We have been quietly montoring the situation in Australia and New Zealand as they have encountered an early and brisk A/H3N2-dominant influenza season. Intensivists have noted the following clinical features:
- Australia (namely Queensland) appears to have had a rougher time than NZ, however ICU strain was reported in Christchurch
- more presentations of secondary infections (i.e. Staph aureus pneumonia)
- occasional ECMO use reported
- significant impact on healthcare staff due to near-complete vaccine failure
- one ICU reported seeing 3-4 patients/week being admitted
- strain is sensitive to osteltamivir
- all descriptions indicate notable infrastructure strain, but nothing like what was observed during the H1N1 pandemic
The key question is whether A/H3N2 currently observed in Queensland is antigenically similar to that recommended for the northern hemisphere vaccine, A/Victoria/361/2011 (H3N2)-like virus. Regardless, we are on heightened vigilance this season due to a combination of A/H3N2 variant activity and preceding season of unusually mild influenza that displayed vaccine drift.
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