Dubai: Two persons — one in Haryana and the other in Karnataka — have died of influenza caused by the H3N2 virus, reports in the Indian media said on Friday quoting government sources.
An 85-year-old man in Karnataka’s Hassan is believed to be the first to die of H3N2 in the country. Gowda was admitted to hospital on February 24 and died on March 1, NDTV quoted officials as saying.
He was reportedly a diabetic and suffered from hypertension.
According to health department sources in Karnataka, the elderly man from Alur in Hassan died on March 1, Indian agency IANS reported.
It quoted Commissioner of Health Department D. Randeep confirming the death due to H3N2 variant on Friday.
Samples sent for testing
The man carried symptoms similar to COVID-19 — fever, chills, persistent cough and sore throat.
Health department teams are on alert and are carrying out medical tests at Alur and surrounding regions. The swab samples are being collected from people with symptoms and sent for testing.
These symptoms can persist for about a week.
According to experts, the virus is highly contagious and spreads through coughing, sneezing and close contact with an infected person.
The department has directed officials to monitor people with comorbidities and those above 60 years.
People are being warned against self-medication if they develop symptoms.
More than 50 cases of H3N2 have been reported across the state and six cases are confirmed in Hassan district alone, sources told IANS.
Children face more danger
Karnataka's Health Minister Dr K. Sudhakar said “children below the age of 15 face more danger from the H3N2 variant. It also infects persons above the age of 60 years. Sudhakar also advised that pregnant women should be careful.
COVID-19, which has infected millions across the world and caused 6.8 million deaths. After two years of the pandemic, the rising flu cases in India due to H3N2 and H1N1 infections have triggered concern among people.
Pattern of viruses changed unexpectedly: Expert
In Delhi, health expert at Sir Gangaram Hospital has pointed out that the pattern of viruses has changed remarkably and unexpectedly in the past six months.
Hospitals across the country are reporting thousands of cases of H3N2 influenza, he said.
According to Dr Dhiren Gupta, Senior Consultant, department of paediatric emergency and critical care, Sir Gangaram hospital: “Over the past 6 months pattern of viruses has changed remarkably and unexpectedly. Normally, we expect influenza as the number 1 virus which can lead to hospitalisation. This time Influenza A virus subtype H3N2 has led to a lot of respiratory tract infections.”
DNA virus mainly affects the upper respiratory tract
Dr Gupta further said: “Another observation - type B influenza (past two months 5 leading to PICU admission) has led to more severe pulmonary infections in form of ARDS, severe pneumonia requiring ventilation.”
He said that another virus which is leading to serious disease is adenovirus.
“Over the past 2 months, there is a significant rise in adenovirus leading to intensive care unit admission. (11 patients required PICU over two months (January and February 2023) vs 17 in last one year (January till December 2022),” he pointed out.
Further explaining adenovirus, Dr Gupta said that DNA virus mainly affects the upper respiratory tract, and eyes and spreads like COVID.
“Adenovirus is a DNA virus, with more than 60 subtypes, severe disease has been associated with serotype 7, 14, serotype 5, 21, 14. Mainly affect the upper respiratory tract, and eyes. It can cause pneumonia in immunocompromised. Spread like COVID. Previously thought that this virus mainly affects less than two years and immunocompromised but this year its behaviour was very different, Cidofovir can be used in progressive disease in immunocompromised.” he explained.
Mega fever camps set-up in Tamil Nadu
In Chennai, Tamil Nadu Health Minister Ma Subramanian inspected the mass fever camp on Friday organised in the Saidapet area in Chennai.
“About 1,000 fever camps have been set up all over Tamil Nadu of which 200 fever camps are in Chennai,” Health Minister said.
People have been instructed to wear masks and maintain proper hygiene to avoid the virus infection.
“Apart from the fever camps, about 11,333 public health centres in the state have been instructed to conduct frequent fever check-ups,” said the minister in the statement.
