New Zealanders are being warned to stop dismissing influenza as a minor winter illness as a highly infectious strain of Influenza A continues to sweep across Aotearoa, filling GP clinics, after-hours services and hospital emergency departments.
Specialist GP Dr Bryan Betty says the country is experiencing an unusually late and highly infectious outbreak, with the sheer number of people becoming sick creating significant pressure throughout the health system.
The dominant Influenza A/H3 strain detected through sentinel surveillance this year belongs to subclade K, which health authorities say spreads readily and was also significant during the northern hemisphere winter.
Betty says the critical issue is not necessarily that the strain causes more severe disease than ordinary influenza, but that so many people are being infected at the same time.
A NUMBERS GAME WITH SERIOUS CONSEQUENCES
For most people, influenza means a miserable seven to 10 days of fever, headaches, muscle aches, fatigue and other respiratory symptoms.
But Betty says the common description of it being only the flu risks disguising how serious the virus can become.
He estimates around two to three percent of people infected with influenza can develop severe disease. If 100,000 people become infected, that could translate into 2,000 to 3,000 people becoming seriously ill.
That mathematics becomes particularly important during a highly infectious outbreak.
Even if the proportion developing serious complications remains relatively small, dramatically increasing the number of infections can produce thousands of people needing additional medical care.
For hospitals, GPs and after-hours centres already operating under considerable pressure, that additional demand matters.
GP CLINICS ARE BEING SWAMPED
Betty has described his own general practice as being inundated with respiratory illness.
Some clinics have reintroduced measures familiar from the COVID-19 pandemic, including phone-first triaging and separating respiratory patients from other patients.
The Royal New Zealand College of General Practitioners has advised practices to triage people with respiratory symptoms and separate potentially infectious patients where possible.
Betty has previously reported operating what is effectively a dedicated respiratory clinic, separating patients with respiratory symptoms and asking people attending to wear masks.
The pressure is not confined to general practice.
After-hours centres and hospital emergency departments have also been experiencing heavy demand, while other respiratory viruses including RSV and COVID-19 continue circulating.
PNEUMONIA AMONG THE BIGGEST RISKS
One of the most serious complications doctors are watching for is pneumonia.
That can result in hospitalisation and, for some patients, treatment in intensive care.
Children can also become seriously unwell through dehydration, particularly where influenza is accompanied by vomiting or diarrhoea.
While serious complications can occur in otherwise healthy people, the greatest risks generally fall on vulnerable groups including older people, hapū māmā, very young children and people with underlying medical conditions such as diabetes, respiratory illness and heart disease.
The current outbreak has also been hitting some communities particularly hard, with Betty previously identifying significant impacts among Pasifika communities.
For Māori communities already experiencing persistent inequities in access to primary and hospital care, preventing serious respiratory illness remains particularly important.
FLU SEASON HAS PUSHED INTO SPRING
Another unusual feature of the 2026 outbreak has been its timing.
Instead of influenza activity easing as winter ends, cases surged relatively late in the season.
Betty warned last month that the outbreak could continue into spring, with practices seeing substantial increases when influenza would normally be expected to be declining.
Health New Zealand says influenza is continuing to circulate widely and that the 2026 vaccine remains well matched to circulating strains, including subclade K.
That means health authorities are stressing it is not too late to be vaccinated.
FREE VACCINATION EXPANDED FOR UNDER-FIVES
The pressure has already prompted a significant change to New Zealand’s vaccination programme.
From 1 September, Pharmac expanded funded influenza vaccination to all children aged from six months to under five years, bringing forward protection for a group particularly vulnerable to hospitalisation.
Health New Zealand has instructed general practices to actively recall children in that age group and prioritise those already at increased risk of severe influenza.
Before the expansion, uptake among enrolled young children already eligible because of higher medical risk was low. Health NZ reported in August that only 9 percent of children on lists supplied to primary health organisations had received their influenza vaccination.
Babies younger than six months cannot receive the influenza vaccine, making vaccination during pregnancy particularly important because some protection can be transferred to pēpi before birth.
VACCINATION STILL MATTERS
Betty says vaccination remains the simplest way of reducing the likelihood and severity of influenza.
But vaccine hesitancy remains a challenge.
He believes some of that hesitation is a legacy of the COVID-19 pandemic and misinformation surrounding vaccination.
Health NZ says the influenza vaccine reduces both the risk and severity of infection and continues to recommend vaccination for people at increased risk of complications.
Importantly, people who have already had Influenza A this season may still benefit from vaccination because other influenza viruses can continue circulating.
WHEN THE FLU BECOMES A HEALTH SYSTEM PROBLEM
The lesson from the current outbreak is that the seriousness of influenza cannot simply be measured by how sick the average person becomes.
It also has to be measured by scale.
When hundreds of thousands of people become infected, even a relatively small percentage requiring medical treatment can translate into enormous pressure on primary care, ambulances, after-hours services and hospitals.
That pressure also affects people who do not have influenza.
Every overflowing emergency department, fully booked GP clinic and exhausted health worker has consequences for patients seeking treatment for other illnesses.
For Betty, that is why language matters.
Calling influenza only the flu can create a false sense that it is something New Zealanders simply need to tolerate every winter.
For many people it will mean a week of feeling terrible and recovering at home. For others it can mean pneumonia, hospitalisation, intensive care and, in rare cases, death. And when a highly infectious strain spreads through hundreds of thousands of people, the consequences are felt across the entire health system.
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