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Tengrinews.kz – Since early September, Kazakhstan has confirmed 590 flu cases, most of them caused by influenza A (H3N2), known as the Hong Kong flu strain. Family doctor Elena Khegay explains why the illness is more severe this year and what people should do if they get sick.
What makes Hong Kong flu different
According to Khegay, Hong Kong flu (H3N2) is one of the seasonal strains circulating worldwide year after year. It is known for causing a more intense intoxication syndrome: a rapid spike in temperature, severe body aches, weakness, and a feeling that “a train ran you over.”
This strain carries a slightly higher risk of complications among vulnerable groups — the elderly, pregnant women, and patients with chronic diseases. Overall, however, it is a typical seasonal flu strain and cannot be considered new.
Elena Khegay, family physician. Photo from personal archive.
Why the flu is more severe this year
H3N2 has historically been considered a “heavier” strain: the first Hong Kong flu pandemic of 1968–1970 caused between 1 and 4 million deaths globally. But the difficult symptoms people report this year are not solely due to the strain itself.
For several consecutive seasons people were not exposed to flu viruses at typical levels. First came the COVID-19 pandemic; after that, mask use, distancing, and improved hygiene persisted for some time. As a result, population immunity decreased — a trend confirmed by epidemiological studies worldwide.
Experts are now discussing the “immunity debt” hypothesis, which suggests that COVID-19 restrictions reduced exposure to seasonal pathogens, including influenza, lowering immunity levels globally.
A rise in flu cases, severe illness, and related hospitalizations is being observed in many countries. Kazakhstan is not an exception.
Do you need to know the strain?
In most cases, no. Treatment within the first 48 hours is the same, and antivirals may be prescribed even without laboratory confirmation. Testing is recommended when:
- diagnosis must be confirmed in a hospital,
- symptoms are severe or complications are suspected,
- the patient is in a risk group (pregnancy, very young age, immunodeficiency),
- tests are needed for epidemiological surveillance.
For everyone else, knowing the strain does not change treatment.
Symptoms of H3N2
- Sudden fever of 38–39°C
- Noticeable worsening within a few hours
- Severe weakness, body aches, headache
- Cough may begin later; runny nose may be absent in the first 24 hours
- Only a rapid test or PCR can confirm the flu.
Khegay notes that official case numbers reflect only the “tip of the iceberg”: most people treat themselves at home and never seek medical care, so actual numbers are always higher.
Is it too late to get a flu shot?
No. Vaccination is recommended from September to April.
The peak usually occurs from December to February, but infections can occur later. Even after recovering from the flu, it is still useful to vaccinate, as it does not protect against other circulating strains.
Public clinics typically vaccinate until mid-November or early December, but private centers continue until spring. It is also possible to get sick twice in one season. Flu includes several strains, plus numerous other respiratory viruses circulate simultaneously.
When will the peak end?
The peak is identified only retrospectively, once the case numbers start declining steadily. Waves may reappear due to holidays, mass events, school vacations and returns, cold weather, and crowding.
Why is the virus spreading actively in Astana?
Astana is a dense, cold megacity where people spend lots of time indoors with poor ventilation — ideal conditions for virus transmission.
With high population turnover and internal migration, the virus tends to spread outward from cities like Astana. Respiratory virus seasons always move in waves from one region to another.
What to do if you get the flu
- Don’t lower fever of 38°C automatically if it is tolerable. Fever helps the immune response.
- Rest and drink plenty of fluids.
- Do not go to work sick; do not send sick children to school or kindergarten.
- Watch for warning signs (red flags): shortness of breath, confusion, fever lasting more than 5 days, chest pain, severe weakness.
- Take antivirals only when indicated.
- Vaccination remains recommended, especially for at-risk groups.
- Maintain hygiene, ventilation, and avoid large crowds.
Which antivirals to take
Antivirals must be prescribed for suspected influenza, but should not be taken “just in case.” Viruses can develop drug resistance.
Unlike antibiotics, antivirals are very specific:
- Oseltamivir — only against influenza
- Zanamivir, baloxavir marboxil — only against influenza
- Acyclovir, valacyclovir, ganciclovir — only against herpes viruses
Acyclovir does not help with flu; oseltamivir does not help with COVID-19.
Oseltamivir reduces the risk of complications but does not shorten flu duration to 3–4 days. Recovery takes about a week. It is taken twice daily for 5 days.
If symptoms do not improve by day 5, you must see a doctor. If red flags appear, seek help immediately.
Red flags for adults
- Shortness of breath, difficulty speaking in full sentences
- Chest pain or pressure radiating to back or shoulders
- Confusion, lethargy, inability to stay awake
- Severe dehydration
- Sudden deterioration after temporary improvement
- Persistent vomiting
Red flags for children
- Rapid breathing (40–50 breaths/min in children aged 2–5)
- Chest retractions, groaning, blue lips
- Extreme weakness or inability to wake fully
- Inability to drink due to weakness
- Seizures
- Rash that does not fade under pressure
- Persistent fever in infants under 3 months
If any of these signs are present, call emergency services immediately.
Disclaimer: This material is for informational and educational purposes only. It is not a substitute for medical advice. Consult a healthcare professional before using any diagnostic or treatment methods. The author and editorial staff are not responsible for consequences related to the use of information presented.
