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The real flu

A rapid rise in the confirmed cases of swine flu and deaths due to it in the National Capital Region (NCR) and many other parts of the country is a clear indication that not enough is being done to contain this menace. Delhi alone has recorded over 100 positive-tested cases of swine flu and five deaths so far in January. Fatalities in adjoining Rajasthan are even higher, at nine. Worryingly, the H1N1 virus that causes this flu is not confined to the north, where cold conditions aid its spread. Numerous cases have been registered even in some southern cities, like Hyderabad. The real problem is that the number of confirmed cases may be an underestimate. Many cases of swine flu are misdiagnosed; in other cases, they are simply not registered. Thus the spread of the disease could be larger than the numbers suggest.

Thankfully, the current strain of H1N1 virus may not be as deadly as the one that caused thousands of deaths in 2009. But, if neglected, it is still more virulent than most similar infections. Unfortunately, health authorities are not taking this highly contagious infection with the seriousness it merits. Barring advising people not to panic, not much else has been done to check its spread. Many of the special cells that have been created in the designated hospitals to treat swine flu patients are not adequately equipped. In the absence of proper hygiene, some of these centres have, in fact, become hotspots for the dissemination of the H1N1 virus. Indeed, calling this respiratory disease “swine flu” is a misnomer. It is now a seasonal human disease that also circulates in swine. It spreads from human to human through inhalation of contaminated droplets or physical contact with contaminated surface. Early detection and specialised treatment hold the key to reducing mortality due to this infection. However, because of the paucity of diagnostic and testing facilities – there are no more than a dozen in the NCR – timely detection becomes difficult. Moreover, the initial symptoms of H1N1 are indistinguishable from those of the common flu. However, if allowed to last over a prolonged period, these can lead to pneumonia and organ failure.

The health authorities, therefore, need to create more H1N1 testing facilities and launch an intensive public awareness drive focused at ways to avoid catching the infection. Particularly important is to bring home the point that proper tests and specific treatment are essential, especially if the redline symptoms – prolonged cough, fever and chest infection – persist for over a week or 10 days. The government also needs to ensure easy availability of the antiviral drugs like Oseltamivir (Tamiflu) and Zenamivir (Relenza) that have proved effective in preventing as well as curing swine flu. At the same time, the option of using anti-H1N1 vaccines to protect the vulnerable populations, including medical staff engaged in swine flu treatment, should also be explored. Such vaccines, developed during the 2009 swine flu pandemic and upgraded regularly to match the new strains of H1N1 virus, have shown their worth in several swine flu endemic countries. India must start using them.

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