“We have adequate medicines for the fever. As of now, there are no severe cases and there is no need to panic.”
The Health Minister added, “According to ICMR, we have to be cautious with H3N2 virus spread like we were during the Covid Pandemic. People with fever symptoms should isolate themselves as per ICMR guidelines to prevent spread.”
Reportedly, corona cases have also been increasing in Tamil Nadu and also India, in general.
“PTPCR tests are done and the number of tests has been increased. There were only 2 cases last month but now it’s 20 to 25 cases in Tamil Nadu and we are preparing to curtail it,” assured the Health Minister.
Health Minister also said: “As of now it’s not a community spread of H3N2 virus in Tamil Nadu. We are taking precautions to make sure it does not spread rapidly and turn into a community spread. I appeal to the people of Tamil Nadu to avoid going to public places if they identify themselves with the symptoms and immediately inform the authorities.”
According to the administration, the mega fever camps will continue their operations on Saturday, Sunday and also in the coming days in the state.
Cases of H3N2 are expected to decline from March end
Amid rising cases of the H3N2 virus across the country, the Federal Ministry of Health on Friday said that the cases arising from seasonal influenza including H3N2 which has claimed one death each in Haryana and Karnataka are expected to decline from March end.
“India every year witnesses two peaks of seasonal influenza: one from January to March and the other in the post-monsoon season. The cases arising from seasonal influenza are expected to decline from March end,” the Union Health Ministry said in a press release.
Seasonal influenza is an acute respiratory infection caused by influenza viruses which circulate in all parts of the world, and the cases are seen to increase during certain months globally.
It further said that real-time surveillance of cases of Influenza-like Illness (ILI) and Severe Acute Respiratory Infections (SARI) presenting in OPDs and IPDs of health facilities is undertaken by Integrated Disease Surveillance Programme (IDSP), National Centre for Disease Control (NCDC).
According to the latest data available on IDSP-IHIP (integrated health Information Platform), 3,038 laboratory-confirmed cases of various subtypes of Influenza including H3N2 have been reported till March 9 by the States. This includes 1245 cases in January 1307 in February and 486 cases till March 9.
Further, the IDSP-IHIP data from health facilities indicate that during the month of January 2023, a total of 397,814 cases of Acute Respiratory Illness/Influenza Like Illness (ARI/ILI) were reported from the country which increased slightly to 436,523 during February 2023. In the first 9 days of March 2023, this number stands at 133,412 cases.
The corresponding data for admitted cases of severe acute respiratory illness (SARI) is 7041 cases in January 2023, 6,919 during February 2023 and 1866 during the first 9 days of March 2023.
Till February 28, a total of 955 H1N1 cases have been reported. The majority of the H1N1 cases are reported from Tamil Nadu (545) following Maharashtra (170), Gujarat (74), Kerala (42) and Punjab (28).
So far, Karnataka and Haryana have confirmed one death each from H3N2 influenza, it added.
The Ministry is also tracking and keeping a close watch on morbidity and mortality due to the H3N2 subtype of seasonal influenza.
Most vulnerable groups
Young children and old age persons with co-morbidities are the most vulnerable groups in the context of seasonal influenza.
The ministry has provided guidelines on the categorization of patients, treatment protocol, and guidelines on Ventilatory management to the states and UTs which are also available on the website of the Ministry (www.mohfw.nic.in) and NCDC (ncdc.gov.in).
It has also advised the state governments to vaccinate healthcare workers dealing with H1N1 cases.
However, according to the ministry, Oseltamivir is the drug recommended by the World Health Organization (WHO) for curing the infection.
“The drug is made available through the Public Health System free of cost. The government has allowed the sale of Oseltamivir under Schedule H1 of the Drug and Cosmetic Act in February 2017 for wider accessibility and availability,” it said.
Additionally, NITI Aayog will hold an inter-ministerial meeting on March 11 to review the seasonal influenza situation in the states and for ways to further support them in terms of public health measures, management guidelines and protocols.
