Families in Nairobi are trying antibiotics and herbal brews for coughs that will not clear. Doctors say the Flu is likely to surge from October and drugs cannot touch a virus.
Moses Mwangi, a butcher at Nairobi’s Burma Market, has coughed for more than three weeks. He notices more customers coughing as they buy meat, and the illness has reached his household. Antibiotics have not helped, so the family now takes herbal concoctions.
Across Nairobi, people describe coughs that refuse to clear and repeated antibiotics without a diagnosis. Laboratory data show a rise in influenza A, and the Ministry of Health (MoH) expects a seasonal peak around October. Doctors warn that antibiotics cannot treat a virus.
Camila Ekomor, 20, fell ill with a light flu on 27 August. About three days later came a cough that has now lasted more than a month.
“I have never had personally a flu that has lasted over a month,” she says.
The cough is worst at night, and people asked whether she had tuberculosis (TB). Her mother, three sisters and five-year-old niece fell ill after her. “My niece missed two weeks of school and needed injections,” she says.
She sought care at Kangemi Health Centre and then a private clinic, where a blood test and a chest examination showed nothing worrying. “I have taken antibiotics on antibiotics. I am worried about the effects, including aching ulcers. No one has given me a diagnosis,” she says.
Since COVID-19 in 2020, some hospitals have recorded cases of influenza peaks with surges around March for the past three years
Prof Rodney Adam, an infectious disease specialist at Aga Khan University Hospital, says “flu” covers many respiratory illnesses, while influenza is one specific virus. COVID-19 and respiratory syncytial virus (RSV) look the same, and symptoms alone cannot tell them apart.
The hospital’s laboratory, which tests for a panel of respiratory viruses, has recorded a clear upsurge of influenza A in recent weeks.
“Since COVID, we have had influenza peaks with surges around March in each of the past three years. This year’s March rise was small before the latest one,” he says.
But the lab sees only the samples clinicians send, so it cannot say whether respiratory infections have risen overall. “You would require a population-based assessment,” he says.
The MoH describes peaks between late February and May, and again from July to October. In a 5 March advisory, Director General of Health Dr Patrick Amoth said surveillance showed higher-than-average respiratory illness activity.
Kenya National Public Health Institute (KNPHI) data reported in March showed more than 3,700 acute respiratory infection cases in a single week at public facilities.
An analysis by the MoH, the Kenya Medical Research Institute (KEMRI) and the US Centers for Disease Control and Prevention (CDC), reported in September, found that the larger of the two annual waves usually comes in October.
Antibiotics do not help viral infection and unnecessary use can cause diarrhoea, rashes, besides breeding resistant bacteria
“Influenza is highly contagious, one of the most contagious of the viral infections,” Prof Adam says. It spreads mainly through droplets from coughs and sneezes, which can travel one to two metres, and through direct contact with mucous membranes. For a butcher serving customers all day, exposure is a daily risk.
“Antibiotics do not help viral infection. Unnecessary use can cause diarrhoea and rashes, and it breeds resistant bacteria, which makes the drugs harder to rely on when they are truly needed. Therefore, people who have symptoms of a cough should not self-medicate,” he advises.
The antiviral oseltamivir works best within the first day or two, if a health worker prescribes it. Antibiotics have a place only if a clinician finds a bacterial infection after influenza.
The warning sign is someone who was getting better and suddenly gets worse. “That is a sign that somebody should seek medical attention,” Prof Adam says.
Risk rises with age and chronic illness. The World Health Organization (WHO) warns that severe influenza can lead to pneumonia and sepsis, and recommends annual vaccination for high-risk groups.
For uncomplicated illness, Prof Adam recommends rest, fluids, and paracetamol or ibuprofen for fever and discomfort. These ease symptoms but do not shorten the infection.
For Mwangi’s household, weeks without improvement are reason enough to see a clinician, who can decide whether to test for influenza, COVID-19, TB or another condition. Until the cause is known, the safest course is not to assume that antibiotics or homemade remedies hold the answer.
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