C. Maya

Latest victims have no travel history

Community-level spread suspected

Thiruvananthapuram: Kerala’s picture of influenza A (H1N1) pandemic may be in for a change now that the State has reported its fourth case of death from the infection, also the second case wherein the authorities have not been able to trace any link as to how the flu victims might have contracted the virus.

On August 26, a 44-year-old woman, Jijamma, died in a private hospital in Kochi with severe respiratory illness, later confirmed as H1N1 infection. The latest swine flu victim is 25-year-old Jaya George who died in a private hospital in Kochi on September 1. Kerala has till date reported 253 cases of H1N1 infection, with four deaths.

However, the significance of these two deaths for the State is that in both cases the victims had no known history of travelling outside or contact with anyone from abroad.

Health Department officials confirmed that as no link could be established as to how these persons could have contracted the virus, it should be assumed that community-level spread of the infection or indigenous spread from one person to another is slowly becoming established in the State.

If community-level surveillance of Severe Acute Respiratory Illness (SARI) is not upped and every case of pneumonia in the community strictly monitored, a Pune-like situation, where there has been a flare-up in the indigenous spread of H1N1 virus and more deaths, cannot be ruled out, public health experts warn.

Keeping a close watch on the case history of the deaths and the new cases that could be linked to those persons will indicate the extent of the spread of the virus in the community.

Additional Director of Health Services (Public Health) K.S. Anilkumar said that the staff in the private hospital where Jaya was treated, the immediate family, friends and neighbours have all been contacted and some 22 persons are currently on prophylactic treatment with Oseltamivir. The surveillance of all flu-like illnesses in and around Jaya’s neighbourhood in Kochi has also been strengthened.

According to him, at present, almost all positive cases are now being reported from the community and not through airport surveillance. “It means that our community surveillance is pretty good. If we missed these cases there would have been a rapid spread,” he said. This is an indication that the virus is establishing itself here and that larger numbers of people could become infected.

The challenge for the State’s Health Services would be to ensure that it is well-prepared to handle the burden.

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