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The flu spreads
Effective action early on might have contained the problem
Business Standard / New Delhi Aug 13, 2009, 00:48 IST

The worst fears about a swine flu epidemic are, unfortunately, coming true. A few weeks ago, it was just isolated cases of people returning from abroad, or their kin, reporting positive for the H1N1 infection; now the number of cases has begun to swell by the day, topping 1,100 in all. Deaths on account of this disease have risen to nearly a dozen in less than a week, and are also on the rise. While three states, including the worst-hit Maharashtra, have invoked the law on epidemics to cope with this menace, others need to do so too. The World Health Organisation (WHO) has already pronounced this as the fastest-spreading pandemic in history; between April-end (when the first case was formally diagnosed in Mexico) and now, the scourge has spread to over 120 countries and infected nearly 2,15,000 people, leading to 1,810 deaths. WHO’s India representative has warned that the virus will soon reach small towns and villages, and this will pose fresh challenges as effective public health facilities don’t exist in many places.

The health minister has said that the disease was bound to spread, and that it could not have been contained. Perhaps, but a more determined approach from the beginning might well have warded off the crisis. This infection had seldom been reported in India in the past, so what was needed was to effectively screen incoming passengers at the 22 international airports. This could have been done by installing thermal scanners at the airports, as some other countries did quite early on; this is proposed to be done only now in India, when the infection has already got established within the country.

On the day when the first swine flu death was reported from Pune last week, the government responded strangely by easing the guidelines for handling infected people, asking heath authorities to hospitalise only the very serious cases and letting other confirmed cases go home. Besides, it allowed only a handful of government hospitals in the big cities to keep limited stocks of anti-virus drugs, notably Tamiflu. About 70 per cent of Tamiflu stocks are reported to have been exhausted already. It is only now that the government has come out with plans to allow private hospitals to treat swine flu cases and also import more stocks of Tamiflu as well as diagnostic kits. These steps should have been taken weeks ago.

The growing incidence of the H1N1 infection among school students is a particular worry because they mingle with others far more freely than other groups and can, therefore, disseminate the virus more widely and rapidly. Once the present weak phase of the monsoon ends and it becomes active again, and in the subsequent winter season, the conditions will turn more conducive for the infection to spread. And in case the virus mutates into a more fatal form, the consequences would be disastrous. It was easy to contain the bird flu outbreaks by culling the entire bird populations of the concerned regions; that is not an option in the case of the swine flu.

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