The WHO has said that swine flu?s propagation rate is without precedent, with the new H1N1 virus having spread more in less than six weeks than influenza viruses did in more than six months in past pandemics. As of July 22, 1,34,503 cases had been confirmed globally, with a doubling of the death toll in July. India recorded its first H1N1 case only in May, but the virus has since spread to almost 22 cities and towns, and more than 500 people. Now, it?s taken a life. It?s time for stocktaking of surveillance mechanisms, laboratory and quarantine systems, outlays for treatment and even basic public education. Unfortunately, the case of the 14-year-old who died on Monday shows up lacunae at all these levels. She lived with H1N1 infection symptoms for days without either being isolated?even attending school?or treated with Tamiflu. Neither the school nor the state health department were notified immediately after the National Institute of Virology confirmed a positive sample. These are unforgivable slip-ups given that the current pandemic has shown strong signs of sustained community transmission, plus the WHO advised special alertness to spikes in rates of absenteeism from schools or workplaces.
The H1N1 virus is a vicious mix of avian, swine and human influenza viruses, which can not only hop from person to person but also threatens to mutate and become more virulent. Antiviral drugs like Tamiflu can reduce the symptoms and duration of illness, and thankfully India is stocked up on these (although over-the-counter usage needs to be strictly discouraged). The trick is to prevent clusters of infection from forming, which requires timely laboratory intervention. India reportedly has only 18 laboratories that can conduct the relevant tests. Obviously we need meticulous coordination between all private and public hospitals, not to mention schools, workplaces and similar public institutions, to make sure these facilities are used to maximum effect. There is ,of course, work on the vaccine front too, including at three of India?s top biotech firms. There is talk that the first vaccine batches may become available around October, but widespread availability is likely to take longer. Meanwhile, with temperatures shifting into lower gear, the virus is predicted to start multiplying faster. India has had luck on its side so far and there is still no call to go into a panic mode. Certainly we must avoid the kind of overreaction that China has been guilty of, locking up thousands of international visitors in quarantine. But the WHO reckons that a staggering 30% of the world?s population may get affected in the next two years, and we must prepare accordingly.