Core Programme Clusters

Communicable Diseases and Disease Surveillance

 

Influenza A (H1N1)

Three cases of the new influenza A(H1N1) virus have been confirmed in India. The Ministry of Health and Family Welfare confirmed the first case in a 23-year-old Indian national who traveled from the US transiting through Dubai to arrive in Hyderabad on May 13, 2009. Two Influenza A (H1N1) positive cases were confirmed on June 1, 2009 - an Indian woman and her five-year old son - who had traveled from Boston to Coimbatore in Tamil Nadu and self reported to the health department. While the two tested positive, another member of the family who traveled with them, an eight-year-old girl, has tested negative for Influenza A (H1N1).

All passengers who traveled with the family to Coimbatore are being contacted through the Integrated Disease Surveillance Project for monitoring their health status. The Government has appealed to all passengers who traveled on the flight to self monitor for influenza like illness - fever, cough, difficulty in breathing. 

The Government is communicating risks, personal protective measures and preventive guidelines through mass media. The Ministry of Health and Family Welfare is rolling out a structured media campaign on preventive behavior for flu, what people should do in the event of flu and whom to report to etc.

WHO is also supporting the Indian Red Cross for strengthening community awareness and preparedness to deal with Influenza A(H1N1) through the 12 million members and volunteers of the Indian Red Cross working at the Centre, states and district levels.

The ongoing outbreaks of influenza in humans was initially observed in Mexico and USA. This new Influenza virus has since spread to other countries, including the Americas, Europe and Asia.  Based on available epidemiologic information about the geographic spread, human-to-human transmission, and ability of the virus to cause community level outbreaks, the Director General of WHO has raised the influenza pandemic alert to Phase 5 out of 6 on the advice of the International Health Regulations (IHR) Emergency Committee.

With the onset of Phase 5, WHO recommends that countries should activate pandemic plans addressing surge capacity in critical services, mitigation measures such as personal hygiene, social distancing and isolation of cases and close contacts, enhanced surveillance for disease using the WHO case definitions, reporting of cases, and activation of communications to ensure the widest possible dissemination of information. The latest situation and recommendations can be found at the following website http://www.who.int/csr/disease/swineflu/en/index.html

The clinical manifestations of the illness are similar to that of human seasonal flu which is characterized by high fever and upper respiratory symptoms such as cough and sore throat.  Vomiting and diarrhea have been also been reported in cases of Influenza A (H1N1) virus of swine origin.  A proportion of the cases develop severe acute respiratory illness/infection (SARI) or pneumonia requiring hospitalization.  The illness has resulted in deaths so far in Mexico, USA, Canada and Costa Rica. Epidemiological risk factors that raise suspicion of an influenza like illness (ILI) being due to the new Influenza A (H1N1) swine-origin infection include recent travel to an area where there are confirmed cases or close contact with a confirmed case when the person was ill.  The virus is reportedly susceptible to antiviral agents oseltamivir and zanamivir. Although the illness has been initially termed “swine flu” and the causative organism as “swine-origin” flu virus since it is a reassortant strain from swine influenza viruses, infection with the new influenza A (H1N1) virus has not been shown to be transmissible to people through eating properly handled and prepared pork or products derived from pigs. Details about the disease, its transmission, risk factors, personal protection, treatment etc can be accessed from the following websites:

http://www.who.int/csr/disease/swineflu/faq/en/index.html

http://www.searo.who.int/en/Section10/Section2417_14877.htm

http://www.cdc.gov/swineflu/

The Government of India has initiated a series of preventive actions approved by the Inter-Ministerial Task Force (IMTF) on Influenza at its meeting held on 28th April 2009.  Passengers arriving from the affected countries with flu like symptoms are being screened and suspect cases transferred to identified hospitals for follow up.  Citizens of India have been advised to defer non-essential travel to countries reporting the disease. All health care facilities in states under the country’s Integrated Disease Surveillance Project (IDSP) and medical colleges are being activated to report on ILI and SARI/Pneumonia cases. A 24x7 number 011-2391401 has been activated to receive calls from the public for enquiries about the disease and to report ILI.

The Government is scaling up its oseltamivir stockpile of one million doses tenfold. Oseltamivir and necessary supplies such as personal protective equipment kits and three-layered surgical masks are being distributed to the states.  A preparedness and coordination meeting was held with the Directors Health Services of States/UTs under the chairmanship of DGHS to discuss  actions taken by the centre and activities to be undertaken by the states especially heightened surveillance, prompt collection, and transportation of clinical samples to referral laboratories. http://nicd.nic.in/Tdr_CDA_Swine.pdf

 

 

 

Useful Links:

1.      Ministry of Health and Family Welfare

2.      WHO South-East Asia Regional Office (SEARO)

3.      WHO HQ

4.      Centers for Disease Control and Prevention (CDC)

 

 

*  Situation Updates

*  Frequently asked questions

*  Director-General’s statement

* Personal protection measures

* Briefing to Diplomatic and UN Missions

 

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