With every winter come respiratory illnesses that cause a significant amount of morbidity and mortality worldwide, especially among children and the elderly.
A majority of the deaths caused by these respiratory illnesses are due to the Influenza A virus that kills over 300,000 people annually. According to the latest report of the Centre for Disease Control (CDC), between 291,000 and 646,000 people die worldwide of seasonal influenza-related respiratory illnesses each year. This estimate is higher than a previous estimate of between 250,000 and 500,000.
The infectious nature of this virus is such that it spreads very quickly and can sometimes rapidly turn into an epidemic. It is important to monitor the activity of this virus every year to prevent it from spreading and causing unnecessary morbidity and mortality. For this particular reason, the CDC, WHO and other international organisations have put influenza surveillance programmes in place to monitor the virus every year.
This year, it seems that we are seeing an increase in the number of cases of the flu worldwide. Pakistan is also seeing more than the usual number of Influenza A virus cases this year. There have already been 29 deaths reported in Multan whereas new cases of this virus are being reported on a daily basis across Pakistan. The particular virus that seems to be spreading in Pakistan is Influenza A H1N1, commonly known as the swine flu.
This virus was first reported in Pakistan in 2009 and has caused significant morbidity and mortality since then. This year seems to be worse than the previous one and we are not even close to the end of winter. Most of the deaths that have occurred in Pakistan have been due to the inability to recognise the signs and symptoms of the disease in time.
A late diagnosis in turn leads to complications in the infected person and helps spread the disease. The number of deaths that have been reported is a warning that if nothing is done, the virus can very easily turn into an epidemic and cause unnecessary deaths. A comprehensive and a well-thought-out plan needs to be put in place by the government and the healthcare sector to prevent the situation from spiralling out of control.
First and foremost, people need to be aware of the signs and symptoms of the flu and be able to differentiate it from other respiratory illnesses. Experts in the field should utilise all available forums like seminars, conferences and the media to reach out to the people as well as healthcare workers so as to create awareness. The next step should be the availability and affordability of diagnostic facilities. In Pakistan, the diagnostic tests for influenza are expensive and unaffordable for most of the population. The government needs to take measures and make these diagnostic tests affordable and available for the people.
We also need to have proper facilities and appropriate management for patients afflicted with the virus. The government and private healthcare centres need to have facilities such as isolation wards available as it is a highly contagious virus. The resources and treatment should be available in every medical facility and the government should ensure that the hospitals don’t run out of their stock of medicines.
There is a quadrivalent vaccine available for influenza. An active vaccination campaign against the flu should be made a part of the public health policy of the country. Everyone should be encouraged to get vaccinated against influenza, especially healthcare workers, pregnant women, children and the elderly.
Another latest and an alarming development is that there is a mutated form of Influenza A, the H3N2 virus, which is wreaking havoc in the US and other parts of world. According to experts, the current influenza vaccine only gives 30 percent protection against the virus. The presence of this strain of the virus is yet to be reported in Pakistan. But with the world being a small place where people frequently travel, there is a chance that we might see it surface in Pakistan soon.
Whether it is the H1N1 or the H3N2 virus, healthcare workers and infectious disease specialists should be concerned. If this outbreak is not dealt with in an effective and organised manner, we might suffer serious consequences that result in unnecessary deaths and long hospital stays, which could have been prevented.
The writer is a pediatric infectious disease specialist at Fatima MemorialHospital, Lahore.