I have tried to make my own little mark in this world. My career as a Medical Educator and Clinician in Gastroenterology (see www.gastroindia.net) and my flirtations with Health Promotion, especially amongst school children (see www.hope.org.in) are shown elsewhere.This blog contains my attempts at creative writing, most being write-ups for Health Adda column of HT City of Hindustan Times (also see www.healthaddaindia.blogspot.com) as well as a few others, and some reflections and thoughts that have struck me from time to time on my life journey.Please leave your footprint on this blog with your comment.


Sunday, September 6, 2009

Swine Flu in U.P.

Swine flu has already infected more than a thosand people in this country and claimed 7 Indian lives, and seems poised to spread rapidly across the country causing  a great deal of havoc.  The virus has already infected 1.6 lac people in more than 168 countries of whom 1160 have died. The WHO has termed it a “pandemic”, implying that the disease has become global.  Its entry into India has been late, but with the high population density (jargon for “crowded”) in most cities here, it is expected to spread faster than wild fire.
The swine flu germ is a virus that belongs to the family of Influenza viruses, and has a particular profile termed H1N1.  This particular virus normally causes flu in swines and pigs. Recently this virus mutated and crossed over to man, causing human disease. Further, it has mutated to adapt itself to spread from one person to another and thereby started an infectious cycle amongst humans.  The problem originated in Mexico and spread to other parts of the world. The virus spreads by droplets shed by an infected person while sneezing, coughing or speaking, or when we touch infected places and then put our hands in our nose or mouth.
Infection with any of the influenza viruses (including H1N1) produces similar symptoms: running nose, sore throat, cough, body aches and fever.  Sometimes, the infection becomes severe and the lungs get involved, resulting in shortness of breath or breathlessness. Further progression may cause high fever, fall in blood pressure, shock and failure of several organs of the body and may cause death.
                There is no doubt that this infection is extremely contagious; hence people who come in contact or face to face with an infected person run a high chance of catching it. Hence it is important to isolate infected persons so that they dont shed the virus in the air in crowded places and infect others. Also, personal protection such as wearing masks in crowded places and washing hands with soap and water frequently can help.
                The virus is however not very deadly; what it means is that it proves fatal in a very small proportion of people that it infects. To use statistics, of around a 10000 people that get infected, around 4 will probably have a sever e illness and succumb. Hence the case fatality ration is 0.4, compared to 10 for SAARS in which 100 people died for every 1000 that were infected.  That is the reason why doctors are saying “don’t panic”. It is a relatively lower risk disease.
                Most people who get infected with H1N1 get well on their own, just as they do for all seasonal flu infections: a few days of illness, take a few paracetamol tablets, warm saline gargles, ginger tea, and that is all. Only in a very few, the infection becomes so sever that he needs a special antiviral medicine called Tamiflu.
                Both the testing facilities and the medicine Tamiflu have been made available in a few government hospitals in Lucknow. At the Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, the Department of microbiology has been equipped to carry out the test, and if need be, dispense the medicines.
                The infection is expected to spread and cause illness in many of us over the next few months. The present handicap is the limited places where the test is available and that the government has banned Tamiflu from being sold in medicine shops, as it fears there could be panic testing and buying. It is hoped that the government hospitals and outlets are able to cope with the surge of patients that this pandemic may create.  In UK for instance, any person suspected to have the infection can call into a helpline number, and if the symptoms suggest swine flu, is provided the medicineds without even having to meet a doctor.
                Vaccines to prevent swine flu are not available yet; several countries and laboratories are working hard to develop one. It might take around 6 more months before we can have one in India. Till then, prevention, widespread  and easy availability for testing and easy access to medicines may help check spread of this virus , and save many lives.

As published in HT City ( Hindustan Times) dated 6 september, 2009.

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