Referral cases add to swine flu death tally

PUNE: In Pune city, 579 swine flu casualties have been recorded since the virus first struck in 2009. However, the latest analysis of swine flu casualties in the city has revealed that 56% of the patients who succumbed to the virus-induced complications were not locals. They were, in fact, referred to hospitals in Pune city from adjoining areas for tertiary care treatment.
"We sifted through the medical records of 579 patients who had died of swine flu at public and private hospitals in Pune city between August 2009 and December 2017. Of them, 251 were local residents and the remaining 328 patients, who died of swine flu-induced complications, were not residents of Pune city. They were referred to the hospitals in Pune from adjoining areas for higher medical management," said Anjali Sabne, the assistant medical officer of health (AMoH), Pune Municipal Corporation (PMC).



"There has been a tendency among doctors practising in the peripheral areas and adjoining districts to refer swine flu patients to hospitals in Pune, especially when their conditions worsen," said Pradip Awate, the state surveillance officer. This is true especially for the doctors working in the periphery and rural regions of Pune, Ahmednagar, Satara, Sangli, Kolhapur and Solapur. "We have urged the doctors to treat patients at their own hospitals and have provided them with treatment guidelines. But the referrals continue," Awate added.

When such patients test positive for swine flu at hospitals here, they are added to the city's swine flu tally. "If such a referred patient dies here in Pune city, the death is listed among the city's swine flu deaths. In fact, the actual number of local residents, who contracted swine flu and died of it, is comparatively less," Sabne said.

"We have asked doctors to administer oseltamivir (Tamiflu or Fluvir) within 48 hours if a patient has swine flu-like symptoms and has no other co-morbid condition. Doctors should administer the medicines within 24 hours if the patient has other co-morbid conditions along with the influenza-like illness. But often the patients are not given the drug, and delayed treatment leads to complications," said senior public health expert Subhash Salunkhe.