Swine flu redux: is this a mutated summer strain?

Swine flu is back and this time the epicentres appear to be Pune and Chennai. Although the reported incidence is still sporadic and hasn’t yet reached anywhere near an epidemic situation, the momentum of its spread and public anxiety are worrying. The flu, which was otherwise prevalent in winter during the last epidemic in 2009-10, spreading during peak summer has raised concerns of a mutated virus that might thrive in summer and is resistant to existing vaccine and medicine. [caption id=“attachment_269849” align=“alignleft” width=“380” caption=“So far Pune in Maharashtra has seen the highest number of cases. File image. Reuters”]  [/caption] If the present rise in cases is a sign of the virus mutating to survive in summer in Chennai, or any other city, as some public specialists believe, the count is certainly going to rise. So far, no drug resistance has been reported. However, the fact that some of the patients who have been diagnosed with the flu had no history of contact with patients is also worrying. One of the reasons could be that the infection might have been dormant in the community and has flared up because of environmental factors and/or low immunity of the affected. With 260 patients so far, Pune in Maharashtra has recorded the highest number of cases followed by Tamil Nadu where 29 cases have been confirmed to be suffering from the H1N1 strain of influenza. A bulk of the cases in Tamil Nadu are from Chennai, where 14 cases have been confirmed to be H1N1 patients. Cases, with a few deaths, have also been reported from Shimla, Hyderabad, Bangalore, Nashik, Mumbai and Ahmedabad. In Tamil Nadu, so far there has been one death - a 25-year old farmer in the textile town of Tirupur in the western part of the state. According to reports, Pune, which had recorded the second highest number of deaths in the 2009 epidemic has reported 11 deaths so far, followed by Andhra Pradesh with nine deaths. The state government in Tamil Nadu yesterday started screening of passengers at the crowded Chennai central railway station and the airport. But it is nearly impossible to keep a tab on all passengers who are possibly infected given the huge volume of traffic. At best, the screening seems to be a confidence building public health measure that may also filter stray cases. The Tamil Nadu government also hasn’t lost time in establishing screening, testing and treatment infrastructure across the state with common standards. The medical colleges in the state and the King Institute in Chennai will conduct H1N1 tests for some time while a panel of 12 private labs that the government has certified, will do the test for a uniform fee of Rs. 3,000. The government has notified that the tests ought to be done only at the empanelled labs or the government institutions. The labs will use the kits supplied by the King Institute. The government also sought to play down the panic. State health minister VS Vijay, a qualified medical doctor, who has been quite forthright since the first case was reported, said,“Creating panic among the people is detrimental as this fear would affect the natural resistance provided by the body. Those who are healthy and have good immunity need not worry about contracting swine flu. This virus only attacks people with lowered resistance like infants, elderly people, diabetics and pregnant women.” During the last epidemic in August 2010, more than 40,000 confirmed cases and more than 2,200 deaths were reported from different cities in India, with Delhi recording the highest number of cases and Maharashtra, the highest number of deaths. In Tamil Nadu, where more than 3,100 cases were reported, there were 14 deaths, while Kerala which had fewer cases had a higher number of deaths. The symptoms of swine flue are fever, headache, cough and running nose. Some patients also report breathing difficulty and diarrhea. If symptoms such as running nose, cough and fever persist for more than two days, one should seek medical help from a reliable clinic. The right and timely medical help is extremely crucial to reduce the risk of fatality. To restrict the spread of the infection, people are advised not to cough and sneeze in public and to cover their mouth and nose with a kerchief or tissue while doing so. Public health specialists also advise frequent hand-washing and keeping a hand-sanitizer to ensure that one’s palms are clean, besides avoiding crowded places and even using face masks. Balanced food, regular exercise and a healthy lifestyle will help build one’s immunity to withstand the infection. The standard treatment for H1N1 is Tamiflu, which should be taken only on prescription and supervised by qualified doctors. Doctors take a call on prescribing the drug after assessing clinical symptoms, case history and test results. In some cases, the medicine is administered as a prophylactic (preventive) as well, but it has to be done by qualified doctors at certified establishments.