Published Date: 2012-09-27 23:16:56
Subject: PRO/EDR> Influenza (92): India (MP, MH) H1N1 fatalities
Archive Number: 20120927.1312769

INFLUENZA (92): INDIA (MADHYA PRADESH, MAHARASHSTRA), H1N1 FATALITIES
*********************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

[1]
Date: Tue 25 Sep 2012
Source: PTI via Hindustan Times [edited]
http://www.hindustantimes.com/India-news/Bhopal/Swine-flu-killing-doctors-now/Article1-935279.aspx


Madhya Pradesh
--------------
...The high mortality rate among those afflicted by swine flu in Madhya Pradesh (MP), is actually alarming. Bhopal tops the death toll with 7 out of 28 patients testing positive for the H1N1 virus succumbing during treatment. Indore is not far behind, where 5 of 5 patients have died of the dreaded virus.

In fact, the [doctor] in charge of the swine flu [group] at the directorate of health, Dr K K Thassu, issued a circular some days ago asking people not to be afraid of swine flu, as it is no longer an epidemic but only an endemic disease which can be cured through medication. At that time, swine flu fears seemed to be receding as most of the suspected swine flu patients were testing negative, and those admitted for treatment were responding well at both government and private hospitals. But in the past few days, the situation has changed dramatically. On Saturday [22 Sep 2012], 9 out of 11 samples sent for confirmation of swine flu tested positive, giving a clear indication that the infection was on the rise and facilities for its treatment grossly inadequate.

Another remarkable aspect of the swine flu scare this season [2012-2013] is the fact that a number of doctors are also catching the infection. Two doctors of LBS Hospital in Bhopal tested positive for swine flu on Monday [24 Sep 2012]. In Jabalpur, 2 doctors including the dean of Netaji Subhash Chandra Bose Medical College are being treated for swine flu. Another doctor in the city, who had tested positive for the disease, has since been discharged. But to their credit, doctors in Jabalpur have not allowed any swine flu patient to die, though the number of persons testing positive in the confirmation test is more or less the same as Bhopal and Indore, 26 to be precise. In the wake of a growing number of doctors catching the infection, the directorate of health has made it mandatory for all doctors and paramedical staff coming into direct contact with swine flu patients to get themselves vaccinated.

"We are calling it [a] focal outbreak, as the disease is prevalent more in specific pockets while not so in other areas. In MP the situation is worsening. Climate is also conducive for growth [spread] of H1N1 virus, but to say that we are ill-prepared wouldn't be correct. Had it been so, there would have been more patients and more casualties," Dr Thassu stated.

The chief medical and health officer (CMHO), Dr Pankaj Shukla, said the situation was not so bad in Bhopal as it appeared because patients from all over the state were coming here for treatment. "This season is conducive for spread of infectious diseases, but we are keeping a tight leash on the situation, and constant monitoring is being carried out," he added.

Maharashtra
-----------
In Maharashtra, the situation is worse. Over 1100 people have tested positive and 68 deaths have been reported due to swine flu, and there it has been declared an epidemic.
[Byline: M. Poornima]

--
Communicated by:
ProMED-mail Rapporteur Kunihiko Iizuka

******
[2]
Date: Thu 27 Sep 2012
Source: Press Trust of India via Business Standard [edited]
http://www.business-standard.com/generalnews/news/one-more-diesswine-flu-in-mp-toll-rises-to-17/61488/


One more person succumbed to the H1N1 virus in Bhopal, taking the death toll due to the infection in Madhya Pradesh [MP] to 17 this year [2012]. A 45-year-old man from Sagar, who had been undergoing treatment at a private hospital here, succumbed due to the virus yesterday [26 Sep 2012], health officials said today. Among the 17 swine flu victims, 8 died in Bhopal, 6 in Indore, 2 in Ujjain and one in Gwalior. 10 samples of suspected H1N1 cases in the state had been sent to the ICMR Laboratory at Jabalpur for examination, officials said. Of the 10 samples, 5 are from Bhopal, 3 from Vidisha and 2 from Sehore districts.

On Tue 25 Sep 2012, Chief Secretary R Parsuram, while reviewing the situation following a fresh outbreak of the disease in MP, had advised people as well as doctors and paramedical staff to remain alert while dealing with the infection. He directed officials to speed up sample testing at labs to ensure prompt medical attention to the patients.

--
Communicated by:
ProMED-mail Rapporteur Kunihiko Iizuka

[The above information is supplementary to the WHO report on influenza virus activity in the world,
http://www.who.int/influenza/gisrs_laboratory/updates/summaryreport/en/index.html, which does not include information from India.

According to the WHO, as of 14 Sep 2012, influenza activity continued to decrease compared to recent weeks in the southern hemisphere. Influenza A(H3N2) viruses remained the predominant subtype globally, followed by influenza B and A(H1N1)pdm viruses http://www.who.int/influenza/gisrs_laboratory/updates/summaryreport/en/index.html.

Influenza activity decreased in the Oceania region. Australia and New Zealand reported fewer laboratory confirmed influenza positives of the circulating subtypes, while sporadic activity was reported from New Caledonia.

Influenza B viruses were the predominant viruses detected in the African region, and sporadic detections of A(H3N2) viruses were also reported from the region. Influenza activity remained high in South Africa with co-circulation of A(H3N2) and influenza B viruses.

In southern mainland China, influenza activity began to decrease. Influenza A(H3N2), A(H1N1)pdm09, and influenza B viruses were reported from the region, while A(H3N2) remained the predominant subtype in the region.

Influenza activity remained low in central and South America with fewer detections of A(H1N1)pdm, A(H3N2), and influenza B viruses reported by the region.

Sporadic detections of A(H3N2) and influenza B viruses were reported from the European region. Two independent cases of A(H1N1)pdm viruses carrying the H275Y mutation associated with oseltamivir resistance were reported from Netherlands. Partial sequencing of the NA, HA, PB2 and M genes revealed that the viruses were identical.

In North America, influenza activity remained low. To date, 296 cases of infection with the variant A(H3N2)v viruses have been detected in the United States of America, with 16 cases hospitalized and one death reported.

A(H1N2) variant viruses have also been recently reported from Minnesota in the USA. These A(H1N2) variant viruses are very similar to those found in humans previously but differ as they have the M gene derived from the A(H1N1)pdm09 virus.

***This is the 1st time this variant virus has been isolated from humans.***

The Indian state of Madhya Pradesh can be located on the interactive ProMED/HealthMap at: http://healthmap.org/r/00Vk. - Mod.CP]

See Also

2010
----
Influenza B virus - India: (Mumbai) 20100812.2766
Influenza pandemic (H1N1) (57): India (KA, KE, SM) 20100726.2506
Influenza pandemic (H1N1) (53): India 20100720.2436
Influenza pandemic (H1N1) (48): India, corr. 20100707.2262
Influenza pandemic (H1N1) (48): India 20100706.2249
Influenza pandemic (H1N1) (46): India, monsoon 20100630.2177
Influenza pandemic (H1N1) (34): Indian variants 20100525.1741
.................................................cp/msp/jw