First swine flu death in India

Flaws in government testing policies

 This is the first clear signal of H1N1 virus’ spread in the community, which exposes flaws in the government’s current screening and testing policies.

The student – whose identity has not been disclosed by the government – had sore-throat, running nose and headache on July 21. She consulted a general practitioner and when her symptoms improved, she attended the school two days later.

The fever reappea red on July 25 for which she consulted another private doctor. Her fever continued for the next two days and on July 27, she was admitted to a private nursing home in Pune. Since her condition continued to worsen, she was transferred to an intensive care unit and was put on ventilator on July 29.

Her lung aspirate was sent to Pune-based National Institute of Virology only on July 31. She was tested positive for swine flu.

The patient was put on Tamiflu (Oseltamivir) on July 30 after the NIV results came. But her condition deteriorated again with multi system involvement leading to her death on the evening of August 3, official sources said.

Three doctors and one nurse from presumably the same nursing home have developed respiratory symptoms and are being treated with Oseltamivir. 

As many as 85 hospital contacts of the deceased girl and 31 of her contacts including 11 family contacts have been put on Tamiflu as a cautionary measure.

The girl’s death has raised questions on the government’s policies, which makes it clear that unless somebody had gone to affected countries or came in contact with any infected person, he/she will not be tested.

Because of these strict screening conditions, even if the girl had approached the NIV a week back, her sample would not have been tested because she did not meet any of those two preconditions. But her death shows that H1N1 virus is out in the community and if left untreated, it can kill. Incidentally she was not from any of the affected schools in Pune.

After the death, union Health Secretary Naresh Dayal said that the government may change Tamiflu norms allowing private doctors to prescribe the medicine. Currently, the medicine is dispensed only from recognised government facilities.

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