High swine flu toll worries health experts

Aditi Tandon

Tribune News Service

New Delhi, March 16

Though government data on swine flu mortality is now beginning to suggest a tapering down of the virus with the average daily mortality decreasing gradually from around 17 at the start of last week to 11 now, cumulative death burden from a preventable infection has worried experts.

As of yesterday, the country had reported 29,938 positive cases and 1,731 deaths on account of influenza-A H1N1.

The Ministry of Health has recently rejected a US research which revealed mutation in the currently circulating viral strain, suggesting its higher virulence and resultant mortality. But central health experts have ruled out mutation which means the strain is the same as was circulating in 2009 and the medicines against it continue to be effective. What’s baffling, however, is – why is then the mortality so high.

It is next only to 2009 and 2010 when the country was witnessing a pandemic. The number of cases in 2009 was 27,236 and 981 deaths followed by 20,604 cases and 1,763 deaths in 2010.

Health Ministry experts said it was hard to explain why H1N1 virus behaved the way it did. “It is an unpredictable virus and advanced studies would be required to find out what happened and why,” said an expert.

The Ministry of Health is now in the process of putting in an advanced system for surveillance of seasonal influenza with the National Centre for Disease Control (NCDC) already ready with the project. The NCDC, India’s equivalent of US’ Centre for Diseases Control, is the apex body responsible for monitoring and responding to outbreaks.

The NCDC will lead the seasonal influenza surveillance project to gather evidence on public health burden of the disease and its trends.

“The evidence can then guide vaccination policy on the issue,” said a ministry expert. As of today, India has no vaccine policy on swine flu with the government recommending it only for high-risk health workers against the WHO’s suggestion to vaccinate all high-risk groups. The ministry admits in its swine flu advisory that it doesn’t recommend vaccine for all high-risk groups because it has no evidence to suggest a vaccine would help those categories.

“There is now an attempt to create that knowledge,” said a ministry expert.

Dr Purushottam Lal, former MCI member, said the mortality was very high and worrying and suggested early action against influenza from next year.

“The health authorities must take preventive steps from August to September itself, especially for rural populations. Awareness about precautions must be done by October. Vaccination, which becomes effective after three weeks, must be given much in advance. States must rise to the occasion since disease control is their job,” Dr Lal said.