Influenza has returned to Europe at a faster-than-expected rate this winter after almost disappearing last year, raising concerns about a prolonged "twindemic" with COVID-19 amid some doubts about the effectiveness of flu vaccines.
Lockdowns, mask-wearing, and social distancing that have become the norm in Europe during the COVID-19 pandemic knocked out flu last winter, temporarily eradicating a virus that globally kills about 650,000 a year, according to EU figures.
But that has now changed as countries adopt less strict measures to fight COVID-19 due to widespread vaccination.
Since mid-December, flu viruses have been circulating in Europe at a higher-than-expected rate, the European Centre for Disease Prevention and Control (ECDC) reported this month.
In December, the number of flu cases in European intensive care units (ICU) rose steadily to peak at 43 in the last week of the year, ECDC and World Health Organization data show.
That is well below pre-pandemic levels - with weekly flu cases in ICUs peaking at over 400 at the same stage in 2018, for example.
But it is a big increase on last year when there was only one flu case in an ICU in the whole of December, data show.
The return of the virus could be the start of an unusually long flu season that could stretch well into the summer, the ECDC's top expert on influenza Pasi Penttinen told Reuters.
"If we start to lift all measures, the big concern I have for influenza is that, because we have had such a long time of almost no circulation in the European population, maybe we will shift away from normal seasonal patterns," he said.
He said dismantling restrictive measures in the spring could prolong the circulation of flu far beyond the normal end of the European season in May.
A "twindemic" could put excessive pressure on already overstretched health systems, the ECDC said in its report.