Threat of swine flu outbreak looms large

Islamabad

The number of swine flu cases is on the rise and the threat of its outbreak is much serious though the concerned government authorities have not taken appropriate measures so far for case management, surveillance and to check its transmission.

Pakistan like many other countries in this region of the world is at high risk of facing a possible outbreak of influenza H1N1, swine flu due to frequent travel of persons to and from the endemic countries. There is no mechanism at the moment to identify the suspects from among the travelers, nor are there any scanners installed at our national ports.

The majority of our healthcare facilities including secondary and tertiary care hospitals do not have required equipment for protection of healthcare professionals nor are the healthcare facilities able to follow isolation standards for swine flu suspects. Also majority of staff including nurses and doctors at almost all private and public sector hospitals are not trained on barrier nursing required to provide treatment to a patient of swine flu in isolation to avoid its spread.

Most of the healthcare facilities in twin cities of Islamabad and Rawalpindi do not have personal protective equipment of international standards and N-95 masks to avoid spread of swine flu while providing treatment to a patient of the disease, said District Health Officer at ICT Health Department Dr. Najeeb Durrani while talking to ‘The News’ on Monday.

He added that the situation may become more alarming in the coming days and at the time, maintaining a high level of vigilance and exercising preparedness among staff in at least all secondary and tertiary care hospitals should be a timely objective of the senior health managers and policy makers at the national and provincial levels. “Public awareness is also an important measure to be adopted in the current scenario.”

He said that Personal Protective Equipment (PPE) including N 95 masks, proper gloves, face shields and gowns are to be stockpiled urgently. “A very timely requirement that is lacking is the establishment of isolation units, wards in hospitals and their functioning by technically trained staff for highly infectious diseases.”

Keeping in view our recent experience of Human Influenza A H5 N1 outbreak and the pandemic of Influenza A H1N1 2009 infection, establishment of standard isolation units is the most important field to work on, said Dr. Durrani while responding to a query.

He said the bitter fact is that upon knowing the admission of a patient of a highly contagious disease like swine flu, the staff just tries to avoid proper management due to fear of contracting infection or due to not being trained in infection control protocols or due to the unavailability of sufficient quantity of PPEs.

He said that almost all primary and secondary health care settings in the country are devoid of the facility of such treatment centers with standard isolation facilities having bio-safety measures and barrier nursing facilities.

He believes that good outbreak control relies on applying a package of interventions, namely case management, surveillance and contact tracing, a good laboratory service and social mobilization. “Early supportive care with rehydration, symptomatic treatment improves survival.”

He said that community engagement is a key to successfully avoid and control outbreak of swine flu. Raising awareness of risk factors for the disease and protective measures that individuals can take is an effective way to reduce human transmission, he said.

He explained that the risk of human-to-human transmission from direct or close contact with people with swine flu symptoms should be reduced. Gloves and appropriate personal protective equipment should be worn when taking care of swine flu patients and regular hand washing is required after visiting patients in hospital, as well as after taking care of patients at home, said Dr. Durrani.