Delay in treatment could be the main reason behind deaths of patients with swine flu or H1N1 infection, a preliminary study conducted by the Maharashtra health department has found.
Not a single patient who died of swine flu infection in Nagpur, which has recorded the highest mortality, were administered Oseltamivir, anti-swine flu drug, within 48 hours of onset of symptoms. Majority of the deaths were of urban residents.
On Thursday, a 45-year-old woman from Bhopal, Madhya Pradesh, died of swine flu at Kokilaben Dhirubhai Ambani Hospital (KDAH). She is the seventh person to die of H1N1 infection at a Mumbai hospital since January. The woman was admitted to the hospital four days after experiencing symptoms and was also a thyroid and hypertension patient. “She had severe pneumonia and was air-lifted to our hospital in a critical condition. She had a very severe lung injury owing to the infection,” said, Dr Vatsal Kothari, an intensivist at KDAH.
While 57 Mumbaites have contracted swine flu infection since February, another 33, who are not residents of Mumbai, are being treated for swine flu at city hospitals. This year, 296 cases of swine flu and 43 deaths have been recorded in the state.
“It is known that Oeltamivir, if administered within 48 hours of onset of symptoms, is more effective. After our analysis, we have asked doctors to administer patients with this drug if their symptoms aggravate despite routine flu medications. Also in case of patients with co-morbidity, the drug should be started on day one of symptoms,” said Dr Pradeep Awate, in-charge of swine flu, state health department. He said 62% of deaths were among women.
Nagpur district was selected for the analysis as maximum deaths were recorded there. Thirteen deaths were analysed by the doctors and health officials. The health department’s analysis found that 62% of the patients who died of swine flu had pre-existing illnesses such as diabetes and hypertension. Doctors said any chronic illness can reduce the patient’s immunity to fight against the disease.
The state health department has even directed doctors to administer medicines to patients even before their swine flu test report arrives. “There is no need to wait for the throat swab result to put the patient on treatment,” said Dr Awate.
“Oseltamivir, if given within three days of onset of swine flu symptoms, works best. By the time, you get to the fifth day, the patient starts shedding the virus by himself and hence early treatment is the key to better outcome,” said Dr Om Shrivastav, director, infectious disease department, Jaslok Hospital, Peddar Road.