India’s Flu status
In an overpopulated , economically challenged country like India, any infectious disease ,can raise its ugly head to epidemic proportions.
Swine flu India 2015 is cause for worry due to virulent nature of the virus.
The public panic and terror about the disease is partly justified.
Lack of awareness and extreme challenges of collecting data for surveillance, has focused the world’s eye on India’s battle with the beast “swine flu”.
With the infection spreading by sneezing coughing and close contact and the virus randomly combining with bird and pig influenza virus to produce new virus strains…..its a science fiction horror story unfolding at rapid pace.
- Number of cases so far> 22,000
- Death toll:1198
Suspected factors behind failure to check spread of disease
- Unusual prolongation of winter season
- Lack of sufficient authorised testing centres
- Failure to rope in private sector health care facilities adequately to handle the emerging epidemic
- Limited timely availability even in metro cities and Government setup
- Lack of Public awareness regarding the disease, vaccination and treatment
- Possible major antigenic change in flu virus genetic makeup
7 Measures that might help us fight
- Flu vaccine to people at risk urgently
- Dedicated Flu OPDS at all government and private health care centres.
- Reservation of Isolation beds for Swine flu cases at all government and private hospitals
- Increased number of Private and State run testing centres
- Improved availability of flu drugs
- Flu drugs given only with prescription
- Public Health awareness drive to promote awareness , prevention, testing and treatment.
Symptoms of swine flu are similar to the common flu.But there is an increased risk of complications, specially in the very old and very young.
Treatment of Swine Flu
Prevention is the golden rule? Best treatment is prevention.
- Personal protection , preventive care
- Supportive care
Vaccination who needs it..Risk group
According to CDC Recommendation it is best practice to vaccinate the following groups of patients
- Children 6 months to 59 months/4 years and 11 months
- Adults > 50 years
- Adults and children with chronic pulmonary, cardiovascular, renal, hepatic, metabolic, haematologic, disease
- Immunosuppressive patients including HIV
- Women of reproductive age group planning pregnancy in this period and pregnant women.
- 6 months to 18 year children who are receiving long-term aspirin therapy.
- All Health care professionals
- Household contacts and caregivers of people at high risk for complicated influenza,and care givers of children younger than 5 years and specially less than 6 months.
- Residents of chronic care facilities
- American Indians, Alaskan natives
- Morbidly obese people
What is a flu shot
- Intramuscular vaccine(given in the arm muscle with a syringe and needle)
- Trivalent (commonly) , this means it will contain antigens (infection causing protein particles), from the three most common strains of virus causing influenza.Generally it will have antigens belonging to Type A subtype H1N1, Type A subtype H3N2, and Type B virus antigens.
- Composition: killed vaccine.As the virus in the vaccine is killed it will not cause swine flu in any patients.
1)Anybody with allergy to eggs. Flu virus particles are cultivated in egg cells and are not given to people with egg allergy as it can cause severe allergic reaction.
2) Previous history of severe reaction to flu vaccine.
3) Anybody with moderate to severe illness with fever should wait at least till fever subsides.
4) History of GBS (Guillain-Barré Syndrome , a condition where your bodies immunity may attack its own nervous system
0.25ml for 6 months to 3 years
0.50ml for more than 3 years
It is a yearly vaccine and needs to be given every year prior to flu season .Preferably October onwards, and as soon as feasible.It takes 2 weeks for adequate level of protection to be reached and you are at risk during this period.
Whether your child will need one or two dose will be best advised by your doctor.But CDC recommends.
6 months to 8 years: 2 doses of vaccine > 4 weeks apart during their first year of flu season.
First dose should be offered as part of routine vaccination to avoid missing the chance to provide adequate timely protection.
Opportunity for vaccination should ideally be given to all children as long as flu season persists.
- Complications are generalised
They include :soreness, minor swelling and redness at vaccine site, low-grade fever, nausea.
What is the vaccine efficacy against current swine flu virus
Influenza vaccines are intended to give protection against the most likely flu viruses (as determined by scientific research), which might cause influenza during the next flu season.
Shockingly CDC says the vaccine efficacy this season may be as low as 21% against H3N2
The reason being that 70% of the circulating H3N2 viruses have major genetic variations (antigenic drift) which are different from the virus strain in the vaccine.
But you still need to vaccinate because
- Prevents infection and complications , from the circulating H3N2 Virus which might not have changed.
- May protect against other influenza virus infection like H1N1, and Influenza B
Can you get swine flu even after vaccination
Unfortunately yes.Its possible as:
- You might be infected shortly before vaccination or within the time period it takes for adequate immunity to develop(generally it takes at least 2 weeks to be properly protected , and the protection gradually becomes less as the time following vaccination increases.)
- You might be infected with an influenza virus not included in the Trivalent vaccine (There are many varieties of flu virus, vaccine includes the most common ones causing flu)
- People who have chronic diseases, very young children and old people may not be totally protected.Some of them may still be infected with influenza virus included in vaccine.
This occurs as the protection provided by flu shot , is best in healthy young adults and older children.Protection varies with age, general health and other disease status.
Nasal spray vaccine
Not popular in India
- Live virus
- Intranasal spray containing the virus sprayed into nasal cavity
- Recommended in 2 years to 49 years, healthy people.
- Single dose
- Composition same as that of intramuscular flu shot
- Similar level of protection
Contraindications of nasal spray vaccine (as recommended by CDC)
- people with depressed immunity
- Having egg allergy
- Previous history of GBS syndrome (Guiallane -Barre syndrome)
- Children <2 years and more than 49 years
- Children 2 years to 17 years taking aspirin.
- History of antiviral drugs being taken orally within the last 48 hours.
- Past history of allergy to flu vaccine /it’s components.
- History of chronic respiratory disease like asthma, with episode of wheezing within last 12 months
- Pregnant women
India has a population of 1.27 billion with most cities being overcrowded.What works in western countries may largely not work here, due to the socio-economic , cultural and educational background.
But whatever our drawbacks, if you can follow the personal care precautions and get vaccinated you are halfway prepared to fight the disease. Rest is God’s will.
Vaccination definitely, is still our best chance at protection.
UPDATE..April 10th 2015
According to the data available with the Union Health Ministry , 2167 unfortunate people have lost their lives to this disease.35077 people have fallen ill with Swine flu till date.Gujrat has been the worst affected with the death toll being 467 according to The Hindu.
Even though Delhi and Tamil Nadu both have been reporting high number of cases ,death toll was not as high due to better public awareness and healthcare infrastructure.
Outbreaks of Swine flu had started since late 2014 in India.Increased ability of the H1N1 virus to cause infection ,has been forefront among the many reasons for such a prolonged and severe Flu season .
MIT researchers have claimed that the Indian strain is a more virulent variety of H1NI.A mutation causing changes in the Haemagglutinin protein has been cited as a probable cause of increased virulence.Indian researchers have however challenged this claim by saying that their research doesn’t show any such variation in the genetic nature of H1N1.
India swine flu status