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A 14-year-old girl in Pune, Maharashtra, has become the country’s first swine flu-related death. Overall, India has reported 558 cases of swine flu, says the health ministry
The H1N1 virus, or swine flu, has claimed its first life in India with a 14-year-old girl dying of multiple organ failure at a private hospital in Pune on Monday, August 3, 2009. She was a Class IX student. Officials say three doctors and a nurse who looked after the girl are being treated with Oseltamivir; 85 people have been put on prophylaxis, and 31 people, including 11 family members, are on chemoprophylaxis. The girl’s death raises concerns as, until now, experts have been calling the virus in India a mild strain capable only of expressing itself in a self-limiting form of the disease. Health Minister Ghulam Nabi Azad said that the health ministry would now issue new guidelines to private hospitals on handling swine flu patients. The girl, who was admitted to a private hospital, received the right treatment but “too late”, Azad told a television channel. “It is a deterrent that when a person develops symptoms of flu it is compulsory that he be hospitalised and isolated. Most people don’t like that. We have had talks with experts and doctors and are going to issue new guidelines which say that it is not necessary to isolate a person at the first instance. “There should be tests conducted and if the person tests positive for the H1N1 virus then it can be decided if he needs to be hospitalised or put under medication. This will be a relief to people,” the minister added. The new guidelines will also allow certain private hospitals to collect samples from suspected H1N1 virus patients and send them for laboratory testing. “No private or government hospital has a laboratory where the sample of the virus can be tested. There are 18 laboratories in the country where the tests can be done. But we will now issue guidelines which will designate some private hospitals across the country to take samples from suspected patients and then send it to the laboratories to be tested,” Azad said. “We will try to test and give the results within 24 hours. The patient can then be treated at his or her residence, or be hospitalised.” Explaining the history of the Pune case, Azad said the teen had developed a fever and was taken to a doctor who treated her for ordinary flu. She returned home. When her condition did not improve she was taken to a private hospital where she was treated for ordinary flu for the first two days. “When her condition deteriorated and her lungs were affected then they (the hospital officials) realised that it was not normal because flu doesn’t affect the lungs. But by that time it was too late. It was too late for the Tamiflu medication,” Azad said. Dr Prasad Muglikar, medical superintendent at the private hospital in Pune where the 14-year-old was being treated, said: “She had vague and non-specific symptoms. After admission, her condition deteriorated rapidly and she had to be put on a ventilator. As part of the investigations, we sent samples to the NIV. They confirmed she was infected with the H1N1 virus.” The Maharashtra government has designated two Pune hospitals -- Naidu hospital and Yashwantrao hospital -- to treat swine flu patients. It is unclear why the private hospital did not move the girl to one of these hospitals despite the NIV confirming it as a case of swine flu two days ago. Eleven schools in Pune have reported outbreaks of swine flu; 72 children out of 101 cases contracted the disease due to “indigenous transmission, with no history of travel”. Most cases in the rest of the country are linked to travel abroad. A two-member health ministry team led by Dr Jagdish Singh, senior epidemiologist at the National Centre for Disease Control (previously National Institute of Communicable Diseases), is already in Pune. “The team reached yesterday and they are doing a review,” said Dr Pradeep Avte, nodal officer for swine flu in Pune. The number of people affected in Pune shot up when a team of students returned home after a trip to Indiana in the US. “One of the students who returned contracted the disease there and he passed it on to a cousin who is a student of another school. The cousin in turn passed it on to 22 others. Cases have been spreading like this from one school to another,” Avte said. Panchgani, in Satara district neighbouring Pune, is another hot spot -- all 23 cases in Panchgani involve children, four of whom have been admitted in Pune hospitals. India recorded its first H1N1 case in Hyderabad on May 16; since then the virus has spread to almost 22 cities across the country. Seven more people have tested positive for the virus, taking the total number of cases in the country to 558. Of these, 470 patients have been discharged after treatment. About 2,479 people have been tested so far. India’s announcement of the death came soon after the first fatality due to the virus was reported from Africa, the only region in the world that had not reported any deaths until Sunday night. The death in South Africa of a student on Monday means that the virus has now killed people in every part of the world. Source: The Hindu, August 4, 2009
The Indian Express, August 4, 2009
http://www.bloomberg.com , August 2009
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