Northern India might have more swine flu cases: health official

"With Kerala experience, we are now advocating to all doctors across the country, especially in northern parts of India where good rainfall is expected in the coming months, should strictly follow government public health policies and use ABC management guidelines," Dr Amar Fettle, Chief Nodal Officer, H1N1 control programme, Kerala, said during the day-long seminar on 'Swine Flu H1N1--Flu Fears' held at Nair hospital yesterday.

The northern states must be prepared with the 'surge' capacity -- to put the large number of patients -- and with the state-of-the-art labs for testing as well, he said.
"Do not wait for the test results to start the treatment as it would be late for the patient.If the symptoms are clear, immediately start start treating the cases for H1N1," Fettle said.

Out of the 75 deaths during this second wave of H1N1 infection in the state of Kerala, 21 were pregnant women.

"Therefore, we appeal to all gynaecologists also to follow the public health policies to save several pregnant women from dying," he said.

The virus is more prevalent in the population in the second stage and so the treatment will begin even before the sample test results are available, unlike the first phase.
"In the first phase, we had to adopt different methods like keeping a vigil at entry ports, keeping lot of isolation wards and sending all the samples for testing and then start the treatment. But the strategy now is to strictly follow the public health policy and start the treatment even before the test results are available," he told PTI.

This will prevent any delay in treatment as each day is important for the patient to cope up with the virus.

The two state public health officials -- Dr Pradip Awate, Joint director, Maharashtra Health Services and Fettle emphasized on the role of general practitioners, saying they should treat even common cold vigorously as it may take a dramatic turn on day four or five if not treated properly.

"It is therefore important to cut down the treatment delay," Fettle said.
Kerala was fully prepared for the phase two of H1N1 pandemic and so, by June-July, the number of cases have come down inspite of heavy rains, he said adding, "the public health department even put advertisements in newspapers for H1N1 treatment."
Fettle said the role of Indian Railways was important as the samples to their state labs were carried in the guards van instead of the parcel van so that the samples are intact.
They said community participation was very important in the second or third phase of the infection by adopting hygienic practises and avoid spitting in public places.

The young doctors, who attended the seminar, were informed that the medical colleges in India are giving more emphasis on clinical rather than public health programmes.
Dr Jayanthi Shastri, who is in-charge of the state-of the-art Microbiology Lab at Kasturba Hospital and Head of the Microbiology in Nair hospital said that the civic body has real time PCR, DNA PCR diagnostic tools.

The civic body spent Rs 4 crore in setting up the facility which can cater to all the hospitals including the private ones for fast diagnosis of all the infectious diseases, she said.

"We do the tests free of cost for all the civic and government hospitals. We are also ready to testing for private hospitals but at a nominal cost," Shastri, who organised the seminar along with Dr Om Srivastav, Head, infectious diseases, city's Municipal corporation, said