New Delhi: India launched its effort to combat the potential spread of the swine-flu epidemic to the country, that includes round the clock individual surveillance of incoming passengers at key airports and ports, doubling its stock of antivirals, and asking people to minimize travel to the affected countries: Mexico, the US, Canada, New Zealand, the UK, France and Spain.
Swine flu is an influenza-like illness that affects the respiratory tract and spreads easily. If not treated early, it can be fatal and there are currently no vaccines for its prevention.
In a densely populated and inter-connected country such as India, the flu, if not contained, could quickly turn into a pandemic; India has not yet reported a single suspect case of the flu.
Meanwhile, the World Health Organization (WHO), which is coordinating the global response to human cases of swine flu, is evaluating the situation to decide whether to raise the level of alert to a pandemic.
On Monday, a joint monitoring group comprising senior officials from WHO, the ministry of health and family welfare and the department of animal husbandry met to chart out their action plan to prevent the entry of the flu into India. The officials claimed that close to 1,200 suspect cases have been reported in the affected countries thus far, resulting in 86 deaths.
“Those travelling to the affected areas—Mexico, US, Canada, New Zealand, Spain, France and UK—are advised to defer all non-essential travel. We are also tracking down people who have come into the country from Mexico in the last 10 days to check them for strains of the flu,” said V.M. Katoch, director general, Indian Council of Medical Research at a press briefing in New Delhi.
According to Katoch, all passengers flying into the country from affected areas will be individually checked for symptoms of swine influenza, such as fever, sneezing or cough. “Any suspected case will be quarantined and tested,” he added.
The monitoring group has also identified nine ports and airports—Delhi, Mumbai, Kolkata, Chennai, Bangalore, Hyderabad, Kochi, Jaipur and Goa—where doctors will be deployed 24x7 for flu surveillance.
“In two days from now, the surveillance will be in full swing. We will have 32 doctors round the clock at the Delhi airport and four doctors per shift will be deployed in the low traffic cities. We are still working on the number for Mumbai and Kolkata,” said Vineet Choudhry, joint secretary, ministry of health.
The official, however, declined to reveal the cost of anti-flu efforts, claiming that the government was still assessing the numbers.
“Our concern arises because there have been so many deaths. Otherwise, India has not had any influenza cases of transmission from humans-to-humans,” said Katoch.
Swine flu is similar to avian flu which, since 2003 has infected 351 people in 14 countries, killing 219 of them, according to WHO. No human infections because of the avian flu virus have been confirmed in India.
The government has also mandated the creation of a stockpile of one million doses of oseltamivir (brandname Tamiflu) and the monitoring group has recommended acquiring another million doses.
“This is a clinically proven drug for the treatment of swine influenza. We already had a stock left over from the procurement made during the avian flu outbreak, and we will be inviting interest for one million more doses through a tender. Companies such as Cipla, Hetero and Ranbaxy make this drug in India,” said Dr Shiv Lal, additional director general, National Institute of Communicable Diseases (NICD).
Scientists say they aren’t “shocked” by the emergence of such a contagious, deadly strain, but are worried that there are only few drugs to combat it. “Typically, influenza virus strains of pandemic potential come about once in 30-40 years. So, about four to six months back, the WHO had warned of the possibility of a new, dangerous strain,” said Sunil Lal, a senior scientist at the International Centre for Genetic Engineering and Biotechnology.
The current strain of the flu has been caused by a re-assorted swine flu virus and is a mix of four strains. According to WHO, “the virus is being described as a new sub-type of A/H1N1 not previously detected in swine or humans”.
“In case there is any influenza-like illness, the states have been advised to review and investigate it through their Integrated Disease Surveillance units,” said Choudhry. He added that a directive has been prepared for airlines to sensitize all travellers coming from affected states that they would be checked, tested and could even be hospitalized. “Besides this, we will also be issuing information circulars to passengers separately.”
A 24x7 call centre under the Integrated Diseases Surveillance Project will be attending to calls from the public regarding the reporting of influenza-like illness. (The number is 1075; another outbreak helpline, 23921401, will be operative under NICD).
The government’s action plan: move towards security
* Travel advisory issued to defer travel to Mexico, US, Canada, New Zealand, UK, France and Spain
* Surveillance at nine airports stepped up, doctors deployed to conduct tests on all people coming from affected areas
* Process begun to track down people who entered the country from Mexico in the last 10 days
* One million doses of drug oseltamivir have been stocked and one million more will be ordered
* 24X7 call centres started. Numbers: 1075 and 23921401
* States have been alerted to step up surveillance and the Centre will provide guidelines, experts, material logistics and laboratory support
* Directive will be issued to airlines to sensitize travellers into the country on the on-going surveillance activity at the airports
Jacob Koshy contributed to the story.