As the pandemic influenza disperses throughout India, the media and the government health services have unwittingly collaborated to create and escalate public alarm. The beneficiaries will be private doctors and hospitals, which are known for irrational and profit-driven practices.
Virologists and epidemiologists have repeatedly emphasised that the H1N1/09 influenza virus causes a mild infection in the vast majority of people whom it infects, just like the seasonal influenza. The symptoms are the same. Also like seasonal influenza, the standard treatment is isolation, rest, lots of liquids, and medication for pain and fever if necessary. A small percentage of patients have complications such as pneumonia that require hospitalisation and, possibly, intensive care.
The overall case fatality rate from H1N1/09 is believed to be about 0.5%, about the same as that for the seasonal influenza virus. In Mexico, where the new virus was first noticed, and where the outbreak was severe, about 2% of all reported cases died.
Though seasonal influenza is not generally viewed with apprehension, it causes severe illness in 3 million to 5 million people every year worldwide. 250,000 to 500,000 die from complications of influenza – about 33,000 of these in the US. In temperate regions, epidemics of this influenza occur in the winter; in India the virus is most active during the monsoons.
While everyone is at risk of seasonal influenza (the virus keeps mutating so no one is completely immune to it), the very young, the elderly and those with chronic conditions that compromise their immunity are more likely to suffer severe illness. In the case of H1N1/09, the majority of people who have fallen severely ill are between the ages of 5 and 59. Older people may be protected because they were exposed to a similar virus in their childhood. Other groups at risk of flu complications are pregnant women and people with underlying health conditions such as asthma and diabetes.
The difference between seasonal influenza and H1N1/09 is that the new virus is much more infectious. “So the absolute number of people who get infected – and the number who die – will be much higher,” says Dr S Sridhar, Vadodara-based paediatrician and public health expert and member of the Medico Friend Circle, a group of health activists and analysts. Crowded living conditions and low immunity because of malnutrition are likely to add to the problem.
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