The H1N1 influenza that had first created mayhem in 2009 may no longer hold everyone’s attention, but we can be certain now that swine flu is nowhere near gone.

It has struck back again. The virus has become the most deadly disease in Maharashtra, claiming the lives of 284 people till 9 July. Replying to an unstarred question, Health Minister JP Nadda informed Rajya Sabha on Tuesday that 600 people had died of H1N1 in the first six months of 2017.

The virus, which had claimed 171 lives till May this year, has surpassed dengue and malaria to become the ‘biggest killer’ in the state as per a ToI report.

However, the more worrying part is how the pandemic flu has struck in the summer months, moving away from its trend of spreading in winters.

The most alarming numbers had come in from Maharashtra where 865 cases were reported between 1 January to 3 May. 171 people died of the deadly virus in the state, and only 11 of these deaths occurred in the winter, between January-February.

There was a spurt in the number of H1N1 cases in April, which is the month it usually subsides, state surveillance officer Dr Pradeep Awate told The Quint.

Rise of the Virus in April Is Unprecedented

In comparison, only 11 cases of swine flu were reported in April 2015 when there was an outbreak in the country. In the same year, 59 tested positive in January. The number rose to 1,366 in February and fell to 611 in March.

The virus did not have a significant effect in 2016, with only sporadic cases having been reported. In 2016, flu cases were reported in the winter, with 52 in January, 56 in in February, six in March and only three in April.

It is a new phenomenon of cases being reported in summers in such large numbers.
Dr Pradeep Awate, State Surveillance Officer, Integrated Disease Surveillance Programme

The geographical spread of the disease is vast right now, with cases springing up in Kerala, Telangana, Kolkata, Ahmedabad, Maharashtra, Jaipur as well as in Delhi. Rural and urban areas are equally affected.

On 28 April, an 18-month-old child became the first casualty of swine flu in Mumbai in the last two years. Though the number of cases are sporadic, most of the deaths in Maharashtra have occurred in Pune, Nasik and Aurangabad.

In the last four months, the influenza has claimed 23 lives in Kerala and more than 300 cases have been reported so far. This is higher than the total number of casualties and cases reported last year.

State nodal officer for H1N1, Amar Fettle said the increase in number of swine flu cases was not specific to Kerala alone, but to all southern states.

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Why the Seasonal Shift?

Swine flu is a respiratory disease caused by influenza viruses. It infects the respiratory tract and can be transmitted easily through the air, skin, saliva and contaminated surfaces.

When it first broke out in 2009, it took a while study the disease and find out what treatment works for different sub-groups. The first two seasons recorded high death rates. When severity is high, medicines don’t generally work in the case of such viruses. Therefore, early testing and treating for swine flu is what brought down the numbers in the consequent years.

Now that the cases are cropping up in the summer months, there seems to be a change in the virus.

Speaking to The Quint, Dr Sumit Ray, Critical Care Medicine, from Sir Ganga Ram Hospital said:

This shift may be because of a mutation in the virus. Influenza viruses change with time and there is a possibility that’s what happened in this case.

This may affect how vaccination is given to high-risk groups such as people with diabetes, hypertension and asthma, patients of cancer and HIV, pregnant women, children and healthcare providers. Vaccines till now were administered pre-winters and they wear off with time.

What Measures Are Being Taken?

In Maharashtra, Dr Awate said the government has released advisories in affected areas especially for high-risk groups.

We’re issuing guidelines, especially in affected areas like Nashik, Pune and Aurangabad and for high-risk groups. We’re also conducting workshops for officials and have administered vaccines to more than 27,000 people.
Dr Pradeep Awate, State Surveillance Officer, Maharashtra

In Kerala, Fettle said, necessary steps had been taken to check the spread of the flu.

All government hospitals, including primary health centres, have been equipped with enough quantity of medicines and guidelines issued with regard to the treatment.

He added that a programme to sensitise and create awareness about various aspects of the disease is already on in government hospitals.

People affected with common cold and fever have also been advised to seek medical attention, stay at home and take plenty of hot and nourishing fluids.

(This article was first published on 6 May 2017.)

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Published: 06 May 2017,09:19 AM IST

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