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India’s got the flu

india Updated: Oct 05, 2009 16:00 IST
Samar Halarnkar
Samar Halarnkar
Hindustan Times
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‘They just said my daughter has tonsillitis, but they are not giving it in writing. If she doesn’t have swine flu, why are they not giving in writing!”

The mother from Pune was upset, aggressive and close to tears.

I do not doubt her anguish.

Here are some big-picture statistics though:

More people died on Mumbai’s commuter rail lines than have died from swine flu across the world since the pandemic began five months ago (between 12 and 14 people are crushed on rail tracks or fall off Mumbai’s local trains every day).

Your plain, old flu kills up to 5 lakh people every year across the world. The swine-flu global toll since May 17 is 1,155, killing seven of every 1,000 people infected.

For now, the chances of anyone dying from swine flu — H1N1 to use its official name — in India are, as of Sunday, two in Pune, one in Mumbai and one in Ahmedabad.

If you are that anguished mother, this is a chance too many.

Aside from revealing the sanctity we afford to the phrase “in writing” — a term I heard over and over during the televised swine-flu hysterics last week — the latest affliction to reach India’s shores also reveals how easily we are willing to become mobs led by half-baked, sensation-seeking reportage shorn of perspective.

Restraint, of course, is not a word that was ever a part of our national vocabulary.

There was a reason Nobel laureate Amartya Sen collectively called his essays on history, art and culture The Argumentative Indian. He noted that anger, rage and resentment fuelled post-independence street uprisings.

Tabloid television — which now often includes our mainline channels as well — with its hectoring approach to the day’s news, only accentuates this proclivity to public rage. We all want answers when things go wrong, but there’s a big difference between finding an answer and finding a scapegoat.

With the swine flu, there are no clear answers.

That makes it more difficult for us, the media of the new I-want-answers India.

When you’re living through a pandemic, it’s hard to spread the blame. Let’s focus on damage control, providing perspective and keeping people calm.

That begins at home. Do remember that swine flu resembles the ordinary flu, and it’s not a great idea to rush to a hospital immediately, as thousands are in Pune, Mumbai and Delhi after 14-year-old Rida Sheikh became the first Indian casualty last week.

It’s not easy to stay calm, but it is very important. Swine flu appears to spread easily, so rushing to a hospital where the virus is known to be lurking is not a good idea. As I write this, the only two victims in serious condition are a doctor and chemist from Pune.

Epic outbreaks of disease have always been a part of human societies for millennia, and our increasingly crowded country and planet are only making them worse.

Flu — influenza — has always been a part of civilisation. Some of its avatars have been so horrific as to make swine flu seem like, well, the common cold.

Most notorious is the Spanish influenza, a pandemic that between 1918 and 1919 killed 50 million people, according to the US’ Centre for Disease Control, one of the world’s important disease-fighting institutions. Many more may have died; it’s just that many who died were never diagnosed.

Epidemiologists estimate that at its peak, Spanish influenza infected a third of the world’s population. This was a time before transcontinental flights and the global village.

As I pointed out, the ordinary flu is, thus far, deadlier than swine flu, but that could change. The Spanish influenza spent a calm summer, behaving much like the swine flu has in India.

Then, as the winter of 1918 approached, it turned deadly.

Here is the big reason for disquiet: all cases of what is called influenza A are descendants of the 1918 virus (that excludes humans infected by the bird flu, which is another strain). Its offspring infect both pigs and humans today.

Swine flu, then, is a close cousin of the Spanish pandemic. There is no foretelling where, how and when it may strike, and what turn it might take.

In 1976, a soldier at a US army base suddenly died — a day after feeling tired and weak — and five more were hospitalised. It emerged the virus responsible was swine flu, a strain of the 1918 Spanish version. Health officials panicked and at least a quarter of the US population was vaccinated, as 500 more died of an affliction related to an immune reaction to the vaccine.

There is no vaccine for the present swine flu outbreak. Viruses are tricky creatures, shuffling genetic codes faster than science can crack them. India is just starting work on a swine flu vaccine, but don’t hold your breath. In the US, home to some of the world’s most advanced disease tracking, there isn’t even a surveillance system for viruses circulating in pigs, from where the present virus jumped to humans.

Did this virus come from a 1999 outbreak of flu in American pigs? It’s very similar. But it’s also similar to a strain found in European swine. Did it maybe hop aboard migratory birds and make a trans-Atlantic journey to Mexico? Did it, then, combine with the American strain and piggyback, so to say, on Mexican farm workers to the US? Did it then spread and infect a 23-year-old who travelled from New York to Hyderabad on May 13, becoming the first recorded Indian case? Could all this be irrelevant if the virus dies out?

The questions will keep growing. We must ensure that our fears do not.