The Current - The flu can turn deadly, get your shot, doctors warn

Episode Date: December 17, 2025

We speak with Dr. Jesse Papenburg at Montreal Children's Hospital about the high number of kids coming into the ER and having to be hospitalized with influenza. And then we turn to Angela Rasmussen, virologist at the Vaccine and Infectious Diseases Organization in Saskatchewan who explains why the H3N2 influenza strain this year is causing harsher illness, and what to expect in the years to come as the US begins to taper back sharing its virus data with Canada and the rest of the world.

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It is being called a super flu, and it's hitting hard. Health officials in the Ottawa area say three children between the ages of five and nine have died this month from complications caused by the flu. Dr. Trevor Arneson is Ottawa's Medical Officer of Health. Children are known to be a high-risk group, especially children under five years old for flu. However, this year we're seeing a very rapid. rise and a lot of severe illness. Officials at the Children's Hospital of Eastern Ontario, also known as Chio in Ottawa,

say they have seen a massive spike in kids with the flu, 300 positive flu tests in early December compared to only 11 during the same period last year. Many of the kids showing up at the ER haven't had their flu shot. Michelle McPhail and her son live in Pembroke, Ontario. They've been homesick with what she calls their worst case of the flu ever. My son's had it three times now. just let it run its course. I don't think we will get the flu shot. Officials are urging everyone to get the flu shot to protect themselves and others and the health care system.

Dr. Jesse Pappenberg is a pediatric infectious disease specialist at Montreal Children's Hospital. Dr. Pappenberg, good morning. Good morning. Three children dying from the flu. That sounds alarming. If I'm a parent of young children, how worried should I be in hearing about this? Well, first of all, it's obviously a tragedy for each of these families. whenever a child in Canada dies from an infection. But this is what the flu does. Every year in Canada, somewhere between 5 and 10 on average children,

will unfortunately die from an influenza infection. So those numbers are relatively small, thankfully, but we know that this can happen. And we did a study across Canada looking at that. And what we found was that roughly three quarters of these children who passed away from influenza infection had an underlying medical condition that put them at higher risk for more severe disease.

So they are overrepresented in that group. However, that still meant that one out of every four children that died from influenza infection had no known risk factor for severe disease. So unfortunately, flu can be unpredictable in that way. And should parents be particularly concerned this year? Well, I think what we're seeing is that we had a really rapid rise in the number of cases,

particularly among school age children, in Ontario, the percentage positivity for flu tests in school age kids was in the 50 to 60% range, which is very, very high. So that's an indication of massive amounts of transmission in that age group. That's not uncommon that the flu season starts off with community spent primarily in that age group because of, A, they're more susceptible to infection because they haven't seen, as many flu infections in the past and also because of their social mixing. And then it gets spread to other parts of the population that may be more vulnerable still because even though children, a school age children are at risk of getting the infection, thankfully the rates of hospitalization and other severe outcomes are lower and we're more concerned about this year in particular about our elderly population. And that part of that has to do with the type of flu that's

circulating H3 and 2. What are you seeing in your hospital in the emergency department at Montreal Children's? We're seeing a lot of influenza-like illness. So a lot of children are presenting with fever, cough, sore throat that can go on for several days. Most of these cases don't require hospital admission. Most of these cases don't even require specific testing for the flu. If they don't have any danger signs, they don't have any risk factors for progressing to severe disease, often the emergency doctors can send them home with some reassurance and a plan for when to come back. We are those seeing hospitalizations as well. And in a national surveillance program across 15 different pediatric hospitals, we're really seeing an increase

in flu hospitalizations in children across the country. You had said to our colleagues at CBC that one of the reasons why we're seeing what we're seeing now, particularly with young people, is that kids haven't been previously exposed to this strain of the flu? Can you tell me more about that? Well, what we're seeing is that we're having a predominance of an influenza A, H3N2 season. So influenza A can be split into two subtypes, H1N1 and H3N2. And then there's also influenza B that can circulate as well. But right now it's really H3 and 2.

