Improved surveillance, strengthening of IEC (information, education, communication) activities and good interventions at the community level in the district seems to have paid off, with all viral fever cases, including H1N1 infection, beginning to show a declining trend, Health officials claimed.

Though dengue cases are still being reported, there have not been any recent reports of clustering of cases, they said. The dengue figures in the district have crossed the 500 mark but the pattern is no different from last year when intermittent spells of torrential rains followed by hot and humid days spelt disaster for vector management strategies.

Though the sudden peaking of seasonal viral fever or flu and upper respiratory infection as soon as the rains begin is an annual phenomenon, this year the scene was dominated by H1N1 infection.

“The number of confirmed cases is only around 300. But the viral infection was so widespread that almost 95 to 98 per cent of the cases of mild fever and flu were considered as suspected H1N1 infection and the GoI guidelines were followed in treating them. The number of H1N1 casualties in the district stands at 13, including three ante-natal cases,” District Medical Officer N. Sridhar said. With the increased and totally unexpected burden of H1N1 mortality, the level of alertness in the community was heightened. Oseltamivir was provided at the primary health centre-level, so that there was no delay in treatment. Ante-natal cases with any symptoms of fever were put on chemo prophylaxis using Oseltamivir.

Health workers' role

“The local health workers were alert enough to detect and control local outbreaks of H1N1 before it got out of hand. The screening for H1N1 among ante-natal cases, utilising the services of Accredited Social Health Activists (ASHAs), was successful. It resulted in an immediate lowering of ante-natal mortality in the district due to H1N1,” a senior Health official said.

As all ante-natal cases in a locality would find an entry in the register of the local ASHA, these volunteers were asked to keep track of pregnant women who might have any symptoms of flu. “ASHAs will spot the women and send the report to the local PHC and the women would be asked to report to the doctor immediately. Nearly 15,000 ante-natal women were screened. In the first round, we detected 484 cases and in the second, another 64 women with mild flu symptoms were spotted. All were started on Tamiflu immediately,” NRHM district programme manager Sunil Kumar said.