Economy 1 February 2024, 2:00pm

Nearly 120,000 children seek medical help with respiratory infections in Hungary

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Most infections in Hungary's 2023/24 cold season are still linked to coronavirus, but influenza is coming up. Yet, the 4th week of this year looks vastly different than the same period of 2023. The bad news is that the share of children with severe acute respiratory infection, including influenza-like symptoms has picked up sharply. A lot more people are in hospital with influenza than a year ago, but the share of SARS-CoV-2 in samples remains way higher than that of influenza, which was the other way around in early 2023.

Data worsen further, but...

The flu season generally peaks between the 7th and 10th week of the year, but the highest figures can vary greatly from one year to another. The coronavirus pandemic, for instance, put a serious dent into the spread of the flu (see graph below).

A dip for the holiday season was anticipated, and further moderation on the first week was not a shocker, either. Employees generally take their leave at the end of the year, there's the winter break in schools, and a heightened reluctance to go to the doctor "with a simple cold".

The number of people seeking medical help with influenza-like symptoms per 100,000 population was higher than currently only three times in the past 12 cold seasons (in 2014/15, 2016/17 and in 2018/19).

For the 52nd week of 2023, the NNK published only a couple of figures, hence the gaps in the graphs.

Here's a blow-up of the period in question:

On the 4th week of 2024, a total of 233,400 people sought medical help with severe acute respiratory infection (SARI), of whom 36,900 (15.8%) had flu-like symptoms. The former figure marks a 18.4% increase and the latter a 29% jump growth over the 3rd week.

The graph below allows a comparison with weeks 40 to 4 of 2022/23, showing higher figures for this cold season both for the number of people that visited GPs with flu-like symptoms and of SARI "patients".

We can also compare the SARI and flu numbers for 100,000 inhabitants. Despite the relief observed between the 51st week of 2023 and the 1st week of 2024, chances are that the epidemic will be more severe in 2023/24 than in 2022/23. The share of pathogens in the samples is different, though, but more about this later.

We need to highlight that this year authorities perform more tests than a year ago, even though the number of samples tested remains extremely low (298 in total on a national level last week, down from 309 a week ago and also down from this season's high of 327 on the 50th week). The initial zeal has abated by now. While initially six, eight, and even ten times more samples were tested, the multiplier is now hardly over two.

As regards the number of samples compared to how many people seek medical help with SARI every week..., nah, these figures aren't even worth mentioning. The highest ratio this season was reached on the 45th week of 2023 at 0.17%. A year earlier it was 0.06%.

The number of samples tested on the 4th week was lower than on the 3rd week, with the COVID-19 positivity rate further down at 9.1%. Testing is almost non-existent and we may draw only extremely cautious conclusions from these findings as regards the bigger picture on the current epidemiological situation. This is basically the only set of Covid data authorities provide besides weekly wastewater sampling results. Looking at the numbers, however, it's a pretty safe bet that SARS-CoV-2 remains the key pathogen for the time being.

As regards all samples tested up to the 4th week, the Covid positivity rate continues to stand out.

Covid infections outweigh flu infections

SARS-CoV-2 was the main pathogen found in samples early in the flu season last year too. Actually, the first time the share of flu viruses in samples was higher than the share of coronavirus occurred only at the start of this year in the 2022/23 flu season (after the green and orange lines crossed, see graph).

At the same time, we cannot even estimate when this turnaround will take place this year. In fact, it would be a surprise it if occurred at all. Why? Well, take a look at the two graph below! The share of coronavirus in all samples tested (orange lines) was about half than currently a year ago (13.7% vs. 27.6% currently), while the percentage of influenza in the samples (green lines) is way lower now than in the fourth week of 2023 (6.8% vs. 19.4%).

As regards the prevalence of respiratory syncytial virus (RSV) in the samples (blue lines), the situation is much better in the current cold season than in 2022/23, with the share only at 1.5% on the fourth week this year versus 9.3% a year ago.

For the eighth consecutive week in this flu season (or should we say Covid season?), however, people who tested positive for influenza virus and RSV also had to be hospitalised. The 47th week was the first one in this cold season when one of the samples showed influenza infection (up at 163 in total by the end of the 3rd week). Other pathogens identified between the 40th and 4th week were SARS-CoV-2 (1,003), respiratory syncytial virus (RSV, 56), adenovirus (2), parainfluenza (5), human metapneumovirus (HMPV, 19, and rhinovirus (37).

There were 222 people in hospital with SARI on the 4th week, versus 201 a week ago. 18.5% of them were treated with COVID-19, down sharply from 50% a week earlier.

The graphs below show a comparison with the previous 'flu season'. In 2022/23, there were no reports of people with Covid in hospitals, but that doesn't mean there weren't any (there were 100 on the first week of 2023, so it's a pretty safe bet that it did not happen overnight). The drop on the fourth week this year is inconsistent with previous data.

The second chart depicts the number and share of people with influenza in hospitals. As you can see (orange columns, light blue curve), this 'flu season' is worse from this respect than the previous one. It starts on the 49th week because that was the first week in this season when someone infected with influenza virus had to be hospitalised.

We have the same graph for respiratory syncytial virus (RSV), which shows that this infection was a lot more severe in the previous 'flu season', although both the number of RSV infections and related hospitalisations did pick up on the fourth week of 2024.

Another important indicator of the severity of an epidemic is how many of those hospitalised end up in the intensive care unit (or in the morgue for that matter). The NNK does not reveal mortality stats, though.

As mentioned above, there were 222 people with SARI in hospital on the week under review, up from 201 a week earlier. 19 of them were in the ICU, which corresponds to a 8.6% ratio, which compare with 25 (12.4%) a week earlier.

31.1% of those hospitalised with SARI were children aged 2 years or younger (up from 14.4% a week ago), while only 40% of them were aged 60 and over (down from nearly 63% on the 4rd week).

Tougher on children

Finally, we have an age breakdown both for SARI and flu patients. Children up to the age of 14 are on top of the SARI age rankings in terms of numbers, and for the first time this season they are also on top in the flu rankings, while the second hardest-hit cluster is the 15-34 age group. The right-hand charts show the share of people with SARI and flu-like symptoms by age group.

Looking back on the 2022/23 data we find that the 0-14 age group was the hardest hit throughout the flu season in terms of SARI, while in terms of flu-like symptoms they were the most affected age group between the 3rd and the 15th week of this year, i.e. from mid-January to mid-April.

On the 4th week this year, nearly 120,000 children sought medical help with SARI, more than half of all people that turned to the doctor with some respiratory infection. They also stand out when it comes to flu-like symptoms, with their number up at over 14,000 from 9,000 a week ago.