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Thursday, Oct 17, 2019

Uttarakhand reports over 40% mortality rate from swine flu in January, toll reaches 11

The death toll due to swine flu in Uttarakhand rose to 11 on Wednesday after a one-year-old boy from Uttarkashi succumbed to the disease in Dehradun’s Shri Mahant Indresh Hospital (SMIH).

dehradun Updated: Jan 24, 2019 16:16 IST
HT Correspondent
HT Correspondent
Hindustan Times, Dehradun
Dehradun-based Shri Mahant Indresh Hospital has the state’s only laboratory approved by the National Centre for Disease Control to test samples and check for symptoms of the disease.
Dehradun-based Shri Mahant Indresh Hospital has the state’s only laboratory approved by the National Centre for Disease Control to test samples and check for symptoms of the disease.(HT Photo )
         

The mortality rate in swine flu this year has become a cause of concern in Uttarakhand. In Dehradun, 11 deaths due to the disease have been registered so far out of the total 27 confirmed cases of H1N1 influenza.

The death toll due to swine flu rose to 11 on Wednesday after a one-year-old boy from Uttarkashi succumbed to the disease in Dehradun’s Shri Mahant Indresh Hospital (SMIH).

A 72-year-old French national suffering from the disease had died on Sunday at Max Hospital.

In 2017, the number of deaths in comparison to the total number of swine flu cases stood at around 12% (157 confirmed cases with 19 deaths). Last year, the figure increased to a little over 18% (11 confirmed cases with two deaths). In comparison, the number of deaths reported are more than 41% of the total number of cases registered this year.

While the World Health Organization has declassified it from its list of epidemics, the health department is increasingly trying to underplay the scenario.

Number of suspected patients who have contracted the disease continue to increase across various hospitals in Dehradun.

Lab testing of flu

Seven of the 10 deaths registered so far have taken place in Dehradun’s Shri Mahant Indresh Hospital (SMIH).

Currently, SMIH has the state’s only laboratory approved by National Centre for Disease Control (NCDC) to carry out testing for swine flu disease. Despite the same, on January 16, a team of six members was constituted by the health department to conduct a ‘death audit’ of the mortalities reported by SMIH. Even though a week has passed since the constitution of the committee, there is no update regarding the report of the death audit.

“We only consider the reports which test positive in NCDC’s lab in New Delhi. According to that, there have been just three swine flu deaths in the state so far,” director general of health Dr TC Pant said. When asked about the reports from SMIH’s lab, Pant said, “Once we get the same results of the samples from NCDC’s Delhi lab, we will add them to the tally as well.”

Contrary to the DG’s statement, the official swine flu count given by the chief medical officer of Dehradun also includes the cases that test positive at SMIH.

While Max Hospital in Dehradun also has a microbiology lab, its results are not given weightage by health authorities since it is not approved by NCDC.

Last year in August, the health department had written to central government with a proposal for setting up a swine flu testing lab in Dehradun. After an inspection, the Centre had granted approval for setting up the lab in Government Doon Medical College Hospital (GDMCH) after listing down certain requirements as per NCDC’s standards. Hospital’s microbiology lab needed to be upgraded as per those requirements.

“We have issued the tender for the procurement of the materials that was listed by the Centre. The same has been conveyed to Centre by a letter as well. Hopefully, we should get the system in place within a month,” said Dr Yogendra, in-charge of GDMCH’s microbiology lab.

Testing guidelines

It is also notable that as per GoI’s guidelines, only patients of category C (exhibiting severe symptoms of the disease) are required to be tested for H1N1. Doctors are required to start treatment if the patients exhibit any symptoms of the disease and do not have to wait for the test reports.

However, the scenario is different. “Patients of category C also exhibit co-morbid illness, that is they have some other disease as well. The doctor first starts treating them for the same rather than for H1N1. It is generally later that the patient is tested for swine flu after being suspected of it. Due to this, it sometimes becomes too late and the patient succumbs to the disease,” a doctor said.

Changing nature of the H1N1 virus

Generally, an outbreak of swine flu would occur in the rainy season, that is July to September. For the past few years, cases have also started surfacing in deep winters, starting from December and continuing till March beginning.

“As per the changing conditions, every virus undergoes mutations and keeps upgrading itself. Initially, no cases of swine flu used to emerge in winters, which is not the scenario now. Moreover, owing to the number of deaths occurring this season, it is possible that the virus has become more potent,” said Narotam Sharma, a scientist conducting research on the virus and also the in-charge of SMIH’s molecular diagnostics division.

Health officials, however, say most of the deaths occurred as the patients were suffering from other diseases as well. “If the patient has some medical history which weakens his immune system, then the virus becomes more dangerous for him. This is also the reason behind many of the deaths this season,” a health department official said. 

First Published: Jan 24, 2019 16:16 IST

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