Monsoon, winters hazardous swine flu cases, warn experts

By Live Dr - Wed Aug 05, 4:35 pm

New Delhi, Aug 4 (IANS) A day after a 14-year-old schoolgirl died in Pune of swine flu, doctors and experts Tuesday warned that the H1N1 infections in the country could increase as the virus spreads faster during the monsoon and winter.
Experts said people need to be more vigilant and take precautions as the swine flu virus has entered the country.

“Surveillance and screening has to be given high priority. The virus has been mild so far, but it is a well-known fact that it could change its behaviour. And if it changes, then the virus could be more virulent,” Randeep Guleria, head of medicine at the All India Institute of Medical Sciences (AIIMS), told IANS.

“The swine flu virus can spread rapidly during monsoon and winter months. Therefore, we could see more infections in the coming months. It could be serious,” he added.

However, he pointed out that people need not panic due to the death of a girl in Pune which was caused by “delayed treatment”.

Rida Shaikh, 14, died Monday evening in a Pune private hospital – the first swine flu death in the country. She succumbed to the disease as she got the correct treatment “too late”.

Guleria warned that there were chances the virus could spread in “clusters”.

“People need to be more vigilant as the virus has entered the country. The chances are now that it would spread in a community or in clusters like schools or localities,” he added.

The professor said if people living in a community or a cluster exhibit similar illness symptoms, they should be screened or tested for the virus so that the anti-flu Tamiflu medicine can be given in time.

S. Chatterjee, senior consultant in the internal medicine department in Indraprastha Apollo Hospital, agreed with Guleria, saying there is a “possibility that the second strain of virus might turn lethal in winter”.

“The best thing is to follow precautions and early diagnosis of flu,” he said.

According to Chatterjee, since there is a possibility of the number of cases rising, the government should identify private hospitals for treatment.

“Government hospitals alone cannot handle the swine flu cases if there is an outbreak, and so the government should identify private hospitals to handle such cases,” he said.

Sunil Kumar Lal, assistant scientist at the International Centre for Genetic Engineering and Biotechnology (ICGEB), said: “There is a possibility of the virus mutating as it circulates. We have to watch the virus closely. Scientists across the globe are working to develop a vaccine for the flu that would be effective during the second wave.”

The ICGEB is an international organisation involved in advanced research and training in molecular biology and biotechnology.

Senior epidemiologist and executive director of the Indian Clinical Epidemiology Network (IndiaCLEN) Narendra Arora said no one at the moment knows “how lethal the virus could be in future”.

IndiaCLEN is a cluster of seven regional clinical epidemiology units that are members of the International Clinical Epidemiology Network (INCLEN).

“It is the history of the flu pandemics that is making scientists believe that the second wave of the flu could be deadly. Flu pandemics historically come in waves, often getting worse as they go and there is a likelihood that swine flu may come back in a more severe form,” added Arora.

Citing the example of the 1918-19 Spanish flu pandemic, which was considered the worst of all time that had left 40 million people dead, Arora said: “The Spanish flu started with a mild wave followed by a deadly second wave later in the year,” he said.

According to experts, surveillance is important to halt the mass spread of the virus and the country needs to prepare a database of the flu-affected people.

“Every season 10 percent of the population is affected with common flu, and if the number in the coming season rises to 25-30 percent then we need to worry. We have to have a database of the people affected with swine flu in the country to check against any unusual break,” said Naresh Gupta, senior doctor at Maulana Azad Medical College in Delhi.

The swine flu pandemic is the first since the Hong Kong flu pandemic in 1968, which killed one million people worldwide.

India reported the first swine flu case on May 16. The World Health Organisation (WHO) raised its alert against swine flu to the highest level – Phase 6.

India has reported 558 swine flu cases, of which 470 have been discharged from the identified health facilities till Monday. A total of 2,479 people have been tested for the flu so far.


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