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| If winter comes... | |
| Early detection vital to dealing with H1N1 | | Business Standard / New Delhi November 05, 2009, 0:48 IST | |
With close to 500 officially confirmed deaths reported in India due to H1N1 influenza, popularly still referred to as “swine flu”, and over 6,000 globally in the last six months, the flu pandemic seems far from under control. The danger of the virus turning even more virulent has, in fact, risen manifold with the onset of winter. A recent World Health Organisation (WHO) report has already indicated a spurt in influenza cases in the temperate zone countries where winter has set in early. With international travel picking up, thanks to an improvement in the global economic situation, and the weather having already changed in India, it is only a matter of time before H1N1 cases begin to surge here as well. The H1N1 virus is already rampant in the country and people coming from abroad are adding to this infection load owing largely to lax screening of incoming passengers at the country’s 22 international airports.
Indeed, the real danger is not so much from the H1N1 virus, which is not fatal if treated in time, as from the possibility of its mutating to assume a more deadly form. As it is, the H1N1 virus is a combination of influenza viruses that affect swine, birds (bird flu) and humans and is, therefore, exchangeable between all three of them. This heightens the risk of its mutation as that can take place in any of these. The new strain may be difficult to control as it may or may not respond to the available antiviral drugs — Oseltamivir (Tamiflu) and Zenamivir (Relenza) — which are effective against H1N1.
Fortunately, thanks to fast-tracking of the vaccine approval procedures in many countries, a variety of the pandemic-specific vaccines have been developed. The WHO has also expressed its satisfaction over the new vaccines, though it has also pointed out that no vaccine, including those for other diseases, provides 100 per cent protection. But they do greatly reduce the risk of the illness. Over 50 million people had perished in 1918 influenza pandemic because no vaccine was available then. The death tolls in the subsequent pandemics in 1957 and 1968 were also substantial because of the belated use of vaccines to check the spread of virus. This mistake should not be repeated again.
While it is true that Indian drug companies working on developing H1N1 vaccines are yet to begin human trials, other drugs, including Tamiflu, are there to serve as both curative and preventive. Considering that not all persons catching this infection report to the authorities, these drugs need to be used as a mitigation tool till indigenous or imported vaccines are available. There is an urgent need to protect at least the vulnerable groups — such as medical and paramedical personnel, children and pregnant women and people returning from abroad — from this virus. The fear that such an approach will lead to development of resistance in the virus against these drugs and vaccines, though not wholly unfounded, is highly exaggerated. Information collected by WHO’s Global Influenza Surveillance Network bears this out. Of the countless flu viruses, only 28 have, to date, shown a tendency to develop such resistance. The global health body has emphasised the need for early detection and treatment of infected people with antiviral drugs that can prevent death. This is wanting in the Indian mitigation and disease-control strategy.
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