Swine Flu Visits India

The pandemic of the swine flu, which the World Health Organisation (WHO) now calls influenza A (H1N1), is mutating by the hour. The global health agency has raised its pandemic influenza alert to Phase 5, just one below the highest, in light of evidence showing sustained human-to-human transmission in many communities in the US and Mexico.

With the national capital, Delhi confirming the second case of swine flu on June 8, 2009, the total number of patients affected with influenza A (H1N1) across the country has risen to 11. The 60-year-old mother of the patient who had tested positive in Delhi on June 7 complained of mild symptoms, and tested positive later. She caught infection from her 35-year-old son who had returned from New York two days ago.

The health authorities said the 60-year-old woman was the mother of the 35-year-old man, and appears to have caught the infection from her son, in a confirmed case of human-to-human transmission.

India has also reported cases of human-to-human transmission. There are reasons enough for serious apprehensions if not for pressing the alarm button.

Worldwide, the WHO has reported 139 deaths due to Swine flu. In India, 46,963 passengers have been screened; around 19,856 were from affected countries. About 221 doctors and 90 paramedics have been deployed to man 76 counters at the 21 international airports. Any suspicion of flu-like systems must be taken seriously enough and the patient should get himself checked at a hospital or clinic to confirm or rule out infection. Medication can be administered and follow-up measures taken.

Respiratory Disease
Swine flu, a respiratory disease of pigs viewed as a major risk reminiscent of H5N1 avian flu, was initially detected in Mexico where it took a heavy toll on human life. Later, the flu spread to the US and then to Europe.

Though scientists are still struggling to understand the origins of this new strain of virus — a hybrid of human, pig and avian influenza — the story’s havoc quotient can be gauged by the convulsions it has triggered among diverse sets of people in different corners of the globe.

The swine flu is characterized by common flu symptoms -- sudden fever, muscle aches, sore throat and dry cough -- but may cause more severe vomiting and diarrhea.

Common seasonal flu kills between 250,000 and 500,000 people in an average year, often targeting the elderly. Most people die from pneumonia and flu can kill previously healthy people for reasons no one quite understands. It can also worsen bacterial infections.

New flu strains can spread fast because no one has natural immunity and a vaccine can take months to develop. This new strain of swine flu is genetically different from the H1N1 virus that the seasonal flu vaccine protects against.

The WHO has reported nearly 21,940 confirmed cases of influenza A (H1N1) infection from 69 countries and 125 deaths till June 5. India, where swine flu made its entry nearly three weeks ago, has been taking preventive steps after the WHO sounded a global alert. Besides issuing a travel advisory and stocking up the medicines effective against the virus, it has also been screening passengers at 21 international airports. So far 1.3 million passengers have been screened.

With 20,000 persons infected in more than 50 countries with swine flu as the H1N1 flu is being called since the virus got transmitted to humans from swine farms in Mexico, the WHO has expressed its concern over any further spread of the disease. While it is imperative that the infected patients are quarantined, there can be no letup in screening of inbound passengers. As was feared, air travel has become the easiest way for the virus to spread.

The Precautions
The Government is recommending people avoid crowded places and refrain from greetings like shaking hands, kissing or hugging. People have been told to wash their hands frequently and avoid sharing food or kitchenware. With thousands of foreign visitors and frequent travellers passing through, it would be prudent for authorities here to take concrete proactive measures to keep the disease at bay.

It is to the credit of the Government that it has been seen to be taking the threat seriously. It has set up checking counters and deployed medical staff at airports to screen people coming from flu-affected countries. It has even set up a helpline service to assist people with information on swine flu and how to deal with the same if infected.

Besides, wearing a face mask is one way of avoiding the virus. Face masks should be made freely available, particularly at airports, to enable passengers to wear them before they board their flights. There is no doubt that swine flu has spread rapidly across continents through air travel.

Other general precautions whether one travels or not include paying heed to strict hygiene whether at home, work or other places. Other steps include frequent washing of hands, avoiding crowded places, minimising physical contact like shaking hands and hugging while greeting strangers drinking plenty of fluids, and eating nutritious food. If infected, it is best to stay in quarantine until it is clear that the patient is no longer a risk to others.

Monitoring of pig health and that of piggery workers is starting in the Northeast which has over a quarter of the country’s pig population. If the measures initiated today, outlasts the scare, it would be an achievement.

Positive Aspects
The positive aspect of this pandemic is that the swine flu in Mexico has brought to the fore larger environmental issues, including how pigs are bred in that country. India, too, can use the current scare to its advantage by not only stepping up disease surveillance at ports and airports but also in the rural hinterland where humans and animals often live cheek by jowl, and addressing the environmental triggers.

In fact, this is a good opportunity for the Government to test, and if required, enhance is pandemic response systems. From a long-term perspective it should also invest in developing a multi-strain flu vaccine that could be used to prevent a swine flu-like outbreak in future. In the absence of a major nation-wide pandemic in the last few years there is no telling how we would hold up against the same.

The critical point for India is that of cooperation among nations. A 2007 World Economic Forum report on global risk looked at the hypothetical scenario of combined liquidity crisis and pandemic; the outcome, it was deemed, would be a “backlash against globalisation”. It is precisely this backlash which should be avoided. China’s abysmal track record with SARS and the secrecy around the disease displayed the ineffectiveness of the international system when it is left out of the loop.