Swine Flu Hits ‘Epidemic’ Proportions in India

The H1N1 virus spread across India, which till now has infected 12,000 people with 377 already succumbing to it, according to the Union Health Ministry.

Among the states that have been gripped by swine flu, Rajasthan is reported to have the highest number of people infected—3,508 , of which 127 have died. Gujarat comes second with 1,983 cases of infection and 71 deaths till now.

The capital city of Delhi has also seen seven deaths out of the infected ones that numbered more than 2,000.

The state Govt. of Punjab said that as many as 31 people have died of swine flu in the last four months. The total numbers of cases in Punjab have been reported as 410. Madhya Pradesh follows Punjab with 30 deaths and 128 cases so far. Himachal Pradesh has 224 infected cases and 27 deaths.

Jammu and Kashmir follows Himachal that has reported 22 deaths out of the 293 infected cases. In Haryana 7 people died out of the 752 cases of infection.

The Union Health Ministry’s data showed that 12,191 people have been detected positive with H1N1 virus this year as of now, while last year the number was 14,992 cases with 1103 deaths.

The acute cases of swine flu need intensive care and ventilator facility. Keeping this in view, the Health Ministry has asked the states to strengthen surveillance for early detection and also to keep beds ready for severe and acute cases.

The Infection and the Severity

The H1N1 virus attacks the respiratory tract which makes breathing and oxygen absorbing difficult for the patients. In normal cases, it is cured with flu tablets. Some patients may need oxygen support and recovery takes place within a week.

But in a severe condition a patient might develop major lung infection known as Acute Respiratory Distress Syndrome (ARDS). Under such condition, the patient needs higher oxygen support and if further deterioration happens then the patient has to undergo ventilator support. In a situation where even  ventilator support is not sufficient, the patient needs to be put on the ECMO, which is a machine that functions like an artificial lung.

ECMO—Extra Corporeal Membranous Oxygenation -- is the artificial lung. This machine does the gas exchanges outside the body. A patient that has developed ARDS due to severely impaired function of the lungs suffers from scarcity of oxygen in the blood. This is because it is the lung where oxygen is absorbed through the exchange of carbon dioxide to the air. The ECMO facilitates the process of oxygenating blood and removal of carbon dioxide outside the body. In other words, the ECMO takes over the function of the lungs.

While the ECMO success rate is higher in the West, India is still in the learning phase of its use. The cost of this technique is also higher and most of the government hospitals, especially in interior areas lack this facility. The government, on its part, should take steps in making this facility accessible to a larger section of people. The lack of these facilities claims the lives of patients that develop severe and acute infection by the swine flu virus.

H1N1 is a self-limiting virus that transmits from person to person through large droplets that come out to air by coughing and sneezing by indirect contact like touching the contaminated object or surface and direct contact like handshaking, kissing, hugging.

The best way to avoid the infection of this virus is to avoid touching eyes, nose or mouth without washing hands, avoiding spiting in public, and by avoiding disposing used napkins or cloth in open areas.