And it's been over three years since we've had an H3 and 2 dominant seasons. So what that means is that there are a lot of children who have never been exposed to H3 and 2 in the past. And that means that they're more susceptible to getting that infection once it starts to spread in the community. Another thing that we're learning more and more about the flu, and that still is a matter of scientific investigation, is how our first infection in childhood then imprints our immune system and allows us to be. better respond to that type of influenza infections. So let's say a child gets first infected with H1 and 1, they're better equipped to fight off future H1 infections, whereas if a first infection was with H3 and 2, the opposite would be true. And we've had some, quite a few seasons

with H1 and 1 predominance. So it's possible that there's, within our pediatric population, they're just better equipped to fight off H1 and 1 at this point. But that remains a matter of ongoing investigation. We heard officials in Ottawa at Chio say that many of the kids who are showing up in that emergency department haven't had a flu shot. What are you seeing in Montreal? Is it similar information? Yeah, that's true. And in fact, we know that our coverage rates in pediatrics are quite low. Even amongst the populations that we really do want to have high coverage for influenza vaccination in kids. So the flu shot is free of charge for everybody, across Canada six months in age and above.

And the National Advisory Committee on Immunization suggests that everyone should get influenza vaccination to protect themselves from the flu. But it's especially important in a young children, so those under five, but particularly those under two years of age are increased risk of severe outcomes, as well as children with underlying medical conditions that can increase the risk of a complicated influenza infection. And it varies from one province to the next, but overall, all, we're probably looking at only about one and every three children that gets vaccinated for the flu, including in high-risk groups. So that's something that I think that families

need to be aware of that, especially if your child is at higher risk, it's not too late to get the flu shot to protect your child this year. Not just for the H3 and 2 that's circulating now, but also because we know that there could be H1 and 1 as well later on, and especially influenza B tends to follow the influenza A outbreak when we do have an influenza. winds of the outbreak. We heard that mom earlier from Pembroke saying that her son had been sick, what, three times this year, and they're just going to let it kind of burn itself out. They weren't going to get the flu shot. They're just going to let it run its course. What would you say to someone like her about the importance of getting the flu shot, even though her son has been through

the ringer a few different times already? Well, obviously, I don't know the specifics of her son and whether he has any risk factors or if there are the people in the house who have risk factors for severe influenza that you might want to help protect by vaccinating everybody else. But I can tell you that most likely, most children when they have an influenza-like illness aren't specifically tested for influenza. So it's possible that some of these other infections were other viruses that also circulate in the fall and winter and don't confer any future protection against the influenza outbreak that's ongoing or other outbreaks that could happen this winter. And as I mentioned before, the influenza shot actually contains three different. components to protect against H3 and 2, H1 and 1, and 1, and influenza B.

So even if someone knew that they were infected with influenza A now, getting the flu shot will give them protection against a potential influenza B outbreak that can happen later on in the winter. You said something earlier that I wanted to go back to, which is that you were particularly concerned about the elderly population this year. Why is that? Yeah. So as concerning as it is to have so many children presenting to our murals,

emergency departments right now. I think that what is even more concerning for the health care system and for, I think, our listeners as well, is that we know that H3 and 2 dominant seasons are associated with the greater overall hospitalizations and mortality, and that's because H3 and 2 hits the elderly particularly hard. So H3 and 2 seasons really do, we do see a lot more severe infections in people 65 plus, and especially those 75 plus. Unfortunately, in Canada, we've seen a drop in influenza vaccination coverage among our elderly population. The Public Health Agency of Canada aims for 80% coverage in that population, and we've

