Wednesday, August 12, 2009

H1N1 starting to spread in India

NEW DELHI, Aug 12 — Four-year-old Sanjay Balakrishnan's last days were spent in frantic dashes between hospitals in Chennai.

One problem for health officials is the paucity of testing centres. For instance Chennai, India's fifth largest city, reportedly has just one clinic with the proper facilities. New Delhi has 14, or about one for every million people.

Prone to asthma, he was admitted to a medical facility near his home last week after developing respiratory trouble and diarrhoea. When his condition deteriorated, he was taken to a bigger hospital in the southern Indian city.

There, his kidneys failed.

His parents moved Sanjay to another hospital for dialysis where doctors put him on a ventilator. They also took swabs for testing, and he tested positive for the Influenza A (H1N1) virus.

Although Sanjay was administered Tamiflu four days ago, it was too late.

The boy died two days ago, the first known victim of the H1N1 flu in Tamil Nadu state and the eighth in India.

The health authorities in Chennai have suggested that Sanjay may have been passed the virus by his father, who returned recently from Singapore, but has no signs of the virus himself.

The boy's death underscores the frightening threat posed to India by the H1N1 virus, the lack of preparedness for the disease even in the country's fifth largest metropolis and the ease with which it can be transmitted in the community.

Indeed, with small towns such as Thrissur and Davangere reporting the virus two days ago, there is evidence that the virus is reaching deep into India's hinterland.

Health Minister Ghulam Nabi Azad said he expected about one in every three Indians to catch the flu over the next two years. “We will see many more cases and perhaps some deaths, just as it is happening around the world,” he said. “This is a global pandemic.”

Azad has asked people who have been exposed to the virus to come forward rather than wait for the government to track them down.

He said that after the death of Reeda Shaikh, the 14-year-old girl from Pune who was the first to die of the flu in India, the authorities tracked down 85 people who had come in contact with the teen in some way.

Each of them was treated with Tamiflu. Also, 31 relatives of the child were also given the drug.

One problem for health officials is the paucity of testing centres. For instance Chennai, India's fifth largest city, reportedly has just one clinic with the proper facilities. New Delhi has 14, or about one for every million people.

“I had a child who had been running 104 degree temperature for several days,” said New Delhi paediatrician Pankaj Vohra. “I sent him for testing at a government hospital, but they simply turned him away.”

In the capital for instance, the government has, after much prodding, involved private hospitals to do the testing.

While the government tests for free, private facilities may charge as much as 13,000 rupees (RM959) to 15,000 rupees for a single test, prohibitive by Indian standards.

There is also no uniform response either in cases where the flu has been reported.

This week, all schools in the western city of Pune were closed. So too were theatres and multiplexes in the city. In New Delhi, some schools announced temporary shutdowns while others stayed open.

Sanskriti School in New Delhi's diplomatic district, which is popular with the children of senior civil servants, chose to close for a week after three of its students came down with the flu.

“Parents are anxious and we wanted to avoid any panic,” explained school principal Abha Sehgal.

Sanskriti said 120 students have complained of flu-like symptoms.

“It was too big a number to ignore,” Sehgal added.

The government, mindful of the panic that is being generated, this week advised schools to stay open.

“Given the current magnitude of the spread of the infection and the fact that the current virus is fairly mild, closure of educational institutions on account of any student or staff member falling ill with flu-like symptoms is not recommended,” the Indian Health Ministry advised this week. — The Straits Times

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