Cases of H1N1 influenza continue to surface in many parts of the State. However, the Directorate of Public Health (DPH) has made it clear to doctors to recognise symptoms of high grade fever and sore throat early and prescribe Oseltamivir.
So far, the State has seen nearly 1,300 cases of H1N1 influenza and 17 deaths. “Five to six more persons have died due to the influenza and we are waiting for reports to add to the data,” K. Kolandaiswamy, director of public health and preventive medicine, said.
Anxiety of patients
While there were 20 testing centres — six government centres and 14 private ones — for H1N1 influenza in the State, he said: “Only those in category ‘C’ require investigation.” He added that a lot of general practitioners were not waiting for the category ‘C’ stage, and instead were recommending tests much ahead, in part measure due to the anxiety of the patients to test themselves.
Category ‘A’ are patients with mild fever, cough/sore throat and require no testing or Oseltamivir. Category ‘B’ patients are those with high grade fever, severe sore throat and high risk conditions such as children with mild illness, pregnant women, persons aged 65 and above, patients with diseases of the lungs, heart, liver, kidney, and diabetes. Category ‘C’ patients have signs and symptoms of categories ‘A’ and ‘B’ and one or more of the following such as breathlessness, chest pain, fall in blood pressure and worsening of underlying chronic conditions.
“In case of patients with high grade fever, sore throat and respiratory symptoms, we advice doctors to start Oseltamivir and an appropriate antibiotic so that morbidity and mortality can be reduced. The problem is that this is not being done, and treatment is being initiated after 4-5 days,” he said.
Streamlining protocol
J. Radhakrishnan, Health Secretary said the focus was on streamlining protocol by ensuring that suspected persons in category ‘B’ and category ‘C’ are immediately provided with Oseltamivir. “The present technical guidelines of treatment mandate initiation of Oseltamivir within 48 hours of onset of symptoms. Due to anxiety, everyone wants to get tested, but actually this is not necessary,” he said.
V. Ramasubramanian, director of medical services and infectious diseases consultant, The Capstone Clinic, said there is an outbreak of H1N1 influenza but it was not alarming. Janani Sankar, senior consultant, paediatrician, Kanchi Kamakoti CHILDS Trust Hospital, added that the number of cases have come down in the last one week. “We are reassuring persons that only category ‘C’ children require admission, investigation and treatment. We insist on hand hygiene and cough etiquette,” she said.
In Madurai, the number of cases has begun to show a significant decline. The number of new cases reported a day was around 12 last week, and has come down to five on Monday and Tuesday, Health Department officials said. A senior health official in Coimbatore said the number of diagnostic facilities were adequate to handle cases as per the current trend. Both Thoothukudi Medical College Hospital and Kanniyakumari District Government Medical College Hospital are sending the samples to Tirunelveli Medical College Hospital (TVMCH).