dropped down into the mid-60s last year. That's a big drop. yeah so that means that one and three of our elderly population which are really the highest risk group for severe outcomes are have no protection against influenza and even though we're seeing so many infections in kids right now the data from across canada actually shows that the group in which there's the highest hospitalization rate is the elderly i'll let you go but it's what the 17th of december now you've said that um it's not too late to still get the jab it's not too late it takes 10 to 14 days after the injection to develop protective levels of antibodies and we're not even we had winter is not even officially started yet so there's still a lot of influenza to come it's not too late to get protected dr papenberg we'll leave it there thank you very much it's been my pleasure dr jesse popenberg is a pediatric infectious disease specialist at montreal children's hospital if you want to hear daily news that doesn't hurt your soul and might even be

good for your soul. Check out As It Happens. I'm Chris Howden. And I'm Ilkogsal. Every day we reach people at the center of the most extraordinary stories, like the doctor who restored a patient's eyesight with a tooth. Or a musician in an orchestra that plays instruments made out of vegetables. Take the scenic route through the day's news with As It Happens, and you can find us wherever you get your podcasts. Countries around the world are seeing a big uptick on the scale and severity of the flu this winter. Angela Rasmussen is a virologist at the University of Saskatchewan. Angela, good morning to you.

Good morning, Matt. What do we know, and Jesse hinted at some of this, but what do we know about why this strain of the flu that people are seeing right now that's circulating in many parts of the world? Why is this strain so severe? So as Dr. Pappenberg mentioned, this season appears to be dominated by the H3N2 subtype. And H3N2 is generally thought to be more severe in terms of the disease that it produces compared to H1N1 or the other seasonal subtype of influenza A that circulates. So just the fact that we are seeing a lot of H3N2 circulating as well as the fact that in children, we've had H1N1 dominant seasons in the past. So they may actually not have very much preexisting immunity to H3N2 really suggests that some of the severity that some of the severity, that we're seeing, and some of the spread is due to the fact that it is the H3N2 subtype that is

dominant. And we're seeing this right across the country. We were talking about Ontario. But in Saskatchewan, the head of clinical microbiology at Saskatoon's Royal University of Hospital said, in his words, we're seeing a ton of influenza A in terms of test positivity. You're seeing this as well? Yeah, that's right. So we're actually seeing this all throughout Canada in terms of many of these sentinel hospitals.

as Dr. Pappenberg mentioned, these pediatric hospitals are a source basically for the public health agency of Canada to monitor the situation around Canada. And we are seeing a lot of these sentinel hospitals really seen an uptick in the number of patients that are coming in with influenza-like illness. We heard that many of the kids going to the hospital in Ottawa didn't get the flu vaccine. Jesse said that that was the same in Montreal. The most recent data that we have from 24 shows that 42% of Canadians got the flu shot. In Saskatchewan, where you are, it's only about 20% so far, not just kids. Jesse was talking as well about a huge drop in folks in the elderly population who aren't

getting a vaccine. What's going on there? What do you think is leading to a low uptick in the vaccine? Yeah, you know, there's a few different factors, I think, that are contributing to this, but probably the biggest one is the fact that we have a number of government officials in Canada for example, the Premier of Alberta, as well as in other countries, such as the U.S., that are really decreasing confidence in vaccines overall. In addition to that, there's a scientific reason that may be backing this as well. Some data has shown that the strain of H3N2 that is circulating in the

community right now is not a good match for the vaccine strain. So the vaccine this year and the vaccine every year is selected in February before, before flu season starts, obviously, basically with our best guess of what viruses are going to be circulating. And a variant of H3N2 has emerged that isn't as neutralized as well by antibodies that are produced by this year's vaccine. That information has gotten around, and a lot of people have had questions for me as far as whether the vaccine even still works. And the answer is that it actually does. The vaccine may not prevent people from getting infected as well as it does in years where there's a good match, but it still should actually keep people from developing really severe disease. And I think that

