The number of swine flu deaths in January gives the impression that the country is on the verge of another epidemic. At last count the toll had reached 100 across India, mostly in Gujarat, Rajasthan and Telangana. But the panic in the media, experts say, is premature.
In 2009 and 2010, almost 3,000 people died of swine flu in India as the new disease swept across the world. That high fatality occurred because India’s population had not been exposed to the swine flu virus before, explains Abhay Kudale, a scientist at the Centre for Health Research and Development in Pune. As more groups get exposed to the virus, they also develop immunity to it. And until the full population is exposed, there will be regular outbreaks of swine flu such as the present one.
“We had anticipated this situation after the 2009-10 pandemic,” said Kudale. “The transformation now is the process by which swine flu is going to become endemic in the country.”
Jayaprakash Muliyil, an epidemiologist at the Christian Medical College in Vellore, said swine flu might even be less fatal than common influenza, though this needs to be studied more. Common influenza kills 1 in 5,000 people who contract the virus, whereas swine flu might kill less than 1 in 10,000.
“The reason this round of swine flu seems so severe is because the media reports these deaths more frequently,” Muliyil said. “But people who die of swine flu usually have other underlying causes that the media does not talk about.” These conditions include immune conditions, such as diabetes, bronchitis and asthma, besides pregnancy.
A matter of reporting
Three states and Delhi seem to be reeling from swine flu this year. This is normal as pockets of the country get exposed to the virus. Forty per cent of a population needs to be exposed to the virus for an epidemic to be contained, Muliyil said. The rest of the population remains susceptible, but it will take until a new unexposed generation is born for an outbreak to occur again.
“There are sectors such as Telangana where swine flu might need to be monitored closely,” said Rajeev Chhibber at the Public Health Foundation of India in Delhi. “But these are reversible and controllable diseases. So unless there is a complete failure of the government, there is no need to panic about an epidemic.”
Those states that seem to be affected the most might just have the best diagnostic facilities. Pune, for instance, had the most reported cases of swine flu in 2009-10, but that was largely due to the presence of the headquarters of the National Institute of Virology there, which helped diagnose patients.
What really helped in Pune in 2009, according to Kudale, was the implementation of the Epidemic Diseases Act of 1897. During a plague epidemic in 1897, the British created a unified line of command where all public and private health operators had to directly report to the district magistrate and follow its orders.
There is, however, a less dictatorial way to go about it.
“An unexposed population definitely needs to be cautious about the symptoms of common flu and swine flu,” Kudale said. “They should not take illnesses casually. That will lead to a delay in diagnosis and treatment. The most important thing is prevention and taking early help when you fall ill.”
Diagnose early
Early detection is vital to prevent more fatalities. Swine flu, if left untreated, is more severe and intense than common flu.
“Swine flu can become widespread if initial cases are not nipped in the bud,” said Chhibber. “Those who die usually come for diagnosis at a late stage in the illness. We need diagnostic centres to give results in less than 12 hours before the disease gets worse.”
Another problem could be a lack of awareness among general practitioners who might prescribe paracetamol instead of sending the patient for more tests.
As the media reports more cases, rumours also increase. For instance, there are reports of swine flu being transferred via infected chickens, which is not possible as the virus is airborne. There is also talk that the virus might be developing resistance to the trivalent influenza vaccine that people in areas at risk are advised to take.
“Every year, these vaccines are updated in response to changes in pandemic strains, so there is very little chance of the virus getting resistant to it,” said Kudale. “It is possible that overuse of tamiflu might lead to resistance, but so far we have found it to work in our conditions.”
In 2009 and 2010, almost 3,000 people died of swine flu in India as the new disease swept across the world. That high fatality occurred because India’s population had not been exposed to the swine flu virus before, explains Abhay Kudale, a scientist at the Centre for Health Research and Development in Pune. As more groups get exposed to the virus, they also develop immunity to it. And until the full population is exposed, there will be regular outbreaks of swine flu such as the present one.
“We had anticipated this situation after the 2009-10 pandemic,” said Kudale. “The transformation now is the process by which swine flu is going to become endemic in the country.”
Jayaprakash Muliyil, an epidemiologist at the Christian Medical College in Vellore, said swine flu might even be less fatal than common influenza, though this needs to be studied more. Common influenza kills 1 in 5,000 people who contract the virus, whereas swine flu might kill less than 1 in 10,000.
“The reason this round of swine flu seems so severe is because the media reports these deaths more frequently,” Muliyil said. “But people who die of swine flu usually have other underlying causes that the media does not talk about.” These conditions include immune conditions, such as diabetes, bronchitis and asthma, besides pregnancy.
A matter of reporting
Three states and Delhi seem to be reeling from swine flu this year. This is normal as pockets of the country get exposed to the virus. Forty per cent of a population needs to be exposed to the virus for an epidemic to be contained, Muliyil said. The rest of the population remains susceptible, but it will take until a new unexposed generation is born for an outbreak to occur again.
“There are sectors such as Telangana where swine flu might need to be monitored closely,” said Rajeev Chhibber at the Public Health Foundation of India in Delhi. “But these are reversible and controllable diseases. So unless there is a complete failure of the government, there is no need to panic about an epidemic.”
Those states that seem to be affected the most might just have the best diagnostic facilities. Pune, for instance, had the most reported cases of swine flu in 2009-10, but that was largely due to the presence of the headquarters of the National Institute of Virology there, which helped diagnose patients.
What really helped in Pune in 2009, according to Kudale, was the implementation of the Epidemic Diseases Act of 1897. During a plague epidemic in 1897, the British created a unified line of command where all public and private health operators had to directly report to the district magistrate and follow its orders.
There is, however, a less dictatorial way to go about it.
“An unexposed population definitely needs to be cautious about the symptoms of common flu and swine flu,” Kudale said. “They should not take illnesses casually. That will lead to a delay in diagnosis and treatment. The most important thing is prevention and taking early help when you fall ill.”
Diagnose early
Early detection is vital to prevent more fatalities. Swine flu, if left untreated, is more severe and intense than common flu.
“Swine flu can become widespread if initial cases are not nipped in the bud,” said Chhibber. “Those who die usually come for diagnosis at a late stage in the illness. We need diagnostic centres to give results in less than 12 hours before the disease gets worse.”
Another problem could be a lack of awareness among general practitioners who might prescribe paracetamol instead of sending the patient for more tests.
As the media reports more cases, rumours also increase. For instance, there are reports of swine flu being transferred via infected chickens, which is not possible as the virus is airborne. There is also talk that the virus might be developing resistance to the trivalent influenza vaccine that people in areas at risk are advised to take.
“Every year, these vaccines are updated in response to changes in pandemic strains, so there is very little chance of the virus getting resistant to it,” said Kudale. “It is possible that overuse of tamiflu might lead to resistance, but so far we have found it to work in our conditions.”
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