Thursday, April 15, 2021

Seasonal influenza

Deaths of more than 70 persons and over 1800 testing positive for the Swine Flu that spread in an epidemic form in Rajasthan and its adjoining states need to be taken seriously by both the state as well as the central government. It is tragic that innocent persons have lost their lives for no fault of theirs but definitely the health authorities owe an explanation to the masses for its failure to tackle the seasonal influenza in the very beginning. These deaths have been reported till the evening of Republic Day of this year and the infections have been spreading in most parts of Rajasthan and call for an effective plan to contain it. It is well known that the seasonal influenza poses a significant public health challenge in different parts of for India every year. Rajasthan, which had a big case load last year, is the worst-affected state in the current season, with 1787 cases and 70 deaths as of January 26 as reported by the health authorities. There have been peaks in the country over the past six years, with the number of cases recorded by the Integrated Disease Surveillance Programme soaring to 42,592 and the death toll touching 2,990 in 2015. With better understanding of the nature of active viruses due to advancements in medical science and the availability of a quadrivalent vaccine, state governments have no excuse for failing to sharply reduce the spread. It was only last year, the central government had deputed teams to assist Rajasthan in containing the outbreak. It is pertinent to ask what preventive measures were put in place based on the experience by the state government. Large-scale vaccination covering high-risk groups such as health workers, people with lung, kidney, liver and heart disease, diabetics and the elderly could reduce the impact of the viruses in states such as Rajasthan, Maharashtra, Gujarat, Telangana and the National Capital Region, all of which had a large number of cases three years ago. A universal preventive programme should be considered at least for the future by the centre with the involvement of the state governments. It is unfortunate that the central government reduced the allocation of funds for universal coverage of the population in high-risk category through immunization in these states. Indefinite suspension of immunization programme has also been having devastating effect on common masses in the country. Apart from this, suspension of polio immunization programme for an indefinite period by the centre is likely to have serious impact on ‘Polio Free’ status of the country. It appears that the centre has not given a serious thought to this issue till date. On its part, the central government put out an advisory on the right vaccine to protect against a known set of viruses, such as Influenza A H1N1, H3N2 and Influenza B. But, most public health programmes are not prepared for a mass adoption of the vaccine for the reasons best known to the implementing agencies. The non-availability of sufficient doses of quadrivalent vaccine as well as profiteering on the demand has not been addressed by the centre. If a vaccine has proven efficacy in reducing the burden of seasonal influenza, it must be made part of the public health system. An umbrella scheme such as Ayushman Bharat can easily provide it to everyone using public and private institutions. Campaigns to educate the public through mass media ahead of the season, especially on risk reduction, can help in checking transmission of infection. At the same time, upgrading existing vaccines requires a consistent effort to track viral mutations that take place periodically, and communicate the information to researchers through open access databases. There are at least 41 Virus Research Diagnostic Laboratories in the country and they can study the nature of infections to provide genetic insights to scientists. This can help develop vaccines and remedies. When it comes to treatment, the availability of anti-viral drugs in the public health system should be ensured. Seasonal influenza will, according to the WHO, continue to resurface for various reasons. We must be prepared for it with a comprehensive programme if loss of precious lives is to be prevented.