Prevent an epidemic

Swine flu could be controlled with government action

With the death toll due to swine flu, caused by the H1N1 influenza virus, exceeding 830 and the total number of positive-tested cases mounting to nearly 14,000, the disease could be headed for a bigger outbreak. Unless restrained soon, the spread of the disease may equal or surpass that in 2009, when the officially confirmed death toll was put at 981 (though unofficial reports claimed 3,000). That was also the year when this highly contagious respiratory infection was first discovered in its current virulent form in Mexico and rapidly spread worldwide, spurring the World Health Organization to call it a pandemic. While most other countries have since learnt their lessons and take precautionary measures to stave off this infection, India seems to have failed to do so. The H1N1 virus surfaces with unfailing regularity year after year.

Surprisingly, most affected states, barring Rajasthan that has formally declared it an epidemic, are tending to underplay the threat. But the virus is displaying some distinctly odd characteristics this year, foxing experts - hinting at the need for out-of-the-box approaches. The approach of summer normally reduces the intensity of the seasonal flu infection, but has not done so this year. The other peculiarity, noticed and documented in Telangana, is that a sizable proportion of patients who have died due to swine flu belonged to the 17-40 age group. Normally, the H1N1 virus affects children and the aged more. Experts believe that the causative H1N1 virus may have either reasserted itself or mutated to develop added potency. Or, it may be turning less sensitive to anti-viral drugs. Both indications are scary and merit urgent investigation and well-crafted remedial strategies.

Apart from these, the limited number of diagnostic laboratories and supply inadequacy of anti-flu drug Tamiflu or its generic version Oseltamivir are coming in the way of checking this virus. Many of the laboratories equipped to test H1N1 virus are charging as much as Rs 10,000 a test. Delhi has now capped charges to Rs 4,500, but few laboratories are observing this ceiling. The number of hospitals and chemists authorised to sell the anti-viral drug is too few to meet the growing demand. The procedure for accessing free medicines from the government outlets is cumbersome and time-consuming.

With such being the ground reality, the government's response defies logic. Experts wonder why vaccination, as a preventive measure, is not even being considered although anti-flu vaccination is almost routine in many seasonal flu-endemic countries. An indigenous anti-H1N1 virus vaccine was developed by the Serum Institute of India way back in 2010, but it has remained, by and large, unused. The stocks of the vaccine produced by the institute every year during the flu season have to be destroyed for want of takers, while people are continuing to suffer due to this infection. The government has a duty to act on prevention, before this reaches epidemic status.