100 deaths per month, still doctors say swine flu nothing to worry

The numbers offer little comfort. But doctors say worry not.

State health ministry data on swine flu shows an average 100 deaths per month in 2015. Even in 2009-10, when swine flu was pandemic across three regions in the world, including India, the figure was only 55.

So, what has made the virus deadlier? Health experts say it is not the virus but the delay in detection and treatment that has caused so many deaths.

Maharashtra is among the top five states seeing maximum swine-flu deaths. Out of the 1,731 deaths in the country so far, 1/5th was in the state. Mumbai alone has seen 31 deaths in the last two months.

At present, 26 people across the state are on ventilators and 736 are in various hospitals.

The data also throws up some worrying trends. For one, "this year, we have observed that 35% of those who died of swine flu did not have any secondary disease like diabetes and hypertension," says Dr Pradip Awate, state's epidemiology cell in-charge.

The remaining 65% swine flu deaths were due to multi-factorial diseases on the sidelines like diabetes or hypertension. "People with co-existing diseases have low immunity and have high level of infection," said Dr Awate.

Health experts attribute the 35% deaths to the hyper active immune system of individuals.

"There will be a certain percentage of people who may not have any secondary disease but their body can have hyper active immune system reaction to the virus. This is a fatal condition. Otherwise, only the people with co-morbid factors and low immunity fall under the high-risk category," says Dr Abhay Chowdhary, director, Haffkine Institute.

The second factor, as Dr Chowdhary says, is "in 2009-10, it mostly affected the young and adolescent."

"From 2009, the virus is present in our society though the rate of transmission is very low. The transmission rate peaks mostly during rains and winter. In 2009, if it was the rain, in 2015, it is the winter," says Dr Chowdhary.

The Haffkine Institute had done a study on the virus in 2013-14. "Seeing the present infection, we do not think that there is any mutation," said Dr Chowdhary.

Both Dr Awate and Dr Chowdhary emphasised on the need for early diagnosis. "We have observed that almost all swine flu deaths were related to delayed diagnosis and treatment. If the disease is detected early, 99% will recover. There is nothing to panic about," Dr Chowdhary reassured.

The health department audit also found that 70% swine-flu affected are from urban cities. Dr Pawar said that even those rural people getting swine flu have a history of visiting urban areas.

"Urban cities are congested. That can be one reason why 70% cases are from urban cities," said Dr Pawar.

This is one reason why doctors and the BMC have already warned people falling in the high-risk category to avoid crowded places.

Dr Om Shrivastav, director, department of infectious diseases, at Jaslok hospital said, "The high-risk category has to be extra-cautious. Since the immunity is low, they are more prone to getting infected. Early intervention can prevent complication and mortality."

What causes Swine Flu

Swine flu or H1N1 is part of the influenza A family of viruses. Influenza viruses infect the cells lining your nose, throat and lungs. The virus enters your body when you inhale contaminated droplets or transfer live virus from a contaminated surface to your eyes, nose or mouth.

Though H1N1 is called swine flu, you can't catch swine flu from eating pork. H1N1 is harboured in pigs and spreads to human beings through animal-human being interaction. Swine flu symptoms develop about one to three days after you're exposed to the virus and continue for about seven days.

1 in 4 persons infected with H1N1 virus die of complications
It mimics normal flu-like symptoms, with patients beginning to have dry cough, fever, headache and throat irritation
Subsequently, the symptoms may worsen to cause breathlessness
It spreads from one human being to another through air. When an infected person sneezes or coughs, micro droplets are liberated in the environment which may infect persons who come in contact with the infected person

High-risk groups are those who:
Are hospitalised
Are younger than 5 years, particularly children below 2 years
Are 65 years and older
Are pregnant or within two weeks of delivery, including those who have had pregnancy loss
Are younger than 19 years of age and are receiving long-term aspirin therapy, because of an increased risk for Reye's syndrome, a rare but potentially fatal disease
Have certain chronic medical conditions, including asthma, emphysema, heart disease, diabetes, neuromuscular disease, obesity, and kidney, liver or blood disease
Are immunosuppressed due to certain medications or HIV

Dos and Don'ts
Follow cough hygiene. Cover mouth and nose when you cough or sneeze
Wash your hands with soap or use sanitiser
Avoid touching your nose, eyes and mouth
Drink plenty of water, have nutritious food
Have 8 hours of sleep
Avoid handshakes/contact greetings
Don't spit in the open
Avoid self-medication

BMC has issued a helpline number to counsel citizens on swine flu. Call - 022-24114000

Year Infected case Death

2010 6,118 669
2011 42 6
2012 1,564 135
2013 649 149
2014 115 43
2015 3,579 301 (till March)