LTD & Influenza Update

Last Updated on 2 months by Publishing Team

Public Advisory

Friday 31st March

LTDD Situation up to 26th March

For Leptospirosis, we continue to see an upward trend in the weekly incidence of cases – case numbers were noted to be above the Outbreak Thresholds for each of the 4 divisions and nationally. Cumulatively to date, the majority of lab-reported Leptospirosis cases are from the Western Division (37%), followed then by the Central, Northern, and Eastern Divisions. The majority of lab-reported cases are male (55%) or I-Taukei (75%). Most affected are persons in the 10-29 years old age group. This rise in cases is expected given the current weather conditions.

The general incidence trend of Typhood continues at or is below the Average Threshold, EXCEPT for the Western Division where the incidence rate is approaching the Outbreak Threshold. The majority lab reported cases were male (57%), or in the 10-39 years old age group. The lab-reported cases are predominantly i-Taukei.

There remains a concerning upward trend in the incidence of cases of Dengue throughout all the divisions. Whilst most of the laboratory-reported cases are in the Northern (35%) and Central (31%), upward incidence trends in the Western (23%) and Eastern Divisions (11%) have driven the National trend to surpass the Outbreak Threshold.

The majority of lab-reported cases are male (53%) or i-Taukei (55%), and most affected persons are in the 10-39 years old age group.

We appeal to the public to be aware of the dangerous signs of fever Please immediately seek medical care if you develop any of the following symptoms:

  • Difficulty breathing or shortness of breath
  • Pain or heaviness in the chest
  • Inability to stay awake or confusion
  • Severe muscle pain
  • Weakness and unsteadiness
  • Worsening of a chronic condition such as Diabetes or Hypertension
  • Any other symptom of concern, for example, severe vomiting

We continue to be encouraged that despite the rise in cases, severe cases needing ICU care remain manageable. This is likely due to more awareness leading to timely access to medical care

We continue to request the public to keep their surroundings clean and free from mosquito breeding sites. We are also requesting people wear appropriate footwear in muddy areas and areas with stagnant water. Our health inspectors have been diligently going out to inspect places of concern and actively applying punitive measures to property owners who have not been compliant in keeping their environment clean. Proper adherence to hand cleaning before meals and after using the washroom is strongly encouraged. We also encourage the public to be aware of the early indications of LTDD and ensure early presentation. Despite the high number of LTDD cases, we are grateful that severe disease cases have not been as high as before, primarily because more cases are being treated early.

Influenza and Acute Respiratory Illness

As indicated by the graph below, our surveillance systems show that the resurgence in influenza-like illness and acute respiratory illness continues. There are reports suggesting an increase in absenteeism rates in schools and workplaces.

Earlier this year, we had an outbreak of a type of Influenza type A virus scientifically labelled as FluA/H1 Pdm. This outbreak had receded however, we now have indications of another outbreak of Flu-like illness. Essentially, we are observing a “double peak trend” (bi-phasic) of Influenza-like illness (ILI) case reports over the last several months since December 2022. As observed from past years’ trends, Fiji’s influenza season usually runs from January to May-June annually.

The Fiji CDC confirms that Influenza B/Victoria is now the predominant influenza strain in circulation, and likely the cause of this ‘second’ surge of ILI cases being reported and observed locally. It must be noted that this increased presence of influenza B in circulation is similarly being observed in other countries of the region and the world.

We have Tamiflu (antiviral medications) stock which is being distributed and we are getting more Flu vaccines which will be offered to those vulnerable to the severe effects of Influenza (individuals with chronic illness, pregnant women, and to frontline staff. Surveillance has also been escalated and we await more recent reports to determine ongoing trends. Whilst we still have stocks of flu testing reagents and consumables, we are also working with WHO to increase our stocks.

The Ministry of Health and Medical Services advises members of the public to stay at home when feeling unwell or wear face coverings (masks) when going outside in order to minimize the spread of infection.

We also advise that people living with chronic disease and children, especially babies, need to be protected from the severe effects of influenza. This entails preventing infection by proper masking in crowded and/or poorly ventilated spaces, early recognition of the symptoms, and seeing a doctor early. It is essential that these vulnerable persons are carefully monitored to ensure early access to intervention if severe symptoms develop.

Preventative measures will be familiar as they are essentially the same as for COVID-19. Wear a mask that covers your mouth and nose when in a public place, wash your hands frequently with soap and water or use an alcohol-based hand sanitizer, avoid crowds, stay home if you are sick, and cover your mouth and nose if you cough or sneeze.

Seek medical care: For adults, see a Doctor if the following danger symptoms develop; difficulty breathing or shortness of breath, pain or heaviness in the chest, persistent fever ( more than 3 days, despite home treatment), very high temperature (over 40°C), feeling sicker as time goes by, confusion and persistent drowsiness, severe headache that doesn’t respond to painkillers and unusual symptoms such as hallucinations, severe vomiting, neck stiffness, skin rash, rapid heart rate, chills, uncontrollable shivering, or muscle spasms.

For children, seek medical care right away if your child:

  • has a fever greater than 38°C for more than two days, or a fever of 40°C or higher for any amount of time
  • has a fever of 38°C or higher and is under 3 months old
  • has a fever that doesn’t get better after taking Panadol
  • seems unusually drowsy or lethargic
  • won’t eat or drink
  • is wheezing or is short of breath