With all three A (H1N1) deaths in Tamil Nadu reported from private healthcare institutions, the government has advised them to raise their index of suspicion about such cases and not wait for test results before treating patients with Tamiflu.
Speaking to The Hindu , Health Minister V.S. Vijay said that the deaths in private institutions were a cause of concern, particularly because they could be easily avoided by starting treatment early. Private hospitals must begin to treat patients with Tamiflu even where there is suspicion based on clinical parameters, and patient's account of symptoms.
“Deaths are because of late intervention. Tamiflu will work only during the initial phase of the condition, not when the viral load increases — after three days. When hospitals wait for the results to come (It can take days to produce results from swabs taken from suspected A(H1N1) patients), it delays treatment and thus can lead to death,” Dr. Vijay said.
He added that private hospitals must work in a manner similar to government institutions when it comes to treating A(H1N1). Of the 60 patients treated in government institutions throughout Tamil Nadu so far, or were treated at home by the State, recovery was fast and no deaths had been reported.
“In our institutions, we give the patient Tamiflu even when mere suspicion of A(H1N1) arises. It is because of this that patients admitted with government institutions and those quarantined at home have been able to recover fast.”
But will not giving the prescribed dose of Tamiflu, when a patient does not actually have the A(H1N1) infection, cause side effects and lead to resistance?
“Side effects are not a cause of concern. We even give prophylactic doses (preventive treatment) to people who have come into contact with those who have tested positive for the infection,” he replied.
Studies have shown that the side effects that these prophylactic doses cause are not different from what patients treated with Tamiflu suffer.
Refer to government hospitals
If private institutions are hesitant to treat patients in this manner, it is best that they refer them to the government general hospital for treatment, Dr. Vijay added.
“At the moment, people are being referred to government hospitals when it is too late for intervention. If people come in on ventilator-support, there is nothing we can do to help them at that stage,” he added.
A total of 77 cases of A(H1N1) have been recorded in Tamil Nadu till date, according to the Minister.
