Winter flu: UAE doctors warn of rise in patients with multiple viral infections

The UAE is facing a challenging flu season, with doctors reporting a rise in cases of patients infected with several viruses at the same time, worsening symptoms.

Doctors told The National that more people are testing positive for seasonal viruses paired with mycoplasma pneumoniae, a bacterial infection that damages the respiratory tract.

Like many other Northern Hemisphere nations, seasonal viruses are sweeping through communities – largely due to a lack of immunity against the H1N1 strain of influenza, an airborne virus, which appears to be the most dominant strain of flu this winter.

In the UK, a four-layer pandemic of flu, respiratory syncytial virus (RSV), Covid-19 and stomach bug Norovirus is placing health systems under enormous pressure, with about 5,000 people admitted to hospital for flu every day – more than three times the number last year. In China, surging cases of human metapneumovirus (hMPV) have placed health authorities on alert.

“This year, flu season is quite severe,” said Dr Deepak Dube, an internal medicine specialist at International Modern Hospital Dubai. “Almost 60 per cent of patients coming to the clinic are having some kind of flu, with symptoms like fever, cough and cold.

“The number of patients with influenza has gone up in the last month, which we can treat with anti-viral medications.

He said factors such as schools reopening after the festive season and holiday travels have contributed to the increase.

“Firstly, when the schools restart, children are exposed to the environment and they bring infections. Then travelling is another major factor, where flu spreads from one country to another, which definitely causes an increase in cases.”

Local testing

According to a UN-backed body, the Global Influenza Surveillance Response System, UAE flu cases peaked in the week of November 11.

During that period, FluNet test data revealed 197 confirmed cases of H1N1 influenza, a variant largely absent before the Covid-19 pandemic, indicating a possible decrease in herd immunity. There were also 90 cases of the H3 flu variant, 24 from influenza A, 68 cases of the Victoria B strain and a further 23 cases of the B variant.

A month later, on December 12, there were only 10 recorded cases of H1N1, 16 of influenza B and seven of H3.

Compared with the first week of 2024, there were significantly fewer flu cases. In January last year, there were 143 confirmed cases of flu in total, with influenza A (H3) the most dominant variant circulating.

The trend suggests a shift in the type of strains of influenza currently spreading through communities. “There are a lot of cases, but frankly during these months every year, the cases go up,” said Dr Asim Sajjad, a family medicine specialist at Saudi German Hospital in Dubai.

“The only difference now is that other respiratory infections have become very common. Many patients with influenza are infected with other viruses at the same time, and some atypical bacteria like mycoplasma infection is more common.

“The main difference now is people are infected with two viruses or sometimes one virus and one atypical bacteria.”

Facemasks worn during the global pandemic, and other control measures, did reduce the number of influenza cases circulating in 2020 and 2021. But that also weakened the depth of herd immunity as fewer people contracted the virus, and recovered.

Vaccine hesitancy

The UAE began its seasonal flu vaccine campaign in October, encouraging people to take protection from the latest variant, particularly those most vulnerable to complications – the young, elderly, pregnant or anyone with existing chronic health conditions.

Dr Sajjad said vaccine hesitancy had contributed to fewer people obtaining the shots this year. “We try to convince our regular patients who come for treatment for other conditions to get vaccinated, but somehow they believe it is better to get infected and build natural immunity.

“There are people who generally don't believe in getting vaccinated, so they are not getting their annual influenza vaccine despite all the explanations by their physicians.”

With schools back in attendance, flu figures could begin to increase further into the new year and the winter season.

One school reported a drop in sick cases due to fewer people travelling to their home countries for the winter break. “We’re seeing very solid attendance after the holidays,” said Lisa Johnson, principal at the American Academy for Girls in Dubai. “With the great weather, many families and staff stayed in the country, which may have helped reduce seasonal illnesses.

“We’ve also been proactive in promoting good health by encouraging regular handwashing, reminding parents to keep children home if they have a fever, and monitoring temperatures for students who feel unwell during the day.

“Simple measures like these, along with good hydration and rest, are helping us maintain a healthy school environment.”