Mumbai: The lag between onset of swine flu symptoms and prescription of oseltamivir is one of the main concerns raised by a team from National Centre for Disease Control (NCDC), which is in the State to review the spurt in H1N1 cases.
The five-member team has visited Mumbai, Thane and is currently in Pune to meet scientists from the National Institute of Virology and the State’s health officials.
According to NCDC director Dr. A.C. Dhariwal, the H1N1 outbreak in Maharashtra has been a concern this season. “We have provided the State with a set of suggestions and rectifications in the overall approach towards H1N1,” Dr. Dhariwal said.
He added that there are some lapses in the private sector, and physicians and citizens need to be sensitised. “We have seen a pattern that patients first go to the private sector, and after their condition becomes severe, they land up in public hospitals. This is one of the main points we have discussed, besides other suggestions,” he said.
The team arrived in the State for an eight-day visit on June 27. The team has also issued a basic advisory with suggestions like early initiation of treatment, home isolation, providing health education to all, and the need for high-risk patients to consult a doctor immediately.
Oseltamivir in two days
As of Friday, the State has recorded 1,771 cases of H1N1 and 262 deaths this year. An analysis of the deaths by the State’s health officials has shown that about 18% to 20% patients had received oseltamivir within two days of the onset of symptoms.
In Mumbai, 313 positive cases of H1N1 have been reported since June 1.
“There could be some delay in starting patients on oseltamivir in some cases. But it is across public as well as private sector. Also, the basic human tendency is such that when mild symptoms arise, one treats self at home,” said State epidemiologist Dr. Pradeep Awate.
“The outcome is bad in patients who have underlying issues,”said Dr. Awate, adding that about 150 of the 262 patients who succumbed to the infection had co-morbid conditions. “A large number of these (99) had either diabetes, hypertension or both,”he said. The number of women who have succumbed to H1N1 so far is also higher than men.
Medical experts say that a patient only sheds 5% of the virus as soon as he/she gets the second dose of oseltamivir. Therefore, early treatment in those with high index of suspicion is the key to curb the spread.
