Flu on the rise: How Asia is managing a widespread seasonal threat
Flu rages across Asia, schools suspend classes
In Asia, reports of influenza cases are rising. For countries like the Philippines, it is the downside of the incoming holiday season when the weather turns cooler, while for others like Thailand, the rainy season brings similar health concerns. It is, however, apparent that viral illnesses remain health threats that need to be addressed, managed, and treated.
In the Philippines, onsite classes have been suspended in Metro Manila amid a rise in flu-like illnesses. The Department of Education (DepEd) in the National Capital Region (NCR) has halted face-to-face classes in public schools on October 13 and 14 due to an increase in influenza-like illnesses among students and staff. Several major universities across Metro Manila have also declared health breaks or temporarily shifted to online learning as flu and influenza-like cases spread through campuses.
The Department of Health (DOH) clarified that there is currently no outbreak or epidemic in the NCR. Health Secretary Teodoro Herbosa explained during a public hearing that the rise in flu-like cases remains within expected levels for the season, or the “BER” months. He said there are around 133,000 recorded cases so far, still below last year’s 135,000. Herbosa noted that influenza-like illnesses can be caused by different viruses and are common during the colder months leading to the year’s end. He reminded the public that the ongoing increase is part of the regular flu season cycle.
Japan is also facing a flu surge, with an unusually early and severe influenza season prompting health authorities to declare a nationwide epidemic after infections shuttered more than a hundred schools.
Related: Japan’s flu cases surge; travel warnings and treatment options take focus
The Ministry of Health, Labor and Welfare reported over 6,000 influenza cases from around 3,000 medical institutions as of October 10, surpassing the epidemic threshold.
Okinawa and Tokyo are currently reporting the highest infection rates. Surveillance data show Okinawa averaging more than 12 patients per institution, while Tokyo and Kagoshima have also seen sharp increases. The flu season, which typically begins in late November, has arrived roughly five weeks early.
Reports indicate that more than 135 schools, kindergartens, and childcare centers have temporarily closed in the past two weeks, with one Yamagata school suspending classes after most of its pupils fell ill. Nature also reported that 287 patients have been hospitalized so far, more than half of them children under 14. Hospitals across Japan are seeing crowded outpatient departments and rising demand for antiviral treatments. Experts are urging vaccination, mask use in crowded places, and early medical consultation. Health officials have yet to release details on which influenza strains are circulating but warned that Japan’s early outbreak could spread to other parts of Asia and Europe in the coming weeks.
Meanwhile, Thailand earlier cautioned its population against rising influenza, respiratory syncytial virus (RSV), and dengue cases at the onset of the rainy season. The country’s Public Health Ministry has raised an alert over the rise in cases, with children identified as the most vulnerable group. The warning follows a marked increase in respiratory illnesses recorded between September 7 and 13.
Health officials reported 30,055 new influenza cases and 3,454 new RSV infections during the week, pushing the total influenza tally since January to more than 555,000 cases and 59 deaths. Data from the Department of Disease Control show that flu infections are most common among children aged 5 to 9, while RSV predominantly affects those aged 0 to 4.
Influenza usually presents with high fever, chills, muscle pain, and dry cough, while RSV can cause more severe breathing difficulties and wheezing in younger patients. Officials are urging the public to remain cautious as the rainy season continues to drive viral spread. Dr. Direk Khampaen, Deputy Director-General of the Department of Disease Control, advised wearing masks in crowded places, frequent handwashing, avoiding close contact with sick individuals, and keeping ill children at home to limit transmission.
Malaysia: cases, lessons and expert advice
Over in Malaysia, thousands of students have been reported to be affected by the flu. Recently, an estimated 6,000 students have contracted influenza, prompting the temporary closure of some schools for safety reasons, according to an education ministry official. Director-General Mohd Azam Ahmad said on October 13 that the ministry was drawing on its experience from the Covid-19 pandemic to manage the situation. He added that schools had been advised to enforce preventive measures, including mask use and minimizing large gatherings among students.
While he did not specify the number of schools affected, infections have been confirmed in several parts of the country. The Health Ministry recently reported a sharp increase in influenza clusters, rising to 97 nationwide from 14 the previous week, with most occurring in schools and kindergartens.
