First Swine flu death in India: What initiatives should be taken at least now?

We first of all need to make sure we are educated enough about the symptoms of H1N1, second take precautionary measures. In offices it would a good idea to invite a doctor who can educate and make people aware about the facts and myths about this disease. This would certainly help.

Thanks Claudio, Markand and others for their valuable insights regarding Swine flu and thanks for the Links that you both have given...it was very useful and very informative....i think countries should carefully monitor what is happening and should give advice and information regarding the disease, as recently there was chaos as thousands of people thronged to hospitals in fear whether they had contracted the disease...

Hi Bindu, Hi everybody,

even if I'm no expert at all, I've kept an eye on the outbreak since its beginning.

I'm Italian, we've got to around 1.000 cases in our country (no deaths).

I did not approve the no-alarm approach of the governments to the pandemics. I think the reason for that is merely economic.

Before the change of the strategy of monitoring (mid-july) I published an article at http://www.rihoir.it/rihoir_info/8/nuova_influenza_A(H1N1)_il_punto_di_meta'_luglio.aspx (italian language, good luck with automatic transalation but graphics are clear.

First, with respect, I won't trust governments. The point is our purpose are different. They want to manage the problem, I want to know the truth about what's going on. Think about it, it's not the same. On the contrary, the first can hinder the second.

The current WHO monitoring from WHO (http://www.who.int/csr/disease/swineflu/updates/en/index.htm) is IMHO insufficient. The focus on hospitalized cases prevent us from calculating CFR. Germany is still an old-fashioned and reliable country for which calculating a CFR is possible.

If you what to have a global update on country base, you can get it at ECDC http://www.ecdc.europa.eu/en/Health_topics/novel_influenza_virus/2009_Outbreak/; this is the best you can have around.

Solutions:

- vaccine = to long and late (and dangerous, I think) to represent the only solution.

- a good issue to think about is going towards the virus (be infected with the virus), instead of avoiding it. At the moment the virus hasn't mutated and there are very good probabilities you'll recover briefly and develop antibodies. So I would not exclude this one as an option. The trend was pretty clear, the CFR in the U.S.A. passed from 0,2% (5th June) to 0,7% (24 July). If this is true this is the fatal risk in getting the H1N1 flu by now. You have 993 chances on 1,000 cases to go through it and this is a gross probability, including groups at increased risk of severe or fatal illness include people with underlying medical conditions. Healthy people must have higher favourable chances.

Best regards,

cs

New & strict guideliness will not help....for the sake of the vast majority of the Indian public, though, surveillance is even more critical but takes a very different form. Instead of waiting for people to come to facilities, it is important for outreach on a regular basis to find out what the health status and needs of the people are into. This would be a much more reliable guide to good public policy, saving large numbers of lives on a continuous basis.

Yes Bindu i agree with you there is no proper coordination in this regard, as such there was complete chaos in Pune after the death of that girl and as Government has warned not to go to private hospitals for these cases but only to Government hospitals which has necessary facilities regarding swine flu.

The link is very useful thanks bindu.

Isolation, Prevention and coordination

The answer of WHO to the concerns raised by the press about safety:

- briefing note 6, 6th aug 2009 http://www.who.int/csr/disease/swineflu/notes/h1n1_safety_vaccines_20090805/en/index.html

- press briefing (11 pages), 6th aug 2009 http://www.who.int/mediacentre/pandemic_h1n1_presstranscript_2009_08_06.pdf

Hi Bindu,

you touch another problem. Vaccine is subjected to strict procedures, normally, for productiction testing and approval. Not in this case. And this can be an added risk itself. We could have an unsafe vaccine being administrated on peoples. This an interesting article from Spiegel Online International http://www.spiegel.de/international/germany/0,1518,640853,00.html Please bear in mind that Germany is one of the few countries that is maintaining the traditional methods of lab-confirmation on all cases (100%) against the directives of WHO, which is recommending to focusing on lab-confirmation of hospitalised and severe cases only.

Best regards,

cs