is probably what's underlying the fact that a lot of the patients that we are seeing showing up at the hospital are people who are unvaccinated. I think it's really, really important to get the message across to people that, as Dr. Pappenberg said, it's not too late to vaccinate against flu. There's still quite a lot of flu season ahead of us. And even, even if the vaccine isn't a perfect match, it still does quite a lot to reduce disease severity. There's a doctor who's part of the medical health team based in Saskatoon, a medical health officer who said that one of the reasons why we also might see depressed levels of vaccine uptake is that people have sort of vaccine fatigue after the pandemic, that we've just been through something and that people feel differently in some ways about vaccines. Now, what do you make of that? I think that there's a lot of truth to that. You know, the anti-vaccine movement has really been waiting, I think, for a moment like the COVID pandemic for a very long time. And what happened because of that, because there was so much insistence on getting vaccinated correctly, I mean, the COVID vaccines have saved millions of lives globally, that people, you know, heard a lot of conflicting information about these vaccines. On one hand, the government health,

officials are telling people that they need to get vaccinated, that they need to be able to resume normal life by getting vaccinated and then not really necessarily explaining that the vaccines still work, even if they don't completely protect against infection. That created, I think, an opening for people who are opposed to vaccination to begin spreading disinformation about vaccines and to really decrease people's confidence in them. And I'm sure that that that really is driving a lot of the vaccine hesitancy or vaccine refusal that we're seeing in Canada right now. One of the people doing that, of course, is the head of the U.S. Health Department, Robert F. Kennedy Jr., long history of anti-vaccination sentiments, if I can put it that way. He has also been involved in the Trump administration's slashing of funding to the Centers for Disease Control.

What does that mean? People talk about disease surveillance. What does that mean in terms of how much information we actually have about the flu? Yeah, I'm so glad you asked this question, Matt, because I'm American and I've been following Kennedy for quite a long time being a vaccine researcher and a virologist and an American and also being very familiar with how the system works in the U.S. So in the U.S., the CDC in normal times would be collecting data from all 50 states. It would be coordinating, putting all of that data together so that we can have a national flu surveillance system that will tell us where outbreaks are occurring and who those outbreaks are occurring in so that we can direct resources

to manage those outbreaks effectively so that we can run vaccination campaigns, for example, in communities that aren't well vaccinated so that we can educate people about their risks. That is not happening anymore this year because while the state health departments are still collecting the surveillance data. So they are tracking the number of flu cases. They are tracking which subtype is causing these flu cases. They're tracking this both through clinical diagnostic labs as well as public health labs. And then they're giving this information to the CDC. The CDC has lost 25 percent of its employees. And the CDC is no longer functioning the way that it once did. The CDC is in fact also had a number of experienced leaders within the

CDC who have been either fired or forced into retirement, who have left the agency. And they've been replaced in many cases with political appointees who share Kennedy's views on vaccines. And to be clear, he is not vaccine skeptical or hesitant. He is opposed to vaccination. And he is trying to put as many roadblocks as possible in the way of people accessing vaccines. So the CDC is a non-functional agency that is effectively being run by a number of anti-vaxxers, and that means that it can no longer function as a reliable source for influenza surveillance data or data that we can use in outbreak situations to control these epidemic diseases. I have to let you go. We just have a few seconds left, but given all of that,

what are you most worried about? We're talking about the flu, but there are other preventable diseases that there as well. Well, I'm certainly worried about the entire child. vaccine schedule. And President Trump a couple weeks ago put out a memo saying that basically we need to align our childhood vaccine schedule with other countries that administer fewer vaccines during childhood. So in my view, Kennedy and the Maha movement, the Make America Healthy Again movement, is going to try to continue to block access to as many vaccines as possible, especially those vaccines on the childhood schedule. And that means that both Canada, and the U.S. can look ahead and probably see more outbreaks of measles, more outbreaks of other

preventable diseases, including potentially rebella, pertussis or whooping cough, and even tetanus and things like that. Angela, thank you very much for this. My pleasure, Matt. Thanks for having me. Angela Rasmussen is a virologist at the University of Saskatchewan. She was in Saskatoon. You've been listening to the current podcast. My name is Matt Galloway. Thanks for listening. I'll talk to you soon. For more CBC podcasts, go to cBC.ca.ca slash podcasts.