Crisis H1N1: Outbreak of Swine Flu – Science and Technology

Current Status

The current swine flu outbreak has resulted in 4,571 cases and 169 deaths across the country, with over 40% of the cases in Rajasthan, according to Integrated Disease Surveillance Programme (IDSP) (figures updated until January 27).

Other states that witnessed a high number of cases included Gujarat (576 cases, 20 deaths until January 27), Delhi (479 cases until January 27) and Haryana (363 cases and 2 deaths until January 26).

About Swine Flu

Seasonal influenza is caused by a number of circulating influenza viruses, such as influenza B.

It can affect all age groups, through globally the incidence is higher in young children and those above the age of 65.

Health workers and persons with co-morbid conditions (such as lung disease, heart disease, liver disease, kidney disease, blood disorders and diabetes), as well as immuno-compromised persons are at higher risk for seasonal influenza.

According to doctors, cases generally spike during extreme weather conditions — a dip in mercury during winters and extreme humidity during the rainy season often leads to a rise in numbers.

Hard to identify

Initially recorded in Mexico in 2009, the most common strain, H1N1, first reported in 2009, has since turned into a seasonal flu. Symptoms include fever, cough, nasal secretion, fatigue, headache, body ache and sore throat. There are three categories of the virus — A,B and C. While the first two are considered stable, category C is dangerous and requires immediate ventilator support.

Standard treatment for H1N1 is the Oseltamivir drug, which is to be taken only on doctor’s prescription. Frequent washing of hands and avoiding crowded places are among precautions suggested by doctors to avoid catching swine flu which, because of its symptoms, is easily mistaken for the relatively harmless cough and cold.

Ground reality of Public Health facilties

The sudden surge in cases has also thrown the spotlight on the under-preparedness of authorities. As the number of cases spiked, the Union Ministry of Health and Family Welfare recently circulated guidelines on case diagnosis, management, vaccination, isolation criteria, risk categorization and preventive measures to all hospitals and health facilities. Health advisories, in English and Hindi, on seasonal swine flu were also issued for the general public.

However issues are:

Shortage of the swine flu vaccine in the market.

A majority of doctors and health workers in government hospitals are yet to be vaccinated against the disease.  As per guidelines of the Union Ministry of Health, it takes about two-three weeks for development of immunity after the vaccine is administered. For healthcare workers in an environment that exposes them to the virus, a vaccine should be administered at least a month prior to commencement of the flu season.

Shortage of N95 masks and gloves is also being felt in the markets. At hospitals, to ensure that the infection doesn’t spread to other patients, those diagnosed with swine flu are admitted to isolation wards. Every hospital has set aside 5-10 beds from the existing number for such patients. The facility is generally created away from the emergency and general wards.

Conclusion and Way Forward

Healthcare workers in hospitals such as doctors, nurses and paramedics with a likelihood of exposure to influenza virus should be vaccinated.

According to doctors, like seasonal flu, swine flu can lead to more serious complications, including pneumonia and respiratory failure. It can also make conditions such as diabetes or asthma worse.

Pregnant women, infants, elderly and people on long-term medication or those suffering from immuno-deficiency are at high risk, and should opt for the influenza vaccine.