Swine Scare

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In anticipation of bone-chilling winter, the people have started felling victim to the scare that HINI is around. Saima Bhat reports that the virus has always been around but not everybody needs an HINI shot in the arm

As the winter has set in and mercury is dipping with every passing day, 26-year-old Shaheena’s worries mount. A professional banker, she has a weak immune system. Whenever she comes in contact with any flu patient, she catches it and at least for a week she has to be in bed.

She can not live in isolation. Her job profile involves interacting with customers coming from diverse age groups and different backgrounds. Normally she would get an infection and proceed on leave. But the increasing scare of H1N1 virus (swine flu) is giving her sleepless nights.

“The scare is from last few years,” Shaheena said. “I use a mask throughout the winter and I avoid travelling in public transport as well.”

Not taking a chance, she consulted her family physician and was first to have H1N1influenza virus vaccine ending September, against the advice of the doctors. It was fear triggered by the flu scare that doctors were apparently treating.

Shaheena is not the only person getting goose bumps with the HINI. Majid Ashraf, an engineer, spent most of Sunday in getting his family and families of his brothers and sisters vaccinated. “Why to take chance,” argues Majid. “Even if nothing happens at least it gives satisfaction of being secure.”

Ghulam Mohammad, 68, was recently operated for his prostate problem. Since then he was not keeping well and frequently complained for general weakness.

But his son consulted his family doctor and gave him a vaccine. “I did not want to take any risk. So I thought it better to go for the vaccine and it cost me Rs 900. I am relaxed now.”

The cure comes at cost. Roughly sold at around Rs 900, the vaccine is not affordable for all. In October, there were allegations that this vaccine is being hoarded. “I tried to get four shots for my family, but it was available at few private centres only and that too on exorbitant rate,” says Sajjad Ahmad. He waited and got it done for Rs 920 from uptown clinic of a private doctor.

The vaccine involves a risk. Sameena had a narrow escape for her dream to be shattered last week. Accompanied by husband, four month pregnant Sameena went to a clinic of private doctor for the vaccine. Compelled by the announcements that elders, children and pregnant women need it, she visited the clinic.

Once the doctor was about to push in the needle, he asked her “which month you are in.” As Sameena replied fourth, it was a shock for a doctor. Trembling, he screamed that “don’t you know that this could have been lethal. It is given only after six month of pregnancy.”

But the experts play down both the threat and scare of H1N1. Terming it as an old phenomenon, doctors say ‘social sites have recreated it.’ Kashmir is prone to such scares.

“H1N1 virus is given an unnecessary hype to create panic by some doctors through social networking sites,” Dr Muhammad Salim Khan, the head of Social and Preventive Medicines (SPM) at Government Medical College, Srinagar, said. “The fact is that this virus has been there from last thousand years.”

Every year, Khan said, there are mutations in the virus. In 2009 it was California strain and now it is Michigan strain but there is no need to panic.

Swine flu is actually a respiratory disease of pigs triggered by type A influenza viruses. People are not affected by swine flu, normally but at times doctors say human infections can happen. In 2009, H1N1 was spreading fast around the world for the first time and World Health Organization called it a pandemic. Since then, people have continued to get sick from swine flu and a few were reported dead in Jammu and Kashmir state too but in most of those cases, doctors claimed it as ‘secondary’ cause because victim patients were already diagnosed with other problems.

Though swine flu is not as scary as it seemed a few years ago, it is still important to protect yourself from getting it, an SMHS resident doctor said. Its symptoms include fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and vomiting, as well.

Like the regular flu, swine flu can also lead to problems like pneumonia, a lung infection and other breathing problems, says Dr Abdul Rashid, a chest specialist. “If a patient have symptoms like shortness of breath, severe vomiting, pain in belly or sides, dizziness, or confusion, they should report to their doctors,” he advised.

It is a seasonal flu but it has created more serious health problems for high risk patients with asthma, diabetes or weak immune system. The best bet for them, Dr Hanif says is to get a flu vaccine or flu shot every year. But at the same time he believes it is not recommended for all. Usually the diagnosed cases of H1N1 are given Tamiflu injections.

In Kashmir, two Centers for Disease Control (CDC), at Chest Diseases (CD) hospital and SKIMS, Soura were started to help patients. At SKIMS, five cases of H1N1 virus were admitted since October 1, 2017 of whom three died.

“The ones who died had some other underlying problems as well, mostly they were cancer patients,” Medical Superintendent SKIMS, Dr Amin Tabish, said. “Rest of the two patients were sent home after showing improvements.”

”One lady, 72, was admitted for colon cancer surgery and had tested positive for the virus. Post surgery she was cured,” Dr Amin said. “A male, 43, from Chadoora died of respiratory congestion. Another lady, 25, from Beerwa, also died but I can’t share her details.”

A male patient from Ganderbal, according to Dr Amin says  had undergone bone marrow transplant, “He stayed with us for four hours but he too passed away and one more patient died on Wednesday.” Dr Amin adds they have one more suspected case, whose tests are awaited. At CD hospital, a total of 14 patients visited its CDC for rapid screening.

“Out of them,two patients tested positive for influenza. We have sent his samples to SKIMS to confirm if the influenza is H1N1,” says Dr Naveed Nazir, head of Pulmonary department at CD hospital.

The virology laboratory at the GMC Srinagar’s associated hospital, CD hospital, which was set up two years ago at a cost of Rs 5.6 crore to provide reliable testing for influenza and other viral diseases, is yet to start working.

In March 2015, when Kashmir reported cases of H1N1 influenza and more than 20 deaths were attributed to this infection in J&K, the government ordered setting up of two laboratories, one each at GMC Jammu and one at the Chest Diseases Hospital of GMC Srinagar on emergency basis. The government has sanctioned Rs 6.3 crore and Rs 5.6 crore for the two projects, respectively. But the testing at these centres are yet to start for want of reagents, needed for high end real-time reverse transcriptase-polymerase chain reaction (rRT-PCR), while as Dr Amin Tabish said all tests are available at his hospital.

Currently, GMC associated hospitals rely on rapid influenza diagnostic test- a less sensitive test says Dr Naveed but a source in same hospital told Kashmir Life that this test comes with risks of false negatives.

Doctor told Kashmir Life that there should be proper publicity of all this. “Panic is more deadly than the disease,” they believe.

But Dr Salim says it is impossible for everybody to go for injections. Only people who really need to be tested are those in the hospital or those at high risk for life-threatening problems from swine flu. These include children up to nine years old, people who are 65 years old or older, children and teens (under age 18) who are getting long-term aspirin therapy and who might be at risk for Reye’s syndrome (infection in brain) after being infected with swine flu. This syndrome is a life-threatening illness linked to aspirin use in children. In addition to pregnant women, female patients with chronic lung, heart, liver, blood, nervous system, neuromuscular or metabolic problems and people in nursing homes and other long-term care facilities are prone to get affected.

Khan suggests the people should rather take healthy diets with learn basic etiquette of coughing and sneezing in public. He suggests people should wash their hands frequently with soap and water for at least 30 seconds or use an alcohol-based hand sanitizer, avoid touching eyes, nose, mouth because the virus primarily gets in through these and avoid people who are sick.

Another doctor warns that people may be able to infect others beginning a day before symptoms develop and up to seven or more days after becoming sick. “That means that the flu is contagious before you even know you are sick, as well as while you are sick,” the doctor said.

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