Even as laboratory-confirmed cases of swine flu, and deaths due to it, are mounting, health authorities remain virtually silent spectators, waiting for the weather to turn unfavourable for this virus to spread. There is, clearly, no strategy in place to prevent the disease from spreading; measures are in place merely to treat those affected by the disease. A laid-back attitude is incomprehensible, given that this disease, caused mostly by the H1N1 influenza virus, was almost unheard-of five years ago but has become endemic now. H1N1 coexists with various other influenza viruses — not only making it difficult to diagnose and treat, but also heightening the danger of the evolution of even more lethal forms. Since the global swine flu pandemic of 2009, several new swine flu viral strains have been traced, such as H1N2, H2N1, H3N1 and H3N2.
India seems relatively more vulnerable for several reasons. For one, unlike colder countries where the swine flu peaks just during winter, here the virus surfaces normally twice a year — during the winter months and the monsoon season. In addition, a high population density and scant attention to sanitation and personal hygiene provide ideal conditions for the virus. Interestingly, contrary to common perception, pigs have little role to play in spreading H1N1, which essentially is a human virus that can infest swine as well. In India’s inability to minimise the impact of what is essentially a novel, foreign virus, the deficiencies of its public health system have been laid bare. Public health infrastructure is minimal and works only on “mission mode”; questions of public hygiene are considered low priority.
The country urgently needs an effective strategy to combat the recurring outbreak of swine flu. Many public health strategists favour a two-pronged approach: prophylactic vaccination of at-risk population and making swine flu drugs easily accessible to the public. Sadly, the government’s present swine flu mitigation policies are found wanting in both these aspects. Vaccination is currently confined only to those engaged in treating swine flu-infected patients, and the drugs are made available only through the limited number of designated hospitals and health centres. Fortunately, the available remedies like Oseltamivir (Tamiflu), Zanamivir (Relenza) and a few others are capable of both preventing and curing this infection. This could make the implementation of any proposed strategy to control swine flu simpler. True, these drugs may not provide 100 per cent protection when used as vaccines, but they can certainly help stave off full-blown swine flu epidemics. The government would, therefore, do well to consider extending vaccination facilities to more vulnerable groups and also allowing qualified medical practitioners – if not chemist shops – to stock and dispense anti-flu drugs. Otherwise, swine flu will continue to recur, and other such strains might also become endemic.
