Pakistan issues 'super flu' advisory warning of winter surge as cases rise

• Provinces urged to boost preparedness measures.
• 340,856 suspected ILI cases reported in weeks 44–49.
• 12% of tested samples confirm positive for H3N2.

The National Institute of Health (NIH) on Monday issued an advisory as H3N2 influenza cases rise globally and in Pakistan, warning that a new genetic subclade known as Subclade K, often dubbed “super flu”, has emerged internationally and urging provincial health authorities to step up preparedness and prevention measures.

The NIH said Pakistan is seeing an uptick in influenza-like illness (ILI) and severe acute respiratory infection (SARI) cases, with surveillance data showing 340,856 suspected ILI cases reported nationwide from epidemiological weeks 44 to 49, and 12% of tested samples confirmed positive for H3N2.

In the advisory, the NIH said it aimed to alert provincial health departments and other stakeholders to ensure timely control steps and to prepare for an expected increase in outpatient and inpatient load in the coming months.

The NIH said influenza is an acute viral respiratory illness caused by Influenza A and B viruses and is responsible for annual epidemics worldwide. 

It added that Influenza A is linked to higher transmissibility and more severe disease, particularly among older adults, young children, pregnant women, and people with chronic conditions such as asthma, diabetes, and cardiac or lung diseases.

According to the advisory, since August 2025 a rapid increase in H3N2 cases has been reported across several World Health Organisation (WHO) regions. In the South-East Asia region, influenza positivity has increased significantly, with H3N2 accounting for 66% of all Influenza A cases reported between May and the end of November 2025.

Similar trends have also been observed in Australia and New Zealand, where a substantial proportion of influenza cases belong to the H3N2 subclade, the NIH said.

Keeping in view the recent upsurge of influenza cases, limited access to healthcare services in some areas, gaps in infection prevention and control practices, and low public awareness, the NIH warned the ongoing flu season in Pakistan could be severe.

The advisory said seasonal influenza may initially present with mild symptoms but can progress to severe or complicated illness, stressing that vaccination is the most effective way to prevent infection and reduce severe outcomes, especially among vulnerable populations.

The NIH said influenza viruses spread mainly through coughing and sneezing and via contaminated hands and surfaces, advising frequent handwashing with soap and water or the use of alcohol-based hand sanitisers, covering the mouth and nose while coughing or sneezing, avoiding crowded places when ill, taking adequate rest, and observing social distancing.

The NIH added that the Public Health Emergency Operations Center at the CDC-NIH is continuously monitoring the influenza situation and coordinating response efforts to mitigate the impact of seasonal influenza across the country.