strains.

“I always tell people that regardless of how effective the vaccine is, you should still get it. Even though it may not be 100 percent protective, it will still lessen the effects of the flu. And if you’re elderly or very young, it might be the difference between life and death,” he said.

INFLUENZA PROGRAMS

Birmingham-based Southern Research has been heavily involved in U.S. government influenza programs since 2004, when H5N1, or bird flu, emerged as a pandemic threat. Since 2009, the organization has supported the government as a primary provider of flu vaccine testing and support.

Southern Research has worked extensively on influenza projects in support of clinical trials for the National Institutes of Health (NIH), the National Institute of Allergy and Infectious Disease (NIAID) and the Biomedical Advanced Research and Development Authority (BARDA).

Read a story about Southern Research vaccine research.