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Swine flu cases on the rise, hospitals not adhering to health ministry guidelines

LiveMint logoLiveMint 29-08-2017 Neetu Chandra Sharma

New Delhi: Authorities have failed to contain deaths due to Swine Flu (H1N1)—although there has been no mutation in the virus this year (the virus was last mutated in 2015), as many as 1,094 people have died from the virus in 2017 till 23 August.

The National Centre for Disease Control (NCDC) last week analysed the situation and found out that there is a major lag in management of cases and adherence to the Swine Flu guidelines issued by the Union Health Ministry to prevent and contain outbreak of H1N1 virus. The worst-hit states are Maharashtra (4,245 cases), Gujarat (3,029) and Tamil Nadu (2,994). Most deaths have taken place in Maharashtra (437), Gujarat (237) and Kerala (73).

As per the guidelines, there are three categories of patients. Patients with mild fever plus cough/sore throat with or without body ache, headache, diarrhoea and vomiting will be categorized as Category-A. They do not require Oseltamivir (tablet used for treatment of swine flu) and should be treated for the symptoms. Category-B patients have high grade fever and severe sore throat along with category A symptoms. In addition to all the signs and symptoms mentioned under Category-A, individuals having one or more of the following high risk conditions come in category B -- children with mild illness but with predisposing risk factors, pregnant women, persons aged 65 years or older, patients with lung diseases, heart disease, liver disease kidney disease, blood disorders, diabetes, neurological disorders, cancer and HIV/AIDS, patients on long term cortisone therapy. Broad Spectrum antibiotics are prescribed and the patients should confine themselves to home.

In addition to the signs and symptoms of Category-A and B, if the patient has one or more symptoms, such as breathlessness, chest pain, drowsiness, fall in blood pressure, sputum mixed with blood, bluish discolouration of nails, children with influenza like illness who had a severe disease as manifested by the red flag signs (Somnolence, high and persistent fever, inability to feed well, convulsions, shortness of breath, difficulty in breathing, etc.). All these patients in Category-C require testing, immediate hospitalization and treatment.

“There is no adherence to guidelines and the management of Category B patients are dying. We sent our teams to the Maharashtra, Gujarat and Tamil Nadu to train doctors to manage category B patients. The Virus has not mutated but the virus has an uncertain behaviour every year,” said Dr A C Dhariwal, Director, National Centre for Disease Control (NCDC).

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