CALL THE SHOTS
as the number of H1N1 cases in India soars by 17 times, with delayed diagnosis a major cause of a rising death toll
Her first pregnancy went so smoothly that Archana Panigrahi, 34, foresaw no problems with her second. But then she contracted a fever last month, during her fourth month, which quickly escalated to breathlessness and chest pain.
“On the second day of the fever, my blood pressure fell and my husband rushed me to my gynaecologist, who referred me to a hospital emergency ward,” recalls Panigrahi, a teacher at a private school in Gurgaon.
She was diagnosed with H1N1, or swine flu. “I was terrified that I would lose my baby, but I responded to antiviral treatment and was home in five days,” Panigrahi says. “It was only at my next follow-up that the doctor told me the situation had been touch-and-go… he says if I had waited even a few more hours, I would have lost my baby and perhaps my life.”
TESTING TIME
Unlike in most countries, where children under 5 years and adults over 65 are at greatest risk of contracting swine flu, H1N1 is infecting adults in India.
“Those aged 20 to 60 are also being hospitalised, often because they were diagnosed late,” says Dr KK Aggarwal, president of the Indian Medical Association (IMA).
Does this mean everyone with fever or a cough needs to be tested?
No, says Dr Agarwal. “Current IMA recommendation is ‘no fever, no flu; no breathlessness, no testing’. If you have a cough without fever, it’s not seasonal flu, and if you have fever without breathlessness, you don’t need to get tested for H1N1,” he said.
Instead, he adds, the focus must be on prevention. “People at risk must get vaccinated and, if they develop symptoms, get treated with antiviral drugs to lower their chances of developing potentially lifethreatening complications,” says Dr Malvika Sabharwal, gynecologist and obstetrician at the Nova Specialty Hospitals of the Apollo Healthcare Group, New Delhi. “The key is management, which can be done at home, if it’s done right.”
SHOT OF LIFE
Swine flu is a highly contagious disease that causes symptoms of fever, cough, breathlessness, lethargy, headache and nausea. Most people recover within a week, with deaths occurring from complications such as pneumonia and multi-organ failure in people at risk, such as children with respiratory problems, pregnant women, older adults and those with chronic ailments such as asthma, lung disease, heart disease or diabetes.
With H1N1 cases up 17 times this year as of September 10, the last date for which all-India data is available, physicians are saying annual vaccination is now a must for people at risk.
“I strongly recommend the quadrivalent flu vaccine to women planning to conceive and to pregnant women, preferably in the 26-week of regency,” said Dr Sabharwal. “The vaccine cannot be given to babies younger than six months, so vaccinating the mother during pregnancy gives protection to the baby after birth.”
Prevention is the only way to bring down infection and death rates, adds a Union health ministry official. “India has extensive guidelines for vaccination and we’re now working to ensure people who need it get vaccinated.”