'Flurona': Israeli doctor warns of more combined coronavirus diseases

Medics urged to be on alert for double infections of flu and Covid

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A doctor in Israel where the first case of "flurona" – a combination of flu and Covid-19 – appeared says there could be more harmful combined coronavirus diseases on the horizon.

In an interview with The National just days after confirming the first case – an unvaccinated pregnant woman admitted to hospital with flu and Covid-19 near Tel Aviv – Prof Jaron Rabinovici said doctors can expect to see more hard-to-spot co-infections.

The best defence is vaccination against both viruses, he said, and urged medical staff around the world to be aware of the potential for confusion as new strains mimic other diseases.

If there is a rise in flu cases and what we see with more infections with Omicron, I expect to see a rise in combined diseases

Prof Jaron Rabinovici,
Sheba Medical Centre

Co-infections have now been confirmed in the US, Brazil, Philippines and Hungary.

“Recent influenza cases are rising and we saw low numbers last year due to isolation and masks,” said Prof Rabinovici, vice chairman of obstetrics and gynaecology at Sheba Medical Centre in Israel.

“This year flu is higher because isolation is less and there are new strains of viruses.

“We know influenza is a dangerous disease for pregnant women, with higher morbidity and mortality risk.

“Covid cases during pregnancy can also complicate pregnancy because of the disease and not just the virus itself.

“The best way to avoid both is to take the flu vaccine, take Covid vaccines and use masks.

“Statistically, if there is a rise in flu cases and what we see with more infections with Omicron, I expect to see a rise in combined diseases.”

People being tested for coronavirus at 911 Covid testing drive-through on Wednesday, near the Getty Centre in Los Angeles, where a teenage boy tested positive for 'flurona'. AP

Israel reported 1,352 new cases of Covid 19 on December 24; on January 5 that number soared to 17,232.

Tel Aviv has already launched a fourth booster programme of Pfizer BioNTech to protect medical workers and those most vulnerable to complications.

A recent research paper published by Prof Rabinovici and Dr Aya Mohr-Sasson in the journal of reproduction of the National Centre for Biotechnology Information looked at the ovarian health of 200 women between 18 and 42, during the coronavirus vaccine programme.

Doctors looked for a specific biomarker of ovarian function called anti-mullerian hormone, three months after the women took a vaccine.

“We saw no decline in ovarian function in these women, and that is crucial,” Prof Rabinovici said.

“It is important to encourage those with still some fear or concern of taking a Pfizer RNA vaccine to tell them ovaries and female fertility are not negatively affected by vaccinations.

“We must remember that not every hospital or medical system is testing its patients for influenza.

“It can be similar in appearance, so patients could be diagnosed with corona but not influenza.

“Now we know the combination can be dangerous we need to be more cognisant to this combination and examine cases for both viruses.”

During pregnancy, certain changes in the immune system make an expectant mother more susceptible to severe infections.

They are at greater risk of miscarriage, stillbirth, preterm delivery and hospital admission because of pneumonia brought on by flu or Covid.

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Doctors in the UAE have stepped up information programmes to encourage pregnant women to complete their full course of vaccinations against Covid-19.

“When both these infections co-exist the chance of getting complications is even higher,” said Dr Karthikeyan Dakshinamoorthy, of NMC Royal Hospital in Dubai Investments Park.

“As both influenza and Covid cause respiratory illness, treatment is the same and antiviral medications are available for both.

“The only thing that would work in pregnant mothers is to get vaccinated for influenza and Covid-19 to have a safer pregnancy.”

Generally, Covid-19 is very mild in children. According to the Centres for Disease Control only 803 Americans aged under 18 were killed by the virus between spring 2020 and December 29, 2021.

In the UAE, case numbers overall have soared in recent weeks as the world struggles to contain the new Omicron strain of Covid-19.

Early indications are the virus is more transmissible but could be less dangerous than the previous dominant strain, Delta, with fewer hospital admissions.

“In the last six months we have seen cases with severe infections in unvaccinated mothers,” said Dr Gul Rana Shoaib, at the Canadian Specialist Hospital, Dubai.

“I have worked in the UAE and the UK during this pandemic, and been very close to pregnant women, but I have not come across women with this deadly combination before.

“The international guidance is for all women to be vaccinated, regardless of their fertility status.”