Flu Season Arrives Early

South Africa’s 2025 influenza season has begun unexpectedly early, with official surveillance data marking its onset during the week of 24 March—four weeks ahead of last year’s timeline and the earliest recorded start since 2010. While the early arrival doesn’t necessarily signal a harsher season, it underscores the urgency of immediate public health action, particularly around vaccination and early treatment strategies.

Early Onset, Familiar Risks

Influenza viruses circulate seasonally in South Africa, typically peaking between May and September. However, this year’s early spike—detected through pneumonia surveillance in public hospitals—has accelerated the national timeline for prevention. The National Institute for Communicable Diseases (NICD) warns that although many flu cases remain mild, influenza continues to cause considerable illness and death, particularly among high-risk groups.

Who Should Be Concerned?

According to the NICD’s 2024 influenza guidelines, the individuals most likely to suffer severe outcomes from flu infection include:

• Pregnant women (including postpartum up to 6 weeks)

• People living with HIV (who account for nearly a third of flu-associated deaths among adults)

• Individuals with chronic illnesses (diabetes, asthma, heart disease, TB, kidney or liver disease, and obesity)

• Children under 2 years and adults over 65 years

• Healthcare workers, who are not only at risk themselves but can also spread the virus to vulnerable patients

For these groups, timely vaccination isn’t just recommended—it’s potentially life-saving.

Vaccination: The Best Line of Defense

The 2025 flu vaccine—available at public health clinics, private general practitioners, and pharmacies—is formulated to protect against the most likely circulating strains. This includes both influenza A subtypes (H1N1 and H3N2) and two influenza B lineages (Victoria and Yamagata). The quadrivalent vaccine is recommended for optimal protection.

Although the ideal time to vaccinate is before the season begins, it is not too late to get vaccinated now. Immunity builds within approximately two weeks of receiving the shot, and annual vaccination is necessary due to viral mutations and waning immunity.

The Department of Health provides free vaccination to:

• Healthcare professionals

• Individuals aged 65 and above

• Patients with chronic heart, lung, or metabolic diseases

• People living with immunosuppressive conditions (including HIV and cancer)

• Pregnant women

Treatment and When to Seek Help

For people in high-risk groups or those who develop severe flu symptoms, early treatment with antivirals like oseltamivir is strongly advised.

Prescription antiviral medications—such as oseltamivir (commonly known by the brand name Tamiflu™)—are available at pharmacies and play a crucial role in treating influenza, particularly for individuals at higher risk of complications. These antivirals can significantly reduce the severity of symptoms, shorten the duration of illness, and lower the risk of serious flu-related outcomes when administered promptly.

Ideally, this treatment should begin within 48 hours of symptom onset to be most effective. Hospitalized patients and those showing signs of lower respiratory tract infection, neurological involvement, or exacerbation of chronic conditions should be prioritized for antiviral therapy.

Community Measures: Every Action Counts

Beyond vaccination and early treatment, simple public health practices can limit spread:

Wash hands regularly

Cover coughs and sneezes with your elbow or a tissue

Avoid close contact with sick individuals

Stay home if you are unwell

Seek medical help if symptoms persist beyond 3–7 days or worsen

An early flu season is a powerful reminder of influenza’s unpredictability and potential severity. But with broad access to vaccines and a proactive approach to early detection and treatment, we can collectively reduce its burden.

Whether you’re in a high-risk group or simply want to protect those around you, now is the time to act. Get vaccinated, stay informed, and be vigilant.

NICD