Hungary's 'flu season' is actually Covid season, but no one seems to care

On the 42nd week of 2024 (14-20 October), 201,000 people turned to the doctor with acute respiratory infections, including 20,100 people with flu-like symptoms, according to data by the National Centre for Public Health and Pharmacy (NNGYK). The former figure dropped from 210,400 on the 41st week, while the latter fell from 20,400.

A short-term comparison (for the last three seasons of respiratory illnesses) shows that the number of patients with ARI was slightly higher in 2022/23, but lower a year ago, while the number of people seeking medical help with flu-like symptoms remains higher than in the previous two seasons.

The share of flu-like symptoms in ARI rose to 10.0% on the 42nd week from 9.7% on the 41st and 8.2% on the 40th week, all of which mark the highest ratios in the past three seasons.

We also have data for ARIs and flu-like symptoms per 100,000 population, although a long-term data series is available only for the latter.

in terms of ari, the situation is worse than a year ago, but slightly better than in 2022/23, while in terms of flu-like symptoms this season of respiratory illnesses is worse than any of the past 14 seasons.

In the current flu-season, the surveillance service monitors the occurrence of influenza-like illnesses and acute respiratory infections based on data provided by 1,304 general practitioners and general paediatricians, which is the lowest figure in the NNGYK's publicly available database. The trend is not reassuring (see chart below).

A total of 316 samples were tested on the 42nd week, of which 73 came back COVID-19 positive, i.e. they detected coronavirus in 23.1% of the samples, exactly the same as a year ago, although at that time only 147 samples were tested, of which 34 showed the presence of SARS-CoV-2.

What about COVID-19?

It's interesting to note that this time of the year is usually referred to as the 'influenza season', while in reality it is still 'coronavirus season', although authorities refrain from emphasising this.

They do stress the importance of vaccinating against the flu, but act as if COVID-19 no longer existed, while it's not all the same if we get infected with SARS-CoV-2 (more severe symptoms) or influenza (less severe symptoms). To see the difference, check out the hospitalisation data below.

The NNGYK has recently announced that as in last season, 949,000 doses of the 3Fluart flu vaccine would be available for the high-risk group of people aged 3 years and over, to be used free of charge this season. At the same time, they provide no data on Covid vaccination availability or coverage. Our request for a longer-term data series for flu shot coverage was left without a response. (We asked for data for the past 14 years, a number they quoted in one of their recent press releases.)

The 949,000 3Fluart vaccines compare with a public procurement tender called for only 100,000 COVID-19 vaccines, while the target groups are practically the same. And while the actual 'flu season' will kick in only next year, the number of coronavirus infections is already high.

All of Hungary's Covid vaccines expired at the end of August, and when news portal Telex contacted the NNGYK about this, they replied that they were working on obtaining new doses, but did not say when or how many vaccines would arrive.

The vaccine procurement process has not always been transparent in the past. For example, details of last year's procurement were only revealed by an accidental statement and procurement documents revealed that far less vaccine than planned was purchased. The procurement irregularities led the Public Procurement Arbitration Committee to fine the NNGYK HUF 14 million.

196 people with severe acute respiratory infection (SARI) were hospitalised on the 42nd week, of whom 13 (or 6.6%) required intensive care. The respective figures for the 42nd week of 2023 were 170 people in hospital, and 8 (4.7%) in ICUs.

Further breakdown shows that 92 people (46.9% of SARI patients) were hospitalised with coronavirus infection, down from 103 a week ago and fewer than 111 (65.3%) a year ago.

Of the 196 people in hospital with SARI, 39 (18.4%) were aged two or younger, while 119 (60.7%) were 60 and above. Also, 77 (83.7%) of the 92 COVID-19 patients were over 60 years of age.

A year ago, of the 170 people in hospital with SARI, 22 (12.9%) were aged two or younger, while 104 (61.2%) were 60 or older. Also, 82 (73.9%) of the 111 COVID-19 patients were over 60 years of age.

The age breakdown of people seeking medical help with ARI and flu-like symptoms are shown below, including a comparison with data a year ago.

The majority of ARI patients belonged in the 0-14 age group throughout the 'flu season' last year, while the share of people going to the doctor with flu-like symptoms was the highest in the 15-34 age group up to the 2nd week of this year when the youngest were in majority until the 40th week bar a couple of weeks towards the end. You fund a heat map in our previous article here.

Vaccination

Vaccination against influenza is particularly recommended for people over 60 years of age, the chronically ill, health and social workers and pregnant women.

The lowest number of flu vaccinations administered in the last 14 years was in the 2023/2024 season. As mentioned above, the NNGYK has not yet responded to our enquiry about a longer-term data series, nor it has made COVID-19 vaccination coverage data public recently.

According to aggregate data available at the NNGYK, a total of 594,465 people over the age of three received free flu vaccination, of whom 442,943 (74.5%) were aged 60 or over. While this percentage may seem high, and it is in fact the highest since the 2018/19 flu season, another comparison paints a gloomier picture.

The actual number of shots administered to Hungarians aged 60 and above was by far the lowest in the past six flu seasons.

If we look at the share of the elderly vaccinated as a percentage of their own age group, we also have the lowest figure (17.5%) of the past six years. So, it's all a matter of what you want to emphasise really.

The 'improvement' highlighted by the authority stems from the fact that while the number of 3Fluart shots administered in 2023/24 plummeted 50% from the 2020/21 peak during the covid pandemic, the number of shots administered in the 60+ age group went down by "only" 38%. The respective decreases compared to 2018/19 (i.e. a "normal" year) were 17.3% and 13.3%.

Number of suspected pertussis cases rises again

On the 42nd week of 2024, 41 suspected cases of whooping cough were registered by GPs in Hungary, according to the latest weekly report from the National Centre for Public Health and Pharmacy (NNGYK). It confirmed the clinical diagnoses with microbiological tests in 15 cases and diagnostic tests still ongoing in the remaining patients.

The 42nd week brought a break in a six-week descending trend.

The number of suspected pertussis cases reported for the 40th week brings the cumulative number to 1m019 this year, an outstanding figure compared to previous years when only a few cases were found in Hungary. This is strange, because the high rate of vaccination has meant that GPs have generally encountered these diseases mostly in textbooks, and very seldom in practice.

Portfolio has previously reported in several articles that the most vulnerable group is infants. They were also the group with the highest incidence on the 42nd week. In the first 42 weeks of this year, 219 of all suspected cases, practically one in five, were infants, but the prevalence in the 40-49 age group is also rather high. If we look at a wider age group of children between 0 and 14 years of age, they make up 43.2% of all cases this year (440 in total), while up to 19 years the share is 52.8% (538 cases).

Cover image (for illustration purposes only): Getty Images