By figures, influenza affects an estimated 5 to 15% of the population each year, leading to thousands of severe illnesses and deaths. Though many regard the flu as a seasonal inconvenience, it remains a significant public health concern responsible for millions of serious cases and annual fatalities worldwide.
Dr. Megat Razeem Bin Abdul Razak, Consultant Physician, Respiratory Physician, and Interventional Pulmonologist, as well as Dr. Noor Zehan Binti Abdul Rahim, Consultant Paediatrician and Paediatric Respiratory Specialist from Sunway Medical Centre, Sunway City (SMC), provide insights into how influenza affects adults and children differently and highlight the importance of proactive measures to curb its spread.
According to Dr. Megat, cases often spike during school holiday terms when more Malaysians return from overseas, bringing the virus home. With flu spreading easily through air droplets and close contact, places like schools, offices, and public transport have become hotspots for infection.
Unlike the common cold, influenza hits harder, bringing high fever, sore throat, body aches, and extreme fatigue. “For most, it’s unpleasant but manageable. But for the elderly, pregnant women, young children, and those with chronic conditions like asthma or heart disease, it can turn serious fast,” says Dr. Megat. Complications like pneumonia and respiratory failure can be life-threatening, making early treatment critical.
The challenge is that flu symptoms often mimic COVID-19 and other viral infections. “That’s why testing is important for the right diagnosis,” Dr. Megat explains. Warning signs of severe flu include a fever lasting more than three to four days, dehydration, nausea, vomiting, or diarrhea. “Antiviral medication works best within 48 hours. After five to seven days, complications like bacterial pneumonia can set in,” he warns.
Children at greater risk
Influenza can strike anyone, but young children, especially those under five, are among the most vulnerable. Their immune systems are still developing, making them more prone to severe symptoms compared to older family members. “Influenza can progress rapidly in children, which is why early intervention is crucial to prevent long-term complications that may impact their future lung function,” warns Dr. Noor Zehan.
Severe flu cases in children can lead to pneumonia, dehydration, and, in rare cases, infections affecting the brain or heart, such as encephalitis or myocarditis. Symptoms like high fever, body aches, cough, and fatigue should never be dismissed as just another childhood illness. “If symptoms persist beyond 48 hours or fever doesn’t subside with medication, parents should seek medical attention immediately,” she advises. Difficulty breathing, persistent vomiting, and signs of dehydration are red flags that require urgent care.
Flu vaccination to prevent serious illness
Despite its effectiveness, flu vaccination is often misunderstood. “The flu vaccine is safe and recommended for children as young as six months old,” affirms Dr. Noor Zehan. “It significantly reduces the risk of severe illness and hospitalisation.” She urges parents to ignore myths that the vaccine causes the flu. “It contains inactivated or weakened virus strains, meaning any mild symptoms post-vaccination are part of the body’s natural immune response.”
Beyond immediate flu risks, repeated influenza infections can have long-term effects. “Repeated inflammation from the flu can increase a child’s risk of developing asthma in the future,” warns Dr. Noor Zehan. Children typically experience up to six upper respiratory tract infections per year, but frequent, severe infections may indicate a higher risk. “Regular flu vaccinations and proper asthma management are essential in reducing this risk.”
“Vaccination remains the best defence,” says Dr. Megat. “Fortunately, my patients cooperate in getting vaccinated, and I’m glad awareness has grown, especially after Barbie Hsu’s passing. I’m also encouraged by the government’s initiative to provide vaccines for the elderly and high-risk groups.”
For frequent travellers, particularly to winter destinations, extra precautions are key. Dr. Megat recommends annual vaccination and advising doctors about travel plans, as flu strains vary by region. “Practicing good hand hygiene and avoiding crowded places whenever possible is essential,” he adds. Wearing masks, maintaining a healthy lifestyle, and carrying hand sanitisers can further reduce infection risk.
Protecting children in schools and homes
Prevention must start early, with schools and daycare centres being common flu hotspots. “Schools should encourage regular handwashing, ensure good ventilation, provide nutritious food, and arrange outdoor activities to strengthen children’s immune systems,” suggests Dr. Noor Zehan. Teaching children to cover their mouths when sneezing and washing hands frequently can help reduce spread.
Parents should also remember that flu can spread before symptoms appear, making prevention even more critical. Dr. Noor Zehan says, “Protecting ourselves and our children from the flu is a shared responsibility. Prevention is always better than cure.”
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