Sunday, November 29, 2009

India: Second surge of swine flu batters Delhi

November 29, 2009

A second wave of swine flu is sweeping across the Capital.

Heath officials have confirmed a daily rise of 10 per cent in the number of positive cases in the past one week.

Dr Anjan Prakash, nodal officer for monitoring swine flu in Delhi, said 111 positive cases, including that of 73 children, were reported on Saturday alone.

Experts believe the new surge is linked to a drop in temperature. People tend to huddle in winter, increasing the risk of contracting the flu.

"Things will go from bad to worse from now on because the virus will get an opportunity to genetically re- assort with other human strains," Dr A. K. Prasad, chairman of the Influenza Foundation of India, said.

The ongoing festive and wedding season, which draws people together, helps the infection rate shoot up. The just-concluded trade fair could also be responsible for this spurt in H1N1 infection, according to Prasad. "In such situations of overcrowding, it's impossible to stall the spread of respiratory tract infections," he said.

Thankfully, the city could be better equipped to handle the second wave of H1N1. "There was a delay in the arrival of test reports during the first wave because diagnostic facilities were limited. Now, we have five private laboratories which can carry out the tests. Moreover, treatment is now available in private hospitals also," Prasad said. In fact, Moolchand Medcity, Sri Balaji Action Medical Institute, Sir Ganga Ram Hospital and Indraprastha Apollo Hospital have allocated 20 beds each for swine flu patients.

Delhi, though, has another reason to worry. The rise in infections here comes at a time when news of swine flu mutations have been reported across Europe.

The most recent report of the World Health Organisation (WHO) states that 1,000 patients have died in the past week.

Two of these patients were infected by a mutation that was recently detected in Norway and died in France, according to the Indian government's Health Surveillance Institute.

According to a statement issued by the institute, the mutation could increase the ability of the virus to affect the respiratory tracts and, in particular, the lung tissue. Worryingly, one of these patients had a second mutation to contend with, known to confer resistance to Tamiflu, the only known preventive medication to treat H1N1.

Influenza type A is notorious for its tendency to mutate constantly.

But doctors said this was not necessarily a cause for concern.

"Healthy people with effective immune responses should be able to resist this infection," Prasad said, adding the current vaccine will still be effective.

More than 100 million swine flu shots have been administered in 40 countries. The side effects are similar to or lower than those from regular flu shots, Prasad added.

The WHO said it was investigating these reports and tried to allay fears about the mutations noticed in several countries.

Dr. Keiji Fukuda, WHO special adviser on pandemic influenza, said in the group with Tamiflu resistance, some people had compromised immunity due to cancer treatment, which made them more prone to develop resistant viruses when on Tamiflu.

But the mutant strain appears not to spread easily in people with normal immunity, like hospital workers. "We don't know the full answer, but it is more likely that we are not seeing a major shift," Fukuda added. "The question is whether these mutations again suggest that there is a fundamental change going on in viruses out there - whether there's a turn for the worse in terms of swine flu severity," he said.

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