So far this year, H1N1 or swine flu has infected 18,000 people and killed 871, a nine-fold rise from the 1,786 cases and 265 deaths reported last year.
Two years after a massive outbreak in 2015 that infected 42,500 people and killed almost 3,000, India’s response remains inadequate.
Doctors say young children, the elderly and those with pre-existing chronic conditions are more likely to contract the virus due to lower immunity. Such persons, as well as pregnant women and health workers, should get vaccinated, doctors suggest.
Swine flu or Influenza A is caused by the H1N1 virus, which primarily affects the respiratory system and has symptoms similar to seasonal flu such as sudden onset of fever, chills, sore throat, headache, cough and body ache. Since it spreads through droplets when the infected person sneezes and coughs, its transmission is swift.
Gujarat, meanwhile, has lost 210 lives to swine flu this year–more than 30 within three days from August 13-15.
On August 16, 2017, the Gujarat High Court rapped the Ahmedabad Municipal Corporation for “taking its directions lightly” on curbing the spread of swine flu.
The rise in the number of cases reported is due to better national surveillance and better laboratory detection systems, Devendra Maurya, director, National Institute of Virology, Pune, told IndiaSpend.
Experts say another reason is that the immunity acquired during previous outbreaks has worn off.
Immunity develops either through an infection or by vaccination and wanes over time.
The elderly, young children and those with pre-existing chronic conditions are more likely to contract the virus due to lower immunity.
Seeking medical help as soon as the first symptoms arise is the key to better results.
Although India has an Integrated Disease Surveillance Programme (IDSP) which is supposed to receive samples on a regular basis from 11 laboratories that collect influenza samples, it has been criticised for slackening during years when there is no influenza outbreak.
Manipal Virus Research Centre is part of IDSP.
India lacks a dedicated public health cadre, T Jacob John, a virologist and public health expert who was formerly at Christian Medical College, Vellore, told IndiaSpend.
He added that without surveillance, it is impossible to know the magnitude, year-to-year variations, strains, risk factors, mortality rates, etc. of the virus.
IDSP is not integrated with private or public sector healthcare providers, or with national vertical programmes for tuberculosis, malaria, etc.
“IDSP collects statistics. In public health, surveillance statistics is not the primary objective but it is side product,” he said, explaining that the focus instead should be on addressing social and environmental determinants that cause the disease.
Vaccination is a critical input for preventing H1N1 influenza since it helps develop herd immunity—in which large parts of the population are immune to the virus, slowing down its transmission.
The review noted that the coverage of seasonal flu vaccination is low (<5%) in most low- and middle-income countries but making the vaccine free through the public healthcare system increases coverage.
But can be targeted at the vulnerable such as the elderly, children, those with pre-existing chronic diseases, pregnant women and health workers.
(This piece was first published on IndiaSpend and has been re-published with permission.)
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