An H1N1 outbreak was recently reported in Calicut, a town in north Kerala. With the memory of the dangerous Nipah virus still lingering, the news of another virus outbreak can naturally trigger anxiety among the general public.
The following are important facts to be aware of:
• H1N1 is one of the influenza viruses causing seasonal flu infections in India for several years. As some viruses are known to do, the H1N1 virus also keeps changing form and names. This enables the virus to cause repeat infections in those who already had suffered the flu earlier.
• Flu-like symptoms appear within 3 days of exposure to the virus. As in most cases of flu, fever, sore throat, cough and body pain are the common symptoms of H1N1. When people cough, thousands of tiny droplets containing the virus are released into the air. The virus spreads through these airborne droplets, and by direct contact with hands or objects that are contaminated with droplets.
• H1N1 is not serious in the vast majority of cases; there is no need to panic. Even if symptoms occur, there is no need to rush to see a doctor. Only those with persistent, severe symptoms, and those who are in the high-risk category need medical attention.
• High risk category includes very young children and very old people, pregnant women, people with diabetes, or chronic diseases of the immune system, heart, kidney, liver or lung. These people are more likely to develop complications from the flu. In Kerala, out of 844 confirmed cases of H1N1 in 2019, 44 deaths occurred, compared to 53 deaths out of 879 cases in 2018.
• If flu symptoms appear in people who are in good health, they are advised to take plenty of fluids and get some rest at home. To reduce the risk of spread of virus, they must stay home till two days after the fever has settled down. This is especially important for schoolchildren who could spread the infection to large numbers of people.
• Cough etiquette is an essential life skill for everyone. Whether they have the flu or not, no one should cough or sneeze directly at other people under any circumstance. Experts recommend that we direct our cough or sneeze at our bent elbow, and not at our fingers. Unlike our fingers, since the elbow does not come in contact with other people, the chance of spreading infection is lower.
• Those who have symptoms of flu must wash their hands thoroughly and frequently. Special care must be taken not to shake hands with others, especially while having a cold. These simple steps will help reduce the spread of infections in the community.
• Not everyone with H1N1 needs antiviral medicine, as it is a self-limiting disease among those in good health. In other words, the virus goes away on its own, even without treatment. Oseltamivir is used for those in high risk categories as decided by the doctor. It is used for Influenza A (which includes H1N1) and B type viral infections. Unnecessary use of medicine can lead to side effects and resistance.
• Diagnosis of H1N1 virus is made by sending a throat and nasal swab to regional virology institutes, using special transportation protocols. From Kerala, these samples are sent to the National Institute of Virology of Alappuzha or Manipal Medical College. As antiviral medication is effective only when given early in the course of the infection, there is no need to wait for the test result before starting antiviral medicine in high risk patients. It is worth noting that routine flu symptoms in previously healthy people in the low-risk category, do not require testing or treatment for H1N1.
• Along with other flu viruses, both of the latest strains of H1N1 are included in the flu vaccine for 2018-19. Although not fool-proof, yearly vaccination is recommended for high risk groups, as well as for healthcare workers who come into contact with influenza patients.
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Further reading:
• Directorate of Health Services Kerala, publication on H1N1
• Guidelines for Vaccination, Ministry of Health and Family Welfare, India
• List of laboratories in India that are doing H1N1 testing
• Technical guidelines for H1N1, Ministry of Health and Family Welfare, Govt of India
