M A I N   N E W S

Fresh guidelines issued on H1N1 testing, treatment
Aditi Tandon
Tribune News Service

New Delhi, August 14
Confronted with mounting casualties on account of Influenza A H1N1, the government today effected major changes in the testing and treatment guidelines, saying not all patients with flu-like symptoms need to be screened, put on Tamiflu, or hospitalised.

Only those with all flu-like symptoms and added complaints of breathlessness, chest pain, drowsiness, drop in blood pressure, sputum mixed with blood and bluish discolouration of nails would be tested for H1N1 and immediately hospitalised for treatment priority.

The government also cited irritability among children and their refusal to accept food as a major warning sign and said such children would have to be tested immediately and put on treatment. Patients with worsening underlying chronic diseases would also get treatment preference.

All the above-mentioned cases have been placed in the Category C (highest risk), which, the government, said, would get absolute priority in screening and treatment. In all the cases of death due to swine flu so far, chest pain, breathlessness and associated illnesses have been found to be common. Moreover, with limited availability of testing kits, the government needed to identify those at actual risk of H1N1.

“Such patients should be treated for the symptoms they show, their progress should be reassessed at 24 to 48 hours by the doctor,” say the new guidelines, categorically stating that such patients should not be tested. They should be asked to stay home and not mix up with high risk members in the family, the government said.

Tamiflu however may have to be administered to Category-B patients, who would not require testing, said the government. This group comprises people with all flu like symptoms shown by Category A patients, plus high grade fever and severe sore throat. Also in this group are those at high risk - children under 5 years; pregnant women; those over 65 years; 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.

“This group would have to be given Tamiflu and would be recommended home isolation,” the government said, adding that no testing would be required for Group B, but doctors could put them on Tamiflu on the basis of listed symptoms.

These crucial decisions were taken following a five-hour long meeting between the government and public health experts from both the public and private sector. Chaired by health minister, the meeting was attended by representatives of private healthcare majors like Apollo, Max Healthcare, Rockland Hospitals, Public Health Foundation of India and Heart care Foundation of India. Doctors from AIIMS, RML and Safdarjung were also present, indicating that the government has managed to rope in private help for managing H1N1 spread in India.

Toll touches 26; experts doubt strategy
Aditi Tandon
Tribune News Service

New Delhi, August 14
Swine flu claimed more lives, two of them in Chhattisgarh on Friday, thus taking the toll to 26 even as the government decided to issue new guidelines for diagnosis and treatment of suspected patients to calm fear among the people. A 70-year-old woman, Parubhai Shinde, died in Pune while Sitaram Varma (18) and a 40-year-old CRPF constable succumbed in Raipur and Bilaspur, respectively. A 55-year-old man, Shivanna, died in Bangalore.

Meanwhile, India could well be harming its swine flu emergency preparedness plans by depending solely on Tamiflu to beat the obstinate H1N1 virus.

With the fear gripping the world of Tamiflu becoming ineffective against the deadly virus, some countries have even started supplementing their national stockpiles with drugs other than Oselmativir.

Back in India, however, the government is not yet thinking of using a drug combination to fight the fast-moving virus, though several public health experts have advised a strategy that depends on different anti-flu medicines instead of one. In a pandemic situation, the possibility of the virus developing resistance to one drug is always there, they said. “You have to have an alternative arrangement just in case a Tamiflu resistant strain emerges,” said an internal medicine expert.

But the government appears smug for now, with Director General Health Services RK Srivastava informing the Tribune that there was no plan yet of stocking any other anti-viral drug except Tamiflu.

As for Tamiflu, India has asked six pharma firms, including Ranbaxy, Cipla and Roche to produce more capsules for the national stockpile. But experts have apprehensions about the H1N1 battle strategy in most Asian countries, which are reposing too much faith in Tamiflu.

On Janmashtami, gaiety in Mumbai but Pune stays quiet

Mumbai, August 14
Despite warnings to stay indoors to prevent the spread of swine flu, hundreds of revellers today turned out in large numbers in various parts of Mumbai to participate in dahi-handi celebrations as part of Janmashtami.

Dadar, Girgaum and Parel in Central Mumbai saw huge crowds where local organisations hoisted handis several stories high for Govinda groups to form pyramids and break those open. Many Govinda groups were also seen wearing masks due to swine flu scare.

Film and television stars stayed away following an appeal by Chief Minister Ashok Chavan. The Congress, the Shiv Sena and the Maharashtra Navnirman Sena also did not organise celebrations on a very large scale.

Public celebrations were absent from Pune from where a large number of swine flu deaths have been reported. While the major organisers cancelled celebrations, people stayed indoors for most of the day. — TNS