Gurugram: While data from the union health ministry shows 3,038 laboratory-confirmed cases of various sub-types of influenza being reported from across India till 9 March, including the subtype H3N2 which has reportedly killed two people in the country this year, the panic caused by any symptoms of cough, cold and fever is palpable in the National Capital Region (NCR), especially Gurugram, and other parts of Haryana.
One of the two reported H3N2 mortalities was of a Haryana resident, a 56-year-old lung cancer patient who had tested positive for influenza in January. The other death was reported from Karnataka.
Residents and doctors in the region claim cases of flu have gone up in the past few days. These include not just H3N2 infections, but cases caused by other influenza viruses too, confirmed Dr. Dhruv Chaudhary, head of the Pulmonary Medicine Department of Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences (PGIMS), Rohtak.
Chaudhary added: “These viruses are not new. Even before Covid-19 came, these influenza viruses used to come every year around this time of the year, but this time they appear to have come with a vengeance.”
He further said that these viruses cause morbidity and mortality every year not only in India, but also in Europe, the US, Canada, and the UK.
The intense panic in Haryana and Delhi-NCR, following the 56-year-old’s death, is perhaps a result of memories of mortalities caused by the Covid-19 pandemic, which have been refreshed by the symptoms of prolonged fever, coughing and breathing trouble, visible in many influenza patients since January.
While some doctors feel influenza has now become an epidemic, with frequent travels across countries making it difficult to contain the infection, both those from the medical fraternity and the administration, including the Union government, have issued public notices requesting people to not panic.
The Union Ministry is also keeping a close watch on the seasonal influenza situation across the country through the Integrated Disease Surveillance Programme (IDSP) network on a real-time basis.
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“Every member of our family is affected”
“Hardly a member in our family is left who has not been infected. Though we haven’t got ourselves tested for the virus, it is really bad. Fever refuses to go, one keeps coughing throughout the day, and a feeling of breathlessness adds to the uneasiness,” said Ashwani Khosla, a resident of Gurugram city.
Gurugram Health Department Thursday issued an advisory asking people to follow social distancing and use masks in the wake of rise in the number of H3N2 cases. The advisory, of which ThePrint has a copy, said the infection may persist for 10 to 15 days and asked patients to not panic and immediately consult a physician.
“We are seeing an epidemic in the form of a deluge of influenza cases. These cases are of both Influenza A (H3N2) and Influenza B, with the former being dominant,” said Virender Yadav, a civil surgeon who heads government health services in Gurugram, when contacted by ThePrint over phone Friday.
He said this is associated with an increase in the number of patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD), asthma, and pneumonia (both bacterial & viral) across the state and NCR (National Capital Region) in particular.
Yadav added: “We are suggesting a direct reverse transcription-polymerase chain reaction (RT-PCR) test for influenza and prescribing suitable medication.”
“For those who test positive we are prescribing Oseltamivir 75 mg twice a day for five days and for the vulnerable population, those who haven’t taken flu shots, we are prescribing chemoprophylaxis (medicines to prevent infection) with Oseltamivir 75 mg twice a day for five days. Only Paracetamol is advised for those with fever and body aches,” he said.
Yadav further said that if the cough persisted or there was accompanying wheezing, patients should use Budesonide and Formoterol inhalers or nebulizers twice a day.
He also advised people to take five to ten milliliters of honey with lukewarm water twice a day and keep themselves hydrated. “People should watch out for sinusitis, pneumonia and acute suppurative otitis media (ASOM), an acute inflammatory disorder of the middle ear cleft due to bacterial infection,” Yadav added.
“Influenza is an epidemic now”
According to Chaudhary, “with so much global travel happening, one can’t stop an active infection in one country from spreading to another country.”
While testing used to be a problem previously, according to doctors, post-Covid, there are many labs testing influenza viruses.
“We started observing flu viruses in the month of November last year. In December it was quite evident that cases are increasing. In January this year, I informed the state government that influenza is an epidemic now,” said Chaudhary.
He explained that H3N2 is a subtype of the Influenza A virus. The other subtype of Influenza A is H1N1 which is commonly known as Swine Flu.
According to Chaudhary, besides Influenza A (H3N2), incidents of Influenza B and Respiratory Syncytial Virus (RSV) infections were also being commonly noticed these days.
RSV is a common respiratory virus that usually causes mild, cold-like symptoms. Most people recover in a week or two, but RSV can be serious, especially in infants and older adults, he explained.
“All these viruses are highly infectious and hence once a member of a family catches an infection, others also get it unless they take due precautions,” he added.
Advising people not to panic, he said that while doctors didn’t have any medicine to treat Covid-19, they have an effective drug to treat influenza patients.
“This infection witnesses more morbidity and very less mortality. The requirement of oxygen is also rarely needed. To date, we have ventilated just six patients in the PGIMS, Rohtak, this year due to influenza,” he said, advising people to consult the doctor immediately on infection so that treatment can start on time.
Health department prepared to handle situation
Meanwhile, Haryana Health and Family Welfare minister Anil Vij said Friday that the state health department was completely prepared to deal with H3N2 influenza virus and there was no need to panic.
In a statement issued by the Information and Public Relation Department, Vij said that so far 10 patients of H3N2 influenza virus have been detected in Haryana, of which one had died.
“The deceased patient was suffering from lung cancer, so directions have been given to the health department to investigate whether death has occurred due to cancer or H3N2 virus,” he added.
ThePrint has a copy of the statement.
Vij advised people to stay hydrated. “Do not eat outside food at all and take a fluid diet. Also, keep your distance from those who are infected with the virus, use a sanitizer and follow social distancing,” he added.
“The symptoms of H3N2 are like Covid infection. Both are viral infections that may mutate very fast. That is why there is a need to be cautious,” the statement added.
Keeping track of influenza cases real-time
The Union Health Ministry too, in a statement issued Friday, said it was keeping a close watch on the seasonal influenza situation in various states and union territories through the Integrated Disease Surveillance Programme (IDSP) network on a real-time basis. ThePrint has a copy of the statement.
“The Ministry is also tracking and keeping a close watch on morbidity and mortality due to the H3N2 virus. Children and senior citizens with co-morbidities are the most vulnerable groups in the context of seasonal influenza. So far, Karnataka and Haryana have confirmed one death each from H3N2 influenza,” it said.
The statement added: “India every year witnesses two peaks of seasonal influenza: one from January to March and the other post-monsoon. The cases arising from seasonal influenza are expected to decline from the end of March. State surveillance officers are therefore fully geared to meet this public health challenge.”
According to the Union statement, a near real-time surveillance of cases of influenza-like illness (ILI) and severe acute respiratory infections (SARI) presented in OPDs (out-patient department-check) and IPDs (in-patient department) of health facilities is undertaken by Integrated Disease Surveillance Programme (IDSP), National Centre for Disease Control (NCDC).
This IDSP-IHIP data indicates that a total of 397,814 cases of acute respiratory illness/influenza-like illness (ARI/ILI) were reported from the country in January, which increased slightly to 436,523 in February this year. In the first nine days of March, this number stood at 133,412 cases.
The corresponding data for admitted cases of severe acute respiratory illness (SARI) is 7,041 cases in January, 6,919 in February and 1,866 during the first nine days of March.
“In 2023 (till 28 February), a total of 955 H1N1 cases have been reported. A majority of the H1N1 cases were reported from Tamil Nadu (545) followed by Maharashtra (170), Gujarat (74), Kerala (42) and Punjab (28),” the ministry further informed.
(This is an updated version of the copy.)
(Edited by Geethalakshmi Ramanathan)
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