Respiratory illnesses are beginning to increase across the motu as winter approaches, with Healthline receiving more calls for influenza-like illness.
Rhinovirus (common cold) and RSV are currently the most commonly detected respiratory viruses.
Professor Michael Plank, School of Mathematics and Statistics, University of Canterbury, comments:
“The start of winter typically brings an increase in respiratory viruses including the big three – seasonal influenza, Covid-19 and RSV.
“Flu is at very low levels currently – the lowest for this time of year since 2020-21 when the pandemic measures actually got rid of flu altogether. We had a late flu wave last year due to a new strain of influenza A (H3N2 subclade K).
“This could mean that this year’s flu season is late to get started. The same thing seems to be happening in Australia where flu levels also remain very low. After a small wave in February and March, Covid-19 is also at low levels.
“Covid still hasn’t settled into a completely predictable pattern since the pandemic, though the good news is that the impact of Covid has fallen year on year since 2022. The RSV season, on the other hand, appears to be underway with a noticeable increase in RSV detections in the last few weeks.
“Getting sick is not inevitable. We have effective vaccines available for flu and Covid-19. These won’t guarantee a cold-free winter, but they do reduce the likelihood of getting sick enough to need time off work.
“And for over 65s they are highly recommended to reduce the risk of hospitalisation and death. Getting vaccinated is also an effective way to protect babies and young children who are too young to be vaccinated.
“Finally, if you have respiratory symptoms, it’s important to stay home until you feel better so you don’t spread whatever virus you may have to friends and colleagues.”
Conflict of interest statement: “No conflict of interest to declare.”
Dr Nikki Turner, Principal Medical Advisor, Immunisation Advisory Centre, comments:
“Winter has officially arrived, and we expect to shortly see the arrival of a flu surge in New Zealand. It is likely to hit within the next few weeks, and it’s usually accompanied by other nasty respiratory viruses, particularly RSV – which means we need to be prepared now to reduce the severity on individuals and communities, as well as our healthcare services.
“There are two important approaches, one is reducing viral spread. Sadly, we have forgotten many of the learnings from COVID-19 about how to reduce impact on communities. Simple strategies – particularly vaccination – really have an impact on limiting the spread of the virus. Getting vaccinated is important if people are in close contact with those at higher risk of severe disease. Alongside vaccination, remember social distancing, staying at home when sick if feasible, hand sanitiser, cough etiquette, and wearing masks in crowded places.
“The second approach is reducing impact to the individual: Some people are very vulnerable to severe flu and respiratory illness – particularly the elderly, very young, and people with serious medical conditions. Often people are unaware they are at higher risk. Vaccination doesn’t always stop illness, but it is likely to reduce the risk of someone ending up with severe disease – i.e., hospitalisation or worse.
“Also, many may be unaware that flu vaccination has non-specific effects. For example, catching the flu puts people at a six-fold increased risk of heart attacks and strokes in the week following infection. In contrast, having a flu vaccination reduces risk of heart attacks and strokes by about a third.
“Other recommended vaccines this winter – COVID-19 and whooping cough. Remember that COVID-19 is still circulating – and those who are at high risk of severe flu outcomes are also at risk of severe COVID-19. So if you’re eligible for a booster, it’s a good time to get that with your flu vaccination. They can be given at the same visit.
“There is also still a lot of whooping cough (pertussis) around. There have been more than 800 reported cases in New Zealand so far this year. Vaccination in pregnancy is over 90% effective against pertussis for infants up to 3 months of age. This is the vital first protection for infants and many in our communities are unaware of the importance of this vaccination.”
Conflict of interest statement: “No conflicts declared.”
Dr Ji Yeon Park on behalf of the ‘Flu and other respiratory infections: Risk, Resilience and Response (Triple R) research team, University of Auckland, comments:
“Flu season is just around the corner. Whether we are used to getting these unwelcome visitors every year, or even more often for those who travel between hemispheres during flu season, many of us still think of influenza as “just a bad cold”.
“However, influenza can be a serious illness that leads to hospitalisation, intensive care unit admission, and sometimes death. While most people recover after a few days of symptoms, others progress to serious complications.
“We have gathered and read reviews of influenza studies from all around the world, rated their quality and compiled the findings.
“We found that older adults, particularly those aged over 60 years with underlying medical conditions, pregnant people, those with additional risk factors such as long-term heart and respiratory conditions and smoking, individuals with obesity, and those experiencing socioeconomic and environmental disadvantage, are at significantly greater risk of severe illness. Risk gets bigger when multiple factors occur together.
“There is a bright side. Influenza vaccination is consistently the strongest protective factor. Vaccination substantially reduced the risk of severe outcomes, particularly among people with chronic health conditions and children.
“Managing your underlying health conditions, staying home when unwell, practising good hand hygiene, and seeking medical advice early can also lower the risk of severe illness across the population.
“Before influenza lands in Aotearoa this winter, take the opportunity to protect yourself and your whānau. Vaccination is one of the most effective tools we have to reduce the risk of becoming seriously ill from this mislabelled risk, “Just a bad cold”, yeah right!
Conflict of interest statement: “Nothing to declare”
Professor Michael Baker, Department of Public Health, University of Otago, Wellington, comments:
“In a temperate country like Aotearoa New Zealand, the winter months are always the most dangerous. Mortality during the four coldest months of June to September is on average 14% higher than the rest of the year, resulting in around 1,700 additional deaths annually.
“Influenza is estimated to contribute to almost a third of these excess winter deaths with many of the remainder associated with other seasonal infections such as RSV. Covid-19 is still adding to the burden of respiratory illness but is not seasonal.
“These deaths are concentrated in older age groups and those with underlying illnesses. Many other people, particularly children, will also be admitted to hospital with severe respiratory infections over winter.
“Vaccination is still the most direct way to prevent such illnesses. We currently have influenza vaccine supplied each year from 1 April which provided good protection against serious illness, hospitalisation and death from this infection. All New Zealanders should take advantage of this vaccine which is provided free for the highest risk groups. Getting your annual flu vaccine is also a good time to get your Covid-19 booster.
“The official flu season has started – it goes from April to October. Recent surveillance data have not yet shown a substantial increase, but influenza can take off at any time over this six-month period. And it certainly isn’t too late to get vaccinated.
“We’re always looking at the proportion of those 65 years and over who have received the flu vaccine because that’s the most critical group. Vaccine coverage is approximately 52% which is still well short of the 75% target set by Health New Zealand, so we have a way to go.
“The biggest recent change in influenza vaccination will start next year. Pharmac has announced that the vaccine will be supplied free for everyone from six months to six years of age.
“This means we will be catching up with other countries such as Australia and the UK that also fund vaccine for children. This change will not only protect these children from serious illness and hospitalisation, it will also reduce transmission to their parents and grandparents, so this is an important advance.
“There are now effective vaccines and other immunisation options available internationally to protect infants, older people, and some other high-risk groups against RSV.
“In New Zealand, the RSV vaccine Arexvy has been approved by Medsafe and is available for older adults, although it is not currently publicly funded. Additional RSV immunisation options for infants and pregnant women are still being considered for regulatory approval and funding, and will hopefully become available for New Zealanders in the near future.
“Other critical ways to reduce the impact of winter respiratory illnesses is to continue applying what we learnt during the Covid-19 pandemic. In particular, people should stay home when they are sick with a respiratory illness to avoid infecting others at work, school and social events.”
Conflict of interest statement: “No conflicts to declare”
Associate Professor Amanda Kvalsvig, epidemiologist, University of Otago Wellington, comments:
“The smart thing for New Zealand to do would be to treat every flu season as a practice run for the next flu season and the next pandemic. Year on year, we should actively refine our response systems and protections. What would success look like?
“Ultimately, our respiratory infection strategy should be so strong that we can stop new outbreaks and pandemics before they have a chance to spread, with no or minimal disruptions to our daily lives.
“In 2026, we can benefit from rich local and global experience about how to detect respiratory outbreaks early and prevent them from spreading. The high cost of respiratory infections to health and society mean that there are many easy wins here for New Zealand. Clean indoor air in schools, healthcare, and workplaces is a game changer, and it’s just one of many effective options.
“We can’t prevent every infection, but every infection prevented ends the onward transmission chain and its consequences. Likewise, every effective monitoring or response system enables other systems to work better.
“Once we experience winters with consistently low levels of illness and disruption, we’ll never want to go back.”
Conflict of interest statement: “No conflicts of interest.”
Dr Hannah Cooper, Public Health Physician, Health intelligence team at PHF Science, comments:
“The winter illness season is underway in New Zealand, with fairly typical levels of illness in the community and hospital for this time of year. Common cold viruses such as rhinovirus are the leading cause of infections we are seeing at the moment, with RSV, COVID-19 and pertussis also making people unwell.
“Although we saw some flu early in the year, the winter flu season is not yet underway here or in Australia, with lower-than-expected levels of flu for this time of year in both countries.
“This year’s flu vaccine has been updated to better match Influenza A subclade K which dominated the Northern hemisphere season. Now is a great time for people to get their flu jab ahead of the New Zealand season.”
Conflict of interest statement: No declaration